Note. If you are reading this on a mobile phone, please scroll to the bottom for a list of subjects covered.
Learn to repair bicycles first then jet engines.
My name is Mike, retired from working for thirty-nine years in the British national health service and with a little time on my hands.
I worked in the critical care areas of the hospital, Intensive care, Premature baby unit, Central delivery, Cardiac intensive care, Accident and emergency resuscitation area and a little in the theatres, I also specialised in blood gas analysers, nitric oxide administration and the ventilation of premature babies and quadriplegic patients particularly those living in the community.
I decided to put on the net some of my knowledge, the things I have written about and used as teaching material.
It mainly concerns older types of equipment that some new and young technicians will probably never have seen but which can still be found in hospitals dotted around the world, probably in a hospital near you.
I actually first did it in the 1980s in the days when very few people had personal computers, and to write a blog on the internet you had to be able to write in HTML computer language. I taught myself the basics of it and started posting articles. After a few months I became worried someone might misuse my information, do something wrong and sue me so I took it down. Then much later I started again and produced this site only now it is simple to produce with modern computers and no need to understand HTML.
I have taught and worked in Nepal, Uganda and Tanzania.
I was in Nepal twice for five months in all, teaching and doing maintenance in various hospitals in the country. I produced probably the first inventory of critical care equipment in the country.
In Tanzania, I taught on an East African scientific conference.
For ten years I had a couple of teaching spots on the ‘Anaesthetics in Developing countries and difficult locations’ course at the University of Oxford run by Dr Mike Dobson of the Nuffield Department of Anaesthetics. The course was then moved to Uganda and I had a couple of years teaching on it there.
In the early days of my involvement with developing countries anaesthetics and maintenance, I worked with WHO to co-produce a book on maintenance. It was probably the first book ever to cover this subject.
It is now a print on demand book available in English, Portuguese and Russian and below is the link to it.
https://apps.who.int/iris/handle/10665/40508
In some cases, in this blog, the articles need to have photos or drawings added or occasional formatting and spelling adjustments, I am getting around to them slowly. the photos are taken by me.
First to say that whatever advice I give on these pages is correct to the best of my knowledge, you must not follow it blindly but think about what you are doing and satisfy yourself that you are doing the right thing.
When you have finished check and check again that what you have done is correct and that the piece of equipment is working correctly and safely, if in doubt do not use the machine.
If you are a technician, get the doctor who will use the piece of equipment to check they are happy with its working and sign your job sheet to confirm it.
*To the right are a number of links to interesting sites that may be of interest to you. If you need a basic spreadsheet and word-processing package click on the Open office link for a quite good and free package.
Planning a difficult project, go to the X mind link for a basic but free mind mapping program, a program into which you can put your thoughts into a graphic form.
Then there are some links to other sites that might be of interest to you.
To visiting doctors or technicians.
Most of the repairs outlined here will be of a limited nature because they are often being undertaken as a self-help effort and I expect there will be few tools or spares available to you, please use any professional help that may be available.
Before you leave your home hospital, it will be helpful for you to find out something about the equipment in the country you are going to, easy if you know someone who has been there.
Armed with this knowledge, a visit to your local hospital maintenance department should get you a few basic spares (washers, seals, laryngoscope bulbs, fuses, 2ltr bags, that sort of thing) which may prove useful.
You can either take a small tool kit with you or the ubiquitous Swiss army knife or, and some would say better, a tool called The Leatherman or the Gerber, both made in the USA, in a number of sizes and configurations and more of an engineering tool. Remember these are not insulated so use with care if you are working with electrics.
I favour the Leatherman or the Gerber and a small mains testing screwdriver, not the ordinary type but the sort which has a small watch type battery and a bulb inside, these can not only test for voltage but also fuses, bulbs and the continuity of wires.
I am a great believer in travelling light; you should be able to run 200 yards with all your luggage to a plane, train or bus without having to haggle with a porter.
Pack your bags and then discard 25%. The only variation on this is with film, here the rule is to decide how much you need and double it.The reference to film was written in the days of film cameras, these days double the number of picture cards.
For local technicians.
This is only a start and as the saying goes, the wise man moves a mountain by picking up a small rock.
These web pages are designed to get you to start maintenance in your hospital; it is unable to tell you everything if only because I do not know what equipment you have.
You need to collect a basic tool kit, find a place to work, and keep it clean.
Do not be afraid to ask doctors visiting from abroad to contribute tools or other service aids, if you need to know something, and they do not know the answer, ask them to find out when they get home and write to you. If there are medical or religious charities in the area ask them to assist in setting up your workshop.
It is up to you to improve your skills and the standard of maintenance in your hospital.
When doing a maintenance task prepare well.
Find a clean area to work in, a clean bench and a clean floor. Try not to work near a drain or cracks in the floor boards because if you drop something it will surely roll down it.
Plenty of good light and containers to put things in to.
Work in a methodical way, keep removed parts in a logical order, make notes if necessary.
Always plan ahead and have some idea of the consequences of removing something.
Do not take things apart out of interest or because you are bored. You may break or lose something and if you have no replacement you have a problem you did not have before.
Better something is not working very well than not at all. If you have a phone with a camera use it to take pictures of what you are doing to remind you how to put it back, make notes on a piece of paper, do not say to yourself ‘I will remember which wires went where’ you may not, take a photo or draw a diagram.
I would like to explain the idea behind all this writing, it began at the request of Mr Chanchal Kumar Joshi, Chief Technician at the Tribhuvan University Teaching Hospital in Kathmandu, Nepal sometime in 1985 when I was working there on behalf of the British government. He asked me to write down what I was teaching him.
As to the web page, I started one with my maintenance thoughts about twenty years ago in the days before it was simple to create web pages, I had to learn HTML to do it. After a few months I took it down because I was not sure of the legality of it. This effort went live in about 2012.
The present document is far removed from the first attempt.
It has not just been done for the benefit of one person but for anyone who is able to get on to the internet and if it is of help to other people working in the medical field, particularly those who may have little or no training in medical equipment maintenance, then so much the better.
It will not include much in the way of electronic maintenance because that is not my subject and indeed does not even attempt to cover all the different types of equipment that you could get in a hospital.
The range of ventilators, anaesthetic machines, and so on is so huge that it would be an impossible task to cover everything, all the different models and makes, apart from that I don’t have the experience to write about most of it.
Some of it is taken straight from service books, and where I feel that the piece of equipment is quite wide-spread in hospitals around the world I have expanded upon it.
My experience lies in the equipment that we have in our hospital in England and some that I have met else where in England and abroad.
I have also included a little medical information here and there to begin to give you a broader knowledge of the subject.
Learn as much as you can it will help you when talking to the doctors about any problems that they have with their equipment. Take the time to get into the operating theatres and wards as often as you can to see how the equipment is used, it will help you to repair it more easily if you have seen it in use and seen what sort of problems the nursing staff have.
What it also gives you is the confidence to go on to a ward or into a theatre to look at a piece of equipment still on a patient and claimed to be faulty.
There will be times when you might be called to a theatre in the middle of an operation or into the intensive care unit to make a quick repair or to assure the staff that the equipment is working correctly.
What I am trying to do is to guide you along, to give you a little confidence to try to repair equipment which would otherwise not be repaired; it is as much to tell you what NOT to do as well as what you can do.
The guide is not only for technicians but also for doctors in hospitals where there are no technicians, here it may well be a case of doing it yourself as best you may or go without.
Lack of money, this along with the price of medical equipment mainly aimed for sale in rich countries is one of the big problems for health services in developing countries.
Self-sufficiency is one of the most important goals; use the rich countries to train your technicians.
Not only is it difficult to find the money to buy the high technology but more importantly, even if has been given, it is an expensive matter to look after it.
Not having a lot of high technology equipment should not be looked on with sadness or as a matter of national loss because some of it is quite unnecessary.
If you are offered equipment, you should not feel obliged take what you are given regardless, consider what you and your hospital need, consider if it fits in with your way of working and your ability to look after it.
Consider also the possibility of asking for something other than medical equipment, tools and test equipment, these things are very much cheaper and can assist the hospital a great deal. It is worth noting that for the price of modern ventilator you could equip a number of technicians with all the tools and test equipment they could possibly need and probably build a simple workshop.
It will be found that having a workshop, no matter how small, if the staff are keen and have a reasonable level of tooling, will save the hospital money and means that you don’t have to rely upon other people to give you new equipment all the time, it will also give you the confidence to help yourselves.
Lastly, but not least of which, is to improve the standard of patient care, and that is the most important thing.
As a Technician, do not be afraid to stand up and speak, don’t let people rush you into doing repairs faster than you are happy with, remember that people’s lives may well depend upon the equipment that you are repairing, and no-one will thank you if the equipment goes wrong because you rushed the job.
Remember that it is an important job so learn it well so that others have confidence in you.
In my limited experience of hospitals in developing countries and from what I have been told, lack of simple maintenance means a lot of equipment lying around not working just for the want of a simple repair.
It is very easy to look on the doctors as being the most important people in the hospital, and of course they are important, but it must be remembered that the technicians are just as important, and become even more so when the equipment goes wrong.
To my Father, Jack, who loved Africa, especially Ghana, and its people and would have enjoyed these web pages hugely.
I tried sendin u a mail but it would not go. I need some information on how to reorganise a technical services department of a hospital…plz send me an email dat I can,send details…tanks
Hi brilliant site, huge amount of work, may i include a link from our anaesthesia educational site developing anaesthesia?
Cheers David
A/Prof D Pescod
David,
Thanks, more than welcome to give me a link to add, I did click on developinganesthesia.org but it reported unable to find the page.
Regards
mike
David,
Looking at the address I think you have left out the second ‘a’ in anaesthesia which is why the search engine could not find it.
regards
mike
it is a very good link i hope help in the_ Boimedical engineer
in kenya undergraduate BSc Biomedical engineering at Kenyatta university
very helpful contents. this is what i’m searching for long. Thanks for sharing. For used/refurbished Medical equipment Please contact us.
Beautiful site. I’m from Russia. It is not customary for us to write on such topics, it is considered a professional secret. But you are doing the right thing, that you are talking about the maintenance of medical equipment. It is interesting to read.
Samuel, Thanks for your comments, often people in developing countries have little knowledge or money and get taken advantage of by companies from developed countries, given. Most of the information on the pages is for old equipment not used in modern countries like yours and mine.
All the best. Mike
Yes, Mike. Lack of information on the device and methods of service of medical equipment is a serious problem in poor countries.
Many medical equipment breaks down because the technician does not know how to serve or can not solve the problem.
Thanks to you, these people will be able to properly deal with the medical equipment.
To me it is also interesting. I was particularly interested in the differences in the organization of maintenance of medical equipment in the developed countries, the effectiveness of the methods, the profitability of repairs and replacement of parts, methods and effectiveness of extension of service life, methods for finding suppliers and equipment manufacturers.
Sorry for my English
Samuel.
Thanks, nothing wrong with your english at all. 100% better than my Russian I am sad to say. Glad you found it interesting.
all the best.
Mike
Dear Mike
Your blog is an incredible resource. I wish I had found it earlier. May I use some of your photographs? Mary
Mike
I ask your permission to write you a few questions on the organization of medical service equipment UK.
If you do not mind, I would like to write to your email address.
Samuel,
More than happy to answer any questions if I can. mjhyeats@gmx.com
Mike
http://meridianmedical.in/index.php
Hi, I’m a biomedical engineer in Ghana and stumbled upon this site by accident, hugely impressed by your effort, this is a wonderful resource for all interested parties. thank you and best regards.
Thanks for your comments, I am pleased you find it useful. You live in a lovely country I have been to Accra and Takoradi.
Regards
mike
My dad is a doctor and has always spoken to the importance of keeping your equipment clean and running smoothly for patients. I like how you mentioned that it’s crucial to have tools and things like washers, seals, and bags in place to be able to help on the go. Even though they may be a little different keeping that equipment clean helps everything run great. Thanks for the great article!
Wow!!!.. incredible, thanks a lot!… It is a huge amount of valuable info for us (engineers from developing countries). I think your site is one of the top important site on the net relative to medical equipments maintenance. Am going to put a link to this site in my website if you are ok with this, of course.
Thanks, you are than welcome to add a link. Glad you get something out of it.
You can be sure, I will send you the link with the first achievement. Wait a few hours to see the link to this site (too much pressure right now). Have a good day!
The link to your site is ready. You can find it here:
http://www.automaticaneuro.com/neuro_usa_o_recomienda.html
(in websites section)
It gonna take some time to get something out cause there is a lot of articles and readings to understand before to put something on practice.
The best whishes to everyone
Ruben
Thanks Ruben, I notice that the link is not live. all the best Mike
Sorry, you have reason, don´t know what could happens, but Am fixing it right now. Take a look in a hour.
Working fine, thanks.
As I was reading your article, you state that your expertise lies in the knowledge of medical equipment. I’m glad that there are professionals like you that can help fix equipment that is being used to save people’s lives. Without people like you having the knowledge of medical equipment and how it can be fixed, I feel we would be worse off.
Thanks Amy, I have enjoyed writing it, keeps my brain active in retirement. It is one part of a hospital people never get to see.
I am Yosiah Muhindoh, a Biomedical Engineer currently based in Bunia, Ituri region, Democratic republic of Congo. I relate to the above experinces so much. I am finding this job, not only interesting but also very complicated. Several clients buy equipment with little or no knowledge of all the neccesary accesories, software, reagents needed and maintanance requirements on top of how to suse them. The staff that use the machines were not trainned on them. Its a total mess. Every day i find new equipment that was either bought or donated that has never been used. I start the process of contacting the suppliers and then installing!!! Its really cumbersome.
Yosiah Muhindoh
+256703326014whatsapp
+243850367151
Good afternoon Yosiah.
I am pleased you have found my web pages. I hope you get something out of them.
All you can do is to learn how to look after the equipment you have. Learn how a piece of equipment works then you can show the other staff members. Hopefully you have a workshop and some basic tools. Next time you hear that someone is going to donate to the hospital, ask them for tools.
You have access to the internet so you should be able to find maintenance and
user manuals. Try contacting the makers or go to a technicians web site I mention called
‘EBME’. As far as I know it is free to join and you may well find people there who can help you with any problems.
Good luck.
Mike
Thanks for sharing this information
You are welcome, I hope it help you.
Great article 🙂 you wrote so well about and shared useful information, we too encourage people to manage medical equipment and so we have also developed a software called Equicare if you or your friends are looking for a perfect place to manage all your medical equipment then do contact me 😉
Here is the link https://bit.ly/3ebyg7n
you can also try the demo and yes don’t forget to share the experience 😉