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1. Introduction ToBiomedical Test Equipment Michael R. Erwine
Founder & Managing Director
MRE Dynatech NV LLC
Carson City, NV
http://mredynatech.com
2. Topics / Technology Areas Electrical Safety Testers
Patient Simulators
Non-Invasive Blood Pressure (NIBP) Simulators
Electrosurgery (ESU) Analyzers
3. Electrical Safety Testers The oldest piece of biomedical test equipment out there
Various types
Fully manual
Semi-automated
Fully automated
With or without leads or applied parts connectors
120 VAC or 230 VAC or Universal
AAMI ANSI ES1 or IEC (e.g. 60601) Test Loads
2-terminal & 4-terminal resistance measurement
Specialty / special-purpose testers
4. Why do we do electrical safety? Ensure patient safety
Protect against macroshock
Protect against microshock
Test for electrical internal breakdown / damage to power cord, AC mains feed, etc.
Meet codes & standards
AAMI, IEC, UL, NFPA, etc.
Protect against legal liability
In case of a patient incident
5. Simple Manual Testers
6. Simple Manual Testers Require the user to manually.
Select test mode
Step through test steps manually
Take readings manually from display
Simple LED or LCD displays
Rotary switches or pushbutton switches
Low level / limited P functions
Typically 15-amp or lesser service with low duty cycle ratings
Typically utilize 2-terminal resistance technique
7. Advanced Manual Testers
8. Advanced Manual Testers ECG & performance waveform simulation
Larger graphical displays on some newer models
Some have RS232 or USB for remote control
Some are rated at 20-amp (115 VAC) and have more robust duty cycles than simpler units
Heavier duty construction than simpler units longer service life
Typically utilize 4-terminal resistance technique and GFCI breakers
9. Fully Automated Testers
10. Fully Automated Testers Fully automated testing autosequences support minimal user intervention and adjustment
Automatic comparison of leakage readings against accepted limits (regulatory standards) and flagging of out of tolerance results
Some have internal test data record storage
Some can print directly to an external printer
Some have internal strip printers
RS232, USB, Ethernet, Centronics printer ports
High-level P functions
Some have large graphical displays
Some control other test equipment / peripherals
Some interface to computerized record keeping software systems
11. Specialty TestersTEE Transducer Electrical Leakage Current Testers
12. Specialty Testers TEE transducer electrical leakage current testers
Analyze the quality of the insulation barrier that protects the patient from internal electrical signals
Advanced models store test results for printing
Some models can adjust test voltage & frequency
Advanced models support on-board user configurable libraries of manufacturer & model transducers with limits
Meet requirements of major ultrasound manufacturers for TEE transducer testing
13. Electrical Safety Testers How do they basically work?
What do they all have in common?
What are the subtle differences?
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20. Electrical Safety Testers
21. Electrical Safety Testers
22. Electrical Safety Testers
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25. Electrical Safety Testers
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27. Electrical Safety Testers
28. Electrical Safety Testers
29. Electrical Safety Testers
30. Electrical Safety Testers
31. Electrical Safety Testers
32. Patient Simulators Two major types
ECG Only
ECG + some arrhythmias
Multi-Parameter
ECG + arrhythmias
Respiration
Cardiac Output
Temperature
Invasive Blood Pressure
33. ECG-Only Simulators
34. ECG-Only Simulators 5 or 10 lead models
Very simplistic user interface
Single 9-volt battery operation
ECG NSR (Normal Sinus Rhythm) at variable rates
Typically resistively divided lead outputs
ECG Performance Waves
Square waves (0.125 & 2 Hz)
Sinusoidal waves at various frequencies (0.05, 0.5, 1, 10, 25, 30, 40, 50, 60, 100 Hz)
Triangular wave (2 Hz)
Pulse 1 Hz 80 ms
Some arrhythmias in select models
35. Independent vs: Resistively Divided Outputs Resistively divided
Utilizes a resistor divider network to derive various lead & limb ECG signals at near-normal amplitudes but ALL waveforms are the same and only differ in orientation and amplitude
Typically on ECG-only and lower cost multi-parameter simulators due to manufacturing cost
Independent outputs
Utilizes a separate DAC for each lead and produces physiologically correct ECG waveforms
Usually in higher-level multi-parameter simulators only due to cost of manufacturing
36. ECG-Only Simulators
37. ECG-Only Simulators
38. ECG-Only Simulators
39. ECG-Only Simulators
40. Multi-Parameter Simulators
41. Multi-Parameter Simulators Advanced level simulation
Much more complex user interface
ECG output complete library
Independently derived outputs on leads for high-end units
Advanced library of arrhythimas
Respiration various rates
Selective reference electrode
Temperature variable
Cardiac Output
Fetal / Maternal (some with mechanical Toco)
Invasive blood pressures (IBP)
Multi-channel (up to 4 independent channels)
Physiologically synchronized outputs for ECG, IBP, Respiration, etc.
Some models have advanced level controllers available
42. Multi-Parameter Simulators
43. Multi-Parameter Simulators
44. Multi-Parameter Simulators - IBP
45. Invasive Blood Pressure
46. Fetal - Maternal Capability
47. Multi-Parameter Simulators - CO
48. Multi-Parameter Simulators CO
49. Non-Invasive Blood PressureSimulators (NIBP)
50. NIBP Simulators NIBP is weird science simulation
Manufacturer & model specific software algorithms at work in the NIBP monitor
Parameters
Systolic pressure
Diastolic pressure
Mean arterial pressure (MAP)
Heart rate
51. NIBP Simulators The data measured is 90. so what are the two specific test results based upon this data?
This is the challenge of NIBP.
52. NIBP Simulators Todays NIBP Monitors predominantly utilize oscillometric technology
The NIBP Monitor actually directly measures ONLY the MAP and calculates the Systolic AND Diastolic values!!!
Each technology manufacturer has their own proprietary algorithm for calculating Systolic & Diastolic pressure from MAP, as gathered during clinical trials.
The Oscillometric NIBP simulator produces small pressure pulses to simulate the physiological phenomenon that is seen by the monitor as changing amplitude pressure pulses coming from the BP cuff.
Even the acoustical characteristics of the blood pressure cuff and tubing used can have a dramatic effect on the NIBP measurements!
53. NIBP Simulators
54. NIBP Simulators
55. NIBP Simulators
56. NIBP Simulators
57. Electrosurgery Analyzers
58. Electrosurgery Analyzers Two general technologies
Voltage measurement across the test load
Current measurement through the test load
Considered to be a high technology testing application
Very few test equipment manufacturers due to technical challenges
Check output of generators from 400 KHz to 4 MHz (current typical range of general surgery electrosurgery generators)
Continuous output analyzers (conventional)
Valleylab, Covidien, etc.
Pulse output analyzers (newer technology)
Conmed, Erbe, Synergetics, Peak Surgical, etc.
Specialty generators with highly specialized outputs and capabilities bring specialized testing capabilities to the table
59. Electrosurgery Analyzers Typical measurement parameters:
RF current (ma)
RF power (watts)
Crest Factor (CF) the measure of Vpeak / VRMS
1.414 to 1000 range
Duty cycle (pulsed waveforms)
1% - 100% range
Through non-inductive test loads from 0O to > 5000O
5th generation parameters include
Frequency
Pulsed parameters such as time on, time off, total cycle time, duty cycle
60. Electrosurgery Analyzers Five distinct generations of technology
1st: Simple RF Thermocouple Ammeters
2nd: Active processing voltage measurement units
3rd: Active processing current measurement units
4th: Advanced level voltage measurement units
5th: New generation current measurement units
Ultra-high speed digital signal processing
Only generation that can digest pulsed waveforms
Closed loop communications with new technology generators
61. Electrosurgery Analyzers
62. Electrosurgery Analyzers
63. Electrosurgery AnalyzersElectrosurgery 101
64. Electrosurgery Analyzers
65. Electrosurgery Analyzers
66. Electrosurgery Analyzers1st Generation
67. Electrosurgery Analyzers2nd Generation
68. Electrosurgery Analyzers2nd Generation & Forward
69. Electrosurgery Analyzers3rd Generation
70. Electrosurgery Analyzers4th Generation
71. Electrosurgery Analyzers5th Generation
72. Electrosurgery Analyzers
73. Electrosurgery Analyzers
74. Electrosurgery Analyzers
75. Electrosurgery Analyzers
76. Electrosurgery Analyzers
77. Questions ?