Hospital Training Report

 

HOSPITAL TRAINING  A report of training undergone at

REDDINGTON MUILTI-SPECIALITYHOSPITAL, LAGOS Submitted by 

Srishti s Kumar (2016116047) Submitted to FACULTY OF INFORMATION AND COMMUNICATIO COMMUNICATION N ENGINEERING

 In partial fulfillment for the award of the degree of

BACHELOR OF ENGINEERING IN BIOMEDICAL ENGINEERING

DEPARTMENT OF ELECTRONICS AND COMMUNICATION ENGINEERING ANNA UNIVERSITY, CHENNAI: 600025 JULY, 2019

 

ANNA UNIVERSITY, CHENNAI BONAFIDE CERTIFICATE Certified that this Report titled “HOSPITAL TRAINING” is the  bonafide work of SRISHTI S KUMAR (2016116047) who carried out the work under my supervision. Certified further that to the best of my knowledge the work herein does not form part of any other report on the basis of which a degree or award was conferred on an earlier occasion on this or any other candidate.

Dr. S. MUTTAN

Professor and Head, Department of Electronics and Communication Engineering, Anna University, Chennai-600025

Mr. C . KAUSHIK VIKNESH

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ACKNOWLEDGEMENT I owe my sincere gratitude towards Dr. S. MUTTAN(Professor and Head of the Department, ECE), Dr. SHENGAGA DEVI(Professor and Director, Center for Medical Electronics, Department of ECE) and who provided me with the opportunity to get trained at Reddington Multi-Speciality Hospital, Lagos. My special thanks to Mr. C.KAUSHIK VIKNESH (Hospital training Co-ordinator and Faculty Incharge) for conveniently making all the arrangements which helped me complete my training in a smooth and successful manner. This training wouldn’t have been a success without the continuous effort and guidance of ENGINEER COLLINS, ENGINEER ISSAC, ENGINEER ERNEST.

 

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SRISHTI S KUMAR (2016116047)

TABLE OF CONTENTS S.NO 1.

CHAPTER NAME INTRODUCTION  About the hospital 

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Departments Achievementsin the hospital Role of biomedical engineers

2. 

OBSTERICS AND GYNAECOLOGY ABUS 3D Ultrasound Mammography Dexa Scan Cardiotocography Labour ward

3. 

INTENSIVE CARE UNIT Ventilators Patient Monitoring System

 

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Syringe Pumps Infusion Pumps Defibrillator 4.

GASTROENTEROLOGY Endoscopy

5.

NEPHROLOGY Hemodialysis

6.

CARDIOLOGY

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RADIOLOGY

ECG Machine TMT

X-Ray Portable x-ray CT SCAN MRI

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OPERATION THEATRE Electro Surgical Unit  Insufflator Anesthesia Machine Arthroscopy

 

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Heart Lung Machine C-Arm OT Light OT Table

9. TRANSFUSION MEDICINE BLOOD BANK Donor Room Blood Collection Monitor Tube Sealer Platelet Agitator Plasma Extractor Blood Bank Refrigerator Auto Analyser 10.

NEONATAL INTENSIVE CARE UNIT Radiant Warmer  Phototherapy Incubators

 

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CHAPTER-1  INTRODUCTION REDDINGTON HOSPITAL

Hospital training is part of the curriculum to familiarize the student with the current trends of medical care and prevalent technologies and act as a bridge between the theory knowledge and practical applications. This report elucidates the training experience in REDDINGTON HOSPITAL.

Fig 1. REDDINGTON HOSPITAL

 

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ABOUT REDDINGTON HOSPITAL: Their journey as a healthcare provider provider began on the 23rd 23rd of January January 2001 with the establishment of the Cardiac Centre, in Victoria Island, Lagos, Nigeria. The Reddington Hospital has been newly built on nine floors, on the same site as the Cardiac Centre, and provides care in all fields of Internal Medicine, including its special expertise in Cardiology, with its own Coronary and Intensive Care Unit. It now also provides Renal Dialysis, Obstetrics and Gynaecology, Paediatrics, Surgery (including Endoscopy and Day-case Surgery), Ophthalmology, ENT, Surgery, Radiology and Psychiatry. These are all supported by the latest technology, provided by giants in the various fields  –   the MRI is from GE, the CT scanner from Toshiba, the endoscopes from Olympus and Storz, and there is much more from Huntleigh, Datex, Bronelon, Penlon.

Fig 2. REDDINGTON HOSPITAL

 

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DEPARTMENTS IN REDDINGTON HOSPITAL: Reddington hospital houses a vast number of departments and wards which are organized, planned and maintained with care and adherence. During the training period , the following departments and wards were studied:

  Emergency   Intensive Care Unit   Radiology

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and Gynaecolog Gynaecology y    Obsterics Cardiology   Endoscopy Intensive Care Unit   Neonatal Intensive   ENT   Dentistry   Opthalmology

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ACHIVEMENTS OF REDDINGTON HOSPITAL:  

They were the first hospital to establish a CATHLAB and Cardiac Catheterisation programme programme in Nigeria.

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They were the first first healthcare ffacility acility in Nig Nigeria eria to carry o out ut a device closure of a hole in the heart by non-surgical procedure.

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They were the first independent hospital to receive international accreditation and quality awarded by COHSASA, the only body on the African continent.

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They were the first healthcare facility in Nigeria to be reaccredited at the first attempt and they were recently reaccredited scoring over 95% based on an audit carried out in June 2018 which inspected 2000 different criteria in the Hospital.

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They have been certified as an International Internati onal healthcare  provider on quality quality by C COHSASA OHSASA until the year 2021.

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The Reddington Healthcare group has a large pool of highly qualified and experienced Consultants and specialists on full time employment.

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ROLE OF BIOMEDICAL ENGINEER: A biomedical engineer understands the complexities of the human body and also provides technical solutions to the medical equipment both therapeutic and diagnostic types. Hospitals are known worldwide by the services they offer for and the success rate they have achieved with the help of technology which would not be possible without a trained engineering support support to provide services all the time. The keys roles of biomedical engineer include:

  Maintenance of records, manuals, AMC, Preventative

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medicine, warranty periods of the medical equipment.   Training of proper and safe handling of equipment to doctors and technicians technicians..   Periodic check up of instruments.   Attend to emergency breakdown of equipment.

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The Reddington hospital have sister branches around the city. They are: and gynaecology center 1) Breast 2) Maxy super speciality clinic 3) Reddington Hospital in Lekki, V.I. 4)Reddington 4)Reddingt on Hospital in Ikeja, Mainland.

Fig 3. MAXY CLINIC 

Fig 5. B&G CLINIC

Fig 4. R.H- LEKKI

 

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Chapter 2 Department of Obsterics and Gynaecology Obstetrics and gynaecology is the medical specialty that deals with obstetrics and gynaecology. Postgraduate training  programs for for both aspects are are usually comb combined, ined, preparin preparing g the  practicing obstetrician-gynaeco obstetrician-gynaecologist logist to be adept adept at the care of female reproductive organs' health and at the management of  pregnancy, although although man many y doctors go on to develop subspecialty interests in one field or the other. 

  3D Automatic Breast Ultrasound System (ABUS 3D):

Invenia ABUS 2.0- GE Healthcare Mammography may miss over 1/3 of cancers in dense breasts. Mammography The Invenia ABUS 2.0 (Automated Breast Ultrasound System) is a comfortable, nonionizing alternative to other supplemental screening options for women with dense breast tissue. When used in addition to mammography, Invenia ABUS 2.0 can improve breast cancer detection by 37.5 percent over mammography alone. The Invenia ABUS 2.0 acquisition process uses 3D ultrasound technology to comfortably and quickly image women with dense breast tissue. Each exam takes approximately approximately 15 minutes.

 

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Fig 6. ABUS 3D

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  Ultrasound: Voluson S8- GE Healthcare

Maximize the comfort and workflow through a modern designthat which includesofwidescreen 23”mon 23”monitor itor with aergonomic battery backup 20 minutes scan time and 15 second wake time from sleep mode. Effortlessly conduct 3D/4D imaging with RAB6-RS ultralight volume probe that is 40% lighter than the previous version. The image quality is excellent, quick and easy without the need to spend time on adjusting controls.

 

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Fig 7. Voluson S8 ultrasound

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  Mammography:

Senographe Pristina mammography system- GE Healthcare This system was designed to ease the anxiety of the patients. It was designedfor to easier reducepatient the physical strainduring with dedicated functionalities positioning mammography. When positioning patients in mediolateral oblique(MLO), the tube head can be moved to a parked  position away from from the technolo technologists gists head. This cle clears ars the upper space from obstruction so that the radiologist can  position the patient patient without ph physical ysical strain.

 

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Fig 8. Mammography- GE healthcare

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  DEXA SCAN:

LUNAR TECHNOLOGY ADVANTAGES DXA or DEXA stands for Dual-Energy X-ray A bsorptiometr  bsorptiometry. y. It is a measurem measurement ent method that that uses the differences in the absorption of high energy and low energy X-ray photons by different elements in a body to quantify the amount of bone and soft tissue in the body. For example, certain elements in bone minerals (e.g. calcium) will absorb more low-energy X-rays than the elements in soft tissue, enabling a precise and accurate estimate of bone mineral density (BMD).

 

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By using relevant algorithms, algorithms, we can also us usee the same measured data to determine body composition compositio n due to the different density and composition of fat and lean tissue. Based on DXA technology, the Lunar bone densitometry empowers  physicians and clinicians clinicians to diag diagnose nose osteopor osteoporosis osis and fracture risk . There are two fundamental approaches to create the X-ray  beams needed for for a DXA scan: K-edg K-edgee Filter techniq technique ue and Energy Switching technique.

Fig 9. DEXA SCAN- GE HEALTHCARE

 

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  CARDIOTOCOGRAPHY (CTG): GE HEALTHCARE

Cardiotocography (CTG) is a technical means of recording the fetal heartbeat and the uterine contractions during pregnancy. The machine used to perform the monitoring is called a cardiotocograph, more commonly known as an electronic fetal monitor(EFM).

Fig 10. Cardiotocography (CTG)

 

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  LABOUR WARD:

The labour room is one of the most versatile rooms within a hospital. It is called a labour, delivery, and recovery room (LDR). This is the type of room that some hospitals and almost all birth centers use for their care.

INSTRUMENTS USED IN LABOUR WARD: 

  Operating light: A surgical light light –   –  also  also referred to as an operating lighter surgical lighthead –  lighthead –  is  is a medical device intended intended to assist medical personnel during a surgical procedure by illuminating a local area or cavity of the patient.

  Forceps:

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A forceps delivery is a type of assisted vaginal delivery. It's sometimes needed in the course of vaginal childbirth. In a forceps delivery, a health care provider applies forceps an instrument shaped like a pair of large spoons or salad tongs to the baby's head to help guide the baby out of the birth canal.

  Scissors:  Scissors: 

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Scissors are used to cut the tissue tis sue during surgery.

  Laparoscopic sponges: 

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Laparoscopic sponges are used to control the bleeding during surgery

 

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  Sutures: 

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sutures are used to stitch up a cut or torn tissue.

  Vaccum: 

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During vacuum-assisted vaginal delivery, your doctor uses a vacuum device to help guide your baby out of the  birth canal. The The vacuum device, device, known as a v vacuum acuum extractor, uses a soft cup that attaches to your baby's head with suction.

 

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Chapter 3  Intensive care unit The ICU is the Intensive Care Unit where Patients who have undergone a transplant who need anmedicine. Organ transplant are provided and withPatients intensive treatment They are staffed by highly trained doctors and nurses who specialized in caring for critically ill patients. The equipment present in the ICU includes Ventilators, Patient Monitoring systems, Cardiac output monitors, syringe  pump, Infusion Infusion pump and and BIPAP Ventilato Ventilators. rs.

  VENTILATORS:

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GE HEALTHCARE- r860 Ventilator is a machine designed to move breathable air into and out of the lungs, to provide breathing for a patient who is  physically unable unable to breathe, breathe, or breathin breathing g insufficiently. Ventilators are chiefly used in intensive care medicine and in anesthesia. CARESCAPE R860 is the new GE Healthcare Critical Care ventilator designed to improve ease of use with a new generation of clinical excellence in Lung Protection. The ventilator consists of a patient circuit, valves, tubes, air reservoir and oxygen supplies. The air reservoir is compressed several times a minute to deliver oxygen to the patient. The ventilator electronically controls pressure and flow characteristics according to patient’s needs. The system also consists of a monitor which provides visual tracking of the volume of the patient’s patient’s breath and indicates that the patient is

 

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 properly connected connected to the ventilator. ventilator. The circuit circuit connects the ventilator to an endotracheal tube for invasive ventilation or a noninvasive mask. For invasive ventilation, an endotrach endotracheal eal tube is inserted through the patient’s mouth or nose, or a tracheostomy tube is through inserted through an opening made by incision in the neck. In noninvasive ventilation, ventilation, the patient circuit connects to a mask covering the mouth and nose. Some patients require mechanical ventilation for a short period, such as during recovery from traumatic injury.

 

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Modes of Ventilation: 

 

A/C VC (Volume Control)

 

A/C PC (Pressure Control)

 

A/C PRVC (Pressure Regulated Volume Control)

 

SIMV VC (Synchronized Intermittent Mandatory Ventilation, Volume Control)

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SIMV PC (Synchronized Intermittent Intermittent Mandatory Ventilation, Pressure Control)

 

CPAP/PS (Continuous Positive Airway Pressure/ Pressure Support)

 

SBT (Spontaneous Breathing Trial)

 

APRV* (Airway Pressure Release Ventilation)

 

BiLevel* (BiLevel Airway Pressure Ventilation)

 

BiLevel VG* (BiLevel with Volume Guarantee)

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SIMV PRVC* (Synchronized Intermittent Mandatory Ventilation, Pressure Regulated Volume Control)

 

VS* (Volume Support)

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 NIV* (Non-invasive (Non-invasive Ventilation)

Take Snapshot:  Immediate capture and storage of critical data currently on the CARESCAPE R860’s display  display 

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Operating Operatin g temperature

10 to 40°c

Atmospheric pressure

600 to 1060 hpa

Invasive ventilation Pressure

16 to 120 cm H20

on- invasive ventilati ventilation on Pressure Weight

16 to 40 cm H20 20 Kg

 

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Fig 11. VENTILATOR-GE HEALTHCARE

  Patient Monitoring System:

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Mindray iMEC 15 Patient Monitoring system is used to continuousl continuously y monitor the  patient’s vital parameters parameters such as Temperature, Temperature, B Blood lood  pressure, ECG, Heart Heart rate and SpO2.It SpO2.It is used. If readings fall outside the range specified for patient or if device fails an alarm rings. These allow for continuous

 

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monitoring of a patient, with medical staff being continuousl continuously y informed of the changes in general condition of a patient. Some Physiological data are displayed continuously on the monitor as data channels along the time axis. They may be accompanied by numerical readouts of computed parameters on the original data, such as maximum, minimum and average values, pulse and respiratory frequencies, and so on. Its portable structure, a touch screen with intuitive user interface, flexible networking capabilities and accurate monitoring functions make iMEC the optimal choice for subacute care. At the same time, iMEC is also a patient monitor series with “green” credentials. It reduces your hospital’s ecological footprint and contributes to a sustainable environme environment. nt. Based on its optimized hardware design, iMEC achieves a 50% lower power consumption compared to conventional  patient monitors. This allows for an improved batter battery y life and a fan-less design,  providing for a cleaner an and d quieter care env environment. ironment.

 

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Power consumption