MAKERERE UNIVERSITY

COLLEGE OF HEALTH SCIENCES

SCHOOL OF BIOMEDICAL SCIENCES
DEPARTMENT OF PHYSIOLOGY
BACHELOR OF SCIENCE IN BIOMEDICAL ENGINEERING

A REPORT ON INTERNSHIP TRAINING CARRIED OUT AT ON INDUSTRIAL

TRAINING AT ARRAY MEDICAL SUPPLIERS AND CONSULTS LIMITED

BY
ODONG SAM
REG. NO: 19/U/28364

An Internship Training Report Submitted in Partial Fulfillment of the requirements for

the award of a Bachelor of Science in Biomedical Engineering at Makerere University.

Duration :5th September - 14th October (6 weeks)

DECLARATION
I, ODONG SAM, student of Biomedical Engineering, Makerere University hereby declare
that this is my original work made personally during my six weeks internship period. I also
state that no part of this report has been or is being submitted elsewhere for the award of any
academic purpose.

Signature…………………………………………………

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APPROVAL
This is to clarify that this report was done under supervision and is ready for the submission
as partial fulfillment of the award of Bachelor of Science in Biomedical Engineering at
Makerere University.

ENG. JONAH MUYANJA

COMPANY SUPERVISOR
Sign…………………………………………………….
Date……………………………………………………

MS. RACHEAL NALWOGA

UNIVERSITY SUPERVISION
Sign……………………………………………………..
Date…………………………………………………….

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ACKNOWLEDGEMENT
First, I sincerely thank the Almighty God for helping me to successfully prepare this report. I
am thankful to ARRAY MEDICAL SUPPLIERS AND CONSULTS LIMITED that gave me
the opportunity to carry out internship in their organization and giving me a lot of
information and hands on practical skills in the filed which has helped me relate the
knowledge studied at university and the professional working environment. I also pay my
heart rendering respect and appreciation for the consideration and co-operation which is
given to complete my industrial training work assigned.

I express my profound thanks to the Managing Director Mr. Philip Ddungu Yeko of Array
Medical Suppliers and Consults Limited and the biomedical engineers i.e., Eng. Jonah
Muyanja, Eng. Jimmy Togura, Eng. Phillip Lukwago, Eng. Moses Ochen and Eng. Gabriel
Ategeka whose encouragement and hands on training was very instrumental in accomplishing
this task successfully. lastly, I would like to thank my university supervisor Ms. Racheal
Nalwoga for her encouragement and advise during the supervision process, this was key in
appreciation the importance of the entire internship process.

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ABSTRACT
This report provides details of activities carried out during the internship training at ARRAY
MEDICAL SUPPLIERS AND CONSULTS LIMITED from 6 th September to 13th October
2022 (6 weeks). It consists of four chapters. Chapter one has the introduction, background of
the field attachment, objectives of internship, background of the field attachment
organization, organization structure and main activities of the organization. The second
chapter is made up of the experience acquired in the field i.e. position occupied, duties and
responsibilities, authority etc. The main activities carried out by the engineering department
of the company were; troubleshooting, maintenance, repair, calibration, procurement and
installation of all sorts of medical equipment and also electrical fault repairs. These activities
were done mainly in the clinics, laboratories and equipment maintenance workshop and the
hospitals. Chapter three is made up of the evaluation of the field attachment which includes
interesting experiences, challenges faced and how they were overcome and benefits derived
from field attachment. Chapter four is made up of the conclusions and recommendations
made for both the organization and university.

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 TABLE OF CONTENTS
DECLARATION-----------------------------------------------------------------------------------------i

APPROVAL----------------------------------------------------------------------------------------------ii

ACKNOWLEDGEMENT----------------------------------------------------------------------------iii

ABSTRACT----------------------------------------------------------------------------------------------iv

LIST OF FIGURES-----------------------------------------------------------------------------------vii

LIST OF TABLES------------------------------------------------------------------------------------viii

LIST OF ABBREVIATIONS------------------------------------------------------------------------ix

CHAPTER ONE: INTRODUCTION---------------------------------------------------------------1

1.1 Background industrial training-------------------------------------------------------------------1

1.2 Objectives-------------------------------------------------------------------------------------------1

1.2.1 General objectives----------------------------------------------------------------------------1

1.2.2 Specific objectives.---------------------------------------------------------------------------1

1.3 Background of organization----------------------------------------------------------------------1

1.4 Company profile-----------------------------------------------------------------------------------2

1.4.1 Vision------------------------------------------------------------------------------------------2

1.4.2 Mission-----------------------------------------------------------------------------------------2

1.4.3 Company organization structure------------------------------------------------------------3

CHAPTER TWO: INTERNSHIP EXPERIENCE-----------------------------------------------4

2.1 Position Occupied---------------------------------------------------------------------------------4

2.2 Duties and Responsibilities-----------------------------------------------------------------------4

2.3 Methodology---------------------------------------------------------------------------------------4

2.3.1 Demonstration---------------------------------------------------------------------------------4

2.3.2 Observation------------------------------------------------------------------------------------5

2.3.3Personal reading or research-----------------------------------------------------------------5

2.4 Hands on skills gained during internship-------------------------------------------------------5

2.4.1 Maintenance and repairs---------------------------------------------------------------------5

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 2.4.2 Installation-------------------------------------------------------------------------------------5

2.5 Hematology Analyzers (CBCs)------------------------------------------------------------------6

2.6 Suction Machine----------------------------------------------------------------------------------15

2.7 Oxygen Concentrator----------------------------------------------------------------------------17

2.8 Biochemistry Analyzer--------------------------------------------------------------------------19

2.9 Microscope----------------------------------------------------------------------------------------22

2.10 Vital Signs Monitor (Patient Monitor)-------------------------------------------------------24

2.12 Coagulometer-----------------------------------------------------------------------------------27

2.13 Urine analyzer-----------------------------------------------------------------------------------27

2.14 Biosafety Cabinet-------------------------------------------------------------------------------28

2.15 Centrifuge----------------------------------------------------------------------------------------30

CHAPTER THREE: EVALUATION OF FILED ATTACHMENT------------------------31

3.1 Experience gained and Skills Attained--------------------------------------------------------31

3.2 Challenges-----------------------------------------------------------------------------------------31

3.3 Solution the some of the challenges-----------------------------------------------------------32

3.4 Benefits Attained from The Industrial Training----------------------------------------------32

CHAPTER FOUR: RECOMMENDATIONS AND CONCLUSION-----------------------33

4.1 Recommendations--------------------------------------------------------------------------------33

4.1.1 Recommendations to the organization:---------------------------------------------------33

4.1.2 Recommendations to the University.-----------------------------------------------------33

4.2 Conclusion----------------------------------------------------------------------------------------33

REFERENCES-----------------------------------------------------------------------------------------34

APPENDIX----------------------------------------------------------------------------------------------36

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LIST OF FIGURES

Figure 1: Cleaning of the sample probe of the Dymind DH 36_________________________8

Figure 2: Servicing of a 5-part hematology analyzer________________________________10

Figure 3: Extraction of a WBC counting chamber for service_________________________11

Figure 4: Servicing of 3-part CBC______________________________________________12

Figure 5: Assembling the RBC and WBC counting chambers_________________________15

Figure 6: servicing a suction machine____________________________________________17

Figure 7: Troubleshooting an oxygen concentrator in the company workshop____________19

Figure 8: Reagent programming of a chemistry analyzer_____________________________22

Figure 9: servicing a Novex microscope__________________________________________23

Figure 10: New patient monitor ready for installation_______________________________25

Figure 11: Assembling of a gynecological operating table____________________________26

Figure 12: Service and repair of urine analyzer____________________________________28

Figure 13: Replacing a HEPA filter_____________________________________________29

Figure 14: assembled operation bed_____________________________________________36

Figure 15: WBC differential bath before service(left) and after service (right)____________36

Figure 16: hydraulic diagram of the Dymind DH 56________________________________37

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LIST OF TABLES

Table 1: Showing details of Dymind CBC at Iganga Islamic Medical Centre..........................7

Table 2: Showing details of Zybio CBC at Kairos Medical Centre...........................................9

Table 3: Showing details of Dymind 5-part CBC at ST Jude Entebbe......................................9

Table 4: Showing details of Dymind 5-part CBC at Kampala hospital...................................10

Table 5: Showing details of Zybio CBC at Friends Poly Clinic..............................................12

Table 6:Showing details of Zybio CBC at Nsangi Medical Centre.........................................13

Table 7:Showing details of Zybio CBC at Kairos Hospital.....................................................13

Table 8: Showing details of Edan CBC at Rhona Medical Centre..........................................14

Table 9:showing details of chemistry analyzer Imperial Hospital Iganga...............................21

viii
LIST OF ABBREVIATIONS

BSC Biosafety Cabinet

CBC Complete blood count

Eng. Engineer

FSE Field Service Engineer

HCT Hematocrit Hematocrit

PLT PLT Platelet

MPV MPV Mean Platelet Volume

PDW PDW Platelet Distribution Width

HEPA High Efficiency Particulate Absorption

HGB Hemoglobin

MCH Mean Cell Hemoglobin

MCHC Mean Cell Hemoglobin Concentration

MCV Mean Corpuscular (erythrocyte) Volume

NDA National Drug Authority

PCT Plateletcrit

PPE Preventative Protection Equipment

RBC Red Blood Cell

RDW-CV Red Blood Cell Distribution Width Coefficient of

Variation

RDW-SD Red Blood Cell Distribution Width Standard Deviation

WBC White Blood Cell

ix
 CHAPTER ONE: INTRODUCTION
1.1 Background industrial training
Internship is an opportunity given to a student to have a hands-on experience in a real
working world setting under the guidance and supervision of the experienced supervisor. This
exercise gives a student chance to put into practice what he or she has learnt in the class
environment and it involves wide range of tasks, responsibility, achievements, challenges,
opportunities, observations and experiences.

An internee should be ready to take up assignments and specific tasks which often come with
no financial facilitations, these tasks basically come from your field supervisor and also the
other staff at large. Internship is carried out within a set period of time and by the end of it all,
a student should be able to appreciate the skills gained, experience, challenges and
opportunities of a real working world environment.

1.2 Objectives
1.2.1 General objectives
To understand practical applications, develop skills and advance knowledge necessary for a
biomedical engineer by participating in various equipment management principles and
protocols of the Hospital.

1.2.2 Specific objectives.

To enhance the ability to accurately troubleshoot and diagnose medical equipment problems
including technical and user related problems.

To Strengthen my interpersonal communication skills with the other personnel involved in

my field, for example, doctors, nurses, mechanical engineers, electrical engineers, fellow
intern colleagues and other persons involved with the use of the medical equipment.

To create an understanding in planning, designing and constructing of creative and innovative

projects there by finding solutions to the challenges associated with medical equipment. Gain
an understanding of the inventory control processes. Develop decision making and critical
thinking skills, increased confidence and self-esteem.

1.3 Background of organization

Array Medical Suppliers and Consults Limited Started Operations in 2020. The team has
three experienced directors, collectively they accumulate more than 15 years of experience in
the biomedical engineering workflow. They are involved in the business development,

1
procurement, project management and administration of the company. The management team
proactively gathers feedback, identifies changes in business environment, review work
processes and communicates keys learning points and company policies to all staff at regular
meetings.

The field work teams are crucial in the delivery of their services and solution to clients, in
order to ensure that everyone is equipped with the right skills, knowledge and attitude, a
comprehensive training program is put in place to constantly upgrade people in technical and
management skills, the company believe firmly in providing the right training, accredited
certificate and practical knowledge for its engineers, in order for them to execute their duties
and responsibilities confidently. The aim of the company is to stay relevant and reliable to the
ever-changing market place and client's requirement.
1.4 Company profile
1.4.1 Vision
To be a respectable Biomedical Engineering company delivering beyond expectation, always.
1.4.2 Mission
ARRAY MEDICAL SUPPLIERS AND CONSULTS LIMITED delivers quality and reliable
medical suppliers and hospital equipment, installations and support to meet all your
biomedical engineering needs.

We offer services to the private and public medical facilities. ARRAY MEDICAL
SUPPLIERS AND CONSULTS LIMITED is committed to implementing the latest health
technologies, skills and practices to improve our clients with the solutions needed for success
in today's health sector.

We provide clients with experience, quality, dedication, and professionalism and as a result.

2
1.4.3 Company organization structure

Managing Director
(CEO)

Technical manager

Biomedical engineer Biomedical engineer Biomedical engineer

(sales) (marketing) (medical Lab)

Biomedical engineer
(technician)

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 CHAPTER TWO: INTERNSHIP EXPERIENCE
2.1 Position Occupied
During the internship period, I worked as a Biomedical Engineering intern. I mainly
performed activities such as equipment service, repair, planned preventive maintenance,
installation, user training among others in the various sites i.e., hospitals, medical centers,
clinics etc.

2.2 Duties and Responsibilities

The following are some of the duties and responsivities I was assigned to;
 Perform all tasks allocated to me by the filed supervisors on site.
 Provide technical assistance to machine users whenever necessary.
 Attend all the engineering department meetings.
 Complete the weekly log book provided by the university to record tasks undertaken
during the entire period of field attachment.
 Carry out repairs, installation, maintenance, inspection of the medical devices.
 Seek guidance where necessary.
 Write an internship report and give a copy to the company for improvements and to
the University for Academic Assessment.

2.3 Methodology
There were a number of methods of training that were used by my supervisors that were all
aimed at gathering information about different medical equipment during the industrial
training. The information could be how the equipment works, the possible errors, the cause of
breakdown and so many others. Some of the methods employed to gather information
include;

2.3.1 Demonstration
This method basically involved physical interaction with the machines. In involved the field
service engineers practically demonstrating to us the operation of the devices physically as
we observed. The FSE also demonstrated how the various parts of the machines operates as
they performed their various tasks. The main objective of demonstration was to enable us
interact physically with the equipment we were learning about in class and also be able to
identify them and troubleshoot them accordingly.

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2.3.2 Observation
This method involves one observing or making use of naked eyes to see what the equipment
is doing, how the equipment is operating, how the equipment is installed, and how it is
deviating from the normal operation.

2.3.3Personal reading or research

We were encouraged to read machine maintenance manuals and to do some research for
knowledge about equipment troubleshooting online using the available online resources. This
was made much easier when we were given the password to the Wi- fi. The internet was the
most utilized source of information that helped us to obtained user and technical manuals as
well as translation of them. We always used these online resources whenever we got stuck
when performing any activities e.g., when doing repairs, installations, service, maintenance,
troubleshooting etc.

2.4 Hands on skills gained during internship

2.4.1 Maintenance and repairs
Maintenance is the process of keeping medical equipment in proper condition and it can be
planned on a daily, weekly or monthly basis. Medical equipment must be maintained in
working condition and periodically calibrated and validated for effectiveness and accuracy.

Types of maintenance
Corrective/breakdown
This is work done to take corrective action in the event of a breakdown of equipment.

Planned/scheduled/preventative maintenance
This is work done in a planned way before repair is required and scheduled time for work
circulated well in advance. It involves cleaning, safety tests, and calibration and makes sure
that any problems are picked up while they are small.

2.4.2 Installation

The first step of proper medical equipment setup is placing the equipment item(s) in the
specified area of use. The equipment was located in the area where it is to be used. The next
step is inspection. Inspection is done for each piece of equipment for the following; missing
parts, damaged parts and mismatched parts. After assembling the medical equipment, testing
for functionality is the next step. This is because sometimes everything appears to be fine yet

5
there may be a glitch that cannot be seen unless the device is powered and tested for its use.
Additionally, testing uncovers assembly mistakes before any permanent damage occurs.

Then all packing materials and other debris are removed from the medical equipment area.
This is to help ensure a clean and effective workspace for equipment users. It also prevents
contamination and other mishaps during work. Finally, after all inspections have been done
and everything is working properly, it is crucial that each applicable member of staff is
instructed on the proper use of the medical equipment since these are new models that had
not been used by the hospital before. Clear, detailed instructions were to prevent misuse,
which could lead to poor patient care or damaging of the equipment.

2.5 Hematology Analyzers (CBCs)

A CBC analyzer is a quantitative, automated hematology analyzer and leukocyte differential

counter for in Vitro Diagnostic Use in clinical laboratories.[1] The purpose of this analyzer is
to identify the normal patient, with all normal system generated parameters, and to flag or
identify patient results that require additional studies. CBCs are made of three categories i.e.
3 Part CBC analyzers, 5 Part CBC analyzers and the latest being the 7 Part CBC analyzers.[2]
Measurement Principles
WBC measurement
WBCs are counted and sized by the impedance method.[3] This method is based on the
measurement of changes in electrical resistance produced by a particle, which in this case is a
blood cell, suspended in a conductive diluent as it passes through an aperture of known
dimensions. An electrode is submerged in the liquid on both sides of the aperture to create an
electrical pathway. As each particle passes through the aperture, a transitory change in the
resistance between the electrodes is produced. This change produces a measurable electrical
pulse. The number of pulses generated indicates the number of particles that passed through
the aperture. The amplitude of each pulse is proportional to the volume of each particle. Each
pulse is amplified and compared to the internal reference voltage channels, which only
accepts the pulses of certain amplitude. If the pulse generated is above the WBC threshold, it
is counted as a WBC.[4]

6
HGB measurement

HGB is determined by the colorimetric method. The WBC/HGB dilution is delivered to the
bath where it is bubble mixed with a certain amount of lyse, which converts hemoglobin to a
hemoglobin complex that is measurable at 525 nm. An LED is mounted on one side of the
bath and emits a beam of monochromatic light, whose central wavelength is 525nm, and then
is measured by a photo-sensor that is mounted on the opposite side. The signal is then
amplified and the voltage is measured and compared to the blank reference reading (readings
taken when there is only diluent in the bath). The HGB is calculated per the following
equation and expressed in g/L.

HGB(g/L) = Constant × Log 10 (Blank Photocurrent/Sample Photocurrent)

[5]
RBC/PLT Measurement

RBCs/PLTs are counted and sized by the impedance method. This method is based on the
measurement of changes in electrical resistance produced by a particle, which in this case is a
blood cell, suspended in a conductive diluent as it passes through an aperture of known
dimensions. An electrode is submerged in the liquid on both sides of the aperture to create an
electrical pathway. As each particle passes through the aperture, a transitory change in the
resistance between the electrodes is produced. This change produces a measurable electrical
pulse. The number of pulses generated indicates the number of particles that passed through
the aperture. The amplitude of each pulse is proportional to the volume of each particle. Each
pulse is amplified and compared to the internal reference voltage channels, which only
accepts the pulses of a certain amplitude. If the pulse generated is above the RBC/PLT lower
threshold, it is counted as an RBC/PLT.

Hands on work performed on hematology analyzers

Iganga Islamic Medical Centre

Table 1: Showing details of Dymind CBC at Iganga Islamic Medical Centre

Machine Hematology analyzer

Manufacturer Dymind

Model DH36

Serial number MSH63020181015003

7
Activity: General service and maintenance

Work done;

 General PPM
 Cleaning of the counting chamber was done using probe cleanser solution
 Cleaning of the exhaust valves
 Fastening of loose tubing
 Cleaning of the general interior surface of the machine
 Running of the calibrators and validation using quality control solutions.
 Writing and signing of the equipment service report.

Figure 1: Cleaning of the sample probe of the Dymind DH 36

8
Kairos Medical Centre (Namuwongo)
Table 2: Showing details of Zybio CBC at Kairos Medical Centre

Machine Hematology analyzer

Manufacturer Zybio

Model Z3

Serial number EZY2100Z31200602121

Activity: Installation

Work done:

 The unit was unpacked from the box and placed on a firm flat surface.
 The reagents i.e. diluent and lyse where connected to the machine using the reagents
connection tubes.
 The machine was powered and the startup initiation process done.
 Testing of the machine using a fresh control sample was done to confirm full
functionally.
 User training for the laboratory staff was done and an installation report written and
signed.

St. Jude Diagnostic Laboratory Entebbe

Table 3: Showing details of Dymind 5-part CBC at ST Jude Entebbe

Machine Hematology analyzer

Manufacturer Dymind

Model DH56

Serial number DM11012013018

Activity: Repair

Fault description; machine failure to connect to the computer (network connection loss)

9
Work done:

 It was discovered that the IP address of the machine from the computer set up was
correct but still could not establish a connection machine software.
 The manufacturer was contacted using team viewer to try and rectify this issue but he
concluded that the entire main board of the machine needed to be replaced as the
damage caused was non-repairable.
 The facility was recommended to purchase a new main board in order to rectify this
issue.
 The cause of this according to the manufacture was poor electrical wiring of the
building (no earth protection)

Figure 2: Servicing of a 5-part hematology analyzer

Kampala hospital
Table 4: Showing details of Dymind 5-part CBC at Kampala hospital

Machine Hematology analyzer

Manufacturer Dymind

Model DH56

Serial number DM1101205894

10
Activity: Repair

Fault description; machine unable to differentiate WBCs (No results for WBC differentials)

Work done

 The counting chambers i.e. WBC and RBC were removed and cleaned manually
using clep solution and probe detergent.
 The differential bath was also removed and air blown inside to remove any hard blood
clots within its channels.
 The removed parts were assembled and the machine retested.
 On testing the problem was persistent and after consultations with the manufacturers,
the recommended that the entire flow cell unit be replaced as it is the one primarily
responsible for differentiation of the WBCs.

Figure 3: Extraction of a WBC counting chamber for service

11
Friends Poly Clinic
Table 5: Showing details of Zybio CBC at Friends Poly Clinic

Machine Hematology analyzer

Manufacturer Zybio

Model Z3-1

Serial number EZY2100Z31200669835

Activity: General service and maintenance

Work done:

 Cleaning of the WBC and RBC counting chambers was done

 Dusting of the interior and of the machine using a blower
 Running of quality control samples was done for Low, Normal and High samples and
passed.
 A job card was written and signed by the laboratory manager.

Figure 4: Servicing of 3-part CBC

12
Nsangi Medical Centre
Table 6:Showing details of Zybio CBC at Nsangi Medical Centre

Machine Hematology analyzer

Manufacturer Zybio

Model Z3

Serial number EZY2100Z31200652360

Activity: Repair

Fault description: failure of the thermal printer to print test results.

Cause: poor installation of the printer rolls into the printer. This cause damage to the printer
gear rollers hence preventing it from printing the test results.

Work done;

 The thermal printer of the machine was extracted and checked.it was discovered that
the paper drive gears were broken.
 The thermal printer unit was replaced with a new thermal printer as the broken gears
could not be repaired.
 The laboratory staff were trained on the proper procedure of installing the thermal
paper.
 A job card was written and signed by the laboratory in charge.

Kairos Hospital Kigunga

Table 7:Showing details of Zybio CBC at Kairos Hospital

Machine Hematology analyzer

Manufacturer Zybio

Model Z3-1

Serial number EZY2100Z31200652231

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Activity: General service and maintenance

Work done;

 General service and maintenance

 Cleaning of RBC and WBC counting chambers using clep solution and probe
detergent
 Blowing of the machine to remove dust was done
 Testing of the machine using QC samples for Normal, High and Low
 Job card was written and signed by the laboratory staff.

Rhona Medical Centre

Table 8: Showing details of Edan CBC at Rhona Medical Centre

Machine Hematology analyzer

Manufacturer Edan

Model H30

Serial number 860138-M183107710001

Activity: General service and maintenance

Work done;

 General service and maintenance

 Cleaning of RBC and WBC counting chambers using clep solution and probe
detergent
 Blowing of the machine to remove dust was done
 Testing of the machine using QC samples for Normal, High and Low
 Job card was written and signed by the laboratory staff.

14
 Figure 5: Assembling the RBC and WBC counting chambers
2.6 Suction Machine
A suction machine is a portable apparatus used in patient wards and operating theaters for
aspiration of fluids from the mouth, airways, or surgical sites by sucking the material through
a catheter into a reservoir bottle.[6] Suctioning is a procedure that removes excess secretions
from the mouth and thorax, from the nose and the throat and from the wind pipe (trachea)
using mechanical aspiration device.

Components of the Suction Machine.

 Disposable or rechargeable batteries: Suction machines are outfitted with powerful
batteries to ensure that they can provide suction capabilities when a reliable power
source is not available.
 Suction/vacuum pump: the vacuum pump is often located inside of the aspirator. This
is what causes negative pressure and is necessary for a functioning suction machine.
 Connection tubing: this connects the vacuum pump to the collection canister. It
should never touch the contents within the collection canister.

15
  Sterile patient tubing: Patient tubing attaches to the suctioning tip and carries the
patient’s secretions into the collection canister. Sterile patient tubing should be
properly disposed of after each suctioning session.
 Disposable canister: the disposable canister holds the patient’s secretions and often
provides overflow protection capabilities in case too much fluid is suctioned out of
the patient. This canister should be disposable to ensure all parts of the suction
machine remain sterile.
 Power cord: Portable suction machines come with a power cord that can be used to
charge the machine when you’re close to a power outlet.
 Filters: Ideally, a disposable canister should support the use of bacteria/viral filters to
prevent contamination within the aspirator’s inner components. Certain filters may
also be used to protect against dust and dangerous gases that can damage the machine.

Working principle of a suction machine.

 Suction is generated by a pump. This is normally an electrically powered motor, but
manually powered versions are also often found. The pump generates a suction that
draws air from a bottle.
 The reduced pressure in this bottle then draws the fluid from the patient via a tube.
The fluid remains in the bottle until disposal is possible. A valve prevents fluid from
passing into the motor itself.

Faults description
 Repairing a Suction Machine and troubleshooting. This involved the use of a multi
meter, screw driver and our naked eyes to compare a normal working Suction
Machine to the Machines that were encountered during the training.
 Among the Suction machines, one had its tube that connects to the Vacuum
misplaced.

Work done.
 Replacing the tube on the Suction Machine whose tube that connects to the Vacuum
was misplaced.
 Troubleshooting the machine by checking the power source, continuity and we
realized the fault was with the fuse which was replaced with the new one.

Troubleshooting procedure for Suction Machines.

16
  Checking if there is power at the power supply using a tester or multimeter.
 Checking if the fuse in the top plug is working using a multimeter.
 Checking for continuity in the wire of the machine using a multimeter.
 Ensuring that there are no any blockages in the tubing and filters in the machine.
 Checking for proper continuity in the switch.
 Checking if the pump is in good condition.
 Checking if the winding in the pump is not burnt.

Figure 6: servicing a suction machine

2.7 Oxygen Concentrator

An oxygen concentrator is a device that supplies oxygen percentage at high enough flow
rates.[7] The basic principle is the removal of nitrogen from air by its absorption by the
molecular sieve.

Principle of operation
Atmospheric air consists of approximately 80% nitrogen and 20% oxygen.[8] An oxygen
concentrator uses air as a source of oxygen by separating these two components. It utilizes
the property of zeolite granules to selectively absorb nitrogen from compressed air.[9]
Atmospheric air is gathered, filtered and raised to a pressure of 20 pounds per square inch
(psi) by a compressor. The compressed air is then introduced into one of the canisters

17
containing zeolite granules where nitrogen is selectively absorbed leaving the residual
oxygen available for patient use. After about 20 seconds the supply of compressed air is
automatically diverted to the second canister where the process is repeated enabling the
output of oxygen to continue uninterrupted. While the pressure in the second canister is at 20
psi the pressure in the first canister is reduced to zero. This allows nitrogen to be released
from the zeolite and returned into the atmosphere. The zeolite is then regenerated and ready
for the next cycle.[10]

By alternating the pressure between the two canisters, a constant supply of oxygen is
produced and the zeolite is continually being regenerated. Individual units have an output of
up to five liters per minute with an oxygen concentration of up to 95%.

Parts of an oxygen concentrator

 Humidifier bottle
 Filters e.g., the bacterial filter and dust filter
 Casters
 Tubes
 Sieve tubes

Maintenance
 Always run the machine for few hours after maintenance before patient use.
 Check if the zeolite canister has expired. Granules become grey when not effective.
 Clean the humidifier and tubes wash in warm soapy water and ensure filter is dry
before replacing.
 Remove any dust with a damp cloth and dry off.
 Remove any dust with a damp cloth and dry off.
 Check alarm system battery, an audible alarm, replace battery if necessary.
 Check all screws, connections and parts are tightly fitted.
 Check that the flow rate varies with flow control.

Troubleshooting of the oxygen concentrator

 If the unit is not operating is due to no power from the mains socket. This is rectified
by checking if the main power is present, or checking the main switch if it is on and
the cable inserted.

18
  If the unit is not operating and there is no power failure alarm, possibly the alarm
needs to be replaced.
 No oxygen flow which can be due loose tube connections, blocked flow meter. This
can be rectified by tightening the loose tubing, replace flow meter or flushing the
tubes with water and make them dry.

Activities done
 Tightening of the loose connection tubing.
 Servicing of the concentrator.
 User training and how to troubleshoot.

Figure 7: Troubleshooting an oxygen concentrator in the company workshop

2.8 Biochemistry Analyzer
The Biochemistry analyzer is a medical laboratory device used to calculate the concentration
of certain substances within samples of serum, plasma, urine and/or other body fluids. [11]
Analytes commonly include enzymes, substrates, electrolytes, specific proteins, drugs of
abuse, and therapeutic drugs. The results give clinicians feedback on toxicology and on renal,
cardiac, and liver function.

Principle of operation

Analyzers are highly automated to maximize throughput, to improve user safety from
biohazards, and to diminish the risk of cross-contamination.[12] Samples are loaded into the

19
tray and a pipette aspirates a precisely measured aliquot of sample and discharges it into the
reaction vessel; a measured volume of diluent rinses the pipette. Reagents are dispensed into
the reaction vessel. After the solution is mixed (and incubated, if necessary), it is either
passed through a colorimeter, which measures its absorbance while it is still in its reaction
vessel, or aspirated into a flow cell, where its absorbance is measured by a flow-through
colorimeter. The analyzer then calculates the analyte’s chemical concentrations. Tests are
programmed by the user via a keypad or bar-code scanner and the results are displayed on
screen or sent to a printer or computer.[13]

Troubleshooting the Analyzer

The flow-cell is arguably the most important section of the entire pathway utilized during
flow analysis. This is where everything coalesces and the results of the sample collection,
reagent preparation, and instrument operation come together to produce the final analytical
conclusions. Therefore, examination of the flow-cell has to be done thoroughly when
troubleshooting the analyzer. Check the different components of the flow cell for
performance issues and broken down, inspect, clean and/or rebuild.

The types of problems that signaled us to check the flow-cell included: noisy and drifting
baselines, poor reproducibility, and poor peak shape. These problems were resolved by either
cleaning or replacing the glass flow-cell windows.

Procedure
In order to closely inspect the window simply remove the setscrews on each side of the flow-
cell with the proper size Allen wrench. Remove the O-rings on each side carefully with
tweezers. The O-rings should be replaced if they are cracked, torn, or compressed since they
will not properly press the glass window into the flow-cell housing. Next, remove the glass
windows, which should easily fall out by gently tapping; sometimes they may need to be
tapped more aggressively if there is considerable buildup or much time has gone since it was
last rebuilt.

The glass window should be inspected for physical damage and replaced if any condition
exists that may interfere with the light paths such as stains, buildup/coatings, breaks or
cracks. If everything looks good, clean everything thoroughly with a solvent (alcohol) and
dry thoroughly. Be careful not to contaminate or smudge the glass window when returning it
into the slot. Next, carefully push the O-ring back into place (all the way to the bottom) so as

20
not to damage the rubber with the threads of the setscrew. Finally, tighten the setscrew
securely on each side.

Be sure to leak test the flow-cell before placing it back onto the detector so that no damage
will occur if there is indeed a leak. Test the flow signal first with water, then with reagents,
and finally, with standards.

Installation of A Biochemistry Analyzer at Imperial Hospital Iganga

Table 9:showing details of chemistry analyzer Imperial Hospital Iganga

Machine Biochemistry Analyzer

Manufacturer BIOBASE

Model B 200

Serial number 568992541

Procedure

 Setting up of the machine on a form concrete surface was done. The distilled water
and waste tubes were connected to the machine.
 The test reagents were added into the reagent’s containers into the machine i.e.
reagent R1 for single reagent and reagents R1 and R2 for double reagents.
 The machine was connected onto the computer using an ethernet cable through the
machine’s software and programming of the reagents was done.
 Machine testing using QC samples was to ascertain functionality, repeatability,
accuracy and consistency in the way the machine produces results. User training was
done.
 An installation job card and user training report were written and signed by the
laboratory manager.

21
 Figure 8: Reagent programming of a chemistry analyzer

2.9 Microscope

Microscopes are used especially in microbiology analysis to enable investigation of specimen

such as blood, urine and so on for the presence of parasites or other abnormalities.[14] They
are used for magnification of microscopic organisms such as bacteria, fungi, viruses, blood
cells among others. Microscope types include; binocular and monocular [15], [16]
Mode of Operation.
A specimen sample is prepared in the laboratory, wet or dry sample preparations accordingly,
and placed on a glass slide, on the microscope stage.[17] The specimen is then viewed
through the lenses and adjusted for a clear image. A microscope consists majorly of two
lenses namely; the objective lens that have different magnifications of x4(low power
objective), x10(scanning power objective), x40, x100 (high power objectives) and the eye
piece of specified magnification by manufacturer and a light source with a condenser.[18]
Rays from a light source are directed into the condenser which then brings them to a common
focus on the specimen. The light rays then pass through the objective and produce a primary
image in the focal plane of the eye piece.

The eye piece magnifies the primary image and brings it into focus with the retina of the eye.
The objective and eyepiece are systems of lenses where the distance from each other is fixed

22
by the mechanical length of the tube. To adjust to form a clear image, either the specimen
stage or tube as a whole has to be moved by means of course and fine adjustment knobs.
Total magnification can be got from a product of the magnification of the ocular lens and the
objective lens.
Microscope troubleshooting and repair at the workshop.
Faults of the microscope
 No light from the bulb.
 Potentiometer faulty.
 Due for servicing.

Work done
 Replacement of the faulty halogen lamp with a new 6V 20W one was done.
 Replacement of the faulty potentiometer (variable resistor) 500K ohms with a new
one was done.
 Cleaning of the eye pieces
 Cleaning of the lens using lens paper.

Figure 9: servicing a Novex microscope

23
2.10 Vital Signs Monitor (Patient Monitor)
Vital signs monitor usually provide data on body temperature, pulse rate, respirations, and
blood pressure, though some clinicians also count other measurements along with the basic
vital signs, including pulse oximetry and end tidal carbon dioxide.

Principle of operation
The vital signs have the SPO2 (Oxygen Concentration) measuring probe which also has the
CO2 sensor, the Cuff that measures (NIBP) Human Non-invasive Blood Pressure. To
measure blood pressure/ NIBP, the cuff is placed around the bare and stretched out upper
arm, and inflated until no blood can flow through the brachial artery. Then the air is slowly
let out of the cuff. As soon as the air pressure in the cuff falls below the systolic blood
pressure in the brachial artery, blood will start to flow through the arm once again.[19] As the
blood moves around the body, it puts pressure on the walls of the vessels. Blood pressure
readings are made up of two values:

Systolic blood pressure is the pressure when the heart beats – while the heart muscle is
contracting (squeezing) and pumping oxygen-rich blood into the blood vessels. Diastolic
blood pressure is the pressure on the blood vessels when the heart muscle relaxes. The
diastolic pressure is always lower than the systolic pressure. Blood pressure is measured in
units of millimeters of mercury (mmHg). The readings are always given in pairs, with the
upper (systolic) value first, and followed by the lower (diastolic) value.[20] So, someone who
has a reading of 132/88 mmHg (often spoken “132 over 88”) has a Systolic blood pressure of
132 mmHg, and a diastolic blood pressure of 88 mmHg

To measure the Sp02 there are two principals involved;

1. Oxyhemoglobin and deoxyhemoglobin, which differ in their absorption of red and infra-
red light (that is, Spectrometry)

2. The volume of arterial blood in the tissue (and hence, light absorption by that blood)
changes during the pulse.

The SpO2 probe has a pulse oximeter which determines SpO2 by passing red and infrared
light into an arteriolar bed and measuring changes in the light absorption during the pulsatile
cycle. The Red and Infrared low-voltage light emitting diodes (LEDs) in the oximetry probe
serve as light sources; a photodiode serves as the photo detector. This percentage should be

24
between 94 percent and 100 percent, which indicates a healthy level of hemoglobin carrying
oxygen through the blood. If it is less than 90 percent, one must see a doctor

Tasks done
Checking for all the accessories of the vital signs monitor because it was a new one and I had
to test it for the client and do user training on how the machine works and how different
accessories are connected to the machine.

Common Troubleshooting procedure for the vital signs machine

 Check the Patient Cable for any visible damage, such as cracks or creases where the
wires may be damaged under the protective coating. Also, be sure your leads are
compatible with the devise you are using.
 Check the date on the Electrodes you are using. They have a shelf life, and very often
the individual packages should be used within 7-10 days of opening. The gel has a use
by date also, as it can harden.
 Check the Blood Pressure Cuff & Hose for leakage. They are often wrapped up
quickly and stuffed next to the monitor which can kink the hose causing cracks, or
small tears in the cuff itself. A leaking cuff will give a false reading.
 Check the electrode clips to be sure they are attached firmly. A loose spring action
will not clamp itself tightly against the electrode.
 Check SpO2 Sensors to be sure they are fitting the patients‟ finger correctly. Too
loose, or too tight will give an incorrect reading. The tip of the finger should be in
contact with the Sensor. Nail polish can be an interference to a correct reading, and
cold fingers may not give a reading at all.

Figure 10: New patient monitor ready for installation

25
2.11 Tables (Operating Theaters and Delivery)

Tables are required to hold the patient in a position that is comfortable for both the patient
and for medical staff during procedures.[21] They can include dedicated supports for head,
arms and legs and often have movable sections to position the patient appropriately. They are
made both with wheels and on static platforms and can have movements powered by electric
motors, hydraulics or simply manual effort. They can be found in emergency departments,
operating theatres and delivery suites.
Mode of operation
Where the table has movement, this will be enabled by unlocking a catch or brake to allow
positioning. Wheels have brakes on the rim or axle of the wheel, which locks for moving
sections will normally be levers on the main table frame. Care should be taken that the user
knows which lever applies to the movement required, as injury to the patient or user may
otherwise result. The table will be set at the correct height for patient transfer from a trolley
then adjusted for best access for the procedure.
Work done
 Disinfection of the tables in the different theatres i.e. maternity theatre and main
operating theatre.
 Lubrication of the moving parts so that the joints could freely operate. This was all
done during servicing or preventive maintenance at Kampala hospital.
 Two operating tables were assembled in company’s workshop

Figure 11: Assembling of a gynecological operating table

26
2.12 Coagulometer

Working principle.
Special cuvettes with a steel ball inside are placed on the measuring positions in instrument
related racks. As the measuring block is sloping slightly the ball always remains due to
gravity at the deepest point of the cuvette. In the height of this point there is a magnetic
sensor. At first the sample is pipetted into a measuring cuvette, then if required the first
reagent is added and the incubation is started. The instrument turns the cuvette with the
adjusted speed around the longitudinal axis. When the incubation is finished, the start reagent
is added and the measurement is start simultaneously. When the coagulation begins the
growing clot pulls the ball out of the basic position and the magnetic sensor detects a
magnetic impulse which causes the end of the measurement.[22]

Activity: service

Work done;

 The machine was opened

 Dust was blown out using a blower
 The screen connecting fibers were fastened
 The heating block was cleaned
 The machine was assembled and tested using a patient sample
 A job card was written and signed.

2.13 Urine analyzer

Working principle

The light's absorption and reflection form the basis of the urine analyzer test principle.[23]
The multi-linked reagent strip with various solidified reagents already present receives the
liquid sample right away. The color of the module containing several special reagents on the
multi-linked reagent strip changes in response to the corresponding chemical composition in
the urine. The depth of color is in line with the particular chemical of the urine sample. The
multi-link test strip is inserted into the colorimetric injection tank of the urine analyzer, where
each module is exposed to the instrument's light source and generates various amounts of
reflected light. The component concentration is proportionate. The device receives a light
signal with a variety of intensities and transforms it into the matching signal. The electrical

27
signal is processed by the microprocessor to determine the reflectance of each test item. The
result is then automatically written out in a qualitative or semi-quantitative format after being
compared with the standard curve and corrected to the observed value.

Activity: Repair.

Fault description; failure of the sample/urine strip driver motor to take samples into the
analyzer.

Work done;

 Machine was opened and inspected

 It was discovered that the driver gears were stack due to rust and some urine strips has
fallen out of the strip tray into the gears preventing it from moving accordingly.
 The strips were removed and using WD 40 solution, the gears were sprayed to
lubricate them and protect them from further rusting.

Figure 12: Service and repair of urine analyzer

2.14 Biosafety Cabinet
The primary function of a biosafety cabinet is to protect the laboratory worker and the
surrounding environment from pathogens. It is a primary engineering control and ventilated
enclosure used to protect personnel, the product and environment against aerosols and bio
hazardous or infectious agents which may result from handling   of potentially hazardous

28
micro-organisms. This helps to maintain quality control of the material being worked with as
it filters both the inflow and exhaust air.

Principle of operation

The BSC provides personnel and environmental protection, but no product protection. Air
movement is similar to a chemical fume hood, but it has a HEPA (High Efficiency Particulate
Air) filter in the exhaust system to protect the environment from bioaerosols. Unfiltered room
air is drawn across the work surface by a fun. Personnel protection is provided by this inward
airflow as long as a minimum velocity of 75 linear feet per minute (lfpm) is maintained
through the front opening and appropriate work practices are observed. BSC is hard-ducted
i.e., directly connected to the building exhaust system, and the building exhaust fan provides
the negative pressure necessary to draw room air into the cabinet.

Activity: Replacement of HEPA filter.

Work done: The old HEPA filter was removed and replaced by a new on.

Figure 13: Replacing a HEPA filter

29
2.15 Centrifuge
The centrifuge works on the principle of gravity and the generation of the centripetal force to
sediment different fractions.[24] The rate of sedimentation depends on the applied centrifugal
field (G) being directed radially outwards G depends on Angular velocity (ω in radians/sec)
Radial distance (r in cm) of the particle from the axis of rotation (G = ω2r)

Activity: repair

Fault description; failure of the machine door to open automatically after processing samples.

Work done;

 The centrifuge was opened and the locking system was checked. It was discovered
that opening switch system had rusted due to blood spills on it.
 WD 40 was used to clean and loosen the rusted parts of the locking and opening
system. The device was assembled and the problem was solved.

30
 CHAPTER THREE: EVALUATION OF FILED ATTACHMENT
3.1 Experience gained and Skills Attained
For my technical skill development as intern trainee, I was assigned a number of duties to
carry out in the workshop and outside the workshop in the field at different hospitals and
medical centers.

 Troubleshooting and working with machines. I got an opportunity to have good

supervisor with great experience in medical equipment who gave me good guidance
on how to go about the different medical equipment assigned to me. I acquired great
skills in troubleshooting the major and minor errors on various equipment.
 Knowledge. I was exposed to a number of literatures i.e. user manuals and services
manuals which I had to read and go through thoroughly well before being assigned
any equipment to work on. This helped to broaden my knowledge both in the brain
and hands on skills to be when carrying out any service, user training and repair. It
also helped me gain the engineering terminologies involved with the machines.
 Communication Abilities. Communication is the key to everything in any profession
because you have to speak out the clients on what you have done or doing on the
machine. Also, during user trainings, you need to have the knowledge of the machine
so that you can speak out to the audience and pass on the message clearly.
 Team work Engineering is a collective interaction in that you cannot know everything
therefore team work is very key. I got to learn how to work with other engineers,
trainees and other staff I found at the organization which I have to carry on even to
other places.
 Personal Preventative Equipment Since the machines we work on are highly
infectious and dangerous, protection is mandatory and the right wear has to be worn
when entering different departments in the hospital like gloves in the lab, safety shoes
and lab coats, radiation protection units when in the radiology department etc.

3.2 Challenges
 Filed work was minimal as most of the machines were being carried to the workshop
for repair so no chance to visit other departments in the hospitals.
 Limited access to different tools used as some were limited to only the experienced
engineers.

31
  Access to spare parts such as fuses, transformers, motors, among others was limited
for some of the medical equipment and this delayed hands-on works on such
equipment that could have been done to rectify of current faults.
 Reaching work place late due to bad weather condition.
 Limited time for the industrial training.
 Some machines did not have manuals.

3.3 Solution the some of the challenges

 Acquisition of persona; tools helped to solved the problem of limited tools for work.
 The issue of lack of manuals for some machines was partially solved by getting
softcopy manuals from manufacturers though not all manufactures were willing to
give out especially the technical manuals.
 Limitation of training time was difficult to manage but had to put in all the time I had
to learn all that was in my disposal
 Other challenges were administrative and I could not solve them.

3.4 Benefits Attained from The Industrial Training

I managed to attain various skills from my internship training which I believe will help me in
my career.

 I got a platform to convert my academic knowledge into practical skills. The

university is quite theoretical and my field attachment was an opportunity to apply
knowledge to the real world.
 Not only was I able to develop my technical skills to work but I also acquired
interpersonal skills that I need to work effectively with others. The filed requires us to
work as a team if we are to come up with ideas to accomplish given tasks.
 I gained confidence as I was able to work on the equipment together with other
superiors in the field.
 I was also able to get some contacts even from other departments as well thus
developing professional working relationships with a range of people in and outside
the biomedical department.
 Lastly, internship was a foundation for my experience in the field provided the
evidence for actual field training a valuable asset which will help me stand out from
other engineers.

32
 CHAPTER FOUR: RECOMMENDATIONS AND CONCLUSION
4.1 Recommendations
4.1.1 Recommendations to the organization:
 Equipment manuals could be acquired early from the manufactures to avoid delays
during equipment troubleshooting
 Complicated flow diagrams should be translated into English by the manufacturers in
order to ease their interpretation.
 The workshop should be given more funds in order to admit more internees and
purchase more tools to be used in the workshop
 The organization should work hand in hand with the hospitals, medical centers, clinics
etc. to make proper schedules for service and maintenance of their equipment.
 The organization should facilitate the trainees when going out to the field.

4.1.2 Recommendations to the University.

 The University administration could introduce internal training workshops so that the
students able to acquire basic hands on skills. This would enable them to go for
internship training with some knowledge relevant to the field.
 The University could also purchase some of such medical equipment and tools used in
the field for the institution’s workshop, this would allow students interact with this
equipment freely and broaden their knowledge.

4.2 Conclusion

In a nutshell, this internship has been an excellent and rewarding experience. I can conclude
that there has been a lot I have learnt from my work at Array Medical Suppliers and Consults
Limited. Needless to say, the technical aspects of the work I have done are not flawless and
could be improved provided enough time. As someone with no prior experience with some
medical equipment whatsoever, I can say that most of the objectives of this undertaking were
archived. Two main things that I have learned outside engineering are time management and
self-motivation as key to being a proper engineer.

33
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APPENDIX

35
 Figure 14: assembled operation bed

Figure 15: WBC differential bath before service(left) and after service (right)

36
Figure 16: hydraulic diagram of the Dymind DH 56

37