Department of Moalejat
Important Laboratories
Cardiopulmonary Resuscitation (Basic Life Support training laboratory )
Cardiopulmonary Resuscitation (Basic Life Support training laboratory ) for undergraduate and Post graduate scholar it is equipped with Mannequin and Defibrillator .
List of Equipment
1 CARDIASAFE : Biphasic Defibrillator Monitor
SOP CARDIASAFE BIPHASIC DEFIBRILLATOR MONITOR
Indication for use: Termination of Ventricular Tachycardia and Ventricular Fibrillation
The defibrillator is checked weekly by operating Defib –Check Mode
Press Defib check key on front panel
Default 100 joule is selected
Paddles are placed in paddle cradle
Press charge key on front panel
Defibrillator capacitor is charged to 100 joules, message is displayed on panel
Press discharge button on paddles simultaneously after hearing the voice command
Discharging voice message and capacitor discharging text is displayed on screen
Synchronized Cardioversion:
Synchronized cardioversion is a treatment technique that uses a sensor to deliver a shock that is synchronized with a peak in the QRS complex.
Defibrillators can deliver two types of shocks – synchronized and unsynchronized. Unsynchronized shocks refer to a shock that is delivered immediately after the healthcare professional pushes the shock button. This means that the shock is not delivered precisely in the cardiac cycle; in other words, unsynchronized shocks are more random.
However, when a healthcare provider uses synchronized cardioversion, after pushing the shock button, that shock may not be delivered immediately. Instead, the shock delivery will be synced with the peak of the R wave in the patient’s QRS complex.
Synchronization avoids the delivery of a shock during cardiac repolarization, which is represented on the surface ECG as the T wave. This is a period of vulnerability in which a shock can precipitate VFib.
Synchronized cardioversion uses a lower energy level than normal defibrillation. These low-energy shocks must always be delivered as synchronized shocks to avoid precipitating VFib.
When is Synchronized Cardioversion Used?
Synchronized cardioversion is recommended in some ACLS algorithms, such as unstable tachycardia, particularly when a persistent tachyarrhythmia is causing the following to occur:
· Hypotension
· Acutely altered mental state
· Signs of shock
· Ischemic chest discomfort
· Acute heart failure
Synchronized Cardioversion Steps
ACLS providers should be aware that they may have to modify these steps for the specific device they’ll be using.
1. Sedate conscious patients unless they are unstable or rapidly deteriorating.
2. Turn on the monophasic or biphasic defibrillator.
3. Attach the monitor leads to the patient. Remember lead placement with this – white to right, red to ribs, what’s left over to the left shoulder. You should also ensure that the patient’s rhythm is displayed properly. Then position the adhesive electrode or conductor pads on the patient.
4. Engage the synchronization mode by pressing the sync control button.
5. Look for markers on the R wave which indicate the sync mode.
6. Adjust the monitor, if necessary, until the sync markers occur with each R wave.
7. Choose the appropriate energy level and deliver monophasic synchronized shocks in the following sequence:
a. If treating unstable atrial
fibrillation, the initial dose is 200 J.
b. If treating unstable monomorphic V-tach, the initial dose is 100 J.
c. If treating another unstable SVT or atrial flutter, the initial dose is 50
to 100 J.
8. d. If treating unstable polymorphic V-tach, you should treat it as VFib and deliver a high-energy shock.
9. Make an announcement to the team members that you’re charging the defibrillator and tell everyone to stand clear.
10. Press the charge button.
11. Make sure the patient is clear once more after the defibrillator is charged.
12. Press the shock button.
13. Check the monitor. If tachycardia continues to persist, you should increase the energy level according to the Electrical Cardioversion Algorithm.
14. Activate the sync mode. This should be done after each synchronized shock. Be aware that many defibrillators will default back to the unsynchronized mode after delivery of a synchronized shock. This default allows for an immediate shock if your cardioversion efforts produce VFib in the patient.
Post Graduate Bio-Chemical and Pathology Laboratory
The Department has well equipped Post Graduate Bio-Chemical and Pathology Lab which is serving the patients visiting the Moalijat OPDs as well as catering services for Research purposes.
List of Equipments
- Biochemistry Analyzer
SOP for Robonik Semi Auto Biochemical Analyser:
Switch on the power supply supply
Select the biochemical test (Glucose/RFT/LFT) to be done
Wait for the warm up time
Suck the distil water through sample probe for reference
Standard solution is sucked in probe for standardisation once a week or ten days depending on number of samples.
Put the sample in the incubator at 37 degrees for 10 minutes (as per test specification)
Suck the sample through sample probe
Wait for reading
Enter the patient ID and details
Print out the report by giving print command
Note down the reading and report details in lab record register
After completing the work clean the sample probe by sucking probe cleanser
Lastly switch of the power supply
- Auto Cell Counter
SOP for FULLY AUTOMATIC BLOOD CELL COUNTER
(CBC ANALYSER)
Switch on the power supply
Enter the code of machine
Wait for machine running procedure
Put the blood sample (EDTA) on blood rotator to mix the sample well
Now machine is ready to work
Enter the patient information, name, age, sex, opd/ward number
Suck the blood sample via sample probe
Wait for reading.
Print out the report by giving print command
Note down the reading and report details in lab record register
After completing the work clean the sample probe by sucking probe cleanser
Lastly switch of the power supply
- I. Quant Analyzer
SOP for I quant Rapid Quantitative Immune Assay Analyser
Switch on the machine
Wait for 1-2 minutes for machine to come in operative mode
Put the Serum to be tested on qunaty card
Put the card in the incubator for specified time as per test.
Insert the card in the quant analyser, enter the patient ID and machine is run.
Wait for reading to appear on the screen.
Note the reading in register and on the investigation requisition slip with patient’s ID
Switch of the power supply
- Elisa Analyzer e washer
SOP for ELISA Test Analyser
Switch on the machine
Put the serum along with the specific reagent in the Elisa well plate
Incubate in the machine for specified time.
Put the Elisa well plate in the washer unit
Put the serum in the well in the analyser
Wait for reading to appear on the screen
Give print command for printing the report.
Enter the report in lab record register