BMET101: A CABT Prep Course

What are the 8 steps of lock out tag out?

1. Consult the detailed procedure for how to shut down the equipment 2.Notify affected employees 3. Shut down equipment properly 4. Disconnect all primary energy sources 5. Address all secondary sources 6. Verify the lockout 7. Keep it in force during shift change 8. Bring the equipment back on line

What are the rules of laser eye safety?

1. Laser-safe eye protection (glasses) with appropriate wavelength and optical density must be worn by all health care workers in the room. 2. Patients' eyes must be protected by either moistened eye pads (CO2 laser), or by goggles specific to laser wavelength. 3. Appropriate laser-protective eyewear should be available near the posted warning sign(s). 4. All viewing windows in the laser room should provide adequate protection specific to the laser wavelength.

Three Key Factors that aid in having a successful inspection are what?

A complete and accurate inventory of all medical equipment supported by HTM. Say What You Do: Have clearly documented policies and procedures in place so there is no question for how operations (eg: Recalls) are managed. Do What You Say: If you have a written policy and procedure in place, ensure you are following it!

Define Medical Gasses Quick Connect or Coupler?

A connection used to allow the quick connection of all medical gases. Quick connects are male, couplers are female. Ohio or Omeda, Chemtron, Puritan Bennett, Schrader and Oxeyquip are the different styles.

What is an digital multimeter and what does it do?

A digital multimeter is a test tool used to measure two or more electrical values—principally voltage (volts), current (amps) and resistance (ohms). It is a standard diagnostic tool for technicians in the electrical/electronic industries.

What is a functional check that a HTM performs?

A functional check is performed once the electrical safety check (if applicable) and operational checks are completed. Following the manufacturer's specifications or recommendations, the functions of the device are tested and verified to be functioning to be used on a patient or in a lab.

What is a Multi Parameter Patient Simulator?

A patient simulator is a very important device that mimics the signals generated by a patient. This aids in the testing and troubleshooting of many medical devices.

What is a safety check that a HTM performs?

A safety check on a device is a common test to ensure the unit is properly grounded and will not cause a shock hazard to the patient or the user. There is a specific piece of test equipment (seen later in the module) that measures ground resistance and chassis leakage. Once the unit passes this test then operational and function tests can be performed.

What is a visual inspection that a HTM performs?

A visual inspection is a type of inspection of medical equipment using vision, hearing, touch, and/or smell. Visually inspect a medical device to see if the equipment is undamaged, plugged-in, and working.

What does the acronym ALARA mean?

ALARA is an acronym for As Low As Reasonably Achievable.

When completing a demand work order it is required to have what information?

All times and dates are required to entered into any work order either demand or scheduled. Entering test equipment is critical but a screw driver does not fit that description. The other information while good to have it is secondary to time entries.

Alternative Equipment Maintenance

An Alternative Equipment Maintenance is any maintenance procedure that deviates from the manufacturer's recommendations for process or frequency. To execute an AEM, regulatory agencies require that a formal AEM Plan be documented showing that the HTM Department evaluated the risks involved and the maintenance history of the device.

What is an electrical safety analyzer and what does it do?

An electrical safety analyzer is a device designed to carry out a range of electrical safety tests in order to check that the device being tested complies with electrical safety requirements.

What is a operational check that a HTM performs?

An operational check is an "out of the box" examination to ensure the device is not externally damaged and has all of the accessories. The unit is then set up to be functionally tested.

What is an oscilloscope and what does it do?

An oscilloscope is a device used to test the functionality of equipment that generates an electrical signal. Oscilloscopes measure the changing voltage of an electrical signal over time, and display the signal as a waveform in a graph with sweeps of voltage on a vertical (Y) axis, and time on a horizontal (X) axis.

What equipment can and cannot be included in an AEM implementation? Organizations cannot deviate from these categories of equipment:

Any imaging device (x-rays, etc.), Lasers, Anything regulated by state or federal regulations, and Devices that are new to the industry, as organizations need relative history in order to deviate

What are some Impacts on Patient Safety and Hospital Accreditation?

BMETs and HTM Departments must conform to any federal and state regulations as well as all authorities having jurisdiction (AHJ). HTM Departments must also have documentation to show how medical equipment has been managed and maintained.

Define Basic/Advanced computer skills?

Basic computer skills include word processing, managing computer files, and creating presentations. Advanced computer skills include managing databases and running calculations in spreadsheets.

Biohazard signs indicate?

Biological materials that carry a significant health risk

AABB is in your facility. Which area would they be inspecting?

Blood Bank

What is the color of a Nitrous Oxide Tank or Hose?

Blue

Dress Code

Business Casual Attire or Scrubs/Uniforms

Hospitals must meet eligibility standards established by the federal government in order to receive reimbursement from the federally funded programs Medicare and Medicaid. Which agency sets the standards?

CMS

What does CMS define Medical equipment as?

CMS defines Medical Equipment as devices intended to be used for diagnostic, therapeutic, or monitoring care provided to a patient by a hospital.

Who are some Accrediting Organizations (AO)?

Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC), Healthcare Facilities Accreditation Program (HFAP), Det Norske Veritas Germanischer Lloyd (DNV GL), College of American Pathologists (CAP), American Association of Blood Bank (AABB), DPH - Department of Public Health

Device Classes (As defined by the FAA)

Class I devices are low-risk devices. Examples include bandages, handheld surgical instruments, and nonelectric wheelchairs. Class II devices are intermediate-risk devices. Examples include computed tomography (CT) scanners or infusion pumps for intravenous medications. Class III devices are high-risk devices that are very important to health or sustaining life. Examples include pacemakers and deep-brain stimulators.

Define the Three Classes of Recalls

Class I: Recalls for products which could cause serious injury or death; Class II: Recalls for products which might cause serious injury or temporary illness; Class III: Recalls for products which are unlikely to cause injury or illness, but that violate FDA regulations.

CAP is in your facility. Which areas would they be inspecting?

Clinical Labs

What is considered to be one of the most important skills that employers are looking for?

Communication is considered the most important skill for most professions.

What is a CMMS?

Computerized maintenance management system . Keeping accurate and up to date information is required by all accrediting organizations.

define two levels of recall

Correction - Addresses a problem with a medical device in the place where it is used or sold. Removal - Addresses a problem with a medical device by removing it from where it is used or sold.

What is an example of a negative pressure room?

Decontamination rooms

What does a Defibrillator Analyzer and Pacer Tester test for?

Defibrillator Analyzers are used for testing the functionality, accuracy, and performance of Defibrillators. Pacer Testers evaluate pace outputs.

What are some devices that deliver energy that are dangerous?

Devices almost always pose some danger to the technician but devices that deliver energy are particularly dangerous. Devices include: Defibrillators, Electrosurgical Units, Lasers, and Therapeutic Ultrasounds

What is DISS in hospital gasses?

Diameter Index and Safety System, standard used for Oxygen, Nitrous Oxide, Air, Nitrogen and Suction. Each type has its own pitch (thread type and size) and is not interchangeable.

What is the main feature of DISS?

Each has its own pitch and threads and are not interchange

What program would you use to present a slide show to your department?

Emails, Word Documents and Excel are important applications to use but Power Point (PPT) works best for presentations.

What are some dangers of Ethylene Oxide (EtO) Sterilization?

EtO is both flammable and highly reactive. Acute exposures to EtO gas may result in respiratory irritation and lung injury, headache, nausea, vomiting, diarrhea, shortness of breath, and cyanosis.

What is an FSM?

Factory service manuals (FSM) are the manuals provided by manufacturers that cover the servicing, maintenance, and repair of their products.

What happens if a hospital fails to comply with an accrediting organization?

Failing to comply with the accrediting organizations that report to CMS could result in a loss of reimbursements for all services provided to Medicare and Medicaid patients. Most hospitals could not survive without these reimbursements. Passing a TJC, DVN, or HFAP inspection means the hospital is in compliance with all CMS requirements at the time of the survey.

NFPA 99 is a code that pertains to what?

Fire Safety

What color is an Oxygen Tank?

Green

What tests does a electrical safety analyzer typically perform?

Ground continuity tests, Insulation tests, High voltage tests, and Line leakage tests

What are the measurements required for an Electrical Safety Test?

Ground resistance and leakage current

What is included in an MSDS (SDS)?

Hazardous Ingredients

Define HIPAA

Health Insurance Portability and Accountability Act

TJC, DNV, and HFAP are all what?

Healthcare Facilities

high-risk medical equipment

High-risk medical equipment includes life-support equipment and would typically require vigorous maintenance

Define Hospital Associated Infections (HAI) and explain the two types?

Hospital Associated Infections (HAI) are infections that a patient acquired during their stay in the hospital. These conditions are reported to the safety committee and are tracked to find solutions to limit these infections. HAI's can include: Iatrogenic Diseases - These are infections or illnesses caused by doctors. These are induced by a drug prescribed by a doctor, after a medical or surgical procedure, or failing medical equipment. Nosocomial Infections - These are infections from the facility. These infections are caused by toxins or other germs in the building or area.

What has to be performed on a device before it can be used on a patient?

Incoming Inspection

What is the first activity performed when a new device comes into a hospital?

Incoming inspection is required that each device in tested and entered into the hospital active inventory before put into use.

What does a Infusion Pump Analyzer do?

Infusion Pump Analyzers are used to test the performance and accuracy of infusion pumps. Devices check flow, volume, time and pressure.

Should every BMET department keep service manuals?

It is required by accrediting organizations to have a library of service manuals. This could be electric copies or hard copies.

Is it appropriate to email a work colleague a funny joke or article?

It is wise to follow your organization's policies and procedures on Email etiquette. Just be aware any email you send is recorded and that funny joke may not be funny to everyone.

What is not a part of PPE?

Lead Apron

What would be the most appropriate program to use to create spread sheets?

MS Excel

Define MEMP

Medical Equipment Maintenance Plan

An Orange sign normally would signify?

Moderate risk

What is the National Fire Protection Association (NFPA)?

National Fire Protection Association (NFPA) is a national public health institute concerned with fire and electrical safety. Of particular interest to HTM personnel are NFPA 70: National Electrical Code, and NFPA 99: Health Care Facilities Code. NFPA 70 applies to the design and installation of electrical distribution systems and equipment in general. It is adopted by state and local governments and thus carries the force of law. NFPA 99 is based largely on NFPA 70, but covers more than electrical systems and equipment in healthcare. It also has requirements for healthcare facility and equipment management.

What is the National Fire Protection Association?

National Fire Protection Association is a global non-profit organization that promotes safety standards, education, and training for fire and electrical-related hazards.

Non-high-risk equipment

Non-high-risk equipment are the devices not included in the high-risk category. In other words, there are two categories: high-risk and everything else. Non-high-risk may or may not require maintenance depending on the device and hospital experience.

What does a Non-Invasive Blood Pressure (NIBP) Simulator do?

Non-invasive blood pressure (NIMP) simulators are used to test the function and accuracy of NIBP monitoring equipment.

What does OSHA do?

OSHA helps ensure the safety of employees by enforcing strict standards for healthy and safe working conditions.ds for a safe and healthy workplace.

What is OSHA?

Occupational Safety and Health Administration

The most common computer skills that employers desire?

Operating systems (Windows and MacOS) Office suites (Microsoft Office, G Suite) Presentation software (PowerPoint, Keynote) Spreadsheets (Excel, Google Spreadsheets, etc.) Communication and collaboration tools (Slack, Skype, etc.)

Which activity is required on an incoming inspection?

Operational Check

Definition of OEM/FSE

Original Equipment Manufacturer/Field Service Engineer

What kind of signals does a Multi Parameter Patient Simulator test for?

Patient signals simulated include, but are not limited too, the following: ECG (including arrhythmia waveforms), Temp, Pressure, SPO2,Cardiac Output, Respiration, Fetal ECG/IUP

What service documents would you need to perform an OEM PM?

Performing OEM (original equipment manufacturers) preventive maintenance refers to following the manufacturer's recommended intervals and activities found in the service documentation or service manual. Companies are not required to provide the service manual but one could be requested or purchased. Calling technical support is also an option to acquire service information to perform the PM.

What is PISS in hospital gasses?

Pin Index Safety System is a means of connecting high-pressure cylinders containing medical gases to a regulator or other utilization equipment. It uses geometric features on the valve and yoke to prevent mistaken use of the wrong gas.

Planned/Preventative Maintenance (PM)

Planned/Preventative Maintenance (PM) are scheduled maintenance activities that occur at a defined frequency (e.g.: annually).

What are Receptacle and Polarity Testers and what do they do?

Receptacle testers test the polarity of the AC Outlet and the resistance of the 3 AC outlets connections. These testers help to meet NFPA standards for AC outlets.

The meanings of various colors on safety placards?

Red: Combustible Materials Yellow: Oxidizers White: Poison or Toxic Orange: Explosives Green: Non-Flammable Gas Red and White Striped: Flammable Solid

What is the best way to identify hazards of a specific chemical/product in your department?

Refer to the SDS

BMET Core responsibilities

Repair and Maintenance of Medical Equipment

What are some dangers of medical lasers?

Risks to the operator and service personnel include but are not limited to direct and indirect exposure to the surgical laser by the eye. The Eye is the most at-risk part of the anatomy as the Laser could cause serious injury. Burns to the skin are also a concern but secondary to Eye protection.

What is the SDMA and how is it used?

Safe Medical Device Act (SMDA) of 1990 Sequester the device and all accessories to ensure the device is not used on another patient Ensure the device is clearly labeled, "Do Not Use" to ensure another employee in your department does not put it back into service Report the incident your supervisor immediately Document the incident

When a device is involved in patient harm, what is the BMETs' role?

Sequester the device and follow hospital policy regarding incidents

What information is required to be entered into the inventory for each device?

Serial Number

What does OSHA provide?

Some of OSHA's most important standards are outlined in the Health Communication Standards (HCS)1994-2012. They provide training and assistance in the implementation of these standards.

What does a Electro Surgical Analyzer do?

Test critical ESU functions with precise power, current, frequency, crest factor and load resistance ranges on a variety of makes and models of electrosurgical unit generators.

What is the CDC?

The Centers for Disease Control and Prevention is a national public health institute in the United States. It is a United States federal agency, under the Department of Health and Human Services.

Which agency is in charge of Medicare and Medicaid?

The Centers for Medicare and Medicaid is the correct answer. AABB Is the American Associations of Blood Banks, TJC is The Joint Commission and surveys for CMS, and DNV is an accrediting agency for CMS.

You would like to check volts on a Battery. Which device would you most likely use first?

The Digital Multi Meter or DMM is specially setup to test voltage if the selector is set to AC or DC voltage. ESU and Receptacle testers would not be used to check voltages. Although an Oscilloscope could test voltage on a Battery it would not be the first choice.

What devices will the Hospital Safety Committee cover?

The HTM representative will generally report on: PM completion with expectations to meet certain targets. Any changes in PM intervals with supporting rationale. Repair work order completion. Use errors (by device type and by department to identify possible needs for training). Equipment not located. Recalls or hazard alerts received/addressed with open/pending/in process status. Patient or staff incidents involving medical equipment with investigation results and findings. Devices added and deleted from inventory. Abuse or improper use of medical equipment by clinical staff.

What does the The Safe Medical Device Act of 1990 do?

The Safe Medical Device Act of 1990 (SMDA) is a federal law that requires manufacturers and user facilities to report any adverse events associated with a medical device to the FDA.

The most common computer skills that employers desire for BMET's?

The ability to create documents in Word The ability to save and attach documents Create and manipulate Excel Spreadsheets Create Presentations on PowerPoint Use Email and other communication applications (Skype, Zoom, Web meeting) Use and navigate company software (CMMS)

What information is not important when entering a piece of equipment into inventory?

The color of the device in not a crucial piece of information whereas the Serial number, control number and location are critical pieces of information to enter into the CMMS.

Should a hospital follow it's own AEM?

The hospital or organization must follow its own AEM program as it is written to be successful.

What is OSHA?

Thee Occupational Safety and Health Act of 1970, congress created the Occupational Safety and Health Administration to ensure safe conditions for men and women in the workforce. OSHA sets and enforces safety and health standards worldwide. This is achieved through outreach, education, and assistance programs.

What are some Patient Safety Organizations (PSO)?

There are several agencies that specifically inspect and research the field of patient safety. They include The Joint Commission, ECRI Institute, Association for the Advancement of Medical Instrumentation (AAMI), and the Institute for Healthcare Improvement

What is the most effective way to minimize exposure to radiation?

Time, Shielding and Distance

Is it a requirement for BMET's to continue training throughout their career? T/F

True

Are Hospitals and organizations required to have a library of service manuals?

True Hospitals and organizations are required to have a library of service manuals.

What is the method of infection control to treat all human blood as if they were known to be infectious?

Universal Precautions

When using a Laser in the OR you must?

Wear appropriate eyewear

What is Right-to-Know regarding hazards?

What hazards and chemicals the BMET works with.

When should a Laser sign be used?

When a Class 3 or 4 Laser is used in a Procedure

When would you use PPE?

When there will be contact with blood or other bodily fluids

Is it required to inventory each device before placing the device on a patient?

Yes