HospitalTrainingReport2015

1. INTRODUCTION
Pariyaram Medical College was established in March 1993 at
Pariyaram in Kannur district, Kerala state, South India. The nucleus for this
building complex was the Pariyaram Sanitorium which was inaugurated way
back in 1938 or so. The engineer who built the building was Mr. Appadu Vetil
Narayana Menon who belonged to Payyannur. The Kerala State Co-operative
Hospital Complex (KCHC) and Centre for Advanced Medical Services Ltd. is a
Co-operative Society registered under Kerala Co-operative Societies Act 1969
with an object to build a 1000-bed super-speciality Hospital modern medical
facilities and a medial college. The Management of Kerala State Co-operative
Hospital Complex and Centre for Advanced Medical Services Ltd. formed a
Charitable Trust Named Academy of Medical Science (ACME) under the direct
control of KCHC. The above society was registered under Societies Registration
Act 1860 in November 1993 with the primary objective of running a medical
college.

Pariyaram Medical College, the first self-financing medical college under

co-operative sector in the country. This medical college with full accreditation
of Indian Medical Council started its first batch of MBBS students in 1995.

Pariyaram Medical College is a medical institution of excellence that

offers quality medical and para-medical education with an infrastructure that is
one of the best in the country. Within a short span of its inception, it has made
its marks in the field of medical education as a quality institution growing at
considerable pace, grooming future health care professionals. Eminent faculty
and fully staffed departments with good facilities, sets an excellent educational
environment. The academic achievements of the institution are several, which
include University ranks, admission to higher studies etc. All India toppers in

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competitive exams for PG entrance at AIMS, AFMC, All India Medical

Entrance etc. it has maintained best results in Kerala in all university
examinations consistently. All the courses offered are approved by competent
authority. The institution aims to offer several courses in various areas of
medical science is also running PG degree & Diploma courses.

The Institution is situated in an area of 119 acres (48 ha) in a hilly rural
area (Pariyaram), 31 km north of Kannur and 10 km south of Payyanur on the
National Highway 17. The population in this area lacks specialised medical care
facilities. The nearest Medical College, Mangalore, is 125 km to the north. In
the beginning, the hospital and colleges started functioning in the buildings
owned by the erstwhile tuberculosis sanatorium at Pariyaram.

On 9 February 1997, the state Government look over the Control of the
Management of the institutions. The Government has constituted a Committee
named Board of Control to run KCHC and ACME. The takeover was initially
for a period of 2 year ending on 8 February 1999. The period was extended
periodically six months at time till 2 December 2000. This act was repealed by
the ordinance taking over assets and liabilities of both KCHC and ACME. First
batch started in 1995 with hundred students.

Lot of controversies regarding the fees structure of medical seats are still
prevailing for this institution. Since it is only partly owned by the government,
the fees structure of the college doesn't come under the government college
norms, which means, even if a student gets a medical seat on merit in this
college, he/she would end up paying around 1.5 lakhs per year for MBBS
course . The fight against this is still continued by the political parties to make it
a wholly owned subsidiary of the government.

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FigNo1.1:PariyaramMedicalCollege

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Chapter2

ELECTRICALDEPARTMENT

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2.1POWERSUPPLYUNIT
The11kvlineisusedtosupplytheelectricity.herethenitis
covertedinto400byusingstepdowntransformers.busbarisusedto
transfer the electricity.in which lighting panel,MRI panel,XRAY
panel,andotherpanelshaveandeachisdiffurinvoltages.

2.2OXYGENPLANT
The centralized gas supply system in a hospital supplies gasses like
oxygen,nitrousoxide,andvacuumtothedifferentdepartments.Thesegasses
areveryimportantinalldepartments.SuchasICUneedscompressedairand
operation theatre needs nitrous oxide which are supplied through pipeline
system.Yellowpipesuppliesvacuum,bluepipesuppliesnitrousoxide,white
pipesuppliescompressedairtotheICUandOT.Theoxygenplantcontains
liquidoxygenwithhighpressure.Thevaporizerunitreducesthepressureand
convertsgasintoliquidstateatlowtemperature.Therateofoxygencontaining
incontainerischeckingbythe.satellitecommunication

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Chapter3
LABORATORYDEPARTMENT

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3.1BLOODBANK
Hearweseethebloodkauch.inwhichthepatient issituated
when blood is taking.it have the property to change the head
possition.thenbloodcellmoniteringmechine(modelTC2001B).the
number of blood cells counted by this machine. cealing
machine(model)thismachinecealsorstopsbloodflow.andanother
equipmentusedinbloodbankiscentrifuge(model).thisis
usedtoseparatethebloodparticles.theplasmafreezeristwotypes
:80freezer
itfreezetheplasmaatlongtimeat80
:40freezer
itfreezestheplasmamembraneatfirst40c
inbloodbankanotherequipmentisplateletstoringmechine.whichis
in 20c.this machine continuously shaking to avoid the clotting of
platelets.
3.2CENTRALSTERILESUPPLYDEPARTMENT(CSSD)
Despitetheunprecedentedadvancesmadeinthemedicalfield,
hospital acc infection remains the hospital's single most serious
concern that negates some of its other.: Is, good work. It is
acknowledged that even in advanced countries, approximately five
percentofallhospitalpatientsdevelopinfectionafterbeingadmitted.

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Giventhepoorstandardsinourhospitals,thisfigureislikelytobe
muchhigher:inIndia.Theintangibleandtangiblecostofthisbyway
ofunnecessarysuffering,extrahospitalizationandlossofworking
days can be high. To combat this ubiquitous menace of
infectionscausedbypathogenicmicroorganisms,hospitalshaveover
theyearsdevelopedascientificmethodcommonlyreferredtoasthe
central Sterile and supply system. The method basically involves
cleaning, disinfecting and sterilizing before use all instruments,
materialsandequipmentutilizedinpatientcare.Fromvariouspartsof
thehospitallikeoperatingrooms,wards,outpatientclinicsandother
departments,allsoileditemsarecollectedintheprocessingandthen
transported back to the end users. In the CSSD, the process of
cleaning,disinfecting,packing,sterilizing,storinganddistributingis
carriedoutbyspeciallytrainedpersonal.theCSSDservicesnursing
units, operating rooms ICU's , labordelivery suits, the nursery,
outpatient departments, radiology, pharmacy and the clinical
laboratories.Theprimaryactivitiesofthedepartmentaresterilizing,
storing and distributing the dressing, needles and syringes, rubber
goodsetc..
3.3FUNCTIONS...
Thefunctions oftheCSSDareasfollows: 1)Receivingand
storingsoiledmaterialusedinthehospital.2)Determiningwhether
theitemsshouldbereusedordiscarded.3)Carryingouttheprocess
ofdecontaminationordisinfectionpriortosterilizing.4)Inspecting

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and testing instruments, equipment and linen. 5) Assembling

treatment trays, instrument sets, linen packs, etc.. 6) Packing all
materials for sterilizing. 7) Sterilizing 8) Labeling and dating
materials9)Storingandcontrollinginventory0)issuingand

distributing CSSD includes: 1) Disposable making a) Bandage b)

Cotton wool c) Surgical pad d) Eye pad e) Roller gauge 2)
Sterilization Two methods are involving, they are physical and
chemical.Physicalmethodsincludemoistheatbysteamanddryheat
byhotair.Chemicalmethodinvolvesgasandliquid.
3.4CENTRIFUGE
Acentrifugeisapieceofequipment,generallydrivenbyamotor,that
putsanobjectinrotationaroundafixedaxis,applyingaforceperpendicularto
the axis. The centrifuge works using the sedimentation principle, where the
centripetalaccelerationisusedtoevenlydistributesubstances(usuallypresent
inasolutionforsmallscaleapplications)ofgreaterandlesserdensity.Thereare
many different kinds of centrifuges, including those for very specialized
purposes.Itcanbeusedforviablecounts,whenshakingtheculturee.g.yeast,
outofsuspension.

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Fig3.1Centrifuge

3.5THEORY
Protocols for centrifugation typically specify the amount of
acceleration to be applied to the sample, rather than specifying a rotational
speed such as revolutions per minute. The acceleration is often quoted in
multiplesofg,thestandardaccelerationduetogravityattheEarth'ssurface.
Thisdistinctionisimportantbecausetworotorswithdiffer=diatomsrunningat
thesamerotationalspeedwillsubjectsamplestodifferentaccelerations.Since
themotioniscirculartheaccelerationcanbecalculatedastheproductof'be
73,usmid2.tsquareoftheangularvelocity.Traditionallynamed'Relative
centrifugal7.measurementoftheaccelerationappliedtoasamplewithina
centrifuge_77.=unitsofgravity(timesgravityorx"g").

3.6HISTORYANDPREDECESSORS

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English military engineer Benjamin Robins (17071751) invented a
whirlingarmapparatustodeterminedrag.In1864,AntoninPrandtlinvented
thefirstdairycentrifugeinordertoseparatecreamfrommilk.In1879,Gustaf
de Laval demonstrated the first continuous centrifugal separator, making its
commercialapplicationfeasible.
Types

Thereareatleastfivetypesofcentrifuge:

Preparativecentrifuge
Analyticalcentrifuge
Anglefixedcentrifuge
swingheadcentrifuge
haemacroticcentrifuge

Chapter4

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ICUDEPARTMENT

4.1ELECTROCARDIOGRAPH(ModelNo:8108R)
Electrocardiography (ECG or EKG) is the recording of the electrical
activityoftheheartovertimeviaskinelectrodes.Itisanoninvasiverecording
produced by an electrocardiographic device. The etymology of the word is
derivedfromelectro,becauseitisrelatedtoelectricalactivity,cardio,Greekfor
heart,graph,aGreekrootmeaning"towrite".Electricalimpulsesintheheart
originate in the Sino atrial node and travel through the intrinsic conducting
systemtothemuscle.Theimpulsesstimulatethemyocardialmusclefibresto
contract and thus induce systole. The electrical waves can be measured at
selectively placed electrodes (electrical contacts) on the skin. Electrodes on
differentsidesoftheheartmeasuretheactivityofdifferentpartsoftheheart
muscle.AnECGdisplaystheVoltagebetweenpairsoftheseelectrodes,andthe

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muscleactivitythattheymeasure,fromdifferentdirections,alsounderstoodas
vectors.Thisdisplayindicatestheoverallrhythmoftheheartandweaknessesin
differentpartsoftheheartmuscle.Itisthebestwaytomeasureanddiagnose
abnormal rhythms of the heart, particularly abnormal rhythms caused by
damage to the conductive tissue that carries electrical signals, or abnormal
rhythmscausedbylevelsofdissolvedsalts(electrolytes),.suchaspotassium,
thataretoohighorlow.Inmyocardialinfarction(MI),theECGcanidentify
damagedheartmuscle.Butitcanonlyidentifydamagetomuscleincertain
areas, so it can't rule out damage in other areas. The ECG cannot reliably
measure the pumping ability of the heart; for which ultrasoundbased
(echocardiography)ornuclearmedicinetestsareused.

Fig4.1Electrocardiograph

ECGgraphpaper

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TimedinterpretationofanECGwasonceincumbenttoastylusandpaper
speed. Computational analysis now allows considerable study of heart rate
variability. A typical electrocardiograph runs at a paper speed of 25 mm/s,
althoughfasterpaperspeedsareoccasionallyused.EachsmallblockofECG
paperis1mm2.Atapaperspeedof25mm/s,onesmallblockofECGpaper
translatesinto0.04s(or40ms).Fivesmallblocksmakeup1largeblock,
whichtranslatesinto0.20s(or200ms).Hence,thereare5largeblocksper
second.Adiagnosticquality12leadECGiscalibratedat10mm/mV,so1mm
translates into 0.1 mV. A calibration signal should be included with every
record.Astandardsignalof1mVmustmovethestylusvertically1cm,thatis
twolargesquaresonECGpaper.
PlacementofElectrodes
Tenelectrodesareusedfora12leadECG.Theyarelabeledandplaced
onthepatient'sbodyasfollows:
Properplacementofthelimbelectrodes,colorcodedasrecommendedby
theAmericanHealthAssociation.Notethatthelimbelectrodescanbefardown
onthelimbsorclosetothehips/shoulders,buttheymustbeeven(leftvs.right).

4.2DEFIBRILLATOR.(DC2509)
Defibrillation is the definitive treatment for the lifethreatening cardiac
arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia.
Defibrillationconsistsofdeliveringatherapeuticdoseofelectricalenergytothe
affectedheartwithadevicecalledadefibrillator.Thisdepolarizesacritical
massoftheheartmuscle,terminatesthearrhythmia,andallowsnormalsinus
rhythmtobereestablishedbythebody'snaturalpacemaker,inthesinoatrial
nodeoftheheart.

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Defibrillatorscanbeexternal,transvenous,orimplanted,dependingon
thetypeofdeviceusedorneeded.Someexternalunits,knownasautomated
external defibrillators (AEDs), automate the diagnosis of treatable rhythms,
meaningthatlayrespondersorbystandersareabletousethemsuccessfully
withlittle,orinsomecasesnotrainingatall.

Fig4.2defibrillator

HISTORY
Defibrillationwasfirstdemonstratedin1899byPrevostandBatelli,two
physiologists from University of Geneva, Switzerland. They discovered that
small electric shocks could induce ventricular fibrillation in dogs, and that
largerchargeswouldreversethecondition.
Thefirstuseonahumanwasin1947byClaudeBeck,[11professorof
surgeryatCaseWesternResaveUniversity.Beck'stheorywasthatventricular
fibrillationoftenoccurredinheartswhichwerefimdamentallyhealthy,inhis

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terms"Hearttoogoodtodie",andthattheremustbeawayofsavingthem.
Beckfirstusedthetechniquesuccessfullyona14yearoldboywhowasbeing
operated on for a congenital chest defect. The boy's chest was surgically
opened,andmanualcardiacmassagewasundertakenfor45minutesuntilthe
arrivalofthedefibrillator.Beckusedinternalpaddlesoneithersideoftheheart,
alongwithprocainamide,aheartdrug,andachievedreturnofnormalsinus
rhythm.
These early defibrillators used the alternating current from a power
socket;transformedfromthe110240voltsavailableintheline,uptobetween
300and1000volts,totheexposedheartbywayof'paddle'typeelectrodes.The
techniquewasoftenineffectiveinrevertingVFwhilemorphologicalstudies
showeddamagetothecellsoftheheartmusclepostmortem.Thenatureofthe
AC machine with a large transformer also made these units very hard to
transport,andtheytendedtobelargeunitsonwheels.

TYPES
Manualexternaldefibrillator
The units are used in conjunction with (or more often have inbuilt)
electrocardiogram readers, which the healthcare provider uses to diagnose a
cardiaccondition(mostoftenfibrillationortachycardiaalthoughtherearesome
otherrhythmswhichcanbetreatedbydifferentshocks).Thehealthcare

provider will then decide what charge (in joules) to use, based on proven.
guidelinesandexperience,andwilldelivertheshockthroughpaddlesorpads
onthepatient'schest.Astheyrequiredetailedmedicalknowledge,theseunits
aregenerallyonlyfoundinhospitalsandonsomeambulances.Forinstance,
every NHS ambulance in the United Kingdom is equipped with a manual
defibrillatorforusebytheattendingparamedicsandtechnicians.IntheUnited
States,manyadvancedEMTsandallparamedicsaretrainedtorecognizelethal

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arrhythmias and deliver appropriate electrical therapy with a manual
defibrillatorwhenappropriate.
Manualinternaldefibrillator
ThesearethedirectdescendantsoftheworkofBeckandLown.Theyare
virtuallyidenticaltotheexternalversion,exceptthatthechargeisdelivered
through internal paddles in direct contact with the heart. These are almost
exclusivelyfoundinoperatingtheatres,wherethechestislikelytobeopen,or
canbeopenedquicklybyasurgeon.
4.3INFUSIONPUMP
Aninfusionpumpinfusesfluids,medicationornutrientsintoapatient's
circulatorysystem.Itisgenerallyusedintravenously,althoughsubcutaneous,
arterialandepiduralinfusionsareoccasionallyused.

Infusion pumps can administers fluids in ways that would be

impracticallyexpensiveorunreliableifperformedmanuallybynursingstaff.
Forexample,theycanadministeraslittleas0.1mLperhourinjections(too
small for a drip), injections every minute, injections with repeated boluses
requested by the patient, up to maximum number per hour (e.g. in patient
controlledanalgesia),orfluidswhosevolumesvarybythetimeofday.

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FigNo:4.3InfusionPump

Becausetheycanalsoproducequitehighbutcontrolledpressures,they
can inject controlled ammo of fluids subcutaneously (beneath the skin), or
epidurally(justwithinthesurfaceofthe=Indmamasspoonaverypopular
localspinalanesthesiaforchildbirth).

TypesofInfusionTheuserinterfaceofpumpsusuallyrequestsdetailson
thetypeofinbasionfromtheornursethatsetsthemup:

Continuousinfusionusuallyconsistsofsmallpulsesofinfusion,usually
between500nanolitersand10000microliters,dependingonthepump's
design, with the rate of these pulses depending on the programmed
infusionspeed.
Intermittentinfusionhasa"high"infusionrate,alternatingwithalow
programmableinfusionratetokeepthecannulaopen.Thetimingsare
programmable.Thismodeisoftenusedtoadministerantibiotics,orother
drugsthatcanirritateabloodvessel
Patientcontrolledisinfusionondemand,usuallywithapreprogrammed
ceilingtoavoidintoxication.Therateiscontrolledbyapressurepador
buttonthatcanbeactivatedbythepatient.Itisthemethodofchoicefor
patientcontrolledanalgesia(PCA).
Totalparenteralnutritionusuallyrequiresaninfusioncurvesimilarto
normalmealtimes.

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Somepumpsoffermodesinwhichtheamountscanbescaledorcontrolled
based on the time of day. This allows for circadian cycles which may be
requiredforcertaintypesofmedication.

Typesofpump

Therearetwobasicclassesofpumps.Largevolumepumpscanpump
nutrientsolutionslargeenoughtofeedapatient.Smallvolumepumpsinfuse
hormones,suchasinsulin,orothermedicines,suchasopiates.Withinthese
classes,somepumpsaredesignedtobeportable,othersaredesignedtobeused
inahospital,andtherearespecialsystemsforcharityandbattlefielduse.

4.4VENTILATOR
COMPANY:AIRLIQUID
MODEL:EXTENT
amedicalventilatorisamechinedesighnedtomechanicallymovebreathable
air into and out of the lungs,to provide the mechanisum of breathing for a
patientwhoisphysicallyunabletobreathe,orbreathinginsufficiently.while
modemventilatorsarecomputerizedmachines,patientscanbeventilatedwitha
bag valve mask,a simple handoperated machine.after hurricane
katrina,dedicatedstaff"bagged"patientsinneworleanshospitalsfordayswith
simple bag valve units attached to endotracheal tubes,a "ventilator" system
which can be used with no definite time limit.modem ventilators are
electronicallycontrolledbyasystemtoallowexactadaptationofpressureand
flowcharecteristicstoanindividualpatient'sneeds.

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Figno:4.4Ventilator

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Chapter5
RADIOLOGYDEPARTMENT

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5.1COMPUTEDTOMOGRAPHY(newrograph)
Computed tomography (CT) is a medical imaging method employing
tomography. Digital geometry processing is used to generate a three
dimensional image of the inside of an object from a large series of two
dimensional Xrayimages taken arounda single axis of rotation.Theword
"tomography"isderivedfromtheGreektomos(slice)andgraphein(towrite).
Computed tomography was originally known as the "EMI scan" as it was
developedataresearchbranchofEMI,acompanybestknowntodayforits
music and recording business. It was later known as computed axial
tomography(CATorCTscan)andbodysectionrtintgenography.
CTproducesavolumeofdatawhichcanbemanipulated,throughaprocess
knownas"windowing",inordertodemonstratevariousbodilystructuresbased
ontheirabilitytoblocktheXray.Althoughhistoricallytheimagesgenerated
wereintheaxialortransverseplane,orthogonaltothelongaxisofthebody.
modemscannersallowthisvolumeofdatatobereformattedinvariousplanes
or even as volumetric (3D) representations of structures. Although most
commoninmedicine.CTisalsousedinotherfields,suchasnondestructive
materialstesting

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Figno:5.1ComputedTomography

Diagnosticuse
Sinceitsintroductioninthe1970s,CThasbecomeanimportanttoolin
medicalimagingtosupplementXraysandmedicalultrasonography.Although
itisstillquiteexpensive,itisthegoldstandardinthediagnosisofalarge
numberofdifferentdiseaseentities.Ithasmorerecentlybeguntoalsobeused
forpreventivemedicineorscreeningfordisease,forexampleCTcolonography
forpatientswithahighriskofcoloncancer.Althoughanumberofinstitutions
offer fullbody scans for the general population, this practice remains
controversialduetoitslackofprovenbenefit,cost,radiationexposure,andthe
risk of finding 'incidental' abnormalities that may trigger additional
investigations.
Advantagesandhazards
Advantagesovertraditionalradiography
Thereareseveral advantages thatCT hasovertraditional2Dmedical
radiography.First,CTcompletelyeliminatesthesuperimpositionofimagesof
structuresoutsidetheareaofinterest.Second,becauseoftheinherenthigh
contrast resolutionof CT,differencesbetweentissues thatdifferinphysical
densitybylessthan1%canbedistinguished.Finally,datafromasingleCT
imagingprocedureconsistingofeithermultiplecontiguousoronehelicalscan
canbeviewedasimagesintheaxial,coronal,orsagittalplanes,dependingon
thediagnostictask.Thisisreferredtoasmultiplanarreformattedimaging.
CT is regarded as a moderate tohigh radiationdiagnostic technique. While
technical advances have improved radiation efficiency, there has been
simultaneous pressure to obtain higherresolution imaging and use more
complexscantechniques,bothofwhichrequirehigherdosesoflowerdoseto

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thepatient,becausethescreenstaketheXrayinformationandintensifyitso
thatitcanberecordedonfilmpositionednexttotheintensifyingscreen.

ThepartofthepatienttobexrayedisplacedbetweentheXraysource
andtheimagereceptortoproduceashadowoftheinternalstructureofthat
particularpartofthebody.Xraysarepartiallyblocked("attenuated")bydense
tissuessuchasbone,andpassmoreeasilythroughsofttissues.Areaswherethe
Xraysstrikedarkenwhendeveloped,causingbonestoappearlighterthanthe
surroundingsofttissue.Contrastcompoundscontainingbariumoriodine,which
areradiopaque,canbeingestedinthegastrointestinaltract(barium)orinjected
inthearteryorveinstohighlightthesevessels.Thecontrastcompoundshave
highatomicnumberedelementsinthemthat(likebone)essentiallyblocktheX
raysandhencetheonceholloworganorvesselcanbemorereadilyseen.Inthe
pursuit of anontoxiccontrast material,manytypesofhighatomicnumber
elements were evaluated. For example, the first time the forefathers used
contrastitwaschalk,andwasusedonacadaver'svessels.Unfortunately,some
elementschosenprovedtobeharmfulforexample,thoriumwasonceused
asacontrastmedium(Thorotrast)whichturnedouttobetoxicinsomecases
(causinginjuryandoccasionallydeathfromtheeffectsofthoriumpoisoning).
Moderncontrastmaterialhasimproved,andwhilethereisnowaytodetermine
who may have a sensitivity to the contrast, the incidence of "allergictype
reactions"arelow.(Theriskiscomparabletothatassociatedwithpenicillin.

5.2MRI
ComputedTomographyversusMRIsiemenns2.2ft)Seetheentriesor
paragraphsofthesamenameintheMRIand2DFTNMRIandSpectroscopy

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articles. The basic mathematics of the 2DFourier transform in CT
reconstruction is very similar to the 2DFT NMRI, but the computer data
processinginCTdoesdifferindetail,asforexampleinthecaseofthevolume
renderingortheartifactseliminationalgorithmsthatarespecifictoCT.

Figno:5.1MRI
Process
XrayslicedataisgeneratedusinganXraysourcethatrotatesaroundthe
object;Xraysensorsarepositionedontheoppositesideofthecirclefromthe
Xray source. The earliest sensors were scintillation detectors, with
photomultiplier tubes excited by (typically) cesium iodide crystals. Cesium
iodide was replaced during the eighties by ion chambers containing high
pressure Xenon gas. These systems were in turn replaced by scintillation
systems based on photo diodes instead of photomultipliers and modern
scintillationmaterialswithmoredesirablecharacteristics.Manydatascansare
progressivelytakenastheobjectisgraduallypassedthroughthegantry.They

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arecombinedtogetherbythemathematicalproceduresknownastomographic
reconstruction.Thedataarearrangedinamatrixinmemory,andeachdata
pointisconvolvedwithitsneighboursaccordingwithaseedalgorithmusing
FastFourierTransformtechniques.Thisdramaticallyincreasestheresolutionof
each Voxel (volume element). Then a process known as Back Projection
essentiallyreversestheacquisitiongeometryandstorestheresultinanother

memoryarray.Thisdatacanthenbedisplayed,photographed,orusedasinput
forfurtherprocessing,suchasmultiplanarreconstruction.
Newer machines with faster computer systems and newer software
strategies can process not only individual cross sections but continuously
changingcrosssectionsasthegantry,withtheobjecttobeimaged,isslowly
andsmoothlyslidthroughtheXraycircle.ThesearecalledhelicalorspiralCT
machines.Theircomputersystemsintegratethedataofthemovingindividual
slicestogeneratethreedimensionalvolumetricinformation(3DCTscan),in
turnviewablefrommultipledifferentperspectivesonattachedCTworkstation
monitors.
5.3ULTRASOUNDSCANNING
Ultrasoundis cyclicsound pressure withafrequencygreater than the
upperlimitofhumanhearing.Althoughthislimitvariesfrompersontoperson;
itisapproximately20kilohertzinhealthy,youngadultsandthus,20kHzserves
asausefullowerlimitindescribingultrasound.Theproductionofultrasoundis
usedinmanydifferentfields,typicallytopenetrateamediumandmeasurethe
reflection signature or supply focused energy. The reflection signature can
revealdetailsabouttheinnerstructureofthemedium.Themostwellknown
applicationofthistechniqueisitsuseinsonographytoproducepicturesof

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fetusesinthehumanwomb.Thereareavastnumberofotherapplicationsas
well.

Figno:5.2UltrasoundScanning

Medicalsonography(ultrasonography)isanultrasoundbaseddiagnostic
medical imaging technique used to visualize muscles, tendons, and many
internalorgans,theirsize,structureandanypathologicallesionswithrealtime
tomographic images. It is also used to visualize a fetus during routine and
emergency prenatal care. Ultrasound scans are performedby medical health
careprofessionalscalledsonographers.Obstetricsonographyiscommonlyused
.duringpregnancy.Ultrasoundhasbeenusedtoimagethehumanbodyforat
least50years.Itisoneofthemostwidelyuseddiagnostictoolsinmodern
medicine. The technology is relatively inexpensive and portable, especially
whencomparedwithmodalitiessuchasmagneticresonanceimaging(MRI)and
computedtomography(CT).Ascurrentlyappliedinthemedicalenvironment,
ultrasound poses no known risks to the patient.r51 Sonography is generally
described as a "safe test" because it does not use ionizing radiation, which
imposeshazards,suchparrproductionandchromosomebreakage.However,
ultrasonic energy has two potential pksioloehml effects: it enhances
inflammatory response; and it can heat soft tissue. [7] Ultrasound energy
producesamechanicalpressurewavethroughsofttissue.Thispressurewave
may cause microscopic bubbles in living tissues, and distortion of the cell

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membrane,influencingionfluxesandintracellularactivity.Whenultrasound
entersthebody,itcausesmolecularfrictionandheatsthetissuesslightly.This
effect is very minor as normal tissue perfusion dissipates heat. With high
intensity,itcanalsocausesmallpocketsofgasinbodyfluidsortissuesto
expandandcontract/collapseinaphenomenoncalledcavitation.Thelongterm
effectsoftissueheatingandcavitationhaveshowndecreaseinsizeofredblood
cells in cattle when exposed to intensity higher than diagnostic levels?'
However,longtermeffectsduetoultrasoundexposureatdiagnosticintensityis
notknown?'Thereareseveralstudiesthatindicatetheharmfulsideeffectson
animalfetusesassociated withtheuseofsonographyonpregnantmammals
Obstetric ultrasound canbeused toidentifymanyconditions thatwouldbe
harmful to the mother and the baby. For this reason many health care
professionalsconsiderthattheriskofleavingtheseconditionsundiagnosedis
muchgreaterthantheverysmallrisk,ifany,associatedwithundergoingthe
scan.AccordingtoCochranereview,routineultrasoundinearlypregnancy(less
than 24 weeks) appears to enable better gestational age assessment, earlier
detectionofmultiplepregnanciesandearlierdetectionofclinicallyunsuspected
fetal malformation at a time when termination of pregnancy is
possible.f131Sonography is used routinely in obstetric appointments during
pregnancy,buttheFDAdiscouragesitsusefornonmedicalpurposessuchas
fetalkeepsakevideosandphotos,eventhoughitisthesametechnologyusedin
hospitals.

5.3XRAYMECHINE

company:genaralelectronics
model:wipro
theheartofanxraygenaratoristhexraytube.likeanyvaccumtube

Dept.ofMedicalElectronics 28 AWHPTC
HospitalTrainingReport2015

thexraytubecontainsacathode,whichdirectsasteamofelectrons
intoavaccum,andananode,whichcollectstheelectronsandismade
ofcoppertoevacuatetheheatgeneratedbythecollision.whenthe
electronscollidethetarget,about1%ofresultingenergyisemittedas
xrays,with the remaining 99% released as heat.due to the high
energy of the electrons that reach relaivistic speeds the target is
usually made of tungsten even if other meterial can be used
particularlyinXRFapplications.acoolingsystemisnecessarytocool
theanode;manyxraygenaratorsusewateroroilcirculatingsystems.

Figno:5.3Xraymachine

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6.CONCLUSION

Inthishospitalvisitwestudiedthediffrentmedicalequipments
andtherefu(pariyarammedicalcollege)isaNABHaccredited650
bed super speciality hospital located in kannur. it gives a another
experienceoftraining.

Dept.ofMedicalElectronics 30 AWHPTC