DIAGNOSTIC EQUIPMENT

norm ally supplied w ith the instrum ent. O n the side, there m ay be a small tubing
connector, w hich is used for inflation. It is im portant that the head is airtight.
C heck this b y assem bling the instrum ent com plete w ith the tubing conn ector and
inflation bulb (e.g., from a b loo d pressure machine). W ith a finger over the end of
the speculum, g en tly squeeze the bulb. There should be no obvious leaks. If there
are, check as follow s:

• Check that the speculum fits properly and that it is n ot cracked.

• Check that the tubing nipple is screwed in properly.
• Check that the rear lens fits properly; it m ay be that the lens is cracked or
missing. If so, replacem ent will be necessary. If a spare lens is n ot available, use
a thin piece of glass; shape it on a slow, w ater-lubricated grindstone to fit, and
then glue it into place. A lthough the lens effect will be lost, the instrum ent will
still be usable. D o n o t shape the glass on a high-speed grinder, because it m ay
crack.

If there is no light:

• Check the bulb.

• Check the batteries and the handle as described fo r ophthalm oscopes.
• Check, w ith a m eter, for continuity betw een the b attery contact and the bulb
contact. Use a needle connected to the m eter probe to m ake contact w ith the
bulb contact.

Laryngoscopes
A laryngoscop e (Fig. 3.2) is used to exam ine the pharynx and larynx, and aids the
passing o f an endotracheal tube into the trachea. It consists o f a handle which
contains the batteries, and a blade w hich has a light bulb. T h e bulb lights up
w hen the blade is opened up and locked into position for use. T he blades are
available in different shapes and sizes to suit different needs, e.g., for use on adults
or children. T h e m ost com m on problem is that the bulb fails to light or ju st flickers.
T o determ ine the cause o f the problem :

• Check that the bulb is screwed in tightly, and that it is a goo d one.
• Check that the batteries have pow er and that the contacts are clean.

Fig. 3.2. Laryngoscope.

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MAINTENANCE AND REPAIR OF LABORATORY AND HOSPITAL EQUIPMENT

• Clean dirty contacts w ith sandpaper. T h e spring at the b o tto m o f the handle
often becom es corroded; this m ay be the cause o f the bulb n o t lighting.

If the laryngoscop e still does n ot work, inspect the contact b etw een the blade and
the handle. There is a lead contact, or a stainless steel pin, on the blade, and a brass
spring con tact pin in the handle. Long use can w ear aw ay the lead contacts; if this
is the fault, take a soldering iron and reform the lump into a round shape. If the
instrum ent still does n o t function, check the brass pin. Ensure that it m oves in and
ou t correctly, and that it is clean b o th inside and outside the handle. Install goo d
batteries in the handle, replace the bottom , and check w ith a m eter that there is a
vo ltag e at the pin contact.

If the pin is faulty, unscrew the con tact and its insulating sleeve w ith a long, flat-
bladed screwdriver. T h e sleeve m ay be made o f n ylon or tufnol (which looks like
w ood, but is, in fact, cloth and resin). Repair the dam aged contact as required. If the
laryngoscop e still does n o t function, check (using a m ultim eter) the continuity
b etw een the contact pin at the end o f the blade and the b od y o f the blade. This
checks the bulb, the contact pin, and the wire b etw een them. If there is no reading,
the problem must lie w ith the wire, the bulb contact, or the conn ection o f the wire
to the contact at the base o f the blade. Check the wire b y clipping one m ultim eter
probe to a fine piece o f wire or a needle, and the other probe to the contact at the
end o f the blade. Carefully introduce the needle into the bulb screw hole so that it
touches the bulb contact and n ot the blade, and check continuity. If there is no
continuity there is a problem w ith the wire. It is possible that it is broken or has
becom e unsoldered. It m ay be that the contact that touches the bulb has m oved
to o far back into the holder and is n o t touching the bulb. In either case, it will be
necessary to rem ove the contact and wire and adjust or replace as appropriate.

Proceed as follow s:

1. U nsolder the wire at the lead lump end, or pull out the steel pin.
2. Grasp the contact that the bulb touches, and pull the wire through and out of
the blade. Take care n ot to lose the spring and insulating tube behind the bulb
contact.
3. U nscrew the lead contact, w hich is in an insulating threaded insert (made o f
n ylon or tufnol). T elephone wire m ay be used for rewiring.
4. U nsolder the bulb con tact from the faulty piece o f wire, and solder it on to the
new wire, making sure that the wire is long enough to pass back through the
blade.
5. Feed the wire through the blade from the bulb end. It has to pass around a sharp
bend, w hich m ay be difficult.
6. Cut back the insulation to ju st below where the threaded bush will end when
screw ed in place.
7. Screw in the threaded bush, w ith the bare end o f wire passing through the hole.
(It m ay b e necessary to re-drill this hole.)
8. R e-solder the wire in place, and sm ooth the end. If it is a pin type, do n o t solder,
but wrap the wire around the pin.

If the batteries have corroded in the handle to such an e xten t that it is n o t possible
to rem ove them in the usual way, use the m ethod described for ophthalm oscopes
and otoscop es (page 6 4 ).

C heck the blade for peeling chrom e. This can be sharp. Scrape back to the sm ooth
chrom e, sand the rough edges to obtain a sm ooth finish, and polish.

The new er types o f laryngoscop e use optical fibres in the blade. T h e bulb is in the
handle and the blade has a bundle o f optical fibres to transm it the light to the tip.
T h e blades norm ally g ive no trouble, but the handle m ay g ive rise to the problem s
described above.

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