Ultrasound Cleaning & Disinfection

   It has become increasingly important to establish a proper cleaning protocol for ultrasound systems, probes, accessories, surfaces, and displays used in contact with patients.
The landscape is vast with regards to cleaning solutions, applications, delivery (spray or wipe), and what is approved for use within various facilities. You can most likely walk around your facility and find many brands of cleaning wipes and sprays with varying levels of active ingredients on the label.
According to the CDC website on chemical disinfectants, the list is:
It has become increasingly important to establish a proper cleaning protocol for ultrasound systems, probes, accessories, surfaces, and displays used in contact with patients.
The landscape is vast with regards to cleaning solutions, applications, delivery (spray or wipe), and what is approved for use within various facilities. You can most likely walk around your facility and find many brands of cleaning wipes and sprays with varying levels of active ingredients on the label.
According to the CDC website on chemical disinfectants, the list is:

• Alcohol
• Chlorine
• Formaldehyde
• Glutaraldehyde
• Hydrogen Peroxide
• Iodophors
• OPA
• Peracetic Acid
• Phenolics
• Quaternary Ammonium

In this article, I will reference what most manufacturers show as approved disinfectants and how to use them correctly on each part of the ultrasound system --Conclusion Don't assume. Do the research. Just because a disinfectant is approved for one surface does not mean it is approved for all. Some departments will go to the extreme of having three or four different disinfectants for multiple surfaces, but products are available that are approved for all surfaces. Finding the “unicorn” will simplify your disinfection protocols and save your department money at the same time

Managing Surgical Smoke in Your Operating Room

   Any time an ESU is used, the cutting and cauterization processes produce a plume commonly referred to as surgical smoke. Analyses of surgical smoke show that 95 percent of the smoke is merely water vapor, which isn't harmful to patients and staff. The remaining five percent can contain toxic gas and known carcinogens, vapors and particulates, cellular material, viruses, and bacteria. While five percent might not seem consequential, studies have shown that these toxins are often carried by the water vapor in surgical smoke, allowing them to disperse widely in the operating suite.
The short term effects of surgical smoke include respiratory irritation, eye irritation, dizziness and headaches, nausea, and skin irritation — which are typical symptoms experienced with any kind of smoke exposure. Unlike other workplace smoke hazards, the National Institute for Occupational Safety and Health reports that repeated exposure to the contents of surgical smoke may be cumulative and increases the possibility of developing adverse health effects (Alp et al.).
The long term effects of habitual exposure to surgical smoke are still being studied, but recent findings compare the dangers of surgical smoke to those associated with tobacco smoke. According to a 2021 publication by Boston University School of Public Health, findings derived from an extensive study of nurses indicate that prolonged occupational exposure to these substances within operating rooms is associated with a markedly increased likelihood of developing chronic obstructive pulmonary disease (COPD).
How to Manage Surgical Smoke in Your Operating Room To mitigate surgical smoke in the operating room, regulatory agencies including the Association of periOperative Registered Nurses (AORN), have adopted multi-pronged strategies that include personal protection, local exhaust ventilation, and specialized smoke evacuation technology.
High-Filtration Masks
During electrosurgical procedures that produce surgical smoke, it is recommended that staff wear high-filtration masks. These masks typically guard against particulate matter larger than 0.1 microns, offering staff additional protection for anything missed by local exhaust ventilation or a smoke evacuator.
Local Exhaust Ventilation
Local exhaust ventilation systems can either be portable units, or a built-in function of an operating room. An LEV should be used in conjunction with a smoke evacuation system, and should always be engaged when a surgical smoke plume is being produced

Empowering Women's Health Beyond Pregnancy

   Typically, most people associate ultrasound in healthcare with its applications in pregnancy—assessing the health of both the baby and the mother. This usage appears to be the most widely recognized, with many individuals who have had children having experienced 3D/4D scans, resulting in images featuring profiles of their baby's face or 2D scans reminiscent of old black and white television pictures.
   Obstetrics, primarily focused on pregnancy and childbirth, tends to be a familiar application of ultrasound. However, various health fields, including cardiology, general radiology, breast and cancer detection, and the assessment of muscle and joint concerns, frequently find more extensive use, particularly within women's health. The versatility of ultrasound systems, coupled with advancing technology, has led to the design of systems tailored to these applications. This aims to optimize treatments and simplify diagnostic decision-making more effectively than in previous years.
   Breast ultrasound has experienced remarkable technological progress, expanding its applications as a safer yet equally effective alternative to X-ray-based mammography. Unlike X-ray systems, ultrasound doesn't emit potentially harmful radiation, making it particularly valuable for patients at elevated risk of exposure. BreastCancer.org conducted a case study that demonstrated comparable detection rates between ultrasound and mammography. Additionally, in procedures involving biopsies, ultrasound is the technology employed for pinpointing needle locations and providing real-time visualization during the biopsy process.
   Another prevalent use of ultrasound in women's health, aside from obstetrics, is found within gynecology practices. The integration of 3D ultrasound can significantly enhance the diagnosis and treatment of various concerns, including uterine adhesions, IUD placement and subsequent follow-up examinations, as well as the identification and pinpointing of fibroids and polyps. By having ultrasound services readily accessible within the same site or office, healthcare providers can achieve faster assessments and diagnoses of these issues, eliminating the need to refer patients to external facilities or recommend alternative imaging modalities. This approach substantially bolsters the availability of treatment options, leads to more favorable outcomes, and improves patient care.
   As ultrasound gains prominence as a preferred method for detection and diagnosis, manufacturers are increasingly tailoring systems for specific applications. Concurrently, advancements in technology are resulting in smaller and more portable ultrasound systems, which not only reduces equipment procurement expenses but also lowers the costs associated with servicing these systems and probes. While repair or replacement costs for specialty probes designed for specific applications might initially appear high, their availability is on the rise, potentially contributing to cost reduction for these specialized components. Among the most expensive items to service, besides the system itself, are 3D/4D mechanical probes. However, due to the evolving technology and enhanced repair capabilities, many service providers, like Avante Health Solutions, have managed to offer more cost-effective repairs for these probes.

Access and Evaluate the Siemens CT Tube Report

Siemens CT Tube report in 6 easy steps.
Step 1
At the top of the main screen, navigate to the Options drop down menu, which is the third tab from the right. In the Option menu list, select the Service tab. A sub menu to the right will appear. Highlight and select the Local Service Option with a right click of the mouse.

Step 2
Enter the 20-character alpha numeric password. The left field uses the first fourteen characters, and the right field requires the last six characters. Typically, the left field will be auto-filled only requiring the last six to be entered.
*If no password is available, both fields can be left blank and limited Level Service 1 (Customer) can be accessed. If you start Reports with Service Level 1 (Customer), only the tube history header of the currently installed tube(s) will be displayed.

Step 3
Move the mouse to the top right corner of the home page and select Reports.

Step 4
At the bottom of the left column, the heading Tube will be displayed. The Tube History can be accessed by selecting Current History, which will allow the user to see the history of the tube which is currently installed. Alternatively, All Histories can be selected, an action which will list the files for all tubes that have been installed on the system.

Step 5
When the Current Tube is selected, the window to the right shows the current summary of the tube installed. A summary of all the tube information can be found in the top part of the file.

Step 6
Selecting All Histories will change the screen to the right and depict a list of files for the current tube and separate files for all the tubes that have been installed as well as the reason they were replaced. To exit the program, move the mouse up to the word Exit and click.

6 Ways to Save on Medical Equipment

   If you could save up to 40% on equipment for your medical facility, would you be interested in learning how to do it?
From timing your purchases carefully to offering testimonials on equipment you love, there are clever ways to cut the cost of your medical equipment. Check out these tips to see how much you can save.
Time Your Purchases
Timing your purchases can greatly impact the price you pay for medical equipment. If you time your purchases just right, you may walk away with thousands in savings. Here are the best times of the year to purchase medical equipment:
End of the year: Suppliers are often eager to clear out their existing inventory and may offer discounts between November 15 and December 31.
End of the quarter: Sales managers are often under pressure to hit quarterly sales goals at the end of March, June, and September. If you contact a supplier during the last two weeks of those months, you could enjoy substantial savings.
Before holidays and special events: Take advantage of contests and special promotions that many companies offer for special occasions.

The Video Laryngoscope

Why It Is The Most Powerful Tool In Your Hospital's Arsenal
1. You will enjoy superior illumination
Studies show there is a great degree of variance in light intensity among traditional reusable laryngoscopes. A laryngoscope's effectiveness could be limited depending on the type of blade and type of illumination used. Poor quality illumination ultimately increases the risk for trauma to pharyngeal tissue and other damage.
Today's best laryngoscopes feature the highest quality LED lighting. With an integrated ultra-bright LED light source, video laryngoscopes reduce the risk of tissue damage. Additionally, their superior LED illumination eliminates the risk of heat damage that can be caused by older model laryngoscopes with halogen lighting.
2. Your patients will receive care faster
Every second counts when a patient is on the operating table or in an ambulance. Many traditional laryngoscopes and some video models are not available with disposable blades, which results in a lengthy disinfection and sterilization process that can delay treatment. Additionally, units that lack an anti-fog mechanism may require preheating, which can also be time consuming.
Today's top video laryngoscopes feature an anti-fog system and disposable blades. There is no pre-heating, pre-soaking, cleaning, drying, or packaging of blades required. And because procedures can be completed faster and without delays, physicians and surgeons are able to diagnose and treat more patients during a regular business day.
3. You reduce the risk of cross-contamination
Traditional laryngoscopes are reusable and are typically used on multiple patients each day. Failure to properly sterilize reusable laryngoscopes puts patients and staff at increased risk for exposure to illness and disease. Even improper storage can result in cross-contamination between patients.
4. You will improve your precision
The basic, "one-size-fits-all" design of yesterday's laryngoscopes often placed limitations on users. For example, they were not designed for use by doctors whose hands were smaller or larger than average. As a result, precision was limited because it could be challenging to control the laryngoscope.
The best laryngoscopes have an ergonomic design that improves precision and diagnostic accuracy. They are intuitively designed to boost comfort and handling regardless of the user's hand size. Additionally, they feature a 2.0 anti-fog megapixel lens that prevents condensation from developing and obstructing visibility. Finally, they are made with durable, eco-friendly materials that are designed to withstand extreme temperatures and humidity.
5. You can intubate patients in challenging environments
Laryngoscopes are used all over the world. In many cases, they are purchased from companies in the United States or Europe and shipped overseas to hospitals and clinics in developing countries. The best laryngoscopes on the market feature rechargeable batteries and a micro USB port for easy charging. Here are just a few of the environments that have benefited greatly from portable video laryngoscopes:
Mission hospitals and facilities that lack reliable lighting or access to sterilizers Rural hospitals and clinics that are prone to power outages Mobile anesthesia practices that require fully portable equipment
6. You can use them to train future generations of practitioners
Few things are more important to the field of medicine than ensuring that our next generation of practitioners is properly trained. Laryngoscopes have evolved greatly since 1913 when Professor Chevalier Jackson designed a blade with a distal light source. Today's best video laryngoscopes make it easy to establish and store files for training staff. They feature internal 8G SD memory cards that are able to record intubations for educational purposes. Nurses and doctors in training can effortlessly review saved records to master the art of intubation and treat future patients with increased precision.

Basic Features of a C-Arm and Fluoroscopy Table

   Diagnostic radiology is becoming part of the new standard of care as a non-invasive way to diagnose and treat a variety of patients. As an alternative to costly exploratory surgery, more clinicians are opting to outfit their facilities with new diagnostic imaging equipment including C-arms and fluoroscopy tables.
If your facility is considering new imaging procedures, preemptively purchasing a fluoroscopy table, also known as an imaging table or a C-arm table, is a good investment.
Common Features of an Imaging Table
Most modern surgery tables feature some imaging support, but a true C-arm table is necessary for advanced medical imaging procedures. C-Arm and fluoroscopy tables provide clinicians with precise, flexible movement and feature a sleek design to function with C-arms and other imaging systems.
Radiolucent Carbon Fiber Tabletop
C-arm and fluoroscopy tables feature a carbon fiber top that provides an expanded imaging area compared to typical surgical tables. Carbon fiber is lightweight and durable, and provides clinicians with the radiolucent surface needed for full imaging procedures. Imaging tables with carbon fiber tops allow clinicians to get high-quality, clear images at lower x-ray doses. Fluoroscopy tables usually come with thinner table pads that are also radiolucent.
Precise Table Movements
Table articulation is particularly important when it comes to selecting an imaging table, because the table you choose works in tandem with a C-arm or fluoroscopy machine. For this reason, imaging tables often feature more robust articulation capabilities than traditional surgical tables. Precise movements help clinicians to align the patient properly with the C-arm.
Floating Top Table
Some advanced imaging tables also feature “floating top” movements, or multi-directional positioning. Tables with floating top capabilities usually feature a joystick-like controller that allows clinicians to move the table laterally or in a diagonal lateral direction.
Weight Capacity
The enhanced positioning capabilities and carbon fiber tabletop on most imaging tables can reduce the weight capacity compared to standard surgery tables. While most imaging tables have the ability to lift patients up to 500 pounds, it's important to note that the table's positioning options will probably be limited in these cases. However, it is possible to take advantage of the table's large radiolucent area by repositioning bariatric patients on the table for specific imaging procedures, while still balancing the table weight over the base for increased stability.

Right Anesthesia Machine for Your Practice

   Before purchasing an anesthesia machine for your practice, you need to find answers for these basic questions:
What kind of anesthesia machine do you need?
Does a refurbished anesthesia machine make sense for your facility?
Is your new anesthesia machine compatible with my other operating room equipment?
Is this anesthesia machine a good investment for your facility?
What Kind of Anesthesia Machine Do You Need?
The easiest way to approach this question is asking yourself, “Do I need an anesthesia ventilator?” Ventilators are necessary for all procedures requiring general anesthesia where the patient requires deeper sedation. If your facility performs these kinds of procedures, you'll be needing an integrated anesthesia system.
Integrated Systems
Integrated anesthesia systems are designed for full operating rooms with heavy surgical schedules. Integrated units usually offer ventilation with volume and pressure control and other advanced modes. They also typically feature three vaporizer chambers, integrated monitoring, gas delivery management, and they are compatible with electronic data systems.
Portable Systems
If you don't require an anesthesia ventilator, a table top or portable anesthesia system is a good option. Portable anesthesia systems are designed for field work or office-based procedures that require conscious sedation. Portable anesthesia machines are used especially often in monitored anesthesia care (MAC), where a clinician delivers local anesthesia together with sedation and analgesia.
Does a Refurbished Machine Make Sense for Your Facility?
Purchasing a refurbished anesthesia machine can certainly help your bottom line, but cost isn't the only benefit. A refurbished unit can also save valuable time at your facility that would otherwise be spent training your staff on the latest technology of your factory new unit.
The benefits of refurbished equipment need to be considered with the caveat that a reconditioned anesthesia machine is only as good as the company who completes the refurbishing process. To be sure you're choosing a reputable refurbishing company, make sure that they have the necessary experience, inventory, and refurbishment process to guarantee a quality product.
Are Your Other Systems Compatible?
Unless your anesthesia machine purchase is part of a complete equipment overhaul in your facility, it's a good idea to determine how your new unit will function with your existing equipment.
Check to see the vaporizer mounting options for your new anesthesia machine, and whether you'll need to purchase new vaporizers that are compatible. This is especially important if you plan to switch anesthesia machine brands.
If you're currently using mounting tracks to position exam lights or monitors, be sure that the mounting options on your new machine are consistent. You'll also need to evaluate your current scavenging system and gas delivery system.
Is this Anesthesia Machine a Good Investment?
Determining the true value of your new anesthesia machine involves factoring in a few important factors. Consider the initial price of purchase along with the expected maintenance costs to make sure your facility is prepared to cover those expenses.
It also helps to be prepared for equipment problems that occur outside of the realm of routine maintenance. Ask yourself, “what's the most expensive thing that could go wrong?”
End-of-life Considerations
Determining the eventual “End of Life” for an anesthesia machine is important — especially when comparing refurbished models. Despite the finite-sounding name, EOL simply refers to the time set by the original equipment manufacturer after which they will no longer provide support.
Anesthesia machines can function for years after their EOL dates with the help of qualified, third-party maintenance services. If your machine is nearing its EOL, be sure to find a trusted maintenance provider with access to quality new or used parts and experience in servicing your specific model.
Additional Factors
Do you need an MRI-compatible anesthesia machine?
In situations where the anesthesia machine will be in close proximity to an MRI machine or another imaging system, a MRI-compatible anesthesia machine is necessary. MRI-compatible anesthesia machines are constructed using non-ferrous materials including carbon fiber, plastic, and other metals low in iron. MRI-compatible machines also shield any electronic elements that could be damaged by magnetic resonance in an imaging suite.
Brand-specific anesthesia machine features
If you're in the market for a new anesthesia machine, take the time to compare and contrast anesthesia machine brands. Anesthesia brands often have unique proprietary features which might work well with your practice. For example, Dräger has established itself as the top manufacturer of piston-driven anesthesia ventilators. Piston ventilators don't require drive gas, and are intended to be more precise than traditional bellows-driven technology.