Introduction to Biomedical Instrumentation : The Technology of Patient Care

This book is designed to introduce the reader to the fundamental information necessary for work in the clinical setting, supporting the technology used in patient care. Beginning biomedical equipment technologists can use this book to obtain a working vocabulary and elementary knowledge of the industry. Content is presented through the inclusion of a wide variety of medical instrumentation, with an emphasis on generic devices and classifications; individual manufacturers are explained only when the market is dominated by a particular unit. This book is designed for the reader with a fundamental understanding of anatomy, physiology, and medical terminology appropriate for their role in the health care field and assumes the reader's understanding of electronic concepts, including voltage, current, resistance, impedance, analog and digital signals, and sensors. The material covered in this book will assist the reader in the development of his or her role as a knowledgeable and effective member of the patient care team. Half-title 3 Title 5 Copyright 6 Contents 7 Preface 9 INTRODUCTION TO BIOMEDICAL INSTRUMENTATION: The Technology of Patient Care 11 1 BMET as a career 13 What is the name of this career? 14 What do BMETs do? 14 Who employs BMETs? 15 Field service representatives 21 Is there a national license or certification? 23 What regulatory agencies govern the work of BMETs? 25 What are some ways that BMETs stay connected? 25 STUDY QUESTIONS 26 FOR FURTHER EXPLORATION 27 2 Patient safety 31 Introduction 32 Electrical shock 32 Leakage currents 35 Standards 38 Summary of important values 38 NFPA 99 39 Standard regulatory definitions 39 Electrical wiring in the hospital 42 Manuals 45 The NFPA Life Safety Code 101 46 Government regulations 48 STUDY QUESTIONS 48 FOR FURTHER EXPLORATION 49 3 In the workplace 51 Introduction 52 Applicable codes of ethics 52 Preamble 53 Guidelines principles of ethics 53 Test equipment for the BMET 54 BMET personal safety 55 Universal precautions and isolation 55 Precaution standards 58 Customer service 60 STUDY QUESTIONS 62 FOR FURTHER EXPLORATION 63 4 Electrodes, sensors, signals, and noise 65 Introduction 66 Sensors 66 Optical devices 67 Photoemissive devices 67 Photodetectors 68 Important sources of error in systems with sensors 69 Electrodes 70 Measuring temperature 71 Impedance matching 73 Human signals 73 Signal conversion 75 Signal noise 76 Signal conditioning 77 STUDY QUESTIONS 77 FOR FURTHER EXPLORATION 78 5 The heart 81 Introduction 82 Patient monitoring 82 Electrical activity of the heart 82 ECG monitoring 84 Three-lead ECG monitoring 86 Five-lead ECG monitoring 88 12-lead ECG monitoring 88 Lead identi.cation 89 Long-term ECG recording 90 Fetal heart monitoring 91 Pulse oximetry 91 STUDY QUESTIONS 94 FOR FURTHER EXPLORATION 95 6 Cardiac assist devices 99 Introduction 100 Defibrillators 100 Artificial hearts 103 Pacemakers 105 Implantable defibrillators 106 STUDY QUESTIONS 111 FOR FURTHER EXPLORATION 112 7 Blood pressure 115 Introduction 116 Indirect measurement methods 116 Direct invasive arterial pressure measurement 120 STUDY QUESTIONS 121 FOR FURTHER EXPLORATION 122 8 Respiration and respiratory therapy 125 Introduction 126 Respiration measurements 126 Mechanical ventilation 129 High-frequency ventilation 132 Other respiratory equipment 134 STUDY QUESTIONS 135 FOR FURTHER EXPLORATION 136 9 The brain and its activity 139 Introduction 140 Review of neuroanatomy and physiology 140 Electrical activity in the brain 141 Electroencephalography (or electroencephalogram) 141 Evoked potential testing 142 Depth of anesthesia monitoring 142 Intracranial pressure (ICP) monitoring 142 Brain perfusion 144 EEG monitoring 144 Sleep studies 145 Cerebral spinal fluid shunts 145 STUDY QUESTIONS 145 FOR FURTHER EXPLORATION 148 10 The intensive care unit 151 Introduction 152 Characteristics of intensive care units 152 Types of intensive care units 154 Cardiac care unit 154 Neonatal intensive care unit 155 Pediatric intensive care unit 158 Medical intensive care unit 158 Surgical intensive care unit 159 Other types of ICUs 159 Support common for many patients 160 Telemetry 162 STUDY QUESTIONS 163 FOR FURTHER EXPLORATION 163 11 The operating room 167 Introduction 168 PART I – THE ENVIRONMENT 169 Prior to surgery 169 The operating room 169 Anesthesiology 170 Staff in the OR 171 The sterile environment 172 Types of surgery 173 Equipment sterilization 174 Operating room stress and customer service 175 PACU 177 PART II – EQUIPMENT IN THE OR 177 Equipment used in laparoscopic surgery 180 Electrosurgical units (ESUs) 181 LASERs 184 STUDY QUESTIONS 185 FOR FURTHER EXPLORATION 186 12 Imaging 189 Introduction 190 Ultrasound 190 X-rays 191 Computed tomography or computerized axial tomography 193 Fluoroscopy 194 Common applications of x-ray imaging 195 Magnetic resonance imaging 197 Safety and MRI 198 Nuclear medicine 199 Positron emission tomography 199 Picture archiving and communication systems 201 DICOM 201 STUDY QUESTIONS 201 FOR FURTHER EXPLORATION 202 13 Clinical laboratory equipment 205 Introduction 206 Blood analysis 207 Urine tests 208 Electrophoresis 209 Centrifuges 209 Other clinical laboratory equipment 212 Point-of-care testing 213 STUDY QUESTIONS 215 FOR FUTURE EXPLORATION 215 14 Intravenous pumps and other pumps 217 Introduction 218 Infusion pumps 218 Syringe pumps 221 PCA pumps 221 Feeding pumps 222 Implantable insulin pumps 222 STUDY QUESTIONS 223 FOR FURTHER EXPLORATION 223 15 Miscellaneous devices and topics 225 Introduction 226 Play therapy 226 Fetal monitoring 226 Nurse call systems 228 Infant Tracking 229 Rehabilitation 229 Speech/Audiology 230 Long-term care 230 Terminally ill patients 231 STUDY QUESTIONS 232 FOR FURTHER EXPLORATION 233 Index 235 9780521515122 "This book is designed to introduce the reader to the fundamental information necessary for work in the clinical setting, supporting the technology used in patient care. Beginning biomedical equipment technologists can use this book to obtain a working vocabulary and elementary knowledge of the industry. Content is presented through the inclusion of a wide variety of medical instrumentation, with an emphasis on generic devices and classifications; individual manufacturers are explained only when the market is dominated by a particular unit." "This book is designed for the reader with a fundamental understanding of anatomy, physiology, and medical terminology appropriate for their role in the health care field and assumes the reader's understanding of electronic concepts, including voltage, current, resistance, impedance, analog and digital signals, and sensors. The material covered in this book will assist the reader in the development of his or her role as a knowledgeable and effective member of the patient care team."--Jacket