HIDDEN HEALTH PART 4: The machine menders
On any Monday morning, at least a dozen patients are already lined up waiting to be healed at Dave Gilbert’s office at Surrey Memorial Hospital (SMH).
Crowded on a shelf or in a pile on the floor, they’re a sickly bunch: Ten drug infusion pumps, three or four non-invasive blood pressure kits and an ailing patient monitor unit.
And like triage in an emergency room, his job is to prioritize: Who gets immediate attention, and who can remain on the shelf for a little while.
Electronic medical devices, like human patients, break down, need maintenance and have limited life spans – though in the case of the machines, it’s usually seven to 10 years.
Based in an out-of-the-way basement section of the hospital, Gilbert, the supervisor of Biomedical Engineering (BE), and his staff of nine technicians are responsible for the upkeep of the hospital’s medical equipment.
The machines the BE department deal with can be as simple as electronic thermometers and as complex as CT scanners, as long as they use batteries or wall plugs for power and don’t have disposable or consumable components, such as glucometers or regular pacemakers.
BE’s medical devices, by Gilbert’s definition, are “electronically or physically connected to a patient in order to diagnose, treat or maintain a patient.”
There are more than 7,000 such items at SMH, from temporary pacemakers used for surgeries to full consoles needed to monitor patients in Intensive Care Units.
Their total replacement cost is about $37 million.
While there are some machines such as infusion pumps (of which the hospital has more than 600) that can wait for servicing on occasion, others are given top priority for repairs or maintenance.
“In our world, we like to consider an anaesthetic machine or a ventilator the highest priority because it is truly a device that supports life,” Gilbert explains. “If that machine stops running for any reason, that patient is in trouble.”
While most machines have the safeguards of fallback modes in case of electronic glitches, mechanical breakdowns or power outages, it’s always best to keep them running properly in the first place.
The number of machines in service – a hospital may have only one MRI machine, for instance – means constant day-to-day changes in priorities.
BE’s responsibility begins at conception – the planning of a piece of equipment’s purchase – and continues all the way to the day it’s retired from service.
BE work is a hectic life that involves finances, warranties, recalls, software upgrades, quests for parts, service manuals, communication with users, manufacturers and vendors, and a computer database that keeps a machine’s history updated.
“We’re from birth to death of any medical device,” says Gilbert.
Given the complexity of their work, SMH’s technologists, most of whom already have BE technology diplomas from BCIT and lots of work experience, continue to receive further training outside the office – a costly necessity that comes out of BE’s involvement in purchasing medical devices that constantly evolve.
A week’s tuition for factory training by a “regular” equipment manufacturer costs about $5,000. A one-week course on an anaesthetic machine can cost $15,000.
Photo: A malfunctioning infusion pump.
Gilbert graduated from BCIT in 1984, and has seen machines get much better – and much more complex and expensive – to the point where there are few spares of machines and parts floating around in the health region for hospitals to share.
While reliability has improved in the electronics of devices, peripheral parts of mobile items still get worn down by heavy use – tubing in blood pressure kits, for example.
Then there’s the continuing problem of batteries, which are often not properly charged or used correctly. Batteries are about 30 per cent of BE’s daily work, with a small room in the department dedicated to just testing, charging and repairing batteries.
Gilbert admits busy medical staff or patients can’t be expected to remember that rechargeable lead-acid batteries can be damaged by running them completely down before charging them.
“We’d like people to look after the equipment better,” he says.
Next week: Scrubbing scrubs
How do you wash 3.5 million pounds of laundry each day?
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