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The M.E.T.A. Scholar - Medical Equipment & Technology Association

1. i i Reporting email abuse such as spam Trojans email borne viruses and email threats should be directed to the hacker s internet provider Many times you can report the Ad dress and full email Internet Headers which many times contain time of day information to the hacker s internet provider and the internet provider can further track down the unique end user by examining dates times login and logout logs of the stored hacker s ad dress and they can take corrective action Now back to our story As Kevin did a little digging in the right places and analyzed the hacker s email he was able to figure out who sent Henry that nasty spam email and Kevin was able report them to the proper authorities What a clever girl you are said Kevin to himself Figuring out it was Henry s ex girlfriend who hired the hacker to steal Henry s information so she could get back at him in court All of a sudden the phone rings and it s Henry on the other end of the phone Hey thanks Kevin for helping me out said Henry No problem dude but listen I ll talk to you tomorrow okay I ve got other plans now Kevin replied After we both hang up the phone turn around quickly to see that my Dragnet video has finished streaming on my homemade DVR box grabbed some popcorn a tall glass of milk and then called it a night it s another lonely night for the Hacker Detective THE STORY YOU HAVE
2. Focus First ultrasonic line n a Pulse Pulse BH B G s e a 5 a Crystals Pulse t1 a n D Pulse tI 157 Focus ast ultrasonic line n Pulse t3 1 158 r Pulse 159 my d Pulse t1 160 Fig 11 ELECTRONC PROBES reception Linear sequential array probes or linear array probes As was explained in paper I when a stone falls on the water it generates waves that get away from the falling point and as far as it goes the bigger is the wave front as is shown in figure 12a it also happens when the reflection of the incident ultrasonic waves generates the echoes mechanic waves in the interfaces of the tissues these echoes go toward the probe the point where an echo is generated is alike the spot where the stone falls in the wa ter so as far as the echo travels away from the generating interface the bigger his wave front is so at the probe s crystals the echo has the way shown in figure 12b this figure shows that the wave front arrives first at crystal 3 t1 the crystal is pressed mechanically by the echo strength so the crystal oscillates and produces the electric signal which has the waveform of the echo and for the better understanding they are represented as electric pulses in the figures then the same thing will happen with crystals 2 and 4 at time t2 and finally the echo arrives at crystals 1 and 5 at time t3 As in transmission there were used five cr
3. 2 Last 7 days 54 4A 03 Build Mail Ff SDK 23 F Com zl Tiritopher i Mag USAF GET 325 773102712 Pill we Mad 18 26017 ab 22M ES 7 im ce MEET 4 oai xui elt pie i RAF AF 32 T 23537771 zo kD 4 0 5 gt Bod ceed pede seed 4 nn io ue Ld Speaking 14 M All Mail Folders E est Scott Hanselman i Caml Cor E 59 Current Topics 52 Di 2 5 Deleted Items 113 Comal J Mgl USAF 325 LA 7 23 3012 Drafts PONAT 33 1 3 Inbox NS 3 Gregory aic Ale Emule sou hio nupus By A1 USt Be bl ct aab cog opor lt j Chud 55ikz Eack to the Future gl LRAT LIT ODE MA 2 8 7717 fz comtaae 4 Wear sk ler ae P RET p rc h eer rc B bie densis RATES tris ids 1 2 14 35 jw em e os 8 All folders are up to date al Connected Ring Ring It was the phone and on the other end it was from a certain Henry Home owner answered the phone as Hacker Detective here how may I help you The anonymous caller on the other end of the line said Kevin it is Henry and am in a heap of trouble didn t know who to turn to told him to Calm down asked Henry What is the problem Henry went on to explain that he was su
4. Since learned that have been on a quest gathering data videos and photos on simultaneous monopolar coagulation and cut sub modes have also spent quite a bit of time talking with surgery nurses who have actually been involved with cases dur ing simultaneous coagulation On the other hand have talked with nurses who work with Cardiovascular Surgeons who will not allow the use of simultaneous coagulation in their OR room some feel this mode has some potential patient safety issues was very pleased to be able to share some of my finding so as to get some feedback from the overall biomed population After reviewing this article we would like to hear from others on this subject who can share their findings and viewpoints CONMED Biomed technical training It was in 2004 that started to get interested in electro sur gery It just seemed needed to know more about this device so researched ESU schools In early 2005 attended Conmed Technical Training at their facility in Colorado and to say the least had a blast Our instructor Mike Manes was one of the engineers who actually designed the Excalibur which is widely used in the medical field even today Of all the units liked the oystem 5000 the best and so that became the unit that decid ed to learn the most about We discussed each different unit and followed signal paths through them and learned about dif ferent components inside and what they did as well One p
5. and science before me often times wonder how will forge a legacy of my own that will one day fit together within the community and ultimately make my own discoveries that will help others succeed In any case cannot predict the future and those who already know me would tell you that am too humble for fame My payment is knowledge and would conclude by saying exactly how much fun have had along the way have studied great minds such as Hieronymus Fabricius Robert Boyle Alessandro Volta Michael Faraday Georg Ohm as well as Carl Gauss Christian Doppler Charles Wheatstone Nikola Tesla and more All of which were great mathematicians inventors engineers and scientists of their time My absolute favorite is Nikola Tesla A Croatian born engineer who could speak eight languages and almost single handedly developed technol ogy that harnessed the power of electricity for wireless household use Nikola invented elec trical generators tFM radio remote control robots spark plugs fluorescent lights and giant a machines that shoot enormous lightning bolts all over the place Tesla Coils Tesla had an unyielding photographic memory and an insane ability to visualize and simplify even the most complex pieces of machinery the man did advanced calculus and physics equa tions in his head memorized entire books at a time and successfully pulled off scientific ex periments that modern day engineers STILL can t replicate
6. to modulate the pulses to delay in time the pulses to apply a logarithm amplification to filter the pulses Question 3 The phase array probes build the sector ultrasound image by steering the ultrasonic lines sending half of the total line first and another half later sending the ultrasonic lines with an angle of 45 degree sending the ultrasonic lines with three focus Question 4 Enumerate three examples that shows the advantage of the electronic probes over the mechanic ones The possibility of move the focus along the image area The possibility of focusing continuously the reception of echoes Eliminate the complexity of mechanic devices Electronic probes are smaller It is possible to obtain images in B and M mode C2009 Question 5 The focus build by the ultrasound probes is done under the ciple a Huygens b Ramm and Thurstones c Somers d Gauss Question 6 The summation device located after the delay line circuits a synchronizes the echoes b outputs a signal which is representative to the original echo c adds the smaller echoes d stabilize the level of the echoes Answers 1a 2b 3a 4a b c 5a 6b prin Could Simultaneous Monopolar Electro Surgery be Safer By Gregory J Ward just can t tell you how fascinating it is to me that you can actually pass electricity through the human body as long as it is above 350 KHz with no negative physiological effects to the pa tient
7. 1833 Michael develops the laws of electrolysis During the remainder of the decade he worked on developing his ideas about electricity He was partly responsible for coining many fa miliar words including electrode cathode and ion Faraday s scientific knowledge was harnessed for practical use through official appointments including scientific adviser to Trinity House 1836 1865 and Professor of Chemistry at the Royal Military Academy in Woolwich 1830 1851 However in the early 1840s Faraday s health began to dete riorate and he did less and less engineering and scientific re search He died on 25 August 1867 at Hampton Court where he had been given official lodgings in recognition of his contribu tion to science He gave his name to the farad originally de scribing a unit of electrical charge but later a unit of electrical capacitance Reference BBC Michael Faraday Biography Accessdate http WwW bbc co uk history historic figures faraday michael shtml History Mole Michael Faraday Timeline Accessdate http www historymole com cgi bin main results pl theme 1001 1419 BASIC PHYSIC PRINCIPLES OF IMAGING ULTRASOUD II Eng M Sc Rogelio Leyva Ochoa The purpose of this paper is to enhance the basic principles of the physic knowledge used in the technique of ultrasound imaging shown in the first paper especially regarding ultra sound probes to achieve it there have been included new top ics and als
8. JUST READ MAY HAVE BEEN BASED ON ACTUAL EVENTS THE NAMES WERE CHANGED TO PROTECT THE INNOCENT Reference IPTrackerOnline com How to extract email headers a tutorial August 1 2012 http www iptrackeronline com how to extract email headers php Medical 120000 ISON ANESTHESIA DELIVERY AND DEVICE TIMELINE In the beginning anesthesia delivery had been traditionally been administered in dental surgical procedures by way of a cloth and Analgesic drugs that would reduce sensory mo tor and sympathetic nerve transmissions at the level of the brain resulting in lack of sensation unconsciousness Afterward anesthesia equipment became a wide spread means of delivery for anesthesia using simple pneumatic devices Where did it all begin At present scientists and other scholars are working hard tracing back ancient writings of the ancient Sumerians Babylonians Assyrians Egyptians Greeks Romans and Chinese that mentioned general anesthesia throughout recorded history In 3400 BC Sumerians culti vated and harvested the opium poppy Prior to the introduction of opium 400 BC ancient India and China civilizations pioneered the use of cannabis incense and aconitum a dark poisonous green leaf to be used in the traditional Chinese medicine in very low dosages of course Soon after the Sumerians realized the poppy s analgesic effects and then passed this Knowledge onto the Babylonians 2225 BC Afterward these primitive people
9. be within 2096 of the stated val ue We set in 100 watts the unit delivered 50 watts to each hand piece we found this to be out of compliance with the standard as well This led us to realize another situation that we feel is an area of concern We are talking about Simultaneous monopolar sub modes that uses 2 active hand pieces however there is only one power setting control and one power setting indicator It would only seem natural to have a separate power setting and indicator for each active hand piece this way each surgeon would be able to set and control his de sired power and at a glance look at the unit to see what the setting is The power shift from hand piece to hand piece After repeating the test several times we accidentally stumbled upon another potential patient safety issue We notice that if one surgeon was activating his hand piece and the other surgeon was not the unit would deliver the set in power 100 watts 20 9o Now if one surgeon was activating his hand piece and the other surgeon started to activated his hand piece roughly half of the set in power would immediately shift to the secondary sur geon This is a significant amount of power to have 50 watts 5096 of power just shift from one hand piece to the other hand piece during surgery could render a potential patient safe ty issue at the activation site Test of the Valleylab Force FX 522 unit 1000 ohms of the testing In the above pictur
10. is considered a continuous focalization along the re ception echo line with many pixels generating many echoes so there are focus at each pixel as shown in figure 17 then every time each echo arrive at the probe a different delay is done and a summation is also done for each delay this offer a better image quality be cause the synchronization needed for the summation is continuous this process was imple mented in 1976 by von Ramm and Thurstones Curvilinear probes or convex probes Sectorial ultrasound image This type of probe works the same way the linear probes do but as the surface shape Crystals E 5 Focus at each pixel 3 d d where the crystals are arrange is convex the ultrasound image area is sectorial as the me chanic ultrasound probes as seen in figure 18 Fig 18 Fig 17 Phase array probes transmission Phase array probes work in some way like linear array probes do but as is shown infig ure19 these transmit lines with different amount of angle regarding the y axis to build the shape of the sector ultrasound image in the example of the figure 19 the probe uses 4crystals 1 2 4 and 4 the pulses that activate the crystals are delayed sequentially in time no signal coming from the crystal have the same delay as happen in sequential probes figure 8 the crystal 1 is activated first and crystal 4 is the last this way the four lines arrive at the focus at same time now let s pay attention only to th
11. now Well 26 factory training schools later still love the job and enjoy the unique challenges we as biomed s face on a day to day basis believe we have a responsibility to always be looking out for the safety aspect of all the equipment we deal with We are Patient Safety Advocates looking out for the patient to ensure the equipment he may be ex posed to in the hospital is in excellent working order at all times Mission Statement The mission of Scholar is to provide an educational voice for the wide range area of healthcare technology related sciences and engineering We do that in three ways by providing open access so that people can utilize any of our published articles for multi applications at will so long as you reference properly e by providing engaging didactic analysis of the often complex problems encountered within the medical engineering sciences corps and e by providing a forum for the exchange of all ideas within our community For educational purposes only The META Scholar s journal is published quarterly by the professionals listed under the M E T A education committee Readers may submit articles photos and comments at anytime Suggestions and constructive criticisms are always wel comed New Subscribers To subscribe to the TMS Journal please fill out our membership form http www mymeta org individual membership Do you have a comment about a current article in The META Sch
12. t2 1 4 Echo at t3 J Fig 14 the probe the echo wave front is bigger so the time between the wave front arrival at each crystal is shorter in figure 16 the echo is deeper that s why the wave front is the biggest of three examples and the time between the arrival of the wave fronts at the crystals is the smallest of the three examples so there must be a different delay Crystals Echo at t3 11 Echo at t2 a Echo Rx focus lEchoatt1 Echo at 2 4 Echo J Fig 15 for each focus depths for all the group of pulses to arrive on time at the summation block Commercial ultrasound machines have two three or more delay circuit one for each focal zone wave front is the biggest of three examples and the time between the arrival of the wave fronts at the crystals is the smallest of the three examples so there must be a different delay for each focus depths for all the group of pulses to arrive on time at the summation block Commercial ultrasound machines have two three or more delay circuit one for each focal zone Crystals Echo at t3 18 Echo att2 y Echo Rx focus Echo at tif 1 Echo at t2 4 Echo att3 sE Fig 16 Even there are machines that have a dynamic focalization system this technology does not have focal zones instead the focal zone is reduced to a pixel zone and as the pixels are so close one another the focalization
13. the crystal 3hasO0 angle y axis the line generated by crystal Fig 4 Crystals ES s E NL Fig 5 2 is at some angle degree x at the left and the line generated by crystal 4 is at the same angle degree but with opposite sign x at the right and also it happen with line 1 x at the left and line 5 x at the right of course the angle degree of lines 1 and 5 are bigger than the angle degree of lines 2 and 4 The x components of the lines 1 2 4 and 5 are cancelled but the y components that is why the new ultrasonic line is on the y axis Crystals 1 2 Focus Ultrasonic line Fig 6 Figure 7 shows five lines xA line 5 and xA line 1 xB line 4and x 2 and 0 Line 3 xA and xB have some angle deviation taking as example lines 1 and 5 the line1have two components at the focus L1F yJand L1F x one positive and another nega tive the line L5 at the same point also have two components LDF yJand L5F x both posi tive L1F x and L5F x cancel each other because they have the same magnitude and op posite direction this happens because both angles are equals but one positive and the oth er is negative but L1F y and L5F y add each other in the y direction because both have the same magnitude and direction so their direction are the direction of the ultrasonic line resulting from L1 and L5 then the same way linesL2 andL4 are added line L3is added too but this only ha
14. would stretch out their empire and this knowledge eastwards into Persia In the end Arab traders continued travelling westward into Egypt moving along into the remaining trade routes spreading this valuable information Next in 1540 ether a colorless volatile liquid C H and having a sweet odor result ing from ethyl alcohol were becoming popular as an inhalant anesthetic In fact ether was the first man made anesthesia drug and it was invented by Valerius Cordus a German bot anist and chemist Valerius would call his new discovery the sweet oil of vitriol Moving along in 1772 Joseph Priestly an English philosopher and scientist discovered oxygen as well as 10 other well known gases to include nitrous oxide N2O that would later become commonly called laughing gas which he used in dental surgery This drug had minimal systemic effects on patients physiology and behavior such as respiration blood pressure and heart rate making it the ideal safe and effective drug of choice during that era In 1885 cocaine C 7H NO was introduced into the anesthesia classification and then Thio pental 1930s commonly called Sodium Pentothal C H 7N2NaQ2S would become next to induce anesthesia to patients In fact Sodium Pentothal is thought to still be used by FBI interrogators as a truth serum agent Well is it Subsequently in 1842 became the earliest clinical case recording of anesthesia used and has been attributed to
15. yet effective Soon after he designed Ohio 685 the military model used by the U o Army Medical Corps during World War II and this instrument was primarily for military an esthesiologists to have a lightweight mobile anesthesia machine close to field hospitals for combat related contingencies during the war Later on in civilian medical facilities ad vanced models were designed and employed such as the Clover ether inhaler 1877 Mor ton ether inhaler 1846 Boyles apparatus 1917 Colton nitrous oxide machine 1860 Trendelenburg endotracheal tube 1871 Snow s portable chloroform inhaler etc Almost 10 years later 1924 engineers at Drager developed the model the first cir cular closed system anesthetic machine of its kind Its principle as based on oxygen nitrous oxide and ether that was then based on the rebreathing bag principle This principle acts as a reservoir for the expired and then rebreathed gases in a rebreathing circuit or to be the instrument for propelling gases into the lungs during assisted ventilation Fig 3 Drager developed the model Photo by Drager History of Anesthesia Book at Drager Fig 3 Then 30 years later in 1952 the model Romulus System Anesthetic machine was packed together and manufactured as a trend for more gas es drawers a manual ventilation system and smaller lighter cylinders In the 1970s The Boston Anesthesia System BAS develope
16. 6 139 108 by 10 3 ITID COIUDOLmaril OO0mJ WILD Microsortt SMTPEVC 0 0 9790 959 5 Mon 26 Jan 2009 10 48 49 0800 Received from User 41 222 67 140 authenticated 0 bits by mail cyb asp p jp 8 12 11 20060829 8 11 3 with ESMTP id 0392 2 2009 22 52 54 0900 Message Id lt 200901021352 n02DqpHu020392 mail cyb asp p jp gt Reply To lt mrpeterphillip49 gmail com gt From Technical Support Services uhavebeenhacked gmail com Subject System Password Reset Date Fri 2 Jan 2009 14 53 22 0100 MIME Version 1 0 Content Type text plain charset Windows 1251 Content Transfer Encoding DIE o X MSMatilaPrioricy Normal X Mailer Microsoft Outlook Express 6 00 2600 0000 X MimeOLE Produced By Microsoft MimeOLE V6 00 2600 0000 BOC Return Path sharpl1976 o2 pl X OriginalArrivalTime 26 Jan 2009 18 48 49 0731 UTC FILETIME FRAOBCISZOSOLCO PEG some details are obvious without any further use of software tools In a future article perhaps we will further analyze and decipher this code without software tools but for now let us continue Afterward to get more information about our hacker our next step is to submit the email header to an email header analysis tool such as http www iptrackeronline com email header analysis php This site has a brief tutorial on how to extract and submit email headers for analysis and it is completely free to use We will simply f
17. Dr Crawford W Long Shortly after 1846 was when anesthesia really became publically known along with the help from Dr William Morton Dr Morton invented the first anesthesia device called the Ether Inhaler Fig 1 and 2 After the ether inhaler other makes and models followed by other great inventors such as Bellamy Gardner Joseph Thomas Clover F P de Caux and more began engineering Ether inhaler invented by William G Morton about 1846 Photo by Smithsonian Institution Press Fig 1 Re enactment of the first public demonstration of general anesthesia by William T G Morton on October 16 1846 in the Ether Dome at Massachusetts General Hospital Boston Surgeons John Collins Warren and Henry Jacob Bi gelow are included in this daguerreotype by Southworth amp Hawes Photo by Wikipedia Fig 2 other types of anesthesia instruments to include but not limited to oxygen spectacles masks and aesthetic respirators Next in 1853 chloroform was first used by Dr John Snow to perform general anesthesia In 1910 a mixed gas anesthesia machine named the Ohio Monovalve was being developed by Graham W Clarke Graham was the founder of the Ohio Chemical Company and with the help of Agatha Hodgins a nurse anesthetist this company flourished during WWII Essentially this machine design was only four pressure reducing valves some control knobs four gas tank yokes and two regulator valves pretty basic
18. Nikola held 700 patents at the time of his death which qualifies him as elite What does it mean to be a true engineer or scientist Perhaps it means to serve the public and devote yourself utterly to a set of high moral principles and standards Possibly for us it means to master the way of the electron Or maybe it means to seek a calmness of your mind and remain passionate for those things which are unknown and investigate why When we wake every morning we should devote ourselves to this style of perfection and al ways remain disciplined Here will be your first test Remember there is no pass or fail and no certification for getting the right answer can only offer you one goal that we as engineers must achieve and that is knowledge Can you break this hacker s code M3rry chR1Stmaz AND hApPY n3w y3ARZ 3V3rYON3 PHrOM M3ta jid rich Gauss ee o Carl Ge arg Simon lum 9 A E b apeo Niko Tesla Sir Charles Wihie sts tone Christian Doppler Editors Notes Howel I saw the best minds of my generation destroyed by madness Angel headed hipsters burning for the ancient heavenly connection to the starry dynamo in the machinery of night Quoted from Allen Ginsberg Special Points of Interest Didactic Muses Case Studies College Grounds Certification Equipment amp Diagnostics Medica
19. The M E T A Scholar 4th Ed December 2012 Linked 11 Thank You jGracias Je vous remercie Grazie D Sponsor On behalf of The Medical Equipment amp Technology Association META team we would like to thank you for showing your support and for sponsoring us You dedicated support will open many new opportunities for these men and women within the Healthcare Technology Management field in order to continue developing their professional skills Your contribution will enable them to participate in highly valued training and provide networking events that will broaden their discipline and character on and off work which is invaluable to our healthcare s future As you can imagine there are expenses involved in managing a high caliber team like this You sponsorship will provide for our continued service and support that we provide for all of our members Your contribution is not just a charitable gift but also an advertising opportunity Without the support of people like you we would not be able to reach our goals Thank you once again for you generous support of our team professionals Always Remember That M E T A also spells TEAM Very Respectfully Dustin Telford META President Almighty zeus msn com Individual commitment to a group effort that is what makes a team work Vincent Lombardi WY Keeping It Real Since 1975 Our comprehensive out of the box learning solutions outst
20. anding instructor support materials and customer service and state of the art curriculum and hardware design com bine to make Marcraft solutions the most cost effective and easiest to implement programs in the world For over 30 years Marcraft International Corporation has been producing elec tronics computer and mobile electronics training programs that excel in the classroom environment We engineer and design the lab hardware software and courseware materials for use in career and technical education schools around the globe Marcraft has customers in all 50 states the Cana dian provinces and in more than 30 countries around the world Marcraft s mission is to develop exceptional prod ucts for effectively teaching and training people the technical IT computer and electronics training skills in demand today and in the future Marcraft Administrative Offices 1350 Spaulding Ave WA 99352 509 374 1951 509 374 9250 EDUCATIONAL TECHNOLOGIES GROUP inc sponsor Us and Your Ad Can Go Here TEAMLACKS FUNDING APPLY WITHIN Advertise Your Company What being a META sponsor can do for your dollars Become a business partnership with META will 1 Give your company the opportunity to have METAs 795 members sample a new product or provide demonstration of a product or service from your company We will supply market ing space for your products and services advert
21. art of the coarse discussed PM s and we all had to set up and do a full PM on most of the units following the procedures in the technical manuals we were given At the end of the coarse we all had to trouble shoot units with bugs and owe what fun we had finding those planted bugs It wasn t until was on the plane heading back home that realized we didn t go over test ing the simultaneous monopolar sub mode We only discussed the internal dip switches that allowed you to turn on either dual cut or dual coag but not the operation of the sub mode itself Erbe USA Biomed technical training Erbe was next on my list so off to Georgia went to attend factory technical training for bio med The main instructor was Rick Stewart who may still be there as far as know This school was a bit different than Conmed in that they recommend testing the unit output read ings in current instead of power which is fine with me We went over all their units in the course but it was the VIO 300D that caught my attention It s basically a pc based ESU in a nutshell and is menu driven so to speak And since my facility had 3 of the units decid ed early on that would start to study this unit s ability to deliver simultaneous monopolar electrocautery paid particular attention to every detail and the mode was not even dis cussed much to my dismay While working with a unit was able to find Erbe s Twin Coag monopolar sub mode Select coag mo
22. asquez Industries website s Learning Management System and contributing to that curriculum He is an administrator for BMETWiki also META vice president and education co chair Alberto Vasquez MSMOT CCE CRES CLES CBET is recently pro moted to Assistant Professor and the Program Director for the Healthcare Technology Management Programs at St Philips College a member of the Alamo Colleges in San Antonio TX These include the A A S in Biomedical Engineering Technology and an Advance Certificate in Healthcare Technology Management As a certified Master Teacher he is responsible for researching planning and implementing the degree pong granting program and certificate The BMET program includes course to Healthcare through qualify for the A Net and Security certification exams along with Engineering amp the fundamentals of medical devices in order to prepare for the CBET Education He is also a small business owner of VC Clinical Engineering an online certification and continuation educating industry He is education chair for META Editors Notes What famous engineer or scientist throughout history do you idolize By Lub and Dub for those of you who listened to the car guys will understand this reference How have engineers and scientist from the past inspired you Looking in the glass mirror see my reflection and am forever mindful of those people who made vast discoveries in mathematics engineering
23. ctually heat up the fluids in each cell at each hand piece until it explodes and becomes smoke plume The energy then travels through the patient s body until it finds the return electrode The energy then enters the metallic plate and travels up the wire to reenter the ESU Now this circuit is a bit different we have now created a combination series parallel circuit In this circuit type again in the series portion the current is common and voltage is additive That means the total voltage of the circuit is equal to the sum of the voltages across each individual resistor e g Vtotal V1 V2 V3 However in the parallel portion of the circuit voltage is com mon and current is additive across each branch of the parallel portion of the circuit That means the total current of the circuit is equal to the sum of the current across each individual resistor e g Itotal 11 I2 I3 In our combination series parallel circuit we have a source ESU circuit paths both hand pieces the patient and the return electrode and two resistors the patient and application technique at each hand piece In Physics the ad ditive property of power is due to the additive property of voltage in a series circuit and the additive property of current in a parallel circuit Another way of looking at it is if several ele ments in a circuit are using a certain amount of energy per second then the total energy used per second is the sum regardless of how
24. d and tested two major changes in anesthesia machine design It was the first anes thesia machine engineered by way of human factors studies and the first with computer based operations Some of the functions assisted or con trolled by the computer include the electronic display the flow of gas and liquid anesthetic the oxygen to anesthetic ratio and the alarms with programmable limits for breathing sys tem pressure anesthetic gas flow oxygen concentration and battery function The BAS was displayed at the 1976 annual meeting of the American Society of Anesthesiologists ASA and received an ASA Scientific Exhibit Award Although never commercially pro duced the BAS prototype informed the development of anesthesia machines that came af ter it Fully electronic anesthesia machines became commercially available in the late 1980s Fig 4 Today the introduction of advanced anesthesia systems such as the GE Aisys Caresta tion with Et Control the first anesthesia system to combine end tidal oxygen control and end tidal agent control original equipment manufacturers have met the American Society for Testing and Materials ASTM ASTM F1850 00 2005 Standard Specification for Particular Requirements for Anesthesia Workstations and Their Components and the Underwriters La boratories of safety and design What does the future of Anesthesia hold Perhaps in the more distant future anesthesia machines will operate faster grow even s
25. de Monop receptacle FORCED COAG SPRAY COAG Return TWIN COAG PRECISE COAG In the above photo you can see the menu that allows you to select Twin Coag was fairly excited about getting back to my hospital so could look into this mode and learn more in detail about it was starting to notice a pattern in the simultaneous coagula tion arena it seemed that this mode didn t get a lot of attention was not quite certain why since this mode had an advantage over most generators that didn t have it two surgeons could use the ESU at the same time We all know the value of real estate around the OR table during surgery VALLEYLAB Biomed technical training It was a little over year or so later before could attend Valleylab ESU technical training for biomed which was held in Arizona It was shortly after the release of the TRIAD unit that attended school and though we went over the different models was curious if Val leylabs new unit had simultaneous monopolar capabilities finally got my chance to ask the instructor if the TRIAD has simultaneous monopolar coagulation and what a surprise when he said they had eliminated it from this unit Monopolar Electro Surgery Circuit Let s start by reviewing basic monopolar electro surgery ESU circuit path theory We know that electricity flows through every component one after the other in the ESU until it exits the ESU and enters the hand piece The RF wavefo
26. e a co manager has brought his ESU test device over to my facility so we could test the Force FX during simultaneous coagulation This unit only requires you to plug in a second monopolar hand piece activate it and you are in simultaneous coagulation mode We noted all of the same potential patient safety issues with this unit You may view the test at http ch zYh Exs Other tested VALLEYLAB units that have the same PUT Issues noted are The Force 2 which ECRI did an article on in the 90s some time they gave it a poor review Test of the Erbe VIO 300D The ERBE Company s equivalent to Simultaneous Monopolar Coagulation is called Twin Coagulation It is selectable through the software menus if the option is purchased TWIN COA Jpm x 2000V m In the above photo you can see that Twin Coag is being used at 100 watts in effect 8 We did find some operational warnings and guidance in the Operators manual pertaining to twin coag During testing we noted all of the same potential patient safety issues with this it sent the first test video to this manufacturer they didn t question my test technique However one of their design engineers in Germany recommended using a load value of did so in my second test of the VIO 300 D however it didn t affect the results Conclusion of our Testing With a few changes simultaneous coagulation Twin Coag or Dual Coag would be a safer mode and allow each surgeon to have indep
27. e lines 1 and 4 by now as was explained before at this point all the line are added the adding of line 1 plus line 4 generate new lineL1 x y LA O y L1LA x1 y1 4 L1 has components in x and y but L4 have only one component in y so the x components do not cancel each other as happen in figure 7 where L1 x and L5 x have opposite signs here as L4 x 0 L1 x forces the new line to have an angle different from O regarding the y axis this way the new line has been steered to the right of the center line and this angle of deviation of the new line will be bigger or smaller according of the angle of L1 x Nowlets focusing to all the lines of figure 19 the re sulting line has a deviation angle to the right on account of L1 x L2 x and L3 x as they have equal sign their x components do not cancel instead they add each other and Fe Pulse t1 1 1 X Pulse t2 L2 x Tx ultrasoud Pulset3 line direction 3 4 4 L1 x y L2 x y L3 x y 14 Fig 19 the total strength of the line is dependent of L1 x y L2 x y L3 x y L4 y L7 x y L6 x y L5 x y LA y Pulse t4 4 Pulse t3 5 Pulse t2 6 Pulse tif 7 Fig 20 The analysis of figure 20 is similar to the one done in figure 19 but the lines taken into account in figure 21 are at the opposite sites of the ones taken into account in figure 20 so the x components steer the resultant line to the left of the central li
28. e process is repeated all the time the probe is sending ultrasonic lines ELECTRONIC PROBES transmission Linear sequential array probes or linear array probes We begin to explain the electronic probe which generates a rectangular ultrasonic area as seen in figure 5 the linear array probes have more than one crystal in this explanation we refer to figured in which the probe has seven crystals The way an ultrasonic line is generated by an electronic probe is not the same way it is done by mechanic ones in electronic way an ultrasonic line is generated by more than one crystal as seen in the figure 6 let us focus first in ultrasonic line 3 crystal 3 generates an ultrasonic line the same way the mechanic probes do the crystals 2 and 4 generate one ultrasonic line each these ends at the same point Focus at this point also end the ultrasonic lines generated by crystals 1 and 5 According to the Huy gens s principles the net acoustic signal is the net sum of the signals that have arrived from each source in this paper each source is each crystal At this point the contribution of eve ry element is added in phase to produce a peak in the acoustic signal At the focus all the ultrasonic lines generated by the crystals are added to generate a new ultrasonic line that is the ultrasonic line which will go deep inside the human body as happened with the mechanic probes Taking the crystals as reference let s consider that the line generated by
29. e ultrasonic beam has passed through when the last echo is received a motor moves the crystal to the place where the line 2 is going to be generated as shown in figure 2 the same crystal transmits the ultrasonic beam and receives Tx ultrasoud line direction Fig 2 Fig 3 the echoes the same way as before then at the end of the reception the motor moves again the crystal but now to the place where the line 3 is going to be generated and so forth this process is repeated until the crystal reaches the line 7 as is shown in figure 3 now when the last echo is received the motor moves the crystal to the initial position in order to generates the first line of the next ultrasound area The mechanic probe with crystals that go around an axis have three crystals separated a 60 angle as seen in figure 3 At the beginning the crystal 1 is at the site where the first line point A will be generated from here to point B the procedures is the same as the one done by the pendulum probe but after the last echo is received from the last line point B the motor move the crystal in the same direction away from the ultrasound area and at the same time the crystal 2 is located at the line 1 point A in order to generate another ultra sound area and the process is repeated until the crystal 2 reach the line 7 that is moved away from the ultrasound area and then the crystal 3 is located in the first line of the coming ultrasound area and th
30. emaillquestions com Received qmail 20153 invoked from network 7 Nov 2000 14 Spam Checker YVersion SpamAssassin 3 2 5 2008 06 10 on A SpamLevel A 5SpamrStatus Mo score 0 1 requred 2 4 testszHDNS NON versonz3 2 5 Hecerved from unknown hrndva omtalb mailrr com 77 by mail discussny cam with SMTP Nov 2008 14 02 59 000 Received from 127 0 0 1 really 74 74 14 1 45 by hmd va omta5 mail rr com with ESMTP id 200811071 40313 5 GDw 15470 hrmdva ormtab mail for exampleceEmailduestions com Fri f Now 2008 14 7 Message ID 43144533 SU500 E mailldJuestions com Date Fri 07 Mov 2008 09 02 59 0500 From E Mail Questions examplece mail uestions com gt Reply To example mailQuestions com UserAgent Thunderbird 2 0 0 16 windows 20080 708 MIME Version 1 0 lt wr When you have your header extracted copied and saved you can begin investigating the information within it Essentially you are turning the tides to track down the hacker Let us use an example email from a Nigerian hacker sent to Henry s Microsoft Windows Live Mail Inbox Incoming full header X Message Delivery VjO0xLjE7dXM9MDtsPTA7YTOwO0Q9MjtTQO0w9Ng X Message Status 0 X SID PRA Mr Peter Phillip uhavebeenhacked gmail com gt X SID Result Fall X Message Info jXuonb5 YRm68Ci7Ivfe0Hv KIFdVOY7XxLdfBnLCvCwn8JjEOpGP8WOZNZ36B7 RyRDsMPlTFqG4 uQV8yk1AMg7CiHXRhUBi Received from mail cyb asp p jp 164 4
31. en using this mode The grounds are tied together so as to simulate a re alistic test scenario By doing this we will be able to read the delivered power of each hand piece In the above photo Sales Rep Johnny Boatwright of Erbe USA is filming me while test ing the VIO 300 D in Twin Coag mode am illustrating to him the Power Shift between the hand pieces during Twin Coag when one surgeon deactivates his hand piece and the other surgeon is still activating his Testing the Conmed System 5000 We decided we would use 100 watts as our power setting for all testing to make compar ing results between manufacturers easy The loads used for this test were 150 250 300 500 and 1000 Ohms By using a wide variety of load values we satisfied feedback from on design engineer at ERBE who questioned our load values On this unit we decided to test both the Dual Coag and the Dual Cut sub mode of the monopolar feature Below are the results of the power delivered from each hand piece on the Dynatech 454A electrosurgical analyzer while activating simultaneously with a power setting of 100 watts set into the Co agulation display For purposes of testing we will refer to one active hand piece belonging to the primary surgeon and the second active hand piece as belonging to the secondary surgeon Results for Dual Cut had the same characteristics as Dual Coag Simultaneous Coagulation Simultaneous Coagulation 100W setting Primary Surge
32. endent control of his power 1 Each simultaneous monopolar output receptacle should have its own independent power output controller and a power setting indicator Each simultaneous monopolar output receptacle should deliver power to within 20 of the set in power setting as is indicated on the power setting indicator This should also be true during simultaneous monopolar activation Each simultaneous monopolar HF receptacle output on an ESU shall have its own RF amplifier within the circuitry inside the unit And this amplifier shall not have a parallel output after its final amplification stage Link1 http youtu be QROrUtisRJM Link2 http youtu be W2IfP3W d9vc Link3 http youtu be Cq4qvoB0Px8 Random Quiz Question 1 The transmission of electricity through the human body with no negative physiological effects are Below 350Hz Above 250Hz Below 250Hz Above 350Hz Question 2 Which of the following is NOT part of the normal electrosurgical setup Patient headpiece Bipolar leads Return electrode Monopolar Leads Question 3 A Technician set the unit on the display to 100 watts the test equipment measures 69 95 watts Is the device within tolerance gt Yes No its exceeds the 10 tolerance rating No it should measure between 80watts out of 100watts No its exceeds the 5 tolerance rating Question 4 Who was a student of a student of Harvey Cushing and first develo
33. es from candles a fireplace or heat vent lighters as well as matches can start Christmas tree fires So make sure to water your trees so there is no problem Unplug electrical when watering trees and before you leave your house or go to sleep 7 Wear your seatbelts Encourage your friends and family to wear seatbelts too The fine of not wearing a seatbelt is short term but the fine of death is forever 8 Do not link three light or daisy chain lights as it is unsafe 9 Never text and drive Pull over park and then answer the call Otherwise use an ap proved hands free device 10 Wash your hands with soap and warm water for at least 20 seconds Stay warm by dressing warmly in several layers of loose fitting tightly woven clothing Prepare holiday meals and any meals to keep yourself and your family safe from food related illness Some pr Q WO rd S to make you Sound like an expert LASER Tube This instrument part is used to excite the medium carbon dioxide nitrogen hy drogen and helium filled gas within the tube and pump emit a laser beam Medical device CO2 LASER Tube Code RED hospital emergency code or overhead page used to indicate a fire disaster is occurring or underway Note this is not the military code red that was used in the 1992 blockbuster movie called A Few Good Facilities Engineering Wide Area Network A network that covers a broad area i e any telecommunications network that lin
34. fety tips to consider throughout the holidays 1 Stress Manage your stress Take a break get away from whatever is causing you stress and then come back later to deal with it 2 Winter driving Use risk management techniques if you are traveling on the road Evalu ate hazards like bad weather ice on the roads driving at night or driving long distances without taking frequent rest stops 3 Maintain your vehicles fluids belts tires if unsure how suggest you make an appointment with your local service dealer for a tune up In addition be sure you have a blanket flashlight and emergency flares in the trunk 3 Avoid aggressive driving behaviors and people that contribute to crashes Such as e Failure to obey a stop sign Speeding excessively e Failure to grant the right of way Improper passing e Driving left of center 4 Winter sports Never ski or snowboard alone Wear protective gear and know your limita tions Stay hydrated Fill out a high risk safety form with your safety monitor 5 Drink responsibly Don t drink and drive If you have more than one drink you could be considered illegally intoxicated to drive and could kill yourself or someone Instead call fami ly a friend taxi or co worker to drive you safely home 6 Remain compliant When decorating use a sturdy ladder and approved UL lighting for decorating outside Remain aware of your surroundings Don t take for granted the things you do repetitively Open flam
35. gical infusion pumps autoclaves etc He is also an assistant professor at the University of Oriente East in Bio medical Engineering Lastly he has worked as a service engineer in Jamaica and Honduras and has received extensive training in Tokyo Japan in ultrasound and ontology theory operation and troubleshooting systems Gregory J Ward is a clinical engineering manager that has worked in the Biomedical Engineering field for 12 years Greg has specialized factory training at Erbe ConMed and ValleyLab Currently he works at Sierra View District Hospital for Renovo Solutions in Porterville CA We have a Team of 3 at our facility and our recent accomplishment have been bringing our 45 Dialysis Machines in house We now take care of the Central R O Bicarb and Acid Systems on our 45 Dialysis ma chines My basic electronics training came from the US Navy Electricity and Electronics school in San Diego in the early 80 s attended submarine training and sonar school too before starting a long list of self study courses the Navy offered quickly became a Sonar Supervisor and special ized in Russian Submarines In 1994 entered the biomed industry by doing an internship at the Long Beach Veterans Hospital was assigned to work with the Dialysis Repair technician and did full days for a little over 6 months really liked this kind of work and later had my first biomed job and that was it there was no stopping me
36. isement 2 Provide a self service marketing platform to promote your company profile display com pany events and training classes offered and grant your company access to our members contact information 3 Start building newer and deeper area of networks by means of creating your company or product awareness and visibility within the Healthcare Technology Management community What are the different sponsor packages Tier 1 200 00 US Tier 2 400 00 US Tier 3 600 00 US Tier 4 800 00 US Tier 5 1000 00 US To learn more please visit out link and sign up today http www mymeta org sponsor membership META IS LOOKING FOR PEOPLE WHO LIKE TO SHARE THEIR KNOWLEDGE AND EXPERIENCE WITH OTHERS WHETHER YOU RE A NOVICE OR A VETERN WRITER GET IN TOUCH WITH US TO HAVE YOUR ARTICLES PUBLISHED MORE DETAILS EMAIL ELSUPREMO1 HOTMAIL COM WRITE FOR US gt 4 Christopher Correll MSIMT CBET A is a Clinical Engineer Manager at Tyndall AFB FL He has 18 years of Clinical Engineering experience with focus on patient safety technol ogy management incident investigation etc His professional experience includes multi account management and supervision project management safety healthcare information technology clinical research and investigation and educational program development for his organization Chris is active in the BMET educational community by reviewing courses at the V
37. ks across metropolitan regional city or national boundaries using private or public network transports IT Analog to Digital Converter A D is a electronic device that converts continuous signals to discrete digital numbers or signals Digital Communications Electronics Mucosa Protective tissues that line the oral nasal and external auditory meatus ear providing lubrication and protection against pathogens A amp P Gastric Mucosa Atomic Structures Biomed Girl Welcome C hag aday in chemistry and we will cover the atomit number 2250 known proton number which is fe nium ber OT protona Tound in nudeus of an atom and hereke denka b change number of the miches Professor why does oxygen molecules have two Meawhile there has been an explosion in the biomedical engineering lab Every oye remain calm ala Tha sounds Bie a ob Tor Bacmied Geil Ha Ha Hat Vies meei again Bao ext Gilir You nol Exe mne to atop me again rege fhe cniame auci win en Sees uw andy dive Coe i ciga zunm f only your puny Bte mind only knew how many valance electrones existed in Chxygen a 1 and 2 shells followed by its standard atomic weight would you be e fo deactivate Me Tou kas Biomed Girl 15 seconds nem got d Hahahaha Whal happens IF While you ware babbhi
38. l Header Analysis Engine and click Submit header for analysis Extracting Email Headers from Microsoft Outlook 2010 To extract email headers from Microsoft Outlook 2010 1 Click the File 2 Click Properties 3 Locate Internet Headers bottom of the popup window Highlight copy and paste everything from the Message Source window Ctrl A Ctrl C into the Email Header Analysis Engine and click Submit header for analysis Extracting Email Headers from Microsoft Exchange To extract email headers from Microsoft Exchange 1 To get the complete headers and message source using Microsoft Exchange Click the File menu 2 Click Properties 3 Click the Details tab 1 Click Message Source Highlight copy and paste everything from the Message Source window Ctrl A Ctrl C into the Email Header Analysis Engine and click Submit header for analysis Extracting Email Headers from Yahoo Mail To extract email headers from Yahoo Mail 1 Log into your Yahoo Mail account 2 Click the Mail Options link on the left hand navigation bar 3 Click the General Preferences link on the right 4 Locate the Show Headers heading and select All Click the Save button to put your new settings into effect Next is a screen shot of a full email header and the code that we will have to decipher Full Headers Tutorial Example General Internet headers for this message Return Path examplecoE mail uestions com Delivered To xamplet
39. l Tech History Highlights Games Comic Pro Words Inside this Issue Michael Faraday Hacker Detective Case Study Simultaneous Monopolar Coag ulation Michael Faraday Inventor of the Electric Motor Michael Faraday was born on 22 September 1791 in south London England His family poor and Michael received only a basic education When he was 14 he was a local bookbinders apprentice and during the next seven years educated himself reading books on a wide range of scientific subjects such as physics and chemistry In 1812 He attended four lectures given by the chemist Humphrey Davy at the Royal Institution Subse quently he wrote to Davy asking for a job as his assistant Davy turned him down but in 1813 appointed him to the job of chemi cal assistant at the Royal Institution A year later Faraday was invited to accompany Davy and his wife on a European tour taking in France Switzerland Italy and Belgium and meeting many influential scientists In 1821 he published his work on electromagnetic rotation the principle be hind the electric motor In 1826 he founded the Royal Institu tion s Friday Evening Discourses and in the same year the Christmas Lectures both of which continue to this day Michael Faraday In 1831 Faraday discovered electromagnetic induction i e the magnetic lines of force the principle behind the electric transformer and generator This discovery was crucial in his ca reer In
40. maller to include handheld machines and become less expensive devices that will use smart technology such as artificial intelligence black box technology etc so that the devices will record and automatically correct bad human factor designs on the fly resulting in a safer environment for our patients Anesthesia History and Device Timeline Drager man made by Travenol Laboratory 1968 gt Model A invented inv Invented cultivated Carestation 2000 Opium 3400BC 1951 34008 2225BC 1540 1774 1881 11884 11886 1846 11853 1910 1191211917 1924 11927 11933 11951 1965 11968 1976 1978 1992 1200012010 Chlotoform Babylonians Cyclopropane Realized discovery discoveredby firstused by apparatus Device Aysis effects of credited to August Framd Dr John invented introduce Carestation opium Joseph 1881 Snow Great 7 1933 2010 2225BC Priestley 1853 Britain 1774 Anesthesia History and Device Timeline delivery systems Illustrated by Chris Correll Reference Dictionary com LLC 2002 Retrieved by http dictionary reference com browse ether 2 3 4 Reference com LLC Biography of Valerius Cordus 2009 Retrieved by http www reference com browse Valerius Cordus Smithsonian Institution Press Ether inhaler invented by William T G Morton about 1846 2009 Retrieved by http www smithsonianlegacies si ed
41. nd line L 2 3 4 5 6 15 generated by eliminating crystal number 1from the group of crystals and including the number 6 in the group as is shown in figure 9 so the focus is moved toward number 7 crystal direction the second line is generated in the right place beside the first ultrasonic line with no crystals movements Figure 10 shows how is achieved the process to excite the crystals a pulse generator generates a pulse for each crystal later the pulse are delayed electronically by a device Figure 11 shows a complete circuit to transmits all the pulses needed for generating an ultrasound area One of the bet ter advantages of the electronics probes over the mechanic ones is that changing the time the crystal are excited the transmission focus can be moved forward or backward along the ultrasound interest area and also is possible to generate more than one transmission focus allowing a longer focal zone area Crystals Pulse tif 1 Pulse 2 Pulse t3 t Pulse tif 5 Crystals Pulse 2 Pulse t3 Pulse Pulse ul Focus First ultrasonic line Fig 8 FOCUS second ultrasonic line Fig 9 Crystals Pulse t2 Pulse t3 Pulse ori Pulse tif Pulse if 3 4 FOCUS second ultrasonic line 5 Fig 10 Crystals 1 Pulse tif D Pulse tf n Pulse t3
42. ne as is seen in figure 20 and is dependent of L7 x y L6 x y L5 x y L4 y L Pul ulse t1 2 L2 x y L3 x y LA y L5 x y L6 x y Pulse t2 1 3 1 lt Pulse t2 4 5 Pulse tif 6 Fig 21 Figure 21sows the same array of figure 19 and 20 but the resultant line from the adding ac tion is a straight line along the y axis the analysis is similar to the one done in figure 7 L6 x L 2 and L 5 L 3 cancel each other as these line components are the ones that contrib ute to the deviation angle the resultant line is a straight ultrasonic line along the y axis L2 L3 x y L4 y L5 x y L6 x y Reference The Physics of Medical Imaging Steve Webb IOP Publishing LTD a Company Wholly Owned by the Institute of Physics London 1992 The Biomedical Engineering Handbook Third Edition Joseph D Bronzino 2006 by Tay lor amp Francis Group LLC CRC Press is an imprint of Taylor amp Francis Group service manual Aloka SSD 5500 Aloka Ultrasound Systems 2005 22 1 Mure 6 chome Mitaka Shi Tokio 181 8622 Japan Random Quiz Question 1 The transmission focus in the linear probes are obtained by adding lines transmitted from the crystals means of a convex mirror inside the probe amplifying the transmitted lines activate all the crystal of the probe Question 2 To build ultrasound lines transmission the echoes in reception is neces sary
43. ng quick hy deactivated the bomb ung fne n m aon gathered from you The One 26 16 whnech m dermed Trom ihe atomic structures of rou forget evil cne that of my many super ome of Them intuitive intelligence Ifa time for you beck prison where you belong T 1 z 2 5 g gt 5 al 47 gt E a can t believe thes how wall get you Biomed Mark my Worda 1 wall qet you 9 r1 Remember wiih great power carnes responsi y and be Wang deel you again Deceit Aas Lr ve meal again ER ucl 7 joa 1 O O a G O D O O S S A E ACROSS DOWN 1 Device shall include a key either keyed or combination 1 Energized conductive components 4 Dangerous condition such that contact or equipment failure re 2 Maintaining good housekeeping around equipment sults in electric shock arc flash burn thermal burn or blast and work space 5 Affix to every medical equipment as a central means for estab 3 Safety glasses hearing protection face shield lishing an equipment device record arm guards steel toe boots are all examples of em 6 Conductor connected to earth potential ployee safety related 8 Conductor connected to neutral point
44. o we have gone deepen into other ones briefly ex plained before Learning objectives Basic principles of ultrasound probes In this article you will Be able to describe how the mechanics ultrasound probes transmit the ultrasound lines needed to build the ultrasonic ar ea Be able to describe how the mechanics ultrasound probes receive the echoes coming from the tissues Be able to describe how the electronics ultrasound probes transmit the ultrasound lines needed to build the ultrasonic ar ea Be able to describe how the electronics ultrasound probes receive the echoes coming from the tissues Be able to describe how the electronics ultrasound delay to the echoes coming from near middle and far field of diagnostic area Be able to enumerate the advantages the electronic ultra sound probes have over the mechanic ones Be able to enumerate the basic differences between the mechanics and electronics ultrasounds probes Be able to describe how phase array probes transmit the ultrasound lines Topics 1 Mechanic probes i transmission and reception 2 Linear array probes i delay time li line generation lii focusing Vi echo generation 3 Convex probes 4 Phase array probes i transmission and reception li continuous focalization in reception ULTRASOUND PROBES MECHANIC PROBES transmission and reception Sectorial ultrasound image probes Though mechanic probes are not widely used as electronic ones at
45. of a system that is intend 7 NFPA standard oftentimes used by OSHA inspec ed to carry current under normal conditions tors for electrical safety within the workplace 9 Operation of equipment in excess of normal full load rating or excess rated ampacity that can cause damage over time 10 nonsparking slip resistant and insulated for maximum working voltages are all examples of employee safety related 11 Employers shall post at entrances to areas or protective enclo sures containing laser devices Hacker Text Deciphered Merry Christmas and Happy New Year from everyone here at META Marketplace Certified Ethical Hacker An ethical hacker is usually employed by an organization who trusts him or her to attempt to penetrate networks and or computer systems using the same methods as a hacker for the purpose of finding and fixing computer security vulnerabilities Unauthorized hacking i e gaining ac cess to computer systems without prior authorization from the owner is a crime in most countries but penetration testing done by request of the owner Is not Certification The certification demonstrates competency as a computer techni cian Officially CompTIA A certification is a vendor neutral certification that covers numerous technologies and operating systems The 2009 certification requires passing two exams Essentials and Practical Clinical Engineering Handbook As the biomedical engineering field expands th
46. olar Also help write more articles for our next issue E mail elsupremo1 hotmail com
47. ollow these few steps to investigate our hacker s whereabouts 1 Copy and paste our email header data and click submit header for analysis IP Address Tools Downloads Web Gadgets Buy Credits Email Analysis Register for our Newsletter amp Mailing list First Mame Last Mame Email Address Join Gur Mailing List Email Header Analysis How to extract email headers brief tutorial Paste email header here Incoming full header B Hessage Delivery VjUuxLjET7dzMe9HDbrtsPTA 7TYTOwoODdOgSWjrtTonuweSTIcdg x HNessage Srtratus ni0 SID D FE Mr Peter Phillip sharpi976B8oz pl 5 1 Fail Message Info jXuons5 YRm 68Cci 7Iwvfe 0ID EIFdGwvov 7zxLdadtrBnLcwcouwnag3jEkO0pGcPaGuuzmza3e B7 HByHRbsMPlITFc G2 ugWw AOyklAM7CiHEhUBi Received tram mail cxylh asp p jp 164 46 139 1068 by colo mecs i8 cCol 0 hotmail com with Microsott SMTPSwvi 6 0 3790 395993 Submit header for analvsis Next locate to the far right the originating IP address this is the hacker s original IP ad dress from where he sent Henry that malicious email Also note that the hostname original email address and latitude and longitude of the hacker s origins are present What can we do with this information Hacker Detective Well you can input his latitude and longitude into Google maps for a street view or satellite map of his internet providers city and state or country Additionally we can pe
48. on Second Surgeon 150 Ohms 15 3 watts 150 Ohms 15 9 watts 250 Ohms 23 watts 250 Ohms 25 watts 300 Ohms 27 5 watts 300 Ohms 30 watts 500 Ohms 40 9 watts 500 Ohms 45 watts 1000 Ohms 44 5 watts 1000 Ohms 51 watts If you study the chart above you will notice that we have a very interesting situation in that even though we set the unit 100 watts on the display the unit only delivered roughly half of the power to each electrosurgical analyzer via the hand pieces As you can see the lower the ohmic value the worst the wattage measurement e g prim surgeon using a hand piece at 150 ohms on the unit had delivered and recorded 15 3W that is 15 396 of the rated output out of 100W Recall that it should be close to 80 as stated earlier taken The reason this happens we discovered is because there is a parallel circuit formed as soon as a second hand piece is plugged into the unit The results immediately raised some concerns about simultaneous electrocautery In ANSI AAMI HF18 1993 4 4 titled Accuracy of Performance specifica tions section 4 1 b and c B states that the output power versus load resistance shall be within 20 of the stated value since there is no test procedure in the manufacturers service manual we used the above loads which show at 500 ohms the unit delivered roughly 50 of the set power at each hand piece we find this to be out of compliance with the standard C states that the output power versus control setting shall
49. ound the clock taking corrective measures to assure the safety of every member s personal identifiable Information However we would like to ask that you to take a moment and update your password in accordance with our local policies Please click this link to update password Thank you Dustin Fordtel TEAM President WW team ord bottom of it First rule of detective work is informing the clients to never click any links from random anonymous emails no matter how legit it might be Ronald Reagan once said Trust but verify and very good words to live by The reason is Henry could have a malevolent virus installed onto his computer stealing his passwords user names or other personnel in formation i e bank accounts social security numbers credit cards key dates etc By clicking the link and Henry entering his new information the hacker is stealing his information once he press sends All Henry sees is a link that says the email originated from technicalservices com when in fact the email be disguised and instead your infor mation sent straight to my hotmail account Actually hackers will masquerade as someone else s identity with made up spoofed email names and spoofed email addresses to gain access to targeted system An elite hacker will cover up his malicious intent even further by embedding a Trojan virus i e ACAD Medre A inside a link and when you click the link he or she downloads a worm for the hacker to steal
50. ped the electrosur gical device used today a b C d N W Cornell William T Bovie Arthur Tracy Cabot G H Liebel Answers 1 4 2 a 3 c4 b The Hacker Detective By Chris Correll Learning Objective An appreciation for ethical hacking de velopment for modern day Biomedical Technicians There was a sharp wind blowing that night as the rain drops violently clobbered against my window It was one of those dreary muggy nights with sweat beating upon my brow reading my favorite article and only a glass of single malt scotch to wet my palate Oi ole se cn ho ee See t am Lt wv It is a little slice of Paris always say at least while wait for my 1951 series Dragnet to finish streaming My name is Kevin Timnick was once a convicted criminal and world s most famous hacker turned security specialist Anything can happen on dull night like this when all of a Sudden an anonymous email pops up and into my inbox inbox Microsoft Outlook gaiz mak Bile Edit View Go Tools Actions Plaxo Linkedin Help question for help New ca Reniy Reply to Al Forward MES E Messages Mail 3 Inbox C Inbox Weblog 2 1 Inbox Hanselman 12 Fraser 2 Email ZEB 44 Fe Spec al nifi 0 Action 16 17 Ld eWaiting For 3 z aa Lj Someday 2 us reso TON ca Snooze 1 Spec al editios
51. rfing the internet for beer recipes and all of a sudden a mysterious email popped into his inbox He continued saying that the email did look suspicious but it had been sent from one of his many contacts listed in his Hotmail ac count He said Kevin I know it was dumb but I just opened the so sorry You really shouldn t have Kevin said I know and now am getting phone calls and email replies from all my contacts asking me why I sent them this bad link and so happens is that one of them is my boss who is blaming me said Henry frantically I thought could trust you said Henry s boss And Henry kept rambling on and After calmed down Henry then proceed to look over the suspicious email that he had sent to me only a few moments ago Here is a screenshot of what his email looked like Almost immediately a number of red flags go up as 1 The Hacker Detective get to the password reset 1 Send Save Attach Check names High Low ay x i To technicalservices com 1 Bcc Subject system bassword reset Hide Cc amp Bec AfBFormat amp Add photos O Stoney Aral 127 B I U A gt HESTE 7 68 Dear Henry Kissinger Recently we received notification from our security specialists that 1 268 membership accounts and passwords have been compromised on our system Please do not be alarmed as our technical specialists have been working ar
52. rform a WHOIS command and that will tell us more specific details about the originating IP Addresses provider as well as an address and phone num ber to report abuse In our example 8 12 11 200 originating IP address belongs to a pro viders name Level 3 Communications A WHOIS search reveals that the company is out of Broomfield CO and that a phone number and email is listed to report this type of malicious conduct Email header analysis report All valid IP Addresses found in the header Ip Address 3rd Party Info Provider Country BH Level 3 Communications United States 41 222 67 140 BB Nigeria 164 46 139 108 B Firstserver Inc Japan Probable originating IP address Header Analysis Originating Info Email info Geographical Info Originating IP address From Continent p 12 11 200 Technical Support Services uhavebeenha North America Originating hostname Originating Email address Latitude p 12 11 200 Juhavebeenhacked gmail com 38 Originating Organization Subject Longitude Level 3 Communications System Password Reset 97 Originating Country Date Sent Time zone united States Fri 2 Jan 2009 14 53 22 0100 n a Originating City Message ID GMT offset na 200901021352 n02DqpHu0203928 mail cy n a The screenshot below shows the geographic location of the internet provider s location Google Piap for 1 27 11 200 ES E nya United States nap Satellite ar
53. rm will then enter the patient at the point where the doctor starts to touch the patient s tissue and activate his hand piece It s the RF waveform that will actually heat up the fluids in each cell until it explodes and be comes smoke plum The energy then travels through the patient s body until it finds the re turn electrode The energy then enters the metallic plate and travels up the wire to reenter the ESU In plain electronics talk we simply have a series circuit here that s all We re member from school that in a series circuit current is common and voltage is additive In our series circuit we have a source ESU a path the hand piece the patient and the return electrode and a resistor the patient and application technique i NT SS EN A IR The illustration above shows the equipment minus the patient to complete the monopo lar electro surgery circuit Simultaneous Monopolar Electro Surgery Circuit Now let s look at the simultaneous monopolar electro surgery ESU circuit path theory Like before the electricity flows through every component one after the other in the ESU un til it exits the ESU and enters the hand pieces In this monopolar sub mode you have 2 hand pieces plugged into the same ESU at the same time The RF waveform will then en ter the patient at the point where each doctor starts to touch the patient s tissue and acti vate his hand piece Again it s the RF waveform the frequency that will a
54. roughout the world clini cal engineers play an evermore important role as translators between the medical engineering and business professions They influence pro cedure and policy at research facilities universities as well as private and government agencies including the Food and Drug Administration and the World Health Organization Author Joe F Dyro Practicum For Biomedical Engineering And Technology Manage ment Issues Written by 30 different experts in the profession this publication also in cludes chapters on Quality assurance Establishment of an in house biomedical program Use errors Wireless spectrum management Medi cal equipment replacement Equipment disposal Failure mode and ef fects analysis Introduction to imaging devices Emergency prepared ness Customer satisfaction and an introduction to DICOM Author Les Atles Certified Ethical Hacker Review Guide Complete STUDY GUIDE Quentin Docter amp oum rms appen Dulaney Toby Shandice Click to LOOK INSIDE CLINICAL ENGINEERING 1S UND i100 4 Authors Rogelio L Ochoa Eng M Sc is an engineer that has worked in the Biomedical Engineering field for 30 years as well as at the Electromedicine Center of Santiago de Cuba as a Senior Biomedical Engineer Rogelio has experience in medical imaging ECGs defibrillators electrosur
55. s 0 this way by adding this five lines it has been generated a new line with the direction of the line 3 with the strength of the four y components L2F V LAF y L1F y L5F y plus the total strength of L3 as shown in figure 7 We have seen the way the ultrasound line is generated but not how the lines arrive to the focus with the appropriated direction and angle Figure 8 shows that the path from crys tal 1 and 5to the focus is larger than the path from crystal 2 and crystal 4 to the same focus and the shorter path is from the crystal 3 all the ultrasonic lines have equal speed of propa gation and all the ultrasonic lines generated by the crystals must arrived at the focus at the same time no matter how different the paths distances are among them that is why the crystals 1 and 5 must generate their ultrasonic lines first than the others Pulse t1 later at the right time crystals 2 and 4 generate their ultrasonic lines Pulse t2 and later also just in time crystal 3 generates the center line Pulse t3 and this way the first ultrasonic line of the image area has been generated the mechanic probes has a motor to move the crystals from one place to another in order to generate the lines one by one at the right place but the electronic probes generate the lines one by one at the right place without moving any crystal the first ultrasonic line generated by adding L 1 2 3 4 5 is shown in figure 8 the seco
56. they re configured Total energy used is total energy used The illustration above shows the equipment with two hand pieces plugged into the monopolar active outputs forming the parallel portion of the combination series parallel cir cuit path for simultaneous monopolar electro surgery In 2005 started researching and testing different manufactures ESU s simultaneous monopolar coagulation mode decided needed help so at the time had a Gold Member ship to ECRI s on line database also had the product comparison option as well which made my research a bit easier to do So only wanted to test units that had disclosed to ECRI that they had the simultaneous monopolar capabilities The 3 that chose were the ERBE Vio300D Conmed System 5000 and Valleylab Force FX After reviewing the technical manuals of the three chosen units was unable to find a test procedure for simultaneous monopolar coagulation cut In ANSI AAMI HF18 1993 sec tion 4 1 3 titled Service Manual it is recommended that the service manual have Cali bration procedures and Preventative Maintenance procedures test procedures Simultaneous Monopolar testing method We now needed to develop a way to test the power output while simultaneously energiz ing both monopolar out hand pieces For testing this circuit we simply put a Dynatech 454A electrosurgical analyzer on each parallel branch of the combination series parallel circuit that is formed wh
57. this time it is useful to know how they work for understanding better the electric ones As was explained before the ultrasound area is built with ultrasound lines as seen in figure 1 the mechanic probes generate the ultrasonic lines one by one using only one crystal remember that crystal in this paper means is a quartz crystal or other combine materials with the piezoelectric prop erties though ultrasound probes may have more than one crystal depending the kind of mechanic probe In this paper the ultrasound area is defined by two axes x y the y axis is in the center of the area and has the direction other central ultrasound line emitted by the ultrasound probe and the x axis has a 90 angle respect the y axis as is shown in figure 1 at the left x is negative and positive at the right besides all the lines emitted by the crystals have the same strength that is why when two lines are added and the y components have opposite sing they cancel each other Here we explain two types on mechanic probes one of them has a crystal which swings as a clock pendulum and another has three crystals going around an axis The one that swings has just only one crystal which at the beginning of the generated ar ea is localized at the left of the ultrasound area where the first line has to be as is shown in figure1 the crystal receives the electric pulse needed for sending the ultrasonic beam then it waits for the echoes coming from the tissues th
58. u objectdescription cfm ID 287 Allen amp Hanburys Ltd A Reference List of Surgical Instruments and Medical Appliances Orthopaedic and Deformity Apparatus Hospital Furniture and Equipment Electro Medical and Surgical Apparatus etc 1930 Retrieved by http www oyston com history Wood Library Museum of Anesthesiology Ohio 685 Anesthesia Machine 2011 Re trieved by http woodlibrarymuseum org museum item 91 ohio 685 military machine gt 10 11 Dragerwerk AG History of Anesthesia Book at Drager 1996 Retrieved by http www draeger com media 10 01 39 10013904 anes or history of anesthesia book en pdf You See An outlet that has a Christmas tree plugged into it META Sees A fire hazard that ex ited An overloaded and broken outlet with frayed exposed bare wires can cause fires You See A cozy fireplace META Sees A fire hazard that can set your tree and house on fire You See a damaged Christmas tree META Sees A mishap that could have been prevented by following proper safety tips such ias using only UL ap proved Christmas lights a stand that should have been filled with water and a missing fire extin guisher nearby which could have helped put the fire out METAs Holiday Safety Brief This holiday safety campaign focuses on stress management winter driving winter sports responsible drinking and safety awareness at all times Here are some Sa
59. your information and finally deleting its tracks Truthfully being a hacker detective requires you to able to extract and figure out email header information regardless of what email client you are using All you are trying to do 15 extract the complete email header that tells the detective effectively the route path taken from the sender hacker to your machine the victim Lastly many known internet providers will purposefully strip out a lot of the information to include the senders exact street address therefore you can only track the IP address as far as the internet provider On the other hand knowing the hackers internet provider can and will prove very resourceful later on for reporting purposes The following are some ways to extract email headers by email client Extracting Email Headers from Gmail To extract email headers from Gmail 1 Open the email message 2 Click the down arrow adjacent to the Reply link in the upper right corner of the email message 3 Click Show Original Copy and paste the header information into the Email Header Analysis Engine and click Submit header for analysis Extracting Email Headers from Hotmail To extract email headers from Hotmail 1 Login to your Hotmail account 2 Click on Options tab on the top navigation bar 3 Click on the Mail Display Settings link 4 Change the Message Headers option to Full 5 Click the OK button Copy and paste the header information into the Emai
60. ystal to form an ultrasonic line now the five pulses produced by the crystals must be added to generates an electric signal which represents one echo of the reception line that is why all the five pulses group must be added but for the summation action all the pulses must arrive at the summation block at the same time so alike in transmission the pulses pass through a delay circuit now the circuit delays an amount of time the pulse at t1 com ing from L3 that was generated first by the echo wave front this amount of time delay is to synchronize t1 to the pulses at t2 L2 and L4 also to synchronize it to the pulses at t3 L1 and L5 that are the last pulses generated a smaller delay is applied to the pulses at t2 and no delay is applied for pulses at t3 this way all the pulses arrive at the same time at the summation block coming from crystals as seen in figure 13 Crystals E OY 52 7 d Echo Rx focus AO i a Fig 12a Fig 12b Crystals Echo at 4 4 Echo t2 1 Echoat t1 Echo at t2 Echo at 2 Echo J 4 ert Fig 13 The delay is applied according to the focus depth figure 13 shows the time between the arriving echo front wave figure 14 shows a wave front coming from an echo which is near the probe in figure 15 is further as the echo is farther from Crystals Echo at t3 4 Echo att2 2 Echo Rx focus Echo at t1 3 5 Echo at

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The M.E.T.A. Scholar - Medical Equipment &amp; Technology Association

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The M.E.T.A. Scholar - Medical Equipment & Technology Association