VBA News - November 1998

New members elected to the VBA Board of Directors at the summer meeting in Williamsburg are:

James Anderson - Mary Washington Hospital
Rick Davis - Premier, Riverside Regional Medical Center
Bruce Jones - Premier, Winchester Medical Center
David Peters - Southampton Memorial Hospital
Virgil Smoot - Childrens Hospital of the King's Daughters.

Congratulations to these new members and we welcome them aboard. They'll need your support and input. Phone numbers and email addresses will be in the next issue and are in the membership directory now. Along the same lines we would like to recognize the board members that are stepping down from the board after their maximum 2 term service. Retiring members are: Jim Burden, Mary Coker, Mark Freeman, and Steve Haupt. Many thanks for all hard hard work you've done during your tenure on the board. (But don't change your phone number or email address because I'm sure you'll be called on some more this year)

Mike Carver, vice president of Clinical Technology Services for Premier,jump started the 5th Annual VBA meeting by addressing the role of the Biomed in the year 2000 and beyond . He reviewed the past,-"Why did we get into the biomedical field?", the present- we are in a war waged onmany fronts- dwindling resources, federal intervention, ISO s and OEM s, the future- more challenges and Y2K for everyone. The key for success is to seek excellence and make good choices. Along the way, a positive attitude and desire to learn will certainly help. Mike stressed the importance of seeking education in all areas- academic, technical training, and life experiences.

Ode Keil, vice president of Safety Management Services kicked our second meeting day off with a humorous and witty analysis in addressing 2000 is today and information is the future . He emphasized that the technology evolution has developed from basic data, to information, to knowledge, to wisdom. The biomed must use knowledge and wisdom to improve patient quality. This entails the biomed becoming a knowledge manager specialist. Increasing rates of technological change will create opportunities which adapts well to the nature of biomeds who do not set limits for themselves. Where will knowledge and technology take us? Keil believes the future is in telemedicine and home based medicine therapy.

The VBA would like to extend its appreciation to these two fine professionals for taking the time to share their thoughts and insights with us all of us.

Al Strickler,
Annual Meeting Chairperson

Techs are often confused when given the VA (volt-amps) power rating for equipment instead of Watts. The difference is relatively simple, VA takes into account the power factor for reactive loads and is determined by multiplying the Volts and Amps required to power the circuit. For a purely resistive load, Watts and VA are the same. In equipment with some capacitive or inductive reactance in the load, there is a phase shift between the Voltage and Current waveforms (remember this from school?) which is dependant on the amount of reactance. Because of this phase shift, the peak voltage and peak current do not occur at the same time. If the current waveform is at 70% of peak when the voltage waveform peaks, the power consumed will be only 70% of the power supplied. A piece of equipment with a VA rating of 100 and a the power factor of 70% will actually consume only 70 watts of power. However, the power source must be capable of providing a full 100 watts.Reactance in a load can be caused by a number of things, including a lightly loaded motor or power transformer and power supply rectifier/filter circuits. Enough theory, here is what you need to know:

1. If equipment input power is rated in VA, then the power source must provide the same number of Watts as the VA specified.
2. If equipment input power is rated in Watts, then find out what the power factor is and use this formula: VA = Watts ÷ Power Factor (remember that power factor is in percent, so for 70% power factor, use .70 (or 70/100) in the formula)
3. If you cannot find out the power factor, then try using 70%, this is a guesstimate of the minimum power factor for electronic equipment that is used by most UPS manufacturers and should work in nearly all cases.
4. If the power source's output is rated in VA (as are some UPS's) the Wattage is equal to the VA.

Mark Freeman
Virginia Beach General Hospital

(This technote is also found on the VBA website < www.vbabiomed.org>

Well, the "buzz phrase" wherever you go or wherever there's an impromptu get together is "Where are you with Y2K at your facility?" The discussion is always one of the first thing folks talk about and rightly so -to an extent - (see the editorial article on page 7 this issue) as was covered by ODE Keil in his keynote address at the Annual meeting (see "Kickoff Keynotes" this page)

One real word of warning however. If you are planning to have a vendor come in to upgrade your software or your systems you need to go ahead and contract them now if you haven't already and are not on a software contract of some type.

In a discussion with a major monitoring service rep he told me that he already had over 9000 pieces to upgrade in 1999. That was just his regular contract customers and the T/M agreements already setup. That also did not include any time for repairs or installations. Not all reps will have the kind of volume to deal with but the longer you wait the less chance you have of OEM help if you need it. When they're booked up that's it.

If you haven't signed onto the BIOMEDTALK Bulletin Board yet you need to. There are several vendors there that are monitoring Y2K closely and passing along all new information as it comes out. They list the new websites that have specific vendor compliance lists, etc. There are over 950 BioMed techs and vendors (about 15-20 I think) on the list as well as official reps from AAMI and the FDA. Just send an email to: <listserv@listserv.aol.com> and in the message type; "Subscribe BIOMEDTALK-L (your name)". Within 24 hrs you'll get a return response along with a copy of the listserve rules. It's worth it for the info.

The 2nd annual VBA Golf Tournament teed off at exactly 12 noon on Sept 9 (well sorta close to that time) at the beautiful Stonehouse Golf Course near Williamsburg at Toano,Va. A total of 8 foursomes played in the Captain's Choice match. The winning team shot a low 64. Awards were also given for the -"Longest Drive" - Rusty Coggins and the -"closest to the pin" - Don Burgess. All team scores listed below:

Biggs, Reichenbach, Raquet, Smith
64
---------

Strickler, Haupt, Kim, Burkes
71
---------

Richardson, Paxton, Gangitano, Tracy
73
----------

Hecht, Reese, Nelson, Coggins
73
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Burnette, Holiday, Passarelli, Freeman
74
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Dolimar, Breen, Wexlar, Riggs
76
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Burgess, Mcmillan, Owens, Gayhart
76
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Schmidt, Jones, Barker, Berlen
80

The Virginia Biomedical Association Board, on behalf of its members, would like to especially thank the following exhibitors, without which the 1998 Summer Meeting would not have been possible. Their continued support and commitment to education allows all of us to perform our jobs more efficiently and knowledgeably.

Hewlett Packard
Endocare
AIVP
Bio-Tek Instruments
Richardson Electronics
Datascope
Fiber Tech
Lee Hartman & Sons
Cadmet
ERBE USA
Specialty Services
Dale Technology
Medserv International
MDE
Protocol Systems
Cordell Medical
Precision Endoscopy
Interteam Software
Ditec
Ohmic Instruments
Allied Medical
Marquette Medical Systems
Physio Control
Critikon
Mennen Medical
Welch Allen
Comprehensive Monitoring Services

I suspect some, like me, are overloaded or have over indulged in the staggering amount of data streaming from every imaginable orifice regarding the coming year 2000. I've ingested so much information, I am certain Y2K is the reason for my expanding waistline, perpetual headache and bloated feelings. I've decided it's time to stop the feeding frenzy and reduce my intake in order to loosen a few notches on my belt. Guess I'm looking for a Y2K diet.

I don't want to negate the seriousness of the Y2K problem. Good prudence dictates we must complete a review and testing of systems and equipment located throughout our facilities. And we must document that review. I wonder though, if God gave as much consideration creating the universe in 6 days? Are you concerned the IRS will forget tax day or your administration will forget monthly budget reports? Do you really think the lights will go out, and all computing as we know it in the free world will end? Do you think the earth will stop rotating on its axis that frightful day 14 months away? If you do, I suggest you try my Y2K diet.

My diet consists of the following:

1) Drink 8 large glasses of water per day-, as yet Y2K activities have not infringed upon the bathroom break. So, the more I drink, the more time I must spend in small quiet rooms where there will be no discussion of Y2K. Yet, should I worry the automatic, electric flush will explode in a few months? Is anyone checking to see if our bathrooms are safe? Have you considered a priority check of you workload?

2) Partake equally from the 5 main Clinical Engineering nourishment groups for continued lean growth: Budget, Administration, Planning for the Future, Daily Operations and Y2K. Manage your work time priorities to assure much-needed departmental nutritional growth supplements. The future of Clinical Engineering does not end with the year 2000. And daily operations may be lost without proper planning of work load and budget. By dividing time appropriately, proper nutritional balance is possible without the hunger pain Y2K places on busy departments.

3) Exercise Daily: You can't do everything from the chair, terminal and phone. Get outside the department and learn your organizations education level for Y2K problems, teach where appropriate. Continually look for other areas of concern.

Common sense must supplant the gloom and doom predictions of those who seek to cause chaos and concern. Problems with Y2K are real. But somewhere between predictions of no problems at all and the end of humanity is reality. Respectable vendors are not going to willingly allow their products to fail. Respectable Biomedical or Clinical Engineering departments are going to prepare for the year 2001 as we look towards the year 2000.

How many reading this think this diet will help my waist line?

submitted by:
Ben Clark
Centra Health,Inc, Lynchburg

The VBA Board of Directors and I would like to thank all vendors for participating in our annual symposium. A special THANK YOU goes out to the vendors donating door prizes to our event. The vendors donating the wonderful door prizes are as follows:

ECPI Jim Dozier, Jennifer Brown

ECPI Golf Shirt

ECPI Sweatshirt

ECPI Hat

ECPI Book Bag

MEDSERV INT. Mike Schmidt, Deborah Barker

Denim Jacket

FIBERTECH Cortes Pauls

Nikon 35mm Camera

HEWLETT PACKARD Larry Gasparini

Four HP 10B Financial Calculators

LEE HARTMAN & SONS Cyril Holland, Garry Shorner

Personal Stereo System

CADMET David Guerry

Cordless Screwdriver Versapak & Medical Products Catalog

ALLIED MEDICAL David Lenz

Polaroid Camera

SPACELABS Ms. Andi Schick, Jeff Phillips, Jason Allen

24 Biophysical Measurement Books

hat & four Windbreakers

In addition Spacelabs once again sponsored the "BMET of THE YEAR" award. The lucky winner was TODD RICHARDS , CBET. He is from CHILDRENS HOSPITAL, NORFOLK, VA. Todd was not present to receive award but received it at CHKD Hospital. 9/24/98. The nice Plaque and $100.00 check was presented to Todd by Andi Schick with Spacelabs and Jim Dahling, SR V.P of Clinical Services/COO of CHKD.

Special Thanks to the following individuals for last minute contributions of the following:

A. Two presenters had last minute medical emergencies and were unable to Present. They are :Jim Muelheisen (ERBE) and Manny Roman (Ditec). Sorry you could not make it. ThanksTo Steve Haupt and Don Burgess (HTMS) for standing in an doing an excellent job with their presentations on Cardiology and Technology Management.

B. Rusty Coggins (Mallinckrodt ) for donating his $25.00 golf winnings back to the VBA

C. Cyril Holland and Garry Shorner ( Lee Hartman and Sons) for the frequent loaning of The Audiovisual Equipment. It worked flawlessly.

Submitted by:
Virgil Smoot, CBET
CHKD

Determining the Heat Load of Medical Equipment and Systems

When planning the installation of new equipment or systems, it is necessary to calculate the heat loading so that adequate cooling can be provided. The contractor or hospital HVAC personnel base the design of an HVAC system on the room size and the heat generated by personnel and equipment that will be located in the room. As a BMET you may be asked to provide this information.

The basic idea is relatively simple: each Watt of electricity used generates 3.42 BTUs per hour of heat (for the wattage that is not used to generate other kinds of energy). Equipment generally has the Watts or VA (Volt-Amps) rating listed on a sticker near the power cord. If you find a VA rating instead of Watts use the VA rating (see article on page 2 this issue) in place of watts in the formula (it may give a higher BTU number than actual, but this is OK, you just don't want to be too low) For a typical ultrasound unit rated at 1500 VA, the BTU/hr generated is: 1500 x 3.42 = 5130.

A few notes to bear in mind:

1. Don't rely on the equipment manufacturer's BTU rating, they often give a higher BTU than actually generated to account for personnel expected to be present. For example, Hewlett Packard rates their model 1500 ultrasound at 10,000 BTU/hr while its VA rating is 1500 (giving an actual heat load of 5130 BTU/hr), the additional BTUs are meant to compensate for personnel, and if you are unaware of this you will spend too much on HVAC equipment. Their model 2500 Ultrasound, also rated at 1500 VA of power, they only rated at 7000 BTU/hr.

2. Use the average continuous power in your calculation. While an Ultrasound unit draws a fairly constant amount of power, an X-Ray system's power consumption is highly intermittent. A typical X-Ray room connected to a 480 volt line at 100 amps can draw up to 48,000 watts of power (which calculates to over 160,000 BTU/hr). However, the peak power is drawn only during an X-ray exposure, lasting a fraction of a second. You will need to have the manufacturer provide information on average power consumption, which would be considerably lower.

3. Some equipment also generates energy other than heat. A treadmill, for example, also generates mechanical energy to turn the walking belt. In this case, it would be helpful to get the manufacturer's BTU/hr rating, but be sure to cross check it against your own calculations, also find out if their rating compensates for patients and personnel. Keep in mind that a patient on a treadmill will generate a lot more heat than the staff, who are not exercising.

4. When absolute accuracy is not be possible, it's best to estimate BTU/hr heat load on the high side, since excessive heat can reduce the service life of equipment, and make patients and staff uncomfortable, resulting in a negative impression of your facility.

Some scenarios:

1. A typical ultrasound exam room will have an ultrasound scanner, which generates about 5000 BTU/Hr of heat, and two people, a patient and a sonographer.

2. A cardiology exam room may have an ultrasound at 5000 BTU/hr, a treadmill system at 8000 BTU/hr, two technicians, a physician and an exercising patient, all generating heat at the same time.

3. A lab may have a chemistry analyzer at 5000 BTU/hr, a hematology analyzer at 4000 BTU/hr, numerous smaller pieces of equipment rated at 200 to 2000 BTU/hr and twenty technicians, all working at the same time. This generates a lot of heat.

submitted by:
Mark Freeman
Virginia Beach General Hospital

(this information is also available on the VBA website <www.vbabiomed.org>)

60 Hz Noise in Ultrasound Images

The most common noise found in ultrasound systems is caused by 60Hz interference and is seen as radial spokes in the patient image area of the screen only. Streaks or spokes are formed radially from the near to far field and may be steady, jumping around or intermittent.

I have found several sources of this noise, the most obvious being an open ground in the power cord. This noise can also be caused by a broken shield connection in the transducer cable, which can be often be verified by moving the cable and watching for appearance or disappearance of the noise. A defective ballast in a fluorescent light fixture in the room can also cause this problem, look for it if the noise shows up only when the machine is in a specific area. The most interesting one was in a GE RT3200, where I found the wires to the AC powered cooling fans were routed too close to the front-end circuits, rerouting the wires fixed the problem.

In these cases the noise originated before the scan converter, in the front-end of the system. If you see horizontal black bars or waves floating through the entire screen, you have 60Hz noise in the back end of the system. This problem is usually in the monitor (check for its presence on a hardcopy) and probably caused by a leaking or open power supply filter capacitor.

submittted by:
Mark Freeman
Virginia Beach general Hospital, Va Beach

(this information is also available on the VBA website <www.vbabiomed.org>)