Use of Medical Equipment

1. Identify the Parts


Earpieces – the soft tips that go in your ears. Tubing – carries sound. Chestpiece – placed on the body. Diaphragm (flat side): for high-pitched sounds. Bell (small, concave side): for low-pitched sounds.


2. Put the Earpieces In Correctly


Insert the earpieces pointing forward, toward your nose. They should fit snugly and be comfortable. If sound is weak, adjust the angle or tighten the headset


3. Select the Correct Side of the Chestpiece


Tap lightly on the diaphragm or bell while listening. If you don’t hear tapping, rotate the chestpiece to activate the other side. 

4. Place the Chestpiece on Bare Skin


Always place it directly on skin, not over clothing. Press gently but firmly to create a good seal.


5. Listen to Body Sounds


Common areas to listen: Heart: left side of the chest, just below the nipple line. 
Lungs: upper chest and back (ask the person to breathe slowly and deeply). 
Abdomen: various areas to hear bowel sounds.


6. Use the Correct Listening Technique


Diaphragm: heartbeats, breath sounds, bowel sounds. Bell: low-pitched heart sounds (use light pressure). 
7. Minimize Background Noise


Stay in a quiet environment. Avoid rubbing the tubing or touching the chestpiece during listening


8. Clean After Use


Wipe earpieces and chestpiece with alcohol wipes. Let it dry before storing.


Tips


Warm the chestpiece in your hand before placing it on skin. Practice often to recognize normal sounds. If sounds are faint, check earpiece direction and chestpiece position.

Step 1: Prepare the Equipment


Ensure the pulse oximeter is clean, intact, and has sufficient battery power. Inspect the probe to confirm that the light-emitting and light-detecting surfaces are clean and undamaged.


Step 2: Prepare the Patient


Explain the procedure to the patient and obtain cooperation. Position the patient comfortably, either sitting or lying down. Select a well-perfused site, most commonly the index or middle finger. Remove nail polish, artificial nails, or any substances that may interfere with light transmission. If the patient’s hands are cold, warm them to improve peripheral circulation. Ask the patient to keep the hand relaxed and still.


Step 3: Apply the Pulse Oximeter


Open the clip of the pulse oximeter and insert the selected finger fully into the probe. Ensure that the sensor is properly aligned, with the light source and detector positioned opposite each other, typically with the sensor facing the nail bed. Avoid excessive pressure, which may reduce blood flow. Keep the hand supported at approximately heart level.


Step 4: Obtain the Reading


Turn the device on if it does not activate automatically. Allow several seconds for the device to detect pulsatile blood flow and stabilize. Observe the display until the oxygen saturation and pulse rate readings become steady. If available, check that the pulse rate displayed corresponds with the patient’s palpable pulse and that the waveform or signal indicator is regular.


Step 5: Interpret the Results


Read the oxygen saturation (SpO₂) value, which represents the percentage of hemoglobin saturated with oxygen. In adults breathing room air, normal values are typically between 95% and 100%. Values between 90% and 94% suggest mild hypoxemia, while values below 90% indicate significant hypoxemia requiring urgent assessment. Record the pulse rate and ensure it is clinically appropriate for the patient.


Step 6: Correlate Clinically


Always interpret pulse oximeter readings in conjunction with the patient’s overall clinical condition. Assess respiratory rate, effort of breathing, skin color, and level of consciousness. Be aware that pulse oximetry measures oxygenation but does not provide information about ventilation or carbon dioxide levels.


Step 7: Recognize Limitations and Sources of Error


Understand that readings may be inaccurate in the presence of patient movement, poor peripheral perfusion, hypotension, hypothermia, severe anemia, or exposure to bright ambient light. Pulse oximeters may give falsely normal readings in carbon monoxide poisoning. Results should be interpreted with caution in these situations.


Step 8: Remove and Clean the Device


Once the measurement is complete, gently remove the probe from the patient’s finger. Clean the probe according to infection control guidelines, typically using an alcohol wipe, and allow it to dry before storing.

Step 1: Select the Appropriate Device


Manual sphygmomanometer (aneroid or mercury): requires a cuff, inflation bulb, and stethoscope to hear Korotkoff sounds. Digital automatic monitor: inflates automatically and displays readings on a screen. Ensure the cuff size matches the patient’s arm circumference; a cuff that is too small gives falsely high readings, while a cuff that is too large gives falsely low readings.


Step 2: Prepare the Patient


Explain the procedure to the patient to ensure cooperation. Have the patient sit comfortably with back supported and legs uncrossed. The patient should rest for at least five minutes before measurement. Remove or loosen any tight clothing from the arm to be measured. Position the arm bare, relaxed, and supported at heart level, with the palm facing upward. Ensure the patient has not smoked, exercised, or consumed caffeine in the past 30 minutes, as these factors can affect readings.


Step 3: Apply the Cuff


Wrap the cuff snugly around the upper arm, approximately two to three centimeters above the elbow crease. Ensure the bladder of the cuff is centered over the brachial artery. The cuff should be flat and smooth, not twisted, and allow space to fit one fingertip under the edge comfortably.


Step 4: Position Yourself and the Stethoscope (Manual Measurement)


Place the stethoscope diaphragm over the brachial artery, just below the cuff edge. Ensure the stethoscope earpieces are facing forward toward your nose for proper fit. Position yourself so that you can clearly hear the Korotkoff sounds without obstruction or background noise.


Step 5: Measure Blood Pressure
Manual (Aneroid or Mercury) Method: Close the valve on the inflation bulb. 
Inflate the cuff to 20 to 30 mmHg above the expected systolic pressure. Slowly release air at a rate of 2–3 mmHg per second. Listen carefully for Korotkoff sounds: First appearance of sound indicates the systolic pressure. Disappearance of sound indicates the diastolic pressure. Record the measurement in millimeters of mercury (mmHg).


Automatic Digital Method: Press the start button. Keep the arm still and avoid talking or moving. Wait for the monitor to inflate, measure, and display the readings. Record the systolic, diastolic, and pulse rate as displayed.


Step 6: Repeat Measurements if Needed


Wait one to two minutes before taking a second reading on the same arm. 
Take two to three measurements and calculate the average to improve accuracy. 
Use the same arm consistently for repeated readings to reduce variability.


Step 7: Record and Interpret


Document readings in a logbook or digital record, noting the time, arm used, and patient position. Normal adult ranges are generally: Systolic: 90–120 mmHg 
Diastolic: 60–80 mmHg 
Recheck measurements if values are abnormal or inconsistent, and consider repeating after several minutes.


Step 8: After Measurement


Remove the cuff gently. Clean the cuff if it will be shared, typically using an alcohol wipe. Turn off the device if automatic, and store it properly to avoid damage.


Step 9: Tips and Precautions


Measure blood pressure at the same time of day for consistency. Ensure the patient does not talk or move during measurement. Avoid placing the cuff over clothing or arterial lines (catheters). Reassess if there is arm swelling, injury, or irregular pulse. Persistently abnormal readings require further evaluation by a healthcare professional.