April 17, 2012                                                                                                Hours Rendered: 8

I was told return today after signing the contract and my id last week. I got up early and prepared for my first day in St. Luke’s medical center!

I arrived at SLMC and proceeded right away to the training and education department. Another trainee led me to a room where fellow interns waited for the orientation to start. When Mam Lady of the Training, Education and Development Department came to the room, she explained the do’s and dont’s of the whole internship program. She also discussed procedures when taking a leave of absence and other rules and SOPs to follow. After the short orientation of the policies, we left the room for deployment. I was brought to the engineering and maintenance department of SLMC where and then to the Biomed Workshop to the biomed workshop. There I was told to wait for Mam Chiqui, the supervisor. I observed what the others were doing.

Other interns already started last week, so I already missed a few days. They were already doing tasks and heard lectures from the seniors. In front of me, there were several units of volumetric pumps. My co-interns were testing the units if the unit is still on good condition or if it needs repair. Most of them needed repair. The seniors left the repairing to us since it was just basic troubleshooting. A manual of the device was also provided to help us in troubleshooting the devices.

They have already checked and repaired some units, so I joined them in continuing the task. We encountered different errors. “err.u” “err.n” “err.1” up to “err.8” was the codes displayed by the volumetric pump and they meant a specific error on the machine or the equipment. We encountered a defective LCD display, a defective motor, a defective pressure sensor and many more defective parts. Sometimes, the defect cannot be remedied by the solutions presented in the manual. That would be the time that we ask the seniors. There were also times that we discovered the solution by ourselves.

The repairing of defective units continued until the afternoon. Unscrewing the unit, detaching connecting wires, trying to figure out what is wrong with the unit and finding a solution to make the device work properly according to its function. There were many trials and errors during the repair only to find out that there were just some loose connections and just needs re-connection. Other errors really challenged us because there were missing parts on the device.

Also the syringe pump was introduced to me. It operates the same way as a volumetric pump but it uses a syringe instead.

It was an exciting first day! Not much of the orientation I expected but thumbs up to being able to repair a volumetric pump!

April 18, 2012                                                                                                Hours Rendered: 8

Today is Sir Butch Soriano’s lecture day. He talked about SLMC: vission, mission, its values being upheld and other things we have to know about SLMC. Sir Butch then proceeded with the different divisions and emphasized the biomed department and its importance: as a hospital with advanced technology and equipments, it needs a technical group to support the technology.

Sir Butch then proceeded with the discussion of the different equipments used in the hospital. First in the list: X-ray. He explained how x-rays are generated, how an image is formed, its relation to density of the subject, and how it is being processed. He talked about history of x-ray and its advancement through time. He shared how and why one technology is better than the other like using floating anode shaft instead of using a ball bearing to prevent wear and tear. He also introduced fluoroscopy to us and proceeded with Radiographic Fluoroscopy.

 

April 19, 2012                                                                                                Hours Rendered: 8

On my third day, we did a preventive maintenance on the vital signs monitor for the month of April 2012 at Telemetry and CVU with Mam Rona. Checked if the equipment is accurate by testing its acquisition of different parameters like BPM, heart rate, etc. using a multi-parameter simulator then checked if the alarm is accurate. It is dependent on those tests whether the vital signs monitor is a “pass” or “fail”.  Also, we also did a preventive maintenance on ECG monitors at CCU and Emergency Room.

In the afternoon, I accompanied a supplier from CareStream in checking on the X-ray Processor that was reported to have some problems. He explained the X-ray processor is the equipment responsible for imprinting the patient’s x-ray image stored in a cassette into the film. He explained that using the x-ray processor, the imprinting of the x-ray image became faster than the traditional process done in a dark room as that process when printing/developing pictures using films. The x-ray processor does everything in just a matter of minutes and you now have your x-ray film! However, there is a more advanced technology that most hospitals use today where x-ray images are digitalized and can be saved on flash disks or compact discs. Sir JR checked on the machine. He opened the machine, checked the circuitry, the boards, the mechanical hardware. He then checked on the fuse. It was a blown fuse. It was probably caused by a power interruption that happened the night before as what the nurses in the unit said. He just replaced it and the machine is ready for use. After fixing the problem, he then proceeded with cleaning the machine and doing maintenance on it.

After the x-ray processor, I went to the Neurological Critical Care Unit to join fellow trainees who are also taking up ECE for a site visit for the next day’s agenda of setting up a LAN in the unit together with Mam Chiqui. Tomorrow’s agenda:  to connect bedside monitors to a central monitor located in the nurse’s station. We inspected existing cables that can be used, we checked what rooms has connections already and which rooms needs cabling. Upon inspection, we found out that NCCU 2, 1 and 5 already have cables that are ready to be used so that the patient’s condition at the said rooms can be viewed in the central monitor. However, we have to work on NCCU 3,4 and 6 for them to be connected to the LAN. There were parallel port cables embedded in the walls. These parallel port cables were used in the old monitoring system. For next day: Cabling and configuration of LAN.

 

April 20, 2012                                                                                                Hours Rendered: 8

Fourth day: LAN. This day is allotted to LAN configuration and cabling at NCCU together with Sir Von and Mam Chiqui. We first replaced the CPU at the nurse’s station. Then set up the modem, monitor and other accessories for the computer to be used. Then, we connected CAT5 cables that are connected to the bedside monitors from NCCU 1, 2 and 5 to the modem, configured the program used and there we have it! The patient’s status from rooms 1, 2 and 5 can be viewed in the central monitor.

Next, we have to find a way to use the existing parallel port cables to connect the bedside monitors from the rooms to the CPU in the nurse’s station. However, a modem for the network is used – CAT5 cable with RJ-45 should be used. We used only three wires from the CAT5 and the Serial cable. For the pin configuration of the RJ-45, we assigned Brown wire to PIN3, Green wire to PIN4 and White-Orange wire to PIN5. The other end of the CAT5 cable is then connected to the existing parallel port cable. The other end of the parallel port cable is then connected to another CAT5 cable then to a serial port to be connected to the bedside monitor.  We soldered the wires from CAT5 cable to the serial port. Finding the which is which among the wires inside the parallel port cable is not easy since it is already embedded on the walls. Trial and error worked however and with Sir Von’s experience, the work was accomplished faster. We were set up LAN cabling in rooms 3 and 4 but we can’t set it up in room 6 since a patient is admitted in the room. We have to wait for the patient to be discharged. We finished the work somehow. We were able to connect NCCU 1-5 to the central monitor!

Also during this day, I encountered a new equipment: the Biosafety Cabinet. Biosafety Cabinet is a lab equipment used when working with samples (except acids) that is contaminated or possibly contaminated with pathogens that are harmful. Biosafety Cabinet protects the health of end-users, the sample and the surrounding environment from pathogens by cleaning the air. The exhausted air passes through various filters to remove harmful bacteria and viruses.

The supplier will perform a check-up on the equipment since its UV light is malfunctioning. A protocol is followed to prepare the BSC for a check-up. It must first be decontaminated using formaldehyde or using hydrogen peroxide. Upon inspection by the supplier, they found out that it is the switch that is malfunctioning.

After that, Sir Vince asked my and another trainee to change the two-prong plugs of the volumetric pump to a three-prong plug.