INTRODUCTION :

Biomedical engineering is the study of medical equipment used in an environment of

care or training and how this equipment interfaces with the human body. Biomedical
engineers design, test, modify, recommend modification of, and evaluate all medical
equipment used to interface or interact with the human body. In addition to these
functions, clinical engineers usually supervise the biomedical equipment maintenance
function within an environment of care.
Biomedical engineering (BME) is the application of engineering principles and design
concepts to medicine and biology for healthcare purposes (e.g. diagnostic or therapeutic).
This field seeks to close the gap between engineering and medicine: It combines the
design and problem solving skills of engineering with medical and biological sciences to
advance healthcare treatment, including diagnosis, monitoring, and therapy. It includes
the acquisition of new knowledge and understanding of living systems through the
innovative and substantive application of experimental and analytical techniques based on
the engineering sciences.
The development of new devices, algorithms, processes and systems that advance
biology and medicine and improve medical practice and health care deliver. The use of
engineering technology, instrumentation and methods to solve medical problems, such as
improving our understanding of physiology and the manufacture of artificial limbs and
organs.


Medical equipment :
Medical equipment (also known as armamentarium) is designed to aid in
the diagnosis, monitoring or treatment of medical conditions The medical devices include
man-made hands, arms, and legs to replace lost ones and, also, Dialysis machines which
clean the blood of a person with damaged kidneys.
A medical device is an instrument, apparatus, implant, in vitro reagent, or similar or
related article that is used to diagnose, prevent, or treat disease or other conditions, and
does not achieve its purposes through chemical action within or on the body (which would
make it a drug). Whereas medicinal products (also called pharmaceuticals) achieve their
principal action by pharmacological, metabolic or immunological means, medical devices
act by other means like physical, mechanical, or thermal means.
Medical equipment is any instrument, apparatus or other item that is used to identify,
diagnose, or treat a medical problem with the exception of drugs and dressings. In other
words any instrument, apparatus, appliance, material or health care product, excluding
drugs used by a patient or service for:
--Diagnosis, prevention, monitoring, treatment or alleviation of disease.
--Diagnosis, monitoring, treatment, or alleviation of, or compensation for, an injury or
impairment.
--Investigation, replacement or modification of the anatomy or of a physiological process
Some examples include pacemakers, infusion pumps, the heart lung machine,
dialysis machines, artificial organs, implants, artificial limbs, corrective lenses, cochlear
implants, ocular prosthetics, facial prosthetics, somato prosthetics, and dental implants.


TYPES :
There are several basic types:
(1) Diagnostic Devices
Types of diagnostic devices:
-recording and monitoring devices
-measurement and analysis devices
-imaging devices
Importance of diagnostic devices
-enhance and extend the five human senses to improve to collect data from the
patient for diagnosis
-the perception of the physician can be improved by diagnostic instrumentation in
many ways: amplify human senses; place the observer's senses in inaccessible
environments; provide new senses
(2) Therapeutic Devices
Objective of therapeutic devices:
-deliver physical substances to the body to treat disease
Physical substances:
-Voltage, current
-Pressure
-Flow
-Force
-Ultrasound
-Electromagnetic radiation
-Heat
Therapeutic device categories:
-devices used to treat disorders
-devices to assist or control the physiological functions
















1. Computed Tomography (CT) Scanner

A computed tomography (CT) scan uses X-rays to make detailed pictures of structures
inside of the body. During the test, you will lie on a table that is attached to the CT
scanner, which is a large doughnut-shaped machine. The CT scanner sends X-rays
through the body area being studied. Each rotation of the scanner provides a picture of a
thin slice of the organ or area. All of the pictures are saved as a group on a computer.
They also can be printed.
In some cases, a dye called contrast material may be used. It may be put in a vein (IV) in
your arm, or it may be placed into other parts of your body (such as the rectum or a joint)
to see those areas better. For some types of CT scans you drink the dye. The dye makes
structures and organs easier to see on the CT pictures.

Figure shows the CT Scanner by Philips:
A CT scan can be used to study all
parts of your body, such as the chest,
belly, pelvis, or an arm or leg. It can
take pictures of body organs, such as
the liver,
pancreas, intestines , kidneys , bladder
, adrenal glands, lungs, and heart. It
also can study blood vessels, bones,
and the spinal cord.
Fluoroscopy CT is a special test that is
not widely available. It uses a steady
beam of X-rays to look at movement within the body. It allows the doctor to see your
organs move or to guide a biopsy needle or other instrument into the right place inside
your body.

Essential Precautions while working in CT suite:
1) Always wear Radiation Exposure Monitoring Devices such as TLDs within the
Radiology premises.
2) Wear appropriate PPE (personal protection equipments) at all times. PPEs includes
cloth aprons, lead aprons, hand gloves etc.
3) Ensure patients are exposed with minimum required radiation necessary for each
procedures.
4) Do not keep any open injection vials such as normal saline/contrast etc. As their
use may cause infection to patient and increase the chance of allergic reactions.
5) Discard all open bottles and vials immediately after use & at the end of the day.
6) Never re-use pressure-injector tubes.




Scanner Preparation:
1) Air Conditioning:
The ideal temperature of the scanner room & console is 18-22 degree
Celsius.
Gantry & the room temperature logs are always maintained.
2) Switching ON/OFF Sequence:
Switch ON or ensure the UPS Panel and the Teal transformer is ON.
Press the console CPU start button.
Wait until it asks for username/password.
Type username and press enter key.
Wait until the system completes booting up and you are able to see the
homepage.
Now gently turn on/rotate the gantry switch on key towards you to boot the
gantry.
3) Tube Warm Up:
Click on home, select tube conditioning.
Start tube conditioning.
Tube warm should be done everyday morning. It should be repeated if the
gantry is not used for scans for 3 hours prior to any patient scan.
4) Air Calibration:
Do air calibration every week.
While calibrating the table should not be parked inside gantry unit.
Gantry table should be moved out from the detector area prior to start of air
calibration.
It takes 10-20 minutes for completion of air calibration process.

Different types of CTs:
A) CT Head Plain
B) CT Head Plain and Contrast
C) CT PNS
D) CT Chest Plain
E) HRCT Chest
F) CT Chest Plain & Contrast
G) CT Abdomen Plain
H) CT Abdomen Plain & Contrast
I) CT Liver Triphasic Study
J) CT KUB Plain
K) CT KUB Plain & Contrast
L) CT Lower abdomen/Pelvis Plain & Contrast
M) CT Brain Angiography
N) CT Carotid & Brain Angiography
O) CT Thoracic Angiography
P) CT Pulmonary Angiography
Q) CT Cardiac Angiography
R) CT Abdominal Angiography
S) CT Renal Angiography
T) CT Peripheral Angiography
U) CT Aortography
V) CT Virtual Colonoscopy
W) CT Virtual Bronchoscopy
X) CT Dental Planning
Y) CT Brain Perfusion
Z) CT Lung Nodule Assessment
There in the hospital we practically performed the CT Scan of head. Figure given below
shows the live scanning.


Preparation:
Remove all metallic items from head & neck such as ear pins, hair clips, chains etc.
Ensure patient is not pregnant.
Instruct the patient not to move during the scanning procedure.
Positioning:
Patient lies supine with head first to gantry position.
Both arms extended downward or folded over the chest.
For surview acquisition, keep the table height at EAM level and inner laser light
positioned at Chin.
Head must be supported by a cushion so as to minimise the metal artifacts.
Procedure:
Acquire in axial mode for all routine cases.
Acquire in helical mode for patient who cant lie still for long time (e.g. children,
head injury cases etc.)
Wherever high quality 3D images are required use helical mode acquisitions only.

























2. Ultrasound

Ultrasound is an oscillating sound pressure wave with a frequency greater than the upper
limit of the human hearing range. Ultrasound is thus not separated from 'normal' (audible)
sound based on differences in physical properties, only the fact that humans cannot hear
it. Although this limit varies from person to person, it is approximately 20 kilohertz (20,000
hertz) in healthy, young adults. Ultrasound devices operate with frequencies from 20 kHz
up to several gigahertz.
Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects
and measure distances. Ultrasonic imaging (sonography) is used in both veterinary
medicine and human medicine. In the non-destructive testing of products and structures,
ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning
and for mixing, and to accelerate chemical processes. Organisms such
as bats and porpoises use ultrasound for locating prey and obstacles.

Ultrasonics is the application of ultrasound. Ultrasound can be used for medical imaging,
detection, measurement and cleaning. At higher power levels, ultrasonics is useful for
changing the chemical properties of substances.


Ultrasound scan is a medical test that uses high-frequency sound waves to capture live
images from the inside of your body. The technology is similar to that used by sonar and
radar, which help the military detect planes and ships. An ultrasound allows your doctor to
see problems with organs, vessels, and tissueswithout needing to make an incision.
Unlike other imaging techniques, ultrasound uses no radiation, so it is the preferred
method for viewing a developing fetus during pregnancy. Ultrasound is also known as
sonography.

Preparation:
The steps taken for preparation of an ultrasound will depend on the area or organ
that is being examined.
Fast for eight to 12 hours before ultrasound, especially if abdomen is being
examined. Undigested food can block the sound waves, making it difficult for the
technician to get a clear picture.
For an examination of the gallbladder, liver, pancreas, or spleen, you may be told to
eat a fat-free meal the evening before your test and then to fast until the procedure.
Continue to drink water and take any medications as instructed.
Tell the doctor about any prescription drugs, over-the-counter medications, and
herbal supplements that you take before the exam.
It is important to follow doctors instructions and ask any questions you may have
prior to the procedure.
An ultrasound carries no risks. Unlike X-rays or CT scans, ultrasounds use no
radiation. For this reason, they are the preferred method for examining a
developing fetus during pregnancy.

Procedure:
Before the exam, you will change into a hospital gown. You will most likely be lying
down on a table with a section of your body exposed for the test.
An ultrasound technician, called a sonographer, will apply a special lubricating
jelly to your skin. This prevents friction so he or she can rub the ultrasound
transducersimilar in appearance to a microphoneon your skin. The jelly also
helps transmit the sound waves.
The transducer sends high-frequency sound waves through your body. The waves
echo as they hit a dense object, such as an organ or bone. Those echoes are then
reflected back into a computer. The sound waves are at too high of a pitch for the
human ear to hear.
Depending on the area being examined, you may need to change positions so the
technician can have better access.
After the procedure, the gel will be cleaned off your abdomen. The whole procedure
typically lasts less than 30 minutes.

After an Ultrasound:
Following the exam, doctor will review the images and check for any abnormalities. He or
she will call to discuss the findings, or to schedule a follow-up appointment. Should
anything abnormal turn up on the ultrasound, you may need to undergo other diagnostic
techniques, such as a CT scan, MRI, or a biopsy sample of tissue. If your doctor is able to
make a diagnosis of your condition based on your ultrasound, he or she may begin your
treatment immediately.







Uses:
Most people associate ultrasound scans with pregnancy. These scans can provide
an expectant mother with the first view of her unborn child. However, the test has
many other uses.
An ultrasound can provide a view of the:
bladder
brain (in infants)
eyes
gallbladder
kidneys
liver
ovaries
pancreas
spleen
thyroid
testicles
uterus
blood vessels
An ultrasound is also a helpful way to guide surgeons movements during certain medical
procedures, such as biopsies.

Biomedical Applications:
Ultrasound also has therapeutic applications, which can be highly beneficial when used
with dosage precautions. Relatively high power ultrasound can break up stony deposits or
tissue, accelerate the effect of drugs in a targeted area, assist in the measurement of the
elastic properties of tissue, and can be used to sort cells or small particles for research.













3. X-Ray Imaging

An X-ray is a common imaging test that has been used for decades to help doctors view
the inside of the body without having to make an incision.
X-radiation (composed of X-rays) is a form of electromagnetic radiation. Most X-rays have
a wavelength in the range of 0.01 to 10 nanometers, corresponding to frequencies in the
range 30 petahertz to 30 exahertz(310
16
Hz to 310
19
Hz) and energies in the range
100 eV to 100 keV. However, much higher-energy X-rays can be generated for medical
and industrial uses, for example radiotherapy, which utilizes linear accelerators to
generate X-rays in the ranges of 620 MeV. X-ray wavelengths are shorter than those
of UV rays and typically longer than those of gamma rays. In many languages, X-radiation
is referred to with terms meaning Rntgen radiation, after Wilhelm Rntgen, who is usually
credited as its discoverer, and who had named it X-radiation to signify an unknown type of
radiation. Spelling of X-ray(s) in the English language includes the variants x-
ray(s), xray(s) and X ray(s).
This basic X-ray technology has become a key element in the identification, diagnosis,
and treatment of many types of medical conditions.
Today, different types of X-rays are used for specific purposes. For example,
mammograms are used to examine the breasts and a barium enema is used to detect
bowel problems.

Reason why an X-Ray Is Performed:
A doctor may order an X-ray if he or she needs to look inside the subjects body. For
example, the doctor may want to:
view an area where you are experiencing pain
monitor the progression of a disease, such as osteoporosis
see the effect of a treatment method
Some conditions that may call for an X-ray include:
arthritis
blocked blood vessels
bone cancer
breast tumors
conditions affecting the lungs
digestive problems
enlarged heart
fractures
infections
osteoporosis
swallowed items
tooth decay
Risks of an X-Ray:
X-rays use small amounts of radiation. The level of exposure is considered safe for adults.
However, it is not considered safe for a developing fetus. Be sure to tell the doctor before
the procedure if the subject is pregnant or believe she could be pregnant. The doctor may
suggest a different testing method that does not use radiation, such as an MRI.
If the subject is having an X-ray due to a traumatic event that caused pain and possibly a
broken bone, he/she may experience additional pain during the X-ray. The test requires
the subject to adjust his/her body so that clear images can be taken. This may cause the
subject discomfort.
The doctor will inject the subject with a contrast dye before some X-rays. This is to
improve the quality of the images. The dyeusually iodine can cause some side
effects. These include:
hives
itching
light headedness
nausea
a metallic taste in the mouth
In very rare cases, the dye can cause a severe reaction, such as anaphylactic shock, very
low blood pressure, or cardiac arrest.

Preparation:
X-rays are standard procedures and involve almost no preparation from the patient.
Depending on the area under review, the subject may want to wear loose,
comfortable clothing that they can easily move around in. the subject may also be
asked to change into a hospital gown for the test.
The subject will be instructed to remove any jewelry and other metallic items from
your body before the X-ray is taken. The subject should always tell the doctor if
they have any metal implants from prior surgeries. These can block the X-rays from
passing through the subjects body.
If the test requires contrast dye, a doctor or nurse will give it to the subject as an
injection, an edema, or a pill to swallow before the test.
If the X-ray is examining the intestines, the doctor may tell the subject to fast for a
certain amount of time beforehand, or to clear out their bowels.

Procedure:
X-rays can be done in a hospitals radiology department, a dentists office, or a
clinic that specializes in diagnostic procedures.
Once the subject is fully prepared, a radiologist (X-ray technician) will tell how he or
she needs that subject to be positioned in order to get the right view.
The technician will most likely require the subject to lie, sit, or stand in several
positions during the test. Some images may be taken while the subject stand in
front of a specialized plate that contains X-ray film or sensors.
In some cases, the technician will move a large camera connected to a steel arm
over the subjects body. This can capture the X-ray images of the subjects body
using film or sensors held in the table.
The subject will have to hold the breath and remain still while the images are being
taken. This provides the clearest images possible.
The test is finished as soon as the radiologist is satisfied with the images gathered.

After an X-Ray:

After the test, the subject can change back into your regular clothes and go about
their normal activities.
The radiologist and doctor will review the X-rays and discuss the condition. Results
from the X-ray may be available the same day.
The doctor will view the X-rays and the radiologists report, and determine how to
proceed. He or she may order additional imaging scans, blood tests, or other
diagnostic measures to help the subject get an accurate diagnosis and begin
treatment.