CHAPTER VII

THE DEVELOPMENT, CONCEPT

AND USE OF MEDICAL
EQUIPMENT AS SCIENCE AND
TECHNOLOGY ADVANCES
Introduction
In the history of Physics by period that is from Experimental
Physics (1550-1880) to Classical Physics (1880-1900) to
Modern Physics (1900 to date) there were several
experiments, studies and discoveries made by brilliant men
and women that evolved and generate very important results
and considerable impact for the benefit of the human race.
From all the scientific discoveries and technological
milestones, medical and health care were greatly enhanced
due to the development of equipment, processes and
techniques in medical diagnostics and analysis leading to more
effective treatment and ultimately the improvement and
prolonging of human life.
Introduction
• Before the 19th century, medical technology was a small specialized
world. Doctors in the 1800s were solely dependent on their thinking and
knowledge and that any instrument they possessed would have been
fabricated by local blacksmith.
• The 20th century experienced rapid and revolutionary changes in world
of technology. There was the introduction of anaesthesia , bacteriology,
biochemistry and radiology. Physicians during this period began utilizing
laboratory facilities and radiology sections.
Self awareness as a consequence of improved education and organized
health strategies have driven people to take a more proactive and
preventive stance with regards to health and sanitation. Emphasis were
directed at educational campaigns to recognize health related risks
focusing on diets & lifestyles, disease prevention, early diagnosis and
treatment thus ensuring a healthy population as well as increasing
survival rates for people suffering from dreaded disease.
Acupuncture
This is an ancient therapeutic
technique developed by Chinese to
produce analgesia or altering the
function of the body system.
Needles with length of 0.5 to 5
inches are placed in a specific sites
on the body along a series of lines,
or channels called meridians.
Acupuncture is very effective in
treating both acute and chronic pain
associated with multiple causes. In
addition, common conditions are
effectively treated, including
sinusitis, tinnitus, sore throat, high
blood pressure, gastroesophageal
reflux, allergies, hyperacidity and
peptic ulcer disease, constipation,
diarrhea, spastic colon, urinary
incontinence, bladder and kidney
infection, premenstrual syndrome,
infertility, dysmenorrhea, memory
problems, sensory disturbances,
depression and anxiety.
Air beds
Indicated to patients who have
pressure sore or patients at risk of
having pressure sore because of long
time confinement to bed. It is
inevitable that having pressure sore
would make the condition of the
patient worse and slow down the
recovery of from first hospitalization.,
as there is a secondary treatment
needed.

The idea of Air beds is to reduce the

need of turning schedule as this is
done to some degree automatically.
The mattress is constructed of cells
that are alternately inflated. This is
done by a compressor with 2 outputs
that alternate between each other.
The compressor can sense leak and
sounds alarm. There is a quick
release CPR plug to deflate the
mattress in case of an emergency
where the patient needs to be
resuscitated.
Ambulatory ECG
recorder
Used to record the electrical
activity of the myocardium to detect
the transmission of the cardiac
impulses through the conductive
tissues of the muscle of the heart.

The ambulatory ECG recorder is

about the size of a personal CD
player and is worn as belt or
strapped to the patient. It has
electrodes that are attached to the
chest and this picks up ECG
signals. This is then recorded in a
cassette tape which runs for 24 hrs
recording. The tape is then rapidly
analyzed by a machine that stops
when it detects any abnormalities
in the recording. The technician
who controls the playback machine
makes notes to report to the
physician.
Anaesthetics
In the mid 19th Century anaesthetics ether, chloroform and
nitrous oxide were first used in Europe and America as
pain relief during operations.
Anaesthetic drugs acts on the membranes of nerve cells
and disrupts the transmission of electrical impulses to
CNS which causes the numbness sensation.
Local Anaesthetic blocks electrical
nerve transmission in the site where it is
administered usually via injection
Regional Anaesthesia. The anaesthetic
is introduced to large nerves or to an
area of the spinal cord that would supply
a large area of the body.
General Anaesthetics an initial injection
that quickly dissolves into the nerve cells
of the CNS and causing
unconsciousness
Anaesthetic trolley found in the operating
theatre. It uses different gases and
vapors. Sometimes these machines
incorporate a ventilator and patient
monitoring equipment
Apnea Alarm
Often for neonates and pediatric use,
an apnea monitor detects breathing
with a straining gauge affixed to the
chest to detect the expansion or
electrodes that measures the change
in impedance as the chest moves.

The device sounds an alarm if no

breath is detected after a preset time.
The alarm which is usually quite loud
may actually startle the infant into
breathing again.
An apnea alarm is “loaned” to a parent
of a child by the clinician that may
suspect breathing difficulties.
An apnea alarm is also found in
operating theatre in conjunction with
ventilator which monitor the breathing
of the unconscious patient. The alarm
would alert anaestheticist of a problem
with the breathing circuit or patient.
Autoclave
Used to sterilize medical
instruments or other objects
with steam under pressure.
Surgical equipments are
usually wrapped in a porous
material and sealed with
indicating tape before being
placed in the oven.
The air inside the oven is
evacuated before the high
pressure steam is admitted.
Because the steam is under
pressure it can get to very high
temperature that would be pre-
set on the front panel.
Baby Warmer
Indicated for babies who needs
to be kept warm because they
cannot control their body
temperature as an adult can.
 Blood Pressure
Apparatus
•1st recorded measuring of blood pressure
was when Reverend Steven Hales applied a
cannula in the neck of a horse in 1730. He
measured the blood in a glass tube to be
over 8ft. above the heart.
•In the late 1800s an Italian Riva-Rocci used
a sphygmomanometer to find the systolic
pressure. The idea of listening to the
brachial artery to hear the pulsatile sounds
was noted by a Russian surgeon named
Nicholai Korotkoff. The korotkoff sounds
give indications to the systolic the point
where the pressure in the cuff occludes the
brachial artery and stops blood from passing
through.
Blood pressure is usually measured by the
physician during a diagnosis. The advent of
automated devices now measure blood
pressure automatically and indicate systole
and diastole. These units show Mean
Pressure. The Mean Pressure is not the
average of systolic and diastolic, but the
mean pressure within the arteries during
cardiac cycles
Breast Pump
Used to withdraw milk from the
breast for bottle feeding. A
breast pump causes a low,
adjustable suction and with the
aid of suction cup, the milk is
withdrawn off and is placed
into a container.

The milk can then be used to

feed the baby with use of
bottle.
Cautery machine
A device used in coagulation of
tissue by heat. It is often an
adjustable direct current (DC)
output power supply with leads
attached to a hand piece that
holds a thin wire loop.
As the current passes, the wire is
heated rapidly. The heat of the wire
is controlled by adjustable current,
the heat dissipated through the
tissue causes coagulation and that
can be used to stop bleeding or for
cutting tissue.

The wire loop is self sterilizing as

the heat passes through the wire to
be at very high temperature.
Computerized Axial
Tomography (CT or
CAT Scan)
A radiographic technique that
produces an image of a detailed
cross section tissue which is used
for diagnosis. The procedure was
developed by the British scientist
Godfrey Hounsfield who
constructed the 1 scanner in early
st

1970s.
The patient lies between an X-ray
and an array of detectors, which
receives different amounts of
radiation according too the density
of tissue scanned. The source and
detector array are rotated around
the patient and the data is analyzed
by a computer and presented as
graphic image of the “slice”.
Tomography is a sectional X-ray,
As radiation is of lower power the
patient doesn’t receive large doses
of X-rays.
Carbon Dioxide
Monitoring Machine
Used during anaesthesia. Many potentially
dangerous situations can be detected
using CO2.
The anaesthetic gas breathed by the
patient is continuously sampled by the
device that passes the sample past an
infra-red light source. The absorption of
the light is detected and the results are
displayed in a wave form and percentage
concentration.
The wave form displayed clearly shows
the breathing pattern. The 1st gas exhaled
contains CO2 because this gas has been
in the dead space (neck, mouth, and
facemask) and not in the alveoli therefore
no gas exchange has taken place.
Eventually, during exhalation the gas is
purely from the alveoli and this measured
as “End Tidal CO2 or ETCO2
On inspiration, the minimum level of CO2
is detected (0.096) and this is inspired
CO2.
Cryosurgery Device
A device that uses a gas, typically
CO2 that is fed from pressure
reducing regulator to a hand held
pistol grip with a trigger, attached to
the hand piece in a metal tip.
When the trigger is operated, the
metal tip is rapidly taken to a very
cold temperature, below freezing.
Used in Operating theatre, special
clinics and chiropody, the metal tip
is rapidly cooled on contact with
skin. The freezing action causes the
tissue to die and the surrounding
area coagulated.

Cryosurgery use of subfreezing

temperature to destroy tissue.
Performed in treatment of
Parkinson’s disease, destruction of
the pituitary gland to halt the
progress of some kind of metastatic
cancer and lesions of the skin.
Defibrillator
Used when the heart goes into
fibrillation. In fibrillation the
heart is pumping ineffectively
and is more of a spasm.
It was found that a “short, sharp
shock” could bring the heart out
of fibrillation and bring it back
into normal routine. Fibrillation
could be caused by heart
disease or an electric shock and
can cause death within a few
minutes.
Thee fibrillation signal is rigidly
oscillating wavy trace that can
be monitored using ECG.
Dental Equipments
Drill: works from compressed
air or an electric motor.
Suction: used to remove debris
from the mouth.
Compressed Air: used to look
for cavities and sometimes to
remove debris.
Light source: used to get a
clear view of the mouth.
Dental Chair: it has electric
motors to enable the dentist to
get the patient into the ideal
position.
Dialysis Machine
Use to remove small unwanted
molecules from the patient’s
blood if the kidney’s have
failed.
Dialysis is the process
whereby crystalloid and colloid
substances are separated from
a solution by interposing a
semi permeable membrane
between the solution and pure
water.
Diathermy machine
These machines are high
frequency generators that are used
by surgeons during operations, to
cut and coagulate tissue. They
often incorporate suction and light
source.
There are usually 3 modes to a
diathermy, each with individual
power controls: “cut”, “Coag” and
“Bipolar” & there is a color coding;
yellow, blue and white/black
respectively for the control pedals.

Diathermy is the production of heat

in body tissues for therapeutic
purposes by a high frequency
current that are insufficient intense
to destroy tissues or to impair their
vitality. It is used in treating chronic
arthritis, bursitis, fractures,
gynecologic diseases, sinusitis and
other conditions.
Doppler
Johann Christian Doppler (1805-
1853) 1st put forward the principle of
the phenomenon we now know
today as the Doppler effect.
An ultrasound penetrates tissue,
the sound is absorbed or reflected.
The strength of the echo depends
on the density of the tissue. The
result are displayed on a monitor
where the intensity of the echo is
shown in grey scales or color.
Alternatively, the results of the
echo are amplified to a loud
speaker where one can hear the
pulsation’s of blood flow or fetal
heart.
Electrocardiography
Machine
Einthoven gave an alphabetical
lettering to the ECG
(electrocardiograph) wave form
because he did not know the
origins and did not wish to
suggest interpretation by his
labeling.
Electrocardiograph is a device
used to record the electrical
activity of the myocardium to
detect the transmission of the
cardiac impulses through the
conductive tissues of the
muscle of the heart.
ECG allows diagnosis of
specific cardiac abnormalities.
Electroencephalography
Machine
1st used by Berger (1924) an EEG
is a machine that detects and
records electrical activity in the
brain. It does this by measuring
potential differences (voltages)
between electrodes placed on the
scalp.
During the procedure the patient
remains quiet, with eyes closed,
and refrain from talking or moving;
in certain cases prescribed
activities, especially
hyperventilation, may be
requested.
The test is used to diagnose
seizure disorders, brain stem
disorders, focal lesions, and
impaired consciousness.
Endoscope
An illuminated optic instrument
for the visualization of the
interior of a body cavity or
organ.
The endoscope is inserted
through natural orifice or small
incisions and light guided
down along with specially
designed surgical instruments.
Endoscopes now incorporates
cameras and pictures can now
be displayed on a video
screen.
Ultrasound
The fetal heart can be
monitored using ultrasound
probes attached to the
mother’s abdomen while in
labor.
Pulsations of the fetal heart are
heard through a loud speaker
and the fetal heart rate is
displayed digitally. Also, the
heart rate is printed on a graph
over time to show any
variation.
Additionally, these devices
incorporate transducers
measure the contraction with
the use of a strain gauge also
attached to the abdomen.
Hearing Aids
An electronic device that
amplifies sound used by
people with impaired hearing.
The device consists of a
microphone, a battery power
supply, amplifier and a
receiver.
Some telephones are hearing
aid compatible, which means
that you can switch your
hearing aid to “t” and the sound
is amplified while background
music is cut.
Heart Lung Machine
An apparatus consisting of a
pump and an oxygenator that
takes over the functions of the
heart and lungs, especially
during open heart surgery. The
blood is shunted from the
venous system through an
oxygenator and returned to the
arterial circulation.
The machine was 1st used by
Gibbon in 1953.
Humidifier
A machine designed to adjust
the amount of moisture in the
atmosphere of a room or
respirator device.
It is also used when the patient
is anestheticized or during
ventilation to enrich the gases
with water vapor because the
gases used are too dry.
Hyperbaric chamber
An airtight chamber containing an
oxygen atmosphere under high
pressure. A patient may be placed
in the chamber for the treatment of
certain infections, tumors,
cardiovascular diseases in which
atmospheric oxygen pressures up
to three times normal may have
therapeutic value.
Originally pressurized vessels
were developed to combat
decompression sickness suffered
by deep sea divers. It was later
discovered that an oxygen rich
atmosphere within the vessel aided
the application of oxygen therapy
and accelerated the healing of
wounds.
Incubator
An apparatus used to provide a
controlled environment ,
especially temperature. The
incubator has an electrical
heating element that controlled
by thermostats. There is a fan
that circulates the heat to get
an even distribution.
Most incubators incorporate
oxygen so that specified
oxygen concentration can be
set. Incubators alarm at over
temperature, fan fail, main
failure and oxygen over/under
concentration.
Infusion Device
Mechanical pumps used to
administer liquid drugs in vitro
from a fluid filled bag via a
giving set.
Flow rate & volume infused
can be pre set as can
sometimes the maximum
pressure in the line.
The most common form of
infusion pump uses a
peristaltic mechanism to drive
the fluid through the line. A
drop sensor connected to the
device and attached to the drip
bag counts the drops and
checks for loss of flow or over
infusion.
Insufflator
A device that inflates the abdomen
so that laparoscopes can move
more easily around the organs.
H. Fragenheim introduced a
prototype automatic insufflators in
the 1950s.

A cannula is passed through the

skin into the peritoneum and is
connected to the Insufflator. The
inflation is called a
“pneumoperitoneum”, carbon
dioxide being the most common
gas used.

The gas flow is controlled between

1Li/min & and 10 Li/min at a
pressure of approximately
15mmHg.
Iron Lung device
The iron lung was used in
the treatment of respiratory
disease, paralysis and in
anaesthesia but most
excessively during the
poliomyelitis epidemics of
the 1930s and 1950s.
The iron lung is a device
that provides artificial
respiration by mechanical
means.
Laparoscope
A type of endoscope
consisting of an illuminated
tube with an optical system. It
is inserted through the
abdominal cavity for examining
the peritoneal cavity.
A urethroscope was designed
and built by Segalas of France
in 1826. He used an
introductory cannula and mirror
for light. Kalk of Germany has
dubbed “Father of
Laparoscopy”. He wrote paper
on the subject from 1929 to
1959 and he devised a for
oblique viewing system for use
on his work on liver and
gallbladder disease. It is his
methods that have been widely
adopted and are in use today.