Browsing by Author "Malkin, Robert"
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Item Anesthesia Machines: Clinical Use and Principles of Operation(2006) Malkin, RobertThis article describes the clinical use of anesthesia machines as well as common problems and engineering detailsItem Balances: Use and Principles of Operation(EWH, 2006) Malkin, RobertBalances are accurate and precise instruments used to measure the weight or mass of a substance or material. The ability to measure material as large as 50kg and as small as 10μg makes them quite common. There are two main categories of balances, mechanical and electromagnetic. Mechanical balances tend to be the simpler of the two. They generally consist of springs or lever arms, and use either a known force or mass to determine the unknown measurement.Item Batteries: Clinical Use and Principles of Operation(2006) Malkin, RobertWhile not a medical device in itself, the battery, like the generator, is often the source of problems in developing world hospital equipment. The battery comes in a wide variety of forms and can be used to provide electrical energy and portability to all types of clinical devices, from surgical lighting to high drain clinical devices (e.g., x-ray machine). The underlying purpose of the battery remains the same, to simply convert stored chemical energy into electrical energy which can be readily used by a given device.Item Clinical Laboratory Ovens Use and Principles of Operation(EWH, 2006) Malkin, RobertOvens in laboratories are used to dry samples and for evaporating, dehydrating or sterilizing. On a limited basis some are used as a dry incubator. In many cases, precise temperature control is required. Clinical ovens may be bench, cabinet, or walk-in size. However, bench top are the most common in the developing world. All ovens will include a heat source, a well insulated container (usually including a door with tight sealing gaskets), and a thermostat/thermometer. More advanced ovens may include timers/alarms, fans to circulate air inside the oven to achieve uniform heating, shelving units or racks, humidity control options, or air filtration. The heating mechanism may be electric, natural gas, propane, oil, radiofrequency or microwave, but the electric heater is the most common in the developing world.Item Clinical Use and Principles of Operation of Bottle Gasses(EWH, 2006) Malkin, RobertThis article describes the clinical use of bottle gasses for anesthesia as well as common problems associated with their use.Item Clinical Use and Principles of Operation: Ventilators(EWH, 2006) Malkin, RobertMany patients in an intensive care and the operating room require the mechanical ventilation of their lungs. All thoracic surgery patients, for example, require mechanical ventilation. Some patients simply need assistance breathing, when a patient is recovering from certain illnesses and operations for example. In any case, ventilators can take over the major effort of respiration for the patient. Some people use the term ventilator and respirator interchangeable. They are not the same. A respirator is a device that supplies or filters air in a harsh environment. The patient is breathing on their own when they use a respirator. In most cases, without the ventilator, the patient could not breathe, or would have great difficulty breathing.Item Defibrillators: Clinical Use and Principles of Operation(EWH, 2006) Malkin, RobertA defibrillator is used to reverse fibrillation of the heart, restoring the heart’s normally coordinated contractions. The uncoordinated contractions of the heart can take place in the atrial, or upper, chamber of the heart as well as in the heart’s ventricular, or lower, chamber. Atrial fibrillation (AF) is relatively common and can be well tolerated by the patient. Ventricular fibrillation (VF) causes the heart to stop pumping blood immediately, and is therefore fatal if not treated within minutes. Death from VF is often called a massive heart attack and is the most common cause of death.Item Electrocardiographs: Clinical Use and Principles of Operation(Engineering World Health (EWH), 2006) Malkin, RobertThis article describes the principles of operation of ECGs as well as common problems associated with these devices.Item Equipment Found in OR, ICU and ER(2006) Malkin, RobertIn the developing world, the biomedical engineer will often be called into an active room to do a quick repair or adjustment. You will need to know what procedures to follow. Procedures will vary from hospital to hospital but the core requirements are the same. Most OR suites are set up with 3 distinct areas, clean, dirty and sterile. In the hallways there will be a red line on the floor or wall and a door, which indicates the start of the sterile area. To enter this area you need the proper clothing, head and shoe covers and a mask. In the clean area proper clothing, head and shoe covers are needed. In the dirty area street clothes may be permitted but it is a good idea to be properly clothed, as you may have to cross into other areas.Item Fetal Monitor and Fetal Doppler Clinical Use and Principles of Operation(2006) Malkin, RobertFetal monitors document two major functions: 1) the heart rate of the fetus, and 2) the contractions of the mother. A normal fetal heart rate is between 110 to 160 beats a minute. The sound of the beat is usually strong and regular. It is normal to have some changes in the fetal heart rate during labor, but drastic changes in heart rate before or after a contraction may indicate that the fetus is in distress. A fetus with large changes in heart rate may need to be removed from the womb immediately, by Caesarean section.Item Fetal Monitor and Fetal Doppler: Clinical Use and Principles of Operation(2006) Malkin, RobertFetal monitors document two major functions: 1) the heart rate of the fetus, and 2) the contractions of the mother. A normal fetal heart rate is between 110 to 160 beats a minute. The sound of the beat is usually strong and regular. It is normal to have some changes in the fetal heart rate during labor, but drastic changes in heart rate before or after a contraction may indicate that the fetus is in distress. A fetus with large changes in heart rate may need to be removed from the womb immediately, by Caesarean section.Item Infant Incubator(2006) Malkin, RobertA baby incubator is an isolation chamber that helps regulate the temperature of an infant and can provide air which is enriched in humidity or oxygen. The basic machine has a place for the baby to lie and is surrounded by a clear plastic box. A heating element lies below the baby. There is always a control for the heater, and generally a feedback mechanism to regulate temperature within a degree of a set point. Most incubators in the developing world have latex gloves built into the chamber that allow for manipulation of the baby without entering the isolated environment (see figure).Item Infant Warmer Clinical Use and Principles of Operation(2006) Malkin, RobertThe infant warmer is an open device for keeping a baby warm. True infant warmers use resistance or radiant (infrared energy) heating elements, not heat lamps, which can burn. Warmers are often used for the patients that require the most care, as it is easier to work on the infant on a warmer instead of an incubator which is a closed system. On the other hand, as they are open, warmers do not offer the environmental protection of an incubator from air borne particles, pathogens or humidity variations.Item Instrumentación Médica en el Mundo en Desarrollo(Engineering World Health, 2006) Malkin, Robert¿Cómo prueba usted un desfibrilador en un cerdo recién sacrificado? ¿Cómo puede usted utilizar un pedazo de pollo para probar una unidad electroquirúrgica? ¿Cómo puede usted probar las luces de fototerapia antes de liberarlas para usarlas en infantes cuando usted no tiene un fotómetro? Estas son el tipo de preguntas que un ingeniero trabajando en el mundo en desarrollo se hace todos los días. El equipo de prueba apropiado no está disponible, y el hospital tiene una necesidad urgente. Usted no puede ni liberar el equipo sin probarlo, ni negarle al equipo médico la única pieza de equipo que le podría ayudar al paciente. ¿Qué debería hacer usted? Este libro suministra respuestas: los tipos de pruebas prácticas y sugerencias de reparaciones que los ingenieros pueden utilizar cuando están en un hospital pobremente equipado, lejos de un departamento clínico de ingenieraItem Instrumentación Médica en el Mundo en Desarrollo(2006) Malkin, Robert¿Cómo prueba usted un desfibrilador en un cerdo recién sacrificado? ¿Cómo puede usted utilizar un pedazo de pollo para probar una unidad electroquirúrgica? ¿Cómo puede usted probar las luces de fototerapia antes de liberarlas para usarlas en infantes cuando usted no tiene un fotómetro? Estas son el tipo de preguntas que un ingeniero trabajando en el mundo en desarrollo se hace todos los días. El equipo de prueba apropiado no está disponible, y el hospital tiene una necesidad urgente. Usted no puede ni liberar el equipo sin probarlo, ni negarle al equipo médico la única pieza de equipo que le podría ayudar al paciente. ¿Qué debería hacer usted? Este libro suministra respuestas: los tipos de pruebas prácticas y sugerencias de reparaciones que los ingenieros pueden utilizar cuando están en un hospital pobremente equipado, lejos de un departamento clínico de ingenieraItem Instrumentation médicale dans le monde en développement(Engineering World Health, 2006) Malkin, RobertComment testez-vous un défibrillateur sur un cochon fraichement tué ? Comment pouvez-vous utiliser un morceau de poulet pour tester un bistouri électrique ? Comment pouvez-vous tester les bilirubinomètres avant de les mettre en service sur des enfants quand vous n'avez pas de photomètre ? C'est le type de questions qu'un ingénieur travaillant dans un hôpital d'un pays en développement se pose chaque jour. L'équipement de test approprié n'est pas disponible et l'hôpital en a désespérément besoin. Vous ne pouvez pas mettre en service l'équipement sans le tester ni priver le personnel médical du seul équipement qui pourrait aider le patient. Que devez-vous faire ? Ce livre fourni les réponses : les sortes de tests pratiques et les suggestions de réparation que les ingénieurs peuvent employer dans un hôpital très mal équipé, très loin d'un service de génie biomédical. Si vous êtes un ingénieur qui doit partir bientôt dans un pays en développement, un technicien d'un pays en développement ou simplement un visiteur d'un de ces pays qui désire aider à combler le manque considérable d'équipements médicaux, alors ce livre est pour vous. Ce livre s'adresse principalement aux ingénieurs et techniciens qui vont habituellement travailler dans un établissement de santé public de niveau secondaire d'un pays en développement. Lire ce livre et le prendre avec vous ne vous prépare pas complètement à cette aventure de travail dans les pays en développement, mais il devrait vous aider à comprendre ce qu'il faut en attendre, sur le plan technique.Item Medical Instrumentation in the Developing World(Engineering World Health (EWH), 2006) Malkin, RobertHow do you test a defibrillator without a defibrillation tester? How can you use a piece of chicken to test an electrosurgery unit? These are the types of questions that an engineer working in a developing world hospital asks every day. The proper test equipment isn't available, and the hospital has a desperate need. This book provides the kind of practical testing and repairing suggestions that engineers can use when in a poorly equipped hospital, far from a clinical engineering department.Item Microscopes Use and Principles of Operation(EWH, 2006) Malkin, RobertIn histology, pathology, hematology and other sections of the clinical laboratories the microscope is a critical device. Even the smallest and poorest equipped developing world hospitals will have a microscope. While these units rarely fail they do require cleaning and lubrication on a regular basis.Item Microtomes Use and Principles of Operation(2006) Malkin, RobertHistology is the study of tissue, restricted in the developing world to using visible light and a microscope, magnifying lens or the naked eye. In order to better examine the tissue sample from the patient, it is first cut (or sectioned) in to thin slices, typically 1- 10 microns (micrometers) thick. The tissue is so thinly cut, that it is translucent. The instrument that cuts the tissue into these thin sections is the microtome.Item Oxygen Concentrators: Clinical Use and Principles of Operation(2006) Malkin, RobertThis article describes the clinical use of oxygen concentrators as well as common problems and engineering details.