Preventive Maintenance is a broad concept, its the process at issue entails a multitude of tasks ranging from very simple

to highly complex, it can be difficult to compress them all into a general description Maintaining the manufacturing equipment and plant utility systems equipment : to rigorously and preparing all equipment to start up and run without any unnecessary shutdowns in top condition in the aim of producing quality products while the machinery is in service Having all PM and PDM tasks completed based on a strict schedule without going over the Point of Diminishing Returns on Investment for the labor, equipment and materials and resources needed to carry out the work.

This method of approach is very exact and doesnt leave room for carelessness. Although there are numerous variables to take into account, if properly delineated, implemented and run.
The Predictive and Preventive maintenance system will help to ensure consistent, predictable and measurable performance from all equipments, machines and connected processes in your production line.

Defibrillation is a common treatment for life-threatening cardiac, dysrhythmias, ventricular fibrillation ,and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator.

This depolarizes a critical mass of the heart muscle, terminates the dysrhythmias , and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.

Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no training at all.

 Manual external defibrillator

The units are used in conjunction with (or more often have inbuilt) electrocardiogram readers, which the healthcare provider uses to diagnose a cardiac condition (most often fibrillation or tachycardia although there are some other rhythms which can be treated by different shocks) The healthcare provider will then decide what charge (in joules) to use, based on proven guidelines and experience, and will deliver the shock through paddles or pads on the patient's chest. As they require detailed medical knowledge, these units are generally only found in hospitals and on some ambulances.

Manual internal defibrillator

These are the direct descendants of the work of Beck and Lawn . They are virtually identical to the external version, except that the charge is delivered through internal paddles in direct contact with the heart. These are almost exclusively found in operating theatres (rooms), where the chest is likely to be open, or can be opened quickly by a surgeon.

 Automated external defibrillator (AED)

These simple-to-use units are based on computer technology which is designed to analyze the heart rhythm itself, and then advise the user whether a shock is required. They are designed to be used by lay persons, who require little training to operate them correctly. They are usually limited in their interventions to delivering high joule shocks for VF (ventricular fibrillation) and VT (ventricular tachycardia) rhythms, making them generally of limited use to health professionals, who could diagnose and treat a wider range of problems with a manual or semi-automatic unit.
2 TYPES OF AEDS: Fully Automated. A fully automated AED automatically diagnoses the heart rhythm and advises the user to stand back while the shock is automatically given. Also, some types of AEDs come with advanced features, such as a manual override or an ECG display.

Semi Automated. Most AEDs are semi automated. A semi automated AED automatically diagnoses heart rhythms and determines if a shock is necessary. If a shock is advised, the user must then push a button to administer the shock

What to Do When a Pacemaker Defibrillator Goes Off Purpose

Defibrillation is performed to correct life-threatening arrhythmias of the heart including ventricular fibrillation and cardiac arrest. To be effective, this procedure should be performed immediately after a patient experiences an irregular or deficient rhythm of the heart, which may be indicated by lack of pulse and response. The defibrillator resets the electrical activity of the heart allowing it to regain control of the rhythm.

Pulse/Paddles
Defibrillation should not be performed on anyone who has a pulse or is alert. This could result in a fatal heart rhythm disorder or cardiac arrest. Defibrillation paddles should not be placed directly on a victim's chest or over an internal pacemaker. Proper placement should be on the patient's lower left and upper right sides or lower right and upper left sides of the chest.

 Visual Check The patient's chest needs to be free of nitroglycerine patches or any other medical patches or materials that may cause explosion when in contact with the defibrillator. The victim should not be lying on a conductive surface such as metal bleachers or sheet metal that may transmit shock to individuals in close proximity. Defibrillation should never taken place if close to flammable supplies such as gasoline or open oxygen.

 Touching the Patient No one should touch the patient during defibrillation since this could result in someone receiving an electrical shock. Also, coming in contact with the individual while the defibrillator performs its analysis will result in inaccurate readings and prompts from the machine Cell Phones/Portable Radios o All cell phones and portable radios should be kept at least six feet from the patient and the defibrillator. o These devices may also influence the machine's analysis resulting in inaccurate results and prompts.

Clean the exterior and interior Lubricate and clean fan assembly if required Calibrate if needed Replace filter and battery if needed based on Scheduled Parts Replacement Policies Replace battery if charge time and maximum energy test fails or if batterys life is 2 years or older. It is also recommended that a record of battery replacements be kept, so that technicians can have an idea of when the equipment may need a new battery, so it can replaced promptly.

a. Grounding Resistance: - Using an ohmmeter, electrical safety analyzer, or multimeter with good resolution of fractional ohms, - measure and record the resistance between the grounding pin of the power cord - exposed (unpainted and not anodized) metal on the chassis. - We recommend a maximum of 0.5 Ohms.

b. Leakage Current : - Measure chassis leakage current to ground with the grounding conductor of plug-connected equipment temporarily opened. - Operate the device in all normal modes, including on, standby, and off, and record the maxi- mum leakage current. - Chassis leakage current to ground should not exceed 300A.

This test consists of 18 tests which are:

Chassis/Housing Mount Casters/Brakes AC Plug

Line Cord

Strain Reliefs

Circuit Breaker/Fuse

Cables

Fittings/Connectors

Paddles/Electrodes

Controls/Switches

Battery/Charger

Indicators/Displays

Audible Signals

Labeling

Accessories (gel, pads, or electrodes)

Internal Discharge of Stored Energy

Synchronizer

Consists of 7 assessment:
Grounding Resistance Chassis Leakage Current

Paddle Continuity

Energy After 60 Sec

Internal Paddle Energy Limit

Output Energy

Charge Time and Max Energy (10th Charge)

Many incidents have been reported involving failure of the defibrillator of batterypowered defibrillator/monitors to discharge during cardiac emergency responses

The discharge failure occurred during open-heart surgery when internal defibrillator paddles were needed to restore the heart to normal rhythm

incidents involved battery-powered units, unexpected failure of any type of defibrillator to discharge places additional stress on the members of the advanced life-support team.

requires the immediate availability and use of a backup unit to resume and complete the resuscitation attempt

delay could increase the risk of irreversible injury or death.

 Discharge failures mostly were due to user error Examples: fluids spilled into

the unit
inadequate knowledge of proper device operation
Incorrect placement of the defibrillator chassis into its charger base

Examples:
loose internal defibrillator paddle cable connector

dirty paddles

poor preventive maintenance

Examples:

inconsistent operational checks by clinical users

poor or delayed reporting of operational problems to clinical engineering or other service personnel

Users need to report difficulties in using their devices so that units can be made simpler, safer, and more reliable.

Manufacturers are usually responsive to user feedback and often redesign or modify poorly functioning units.

FREQUENT USER CHECKS; Quick visual inspections - at least daily and after each use of the device to ensure that units are available and ready for use; all necessary supplies should be accessible and in good condition. Confirm once a week that the defibrillator is functioning by setting it at a low energy (e.g., 50 J) and then firing the external paddles into a test load provided with the unit or into a defibrillator analyzer.

training and retraining of advanced lifesupport teams and other clinical personnel in the proper operation, inspection, and maintenance of defibrillators and defibrillator/monitors