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ItemX-ray diagnostic equipment(????, 1990)X-rays are invisible. Because of their high energy and short wavelength they can penetrate almost all materials, but are absorbed to a different extent by different tissues. In the human body, absorption is high for bones, and low for muscles and other soft tissues. These differences in absorption can be shown on a photographic film as differences in density: the result is a radiograph. Thus, radiographic examination consists of irradiating a part of the patient with a uniform beam of X—rays and recording the emerging rays on a double emulsion film sandwiched between a pair of fluorescent screens. The screens convert the X-rays into light, which in turn exposes the X-ray film. The screens and the film are enclosed in a cassette for protection from daylight. After the exposure, the film must be processed, manually or automatically, in a darkroom by means of developer and fixer solutions. ItemOxford miniature vaporizer (OMV)(WHO, 1994)Oxford miniature vaporizer (OMV) This is a small vaporizer (Fig. 4.7) which can be used to administer anaesthetics. It works in the same way as the larger vaporizers, but does not have a built-in temperature compensation device. However, the base is filled with antifreeze to help stabilize the internal temperature. A number of different versions are available, each of which can be fitted with different scales for use with different anaesthetic agents. ItemAnaesthetic and resuscitation equipment(WHO, 1994)The Oxford Bellows is a hand-operated bellows unit for inflating the lungs (Fig. 4.1). It consists of an inlet connection and valve, the bellows in the middle, an outlet valve with outlet connection, and tap. There is a magnet in a holder under the bellows, which is used to immobilize the disk valve when a non-return valve (such as the Ambu) is in use. ItemTesting Anesthetic Machines, Ventilators and Related Equipment(WHO, 1994)Anaesthetic machines and ventilators should be tested in the room or area where the equipment is situated, if at all possible. Service personnel must wear accepted operating-room clothing in the surgical areas. Contact the person responsible for operating-room equipment regarding the movement or servicing of any such equipment. ItemSystems for Continuous-Flow Anesthesia(WHO, 1994)Continuous-flow anaesthetic machines (commonly known as Boyle's machines or simply gas machines) are in widespread use. They rely on a supply of compressed medical gas, either from cylinders attached directly to the machine or piped from a large bank of cylinders or liquid oxygen supply elsewhere in the hospital. The two gases most commonly used are oxygen and nitrous oxide. ItemGas cylinders and gases(WHO, 1994)It is assumed that hospital laboratories, theatres, and other departments that use gas cylinders will be using cylinders owned by the vendor. The problems of refilling will therefore not be considered. Cylinders are intrinsically simple devices (Fig. 2.17) requiring little or no maintenance. However, they are potentially highly dangerous because of the pressure of the contained gas. The pressure within a fully charged cylinder may be governed by local requirements, but can be as high as 20 MPa. For this reason, cylinders should be treated and maintained with care to avoid damage. ItemDisinfection and Sterilisation of Medical Supplies and Equipment(VSO, 1995) Skeet, Muriel; Fear, DavidDisinfection is recommended for equipment that is not intended for piercing the skin, or touching open wounds. Disinfected equipment may safely be in contact with the intact skin and mucous membranes of the body. Equipment which is to be disinfected includes items such as linen, bedpans, crockery, instruments, tongue depressors, etc. Sterilisation is recommended for all items penetrating the skin or which will be in contact with broken skin and mucous membranes or entering otherwise sterile body areas. This includes equipment such as surgical instruments, implants, dressings, gowns, catheters, wound irrigation fluids, syringes, needles and other items which may pierce the skin or be in contact with open wounds. ItemBoiling Water Disinfectors(VSO, 1995) Fear, David; Skeet, MurielThe boiling water disinfector consists of a metal box with a closely fitting lid; in some cases a gasket is fitted between the box and the lid. The water vapour should pass without obstruction via the lid. Inside, the disinfector has a perforated tray which is positioned to allow the water to circulate. The tray may be fitted with removable handles to take it out. Some models of disinfectors are equipped with a handle-operated mechanism for lifting the tray out of the water. The disinfector stands on four small feet allowing air to circulate around it and preventing damage to the underlying surface. Heating can be provided by electricity, a paraffin stove or any other heat source. In the electric models, heat is generated by an electric heating element, either of the immersion or the panel type. ItemAutoclaves: Safety and Diagrams(VSO, 1995)This article covers the different types of loads an autoclave can be designed for and how each type of autoclave is different, it provides information for testing the different parts on an autoclave, and it covers how to maintain an autoclave to ensure it is safe. It also provides detailed procedures for operating a variety of different autoclaves. ItemIncubators for Babies(1995) Skeet, Muriel; Fear, DavidThe general principle is that air is processed before it reaches the baby (Figure 43). An electric fan draws room air through a bacterial filter which removes dust and bacteria. The filtered air flows over an electric heating element. The filtered and heated air then passes over a water tank where it is moistened. It then flows on to the incubator canopy. The incubator canopy is slightly pressurised. This allows expired carbon dioxide to pass back into the room via the vent holes and most of the air to be recirculated. It also prevents unfiltered air entering the system. ItemVacuum Extractors(VSO, 1995) Skeet, Muriel; Fear, DavidThe selected suction cap is placed on the baby’s head when it appears. The screw valve on the vacuum pump is closed and the pump is pumped by hand until a vacuum is created. The level of this is indicated on the vacuum gauge. The suction cap becomes attached to the baby’s head. The traction chain and handle are used to gently draw the baby from the uterus. When the baby is delivered, the screw valve is opened. Air flows in and breaks the vacuum. The baby is released. ItemBattery Maintenance(VSO, 1995)Lead acid batteries are used in hospitals to start vehicles and emergency generators or for lighting including mobile theatre lamps. They are also used as part of solar power systems. It is essential that they are well maintained. A lead acid battery should be stored in a cool (but not cold), clean, well ventilated place. (In some instances it will be kept where it will be used - for example, if it is a vehicle starter, it will be kept in the vehicle.) ItemOperating Room Lamps(VSO, 1995) Skeet, Muriel; Fear, DavidA fixed theatre lamp is suspended from the ceiling of an operating theatre or treatment room, directly over the centre of the table. It can be positioned by moving the lamp head and its outreach arm (Figure 38). It has at least four units which produce a very high level of light without shadow. Usually the light is produced by high intensity tungsten halogen bulbs which are similar to the headlight bulbs of motor cars. Voltage of these bulbs varies depending upon the design but it is either 12 or 24 volts AC or 12 or 24 volts DC. This is a safety measure to prevent electric shocks. At the back of the lamp there is a polished metal reflector whi ItemOxygen Concentrators: Care and Safe Use of Medical Equipment(VSO, 1995)This article describes the principles behind oxygen concentrators, some basic safety routines that should be performed, and how to safely use and maintain an oxygen concentrator. ItemRefrigerators: Care and Safe Use of Medical Equipment(VSO, 1995) Skeet, Muriel; Fear, DavidA refrigerator consists of a heavily insulated cabinet with an efficient door seal which prevents heat from the outside entering the cabinet. The temperature inside a refrigerator is kept low by a closed coiled circuit of copper tubing filled with a ‘refrigerant gas’. This ‘refrigerant gas’ absorbs heat which is then discharged at the back of the refrigerator as room air passes over a closed network of copper tubing. This is the condenser.