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Stethoscopes: M Aintenance and Safety Checking

This document provides information about maintaining diagnostic equipment such as stethoscopes and electrocardiograph (ECG) machines. It discusses checking and replacing parts of stethoscopes as needed. For ECG machines, it recommends safety checking them twice a year, including testing earth continuity, mains circuit insulation, patient circuit insulation, and earth leakage. Common faults of ECG machines include issues with electrodes, leads, the stylus, or batteries. The document provides guidance on troubleshooting electrical or electronic problems in ECG machines.

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51 views3 pages

Stethoscopes: M Aintenance and Safety Checking

This document provides information about maintaining diagnostic equipment such as stethoscopes and electrocardiograph (ECG) machines. It discusses checking and replacing parts of stethoscopes as needed. For ECG machines, it recommends safety checking them twice a year, including testing earth continuity, mains circuit insulation, patient circuit insulation, and earth leakage. Common faults of ECG machines include issues with electrodes, leads, the stylus, or batteries. The document provides guidance on troubleshooting electrical or electronic problems in ECG machines.

Uploaded by

jose_mario1128
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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DIAGNOSTIC EQUIPMENT

Stethoscopes
S tethoscop es require little m aintenance apart from replacem ent o f lost, cracked, or
broken parts, such as ear-pieces and diaphragms (Fig. 3.3). O n the older types, the
tubing m ay perish and need replacing. W hile it is possible to buy proper, but
expensive, stethoscop e tubing, ordinary tubing o f a suitable size m ay be fitted.
M o st new er stethoscop es have tubing that does n o t perish, though it can becom e
sticky if certain chemicals com e into contact w ith it.

If nothing can be heard through a stethoscope, check w hether:

— The earpieces are blocked; if they are, unscrew them, push the blockage out and
clean w ith a little spirit.
— The diaphragm is m issing or split; replacem ents can be purchased or can be made
out o f a piece o f radiographic film or similar plastic sheet.
— The tube is split.

Fetal stethoscop es require no maintenance. T h e servicing o f electronic steth o ­


scopes is outside the scope of this manual.

Electrocardiograph machines and cardiac monitors


Electrocardiograph (ECG) m achines are used to m o n ito r the electrical activity of
the heart and display it on a small screen or record it on a piece o f paper. The
electrical activity is picked up b y means of electrodes placed on the skin. T h e signal
is amplified, processed if necessary, and then displayed.

T here are m any types o f EC G machine and cardiac m onitor, ranging from the very
basic, w hich will ju st show or write the EC G trace, to com plex m achines that will
give much m ore inform ation about the status o f the heart, and m ay com bine a
screen and a paper-w riter. T hese machines run off the mains electricity supply and,
in addition, often have internal rechargeable batteries.

Maintenance and safety checking


T h e follow ing item s o f test equipm ent are required:

— a digital m ultim eter or a goo d analogue m eter;


— a "M e g g e r" (for h ig h-voltag e insulation testing);
— a safety checker;
— an EC G sim ulator (this is an instrum ent that produces a signal similar to that of
the heart and makes w orkshop testing much easier).

67
MAINTENANCE AND REPAIR OF LABORATORY AND HOSPITAL EQUIPMENT

The first tw o item s are essential. A safety checker is n o t essential, but testin g will
be limited w ithout it. (If a safety checker is n o t available, make up an earth-leakage
current tester, as described below .) Follow the instructions and the service manual
supplied b y the manufacturers.

Safety checking is m ost im portant. Faulty insulation or earth connections can be


serious. Safety checks should be undertaken at least tw ice a year. K eep a log b ook
w ith details o f each safety check and each reported fault.

The follow ing four tests should be carried out as a minimum (additional tests are
possible w ith a safety checker).

• Earth continuity: using a m ultim eter, a reading o f less than 0.1 ohm s should be
obtained b etw een the earth pin on the mains plug and the chassis o f the unit.
• M ains circuit insulation: using a "M e g g e r", check that there is at least
5 0 M ohm s betw een the earth pin and live pin, and b etw een the earth pin and
the neutral pin, on the mains plug.
• Patient circuit insulation: using a "M e g g e r", check that there is at least
5 0 M o h m s b etw een the patient lead connections and the earth pin and the live
pin and the neutral pin on the mains plug. (Conduct the tw o insulation tests at
5 0 0 volts.)
• Earth leakage: using the test equipm ent illustrated in Fig. 3.4, check that the
leakage current is less than 5 0 0 microamps.

A fter safety checking, carefully clean the m achine b oth inside and outside.

Earth-leakage current tester

The 1 kohm resistor should be of a non-inductive type, i.e., a carbon-film resistor,


and n ot wire-w ound. M o u n t the circuit show n in Fig. 3 .4 in a b o x. O n e side o f the
b o x should be fitted w ith a mains plug. The other side should be w ired to a socket
into which the appliance to be tested m ay be plugged. The tw o test points are
m ounted on the same face o f the b o x as the socket, but clear o f it. C onn ect the
instrum ent to the mains supply, and plug the equipm ent under test into the socket
o f the instrum ent, then sw itch on the power.

Fig. 3.4. Earth-ieakage current tester.

1 kohm

0 : test points

This test equipm ent is used w ith a multimeter. Select the A C m illivolts settin g on
the m eter and conn ect it to the points shown. The m illivolts reading during the
test will be equivalent to m icroam ps. Thus, it should read less than 5 0 0 millivolts.

68
DIAGNOSTIC EQUIPMENT

Important spares

Patient electrodes
Patient leads
Styli
Paper

Common faults

W hen an EC G m achine does n o t w ork check the follow ing points before taking off
the covers to look for electrical/electronic problem s:

• Check that the m achine is correctly conn ected to the patient.


• Check that the patient electrode connections are clean and in g o o d condition;
dirty or corroded connections will g ive problem s.
• C heck that the leads to the patient are in g o o d condition, that the conductor is
not broken, and that there is n o t a short circuit to the cable screening.
• If the m achine is being run off its battery, check that the b attery is in good
condition and that the charger is w orking correctly.
• C heck that the stylus of the writer is heating correctly, and is n ot w orn or
damaged.
• Check that there is no m echanical damage, e.g., a broken on/off switch.

If there is no fault w ith any o f these, it is likely that there is an electrical/electronic


problem . Send the m achine to the manufacturer or appointed agent.

69

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