MULTIX Impact: Safety Online Training

Welcome to the MULTIX Impact Safety Online Training. This course will discuss information relating to personal, examination, and equipment related safety recommendations when using the MULTIX Impact system.    Upon successful completion of this course, you will be able to: Summarize general fire safety precautions when using the radiographic system Explain safety measures that will protect personal safety of the technologist Identify safe practices during the examination Recognize how to safely use the equipment to prevent injury to the patients and technologists Congratulations. You have successfully completed the MULTIX Impact Safety Online Training. Listed below are the key points that have been presented throughout the course. Take some time to review the material before you proceed to the final quiz.  Summarize general fire safety precautions when using the radiographic system In the event of a fire, shut down the system immediately through the following steps: Disconnect from the system from the main power supply Press the emergency shutdown button or actuate the main disconnecting switch Use a CO2 fire extinguisher Do NOT use water! Contact Siemens Healthineers Customer Service before starting up the system again or performing any refurbishing work In an event of a fire inside or in the vicinity of the system during a patient examination: Switch off the system Help the patient escape from the system Be familiar with the hospital escape routes Be aware of where the fire extinguishers are located and know how to use them Explain safety measure that will protect personal safety of the patients and technologists Patient Safety during Examination All safety related equipment must be installed and functioning, specifically the hand grips and compression belt The hands, arms, legs, head, and hair of the patient must not extend unsecured beyond the edge of the tabletop Always observe the patient while moving the tabletop and during other system movements Radiation Protection Radiation may only be released by authorized operators or persons authorized to apply ionized radiation To avoid unwanted radiation, free exposure should be used with care Air kerma is increased by the following settings: Higher kV Higher mAs Higher ms Smaller SID Recognize how to safely use the equipment to prevent injury to the patients and technologists Cleaning and Disinfection of System Components Before cleaning and disinfecting the system, ensure that the system is shut down properly Clean all parts that have been in direct or indirect contact with the patient The system does not require sterilization The following components have specific cleaning procedures: Plastics Ventilation Shots Touch User Interface Generator Cabinet Monitors, touchscreen, and keyboard Mobile detector Liquid-crystal displays (LCDs) Mechanical Safety Only allow the permitted weight on the tabletop Ensure that weight is distributed uniformly over the tabletop Patient weight includes equipment, prostheses, implants, and plaster casts Avoiding Equipment Damage Ensure the movement range is free of obstructions before starting system movements Remove chairs, steps, stands, waste containers, and similar objects from the movement area Do NOT place objects or consumable material on the cover of the table support, detector cover, and longitudinal guides of the stand carriage Do NOT stand at any place on the covers of the table support Emergency Stop Should be used only if there is a danger to patients, operators, third parties, or the X-ray unit Buttons are located in the following locations: On the table On the generator ON/OFF console On the wall stand Identify safe practices during the examination The technologist should maintain visual and audible contact with the patient at all times during the examination Neither persons nor objects should be in the swivel or rotation ranges of the stands Neither persons nor objects should be in the lifting range of the patient table The knees of sitting staff should not be in the area under the stand or patient table Avoid standing or sitting immediately adjacent to the system Avoid system movements if it is necessary to position the patient with legs or knees under the crossbeam at the head or foot end of the table Be aware of the danger between the patient table and detector tray Select this link to view/print the downloadable course review material before proceeding to the final quiz. The automatic format collimation system for acquisition helps reduce radiation dose to the patient and examiner considerably. Radiation may only be released by authorized operators or persons with proper authorization to apply ionized radiation.  Pay attention to the fact that the air kerma is increased by the following settings: Higher kV Higher mAs Higher ms Smaller SID To avoid unwanted radiation, the free exposure mode should be used with care and always make sure the tube is active and the light marker has been used for positioning prior to releasing the X-ray.    Examiner Radiation Protection Learn about radiation protection for the examiner. Radiation Protection for the Examiner Release the acquisition series in the control room if possible Stay in the examination area as short as possible Use an additional radiation shield or radiation-proof window if the exposure is to be released in the examination room If protective shields are not used, wear radiation protector clothing with a 0.25 mm lead layer or similar clothing Keep the maximum distance from the source of radiation Check your personal radiation dose by wearing a radiation monitoring badge or a pen dosimeter Patient Radiation Protection Learn about radiation protection for the patient. Radiation Protection for the Patient Use the best possible protection in the vicinity of reproductive organs (i.e. gonadal shields and lead-lined rubber covers) Keep the radiation field as small as possible without reducing the active measuring field Remove all radiopaque parts from the radiographic field if possible Set the X-ray tube voltage as high as possible without reducing the active measuring field Optimum is 63 kV for iodine contrast Set the X-ray tube to skin distance as long as is reasonable for each examination A larger focal spot distance leads to lower air kerma The following personal safety measures should be taken into consideration when operating the MULTIX Impact system: ​Unit movements Danger zones Patient safety during the examination Radiation protection   Danger Zones Learn about different danger zones. Slide NumberText BlocksCalloutsAudio ScriptImage File1Patient Table The marked areas on the system show danger zones in which patients or operating personnel could suffer injury by crushing or colliding.  The areas on the system marked in the illustrations on the following slides show danger zones in which patients or operating personnel could suffer injury through crushing or colliding. Specifically for the patient table, make sure that neither persons nor objects are in lifting range of the patient table. Also make sure that the knees of sitting staff members are not in an area under a stand or the patient table.2X-ray Support Tube The marked areas on the system show danger zones in which patients or operating personnel could suffer injury by crushing or colliding.  This image illustrates the potential danger zones around the x-ray tube.3Wall Stand The marked areas on the system show danger zones in which patients or operating personnel could suffer injury by crushing or colliding. This image indicates the potential danger zones around the wall stand.4Wallstand with Pulled Out Detector Tray The marked areas on the system show danger zones in which patients or operating personnel could suffer injury by crushing or colliding. The arrows in this image indicate the danger zones around the wallstand when the detector tray is pulled out.5Lateral Detector Holder The marked areas on the system show danger zones in which patients or operating personnel could suffer injury by crushing or colliding. This image indicates the potential danger zones on the lateral detector holder.6Warning Signs Special danger points are marked on the unit with a warning sign. Example warning signs indicate: Danger of crushing Cardiopulmonary Resuscitation Risk of collision General Danger CalloutsDanger of CrushingCardiopulmonary ResuscitationGeneral DangerRisk of CollisionSpecial danger points are marked on the unit with a warning sign. Example warning signs indicate danger of crushing, cardiopulmonary resuscitation, risk of collision, and general danger.7Alert Tones Alert tones will be played on the TUI when the system is in one of the below situations: All components are ready for use after reboot An exposure is released X-ray tube is too hot (tube heat unit > 65% HU) A confirmation message is displayed on the TUI The tube unit is approaching a detent Top or center alignment is reached The detector unit in the BWS is moved to P1 or P2 using the Wireless Remote Control Console A collision is detected between the tube unit and patient table Motorized movement limit is reached Skin dose threshold is reached (SID < 44 cm) Alert tones will be played on the TUI if one of the following situations occurs on the system: All components are ready for use after reboot, An exposure is released, the X-ray tube is too hot (for example, the tube heat unit is greater than 65% HU), A confirmation message is displayed on the TUI, The tube unit is approaching a detent, Top or center alignment is reached, The detector unit in the BWS is moved to position 1 or 2 using the Wireless Remote Control Console, A collision is detected between the tube unit and patient table, The motorized movement limit is reached, Or the skin dose threshold is reached where the SID is less than 44 centimeters. Patient Examination Safety Learn about safety during patient examination. Element HTMLPatient Positioning All safety-related equipment must be installed and functioning, specifically the hand grips and the compression belt The hands, arms, legs, head, and hair of the patient must not extend unsecured beyond the edge of the tabletop Always observe the patient while moving the tabletop and during other system movements. Sound File Audio ScriptTo ensure patient safety, all safety-related equipment must be installed and functioning, specifically the hand grips and the compression belt. The hands, arms, legs, head, and hair of the patient must not extend unsecured beyond the edge of the tabletop. Always observe the patient while moving the tabletop and during other system movements. Unit Movement Safety Learn about unit movement safety. Tab TitleTextDeadman FunctionAll unit movements are controlled with a Deadman grip (DMG). Movements are only performed while the DMG operating element is being actuated In the event of a danger, the system movement can be stopped immediately by releasing the DMG operating element Danger of CrushingThe patient and operating personnel must only grip the handles which are intended for the proper handling of the equipment or positioning of the patient.  In situations where this is not possible, pay close attention to the possible injury risks of crushing in the vicinity of moving parts. Pay extra attention to the risks of crushing fingers and hands between moving parts and their guide openings Make sure the patient does not grasp the frame of the tabletop before performing unit movements Abnormal MovementsIf any part of the system moves although movement was not released, there might be a fault. Shutdown your system and call Siemens Healthineers Service Collision ProtectionThe MULTIX Impact has a collision control device comprising all motor driven moving components like patient table and wall stand.Floating TabletopPay attention to the behavior of the tabletop when the system is turned off.  Brakes on the table top have reduced force when the system is turned off Make sure nobody is leaning on the tabletop when the system is turned off Avoid positioning patients in a way that a sudden movement of the tabletop could cause them to fall Execute patient transfer with special care Make sure there is visual and audible contact with the patient so that you stay informed about the condition of the patient at all times Avoid danger points in which patients or technologists could suffer an injury. Examples include: Neither persons nor objects are in the swivel or rotation ranges of the stands Neither persons nor objects are in the lifting range of the patient table The knees of sitting staff are not in an area under a stand or the patient table Avoid standing or sitting immediately adjacent to the system Avoid system movements if it is necessary to position the patient with legs or knees under the crossbeam at the head or foot end of the table Be aware of the danger zone between the patient table and detector tray    The Emergency Stop button should only be used if there is a danger to the patients, operators, third parties, or the X-ray unit present. Emergency stop buttons can be found in the following locations: On the table On the generator ON/OFF console On the wall stand (on the same side as the operating elements)   Triggering the Emergency Stop Learn about triggering the emergency stop. Element HTMLIf a malfunction of a unit movement causes an emergency situation that poses danger to the patient, operating personnel, or to the unit, do the following: Press one of the emergency STOP buttons immediately All system motor drives will be shut down and movements are stopped immediately Radiation release is not interrupted and can be released again without canceling the STOP Sound File Audio ScriptIf a malfunction of a unit movement causes an emergency situation that poses danger to the patient, to the operating personnel, or to the unit, press one of the emergency STOP buttons immediately. All system motor drives will be shut down and movements are stopped immediately. Motorized movement can only be continued when the STOP is canceled. However, radiation release is not interrupted and radiation can be released again without canceling the STOP. Canceling the Emergency Stop Learn about canceling the emergency stop. Element HTMLThe emergency STOP button can be released and the system can be operated again ONLY if the cause of the danger has been unequivocally identified and remedied. Turn the emergency button clock wise and pull it out If the stop function does not respond normally, immediately activate an emergency shutdown to turn off the entire system. If this happens, use of the system should be discontinued and Siemens Customer Service needs to be contacted.  Sound File Audio ScriptThe emergency stop button can be released and the system can be operated again ONLY if the cause of the danger has been unequivocally identified and remedied. To cancel the emergency stop, turn the red emergency STOP button clockwise and then pull it out.   If the stop function does not respond normally, immediately activate an emergency shutdown to turn off the entire system. If this happens, use of the system should be discontinued and Siemens Customer Service needs to be contacted.  Please note that the learning material is for training purposes only!   For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training.   The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions.   Note:  Some functions shown in this material are optional and might not be part of your system.   Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country.  Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information.   The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages.   All names and data of patients, parameters and configuration dependent designations are fictional and examples only.   All rights, including rights created by patent grant or registration of a utility model or design, are reserved.   Copyright © Siemens Healthcare GmbH 2019 Please proceed to the final assessment. The Uninterruptible Power Supply (UPS) is a battery-backed system which provides emergency power to the image system in the event of a main power supply failure. The Emergency shutdown method should only be used in an extreme emergency because it is an uncontrolled process!  To prevent data or image loss, your system may have a UPS which shuts down the imaging system in a controlled way in the event of a power failure.   UPS Operation Learn about operating the UPS in the event of power failure. Slide NumberText BlocksCalloutsAudio ScriptImage File1The UPS has a five-button graphical LCD that provides useful information about the UPS itself, load status, events, measurements, and settings. The following information is contained on the graphical LCD: Power ON indicator: green indicates the UPS is operating normally Battery ON indicator: yellow indicates the UPS is on battery mode Alarm indicator: red indicates the UPS has an active alarm or fault CalloutsEscapeUpDownEnterON/OFF buttonThe UPS has a five-button, graphical L-C-D that provides useful information about the UPS itself, load status, events, measurements, and settings. The following indicators are contained on the graphical LCD: The Power ON indicator indicates the UPS is operating normally when it is lit green The Battery ON indicator indicates the UPS is on battery mode when it is yellow The Alarm indicator indicates the UPS has an active alarm or fault when it is lit red Take a moment to familiarize yourself with the functions of the five buttons labeled on the image below. 2In the event of power failure, follow these steps: Stop the examination Do not press any keys Wait for power to return or start emergency power Restart the system In the event of a power failure, all indicators and displays are dark. Only the imaging system and main monitor in the control room will be powered by the UPS in order to end all active tasks. For example, to finish the archiving of images. When the power goes out, first stop the examination. Then, do not press any keys while the imaging system shuts down to prevent the backup battery from being exhausted. Next, wait for the power to return or for the emergency power to start. Lastly, restart the system.3Start-up and Normal Operation To start the UPS: Verify that the UPS power cord is plugged in The UPS front panel display is illuminated and shows an EATON logo Verify that the UPS status screen shows the power button Press the power button on the UPS front panel for at least 2 seconds Check the UPS front panel display for active alarms or notices Resolve any active alarms before continuing Verify that the indicator illuminates solid, indicating that the UPS is operating normally and that any loads are powered and protected To start the U-P-S: First verify that the UPS power cord is plugged in. Confirm that the UPS front panel display is illuminated and shows an EATON (pronounced “eat-on”) logo. Then, verify that the UPS status screen shows the power icon. Press the power button on the UPS front panel for at least 2 seconds. Check the UPS front panel display for active alarms or notices. Resolve any active alarms before continuing. Then, verify that the indicator illuminates a solid light, which indicates that the UPS is operating normally and that any loads are powered and protected. The UPS should be in normal mode. Equipment safety measures that provide protection against electric shock include: Power Supply Power Outlet Socket Covers Potential Equalization Cleaning and disinfection of system components is also required to maintain equipment safety.    Cleaning & Disinfection Learn about cleaning and disinfection of system components. Checklist TitleChecklist TypeChecklist ContentCleaningHTML Before cleaning the system, ensure the system is shut down properly Clean all contaminated parts and all parts that can have direct or indirect contact with the patient Note: When cleaning and disinfecting, use suitable gloves for your own protection   EquipmentHTML Equipment Only use water or a lukewarm diluted household cleaning agent solution Wipe systems parts with a moist cloth (squeeze out the wet cloth before using it) until all contaminations are removed Remove any watery residues immediately Tube Base Rails Recommended to clean the tube base rails once a month Remove dust on the two rails Only use a lint-free cleaning cloth with alcohol WARNING: The use of cleaning agents other than those recommended can result in damage to the equipment.    PlasticsHTML Use only special Plexiglas cleaning agents, dishwashing detergent, soapy water or laundry detergent  WARNING: Harsh cleaning agents such as TCE, acetone, alcohol, and cleaning agents containing any of these agents may cause hairline cracks and eventually breakage even under a small load.    Ventilation SlotsHTML Keep the ventilation slots of all components unobstructed   Touch User InterfaceHTML You must clean the TUI regularly because it becomes dirty with fingerprints: Do not spray the TUI directly Wipe the TUI only with a clean, damp cloth   Generator CabinetHTMLIf cleaning liquids drip into the generator cabinet, electrical parts are damaged.  Make sure that no liquids are used at the top of the generator cabinet Clean the generator cabinet covers very carefully, making sure that no liquid seeps into the cabinet Monitors, touchscreen and keyboardHTML When cleaning the monitor screens or displays, use only a moist cloth without any cleaning agents. Wipe the screen Dry it with a soft cotton cloth Remove immediately any contamination (i.e. contrast medium stains)   Mobile DetectorHTML WARNING: The charge contact plate located on the back of the detector must be completely dry before the detector is returned into the Bucky tray. If the back of the detector is NOT dry, the detector will not charge sufficiently and the charge contact surfaces may corrode.  It is recommended to clean the back of the detector first so that it has more time to dry while the front is being cleaned    Liquid-crystal displays (LCDs)HTML Liquid-crystal displays (LCDs) are very sensitive to mechanical damage. Avoid scratches and shocks Remove drops of water immediately, longer contact with water discolors the surface   DisinfectionHTML Disinfect all parts that directly or indirectly can come into contact with the patient In addition, observe the hygiene plan of your hospital Disinfect the system by wiping only To disinfect surfaces, we recommend solutions of common surface disinfectants based on aldehyde and/or surfactants. The following active ingredient classes can be used: The following active ingredient classes can be used: Guanidine derivatives Peroxide compounds Organic acids ​The following products should not be used: Virex TB Terralin All alcohol-based products All phenol-based products All chlorine-releasing products The safety data sheets of the manufacturer provide detailed information on the composition of the disinfectants.   SterilizationHTML The system does not require sterilization.    Mechanical Safety Learn about mechanical safety for the system. The permitted weight on the tabletop is stated on the label on the tabletop and in the technical data. It is important for the weight to be distributed uniformly over the tabletop. The patient weight includes any parts permanently or loosely connected with the patient (i.e. equipment, prostheses, implants, plaster casts) For Example: A patient with a maximum weight should not sit at the end of a fully extended tabletop.  A damaged tabletop is potential hazard to the patient When the patient table collides with an obstacle such as a bed or instrument table, hairline cracks can result Call Siemens Healthineers Uptime Service to have the table top checked immediately if there is any possibility that it has been damaged   Avoiding Equipment Damage Learn about avoiding equipment damage. Element HTML Make sure that the movement range is free of obstructions before starting system movements Remove chairs, steps, stands, waste containers, and similar objects from the movement area Warning: The system does not have collision monitoring! Do NOT place any objects or consumable material on the cover of the table support, on the detector cover, and on the longitudinal guides of the stand carriage Do NOT stand at any place on the covers of the table support Sound File Audio ScriptThe following precautions are recommended to avoid equipment damage: Before starting system movements, make sure that the movement range is free of obstructions Remove chairs, steps, stands, waste containers, and similar objects from the movement area because the system does not have collision monitoring! Do NOT place any objects or consumable material on the cover of the table support, the detector cover, or the longitudinal guides of the stand carriage. Considerable forces that could potentially damage these objects in the area of movement of the systems occur during movements of the tabletop.  Finally, do NOT stand at any place on the covers of the table support. Standing on the covers could deform them and damage the components located underneath which would lead to operating disturbances. In the event of a fire, shut down the entire system immediately by disconnecting from the main power supply. Press the emergency SHUTDOWN button or actuate the main disconnecting switch Use a CO2 fire extinguisher Warning: Do NOT use water! Contact Siemens Healthineers Customer Service before performing any refurbishing work and before starting the system up again   Patient Fire Safety Learn about patient fire safety. In the event of a fire inside or in the vicinity of the system during a patient examination: Switch off the system Help the patient to escape from the system Be familiar with the hospital escape routes Be aware of where the fire extinguishers are located and know how use of them Periodic maintenance tasks include: Safety inspection Preventive maintenance Quality and function tests Replacement of safety-relevant parts subject to wear   Preventative Maintenance Learn about preventative maintenance checks. Element HTMLPreventative measures to avoid safety risks, overheating, wear and tear, and image artifacts include the following: Checking operating data Checking cables, cable routing and cable connections for damage Cleaning contrast medium, blood, disinfectants from area not accessible to the customer Inspecting and cleaning of coolant and air circulation passageways Inspecting and cleaning of optical transmission paths Removing foreign objects (i.e. positioning aids and injection needles) Touching up paint to prevent corrosion and infection Checking measurement values with tolerance ranges Checking the movement forces Checking the drive characteristics, acceleration and deceleration movements Measures to ensure that all components move smoothly Checking and analyzing points of friction Reading and analyzing the error log files Repairing minor damage Sound File Audio ScriptThe purpose of preventive maintenance is to minimize unforeseen failures. The effects of different operating conditions (for example full or partial load operation, temperature, size of dust particles, humidity, gases, and vapors) are checked by recording and analyzing characteristic values. Preventive measures must be adopted or repairs must be performed as appropriate. The specified maintenance interval of 24 months corresponds to the minimum requirements. Compliance with stricter national legislation may be necessary.  Preventative measures to avoid safety risks, overheating, wear and tear, and image artifacts include the following: Checking operating data, Checking cables, cable routing and cable connections for damage, Cleaning contrast medium, blood, disinfectants from the area, Inspecting and cleaning of coolant and air circulation passageways, Inspecting and cleaning of optical transmission paths, Removing foreign objects (for example, positioning aids and injection needles), Touching-up paint to prevent corrosion and infection, Checking measurement values with tolerance ranges, Checking the movement forces, Checking the drive characteristics, acceleration and deceleration movements, Ensuring that all components move smoothly, Checking and analyzing points of friction, Reading and analyzing the error log files, and Repairing minor damage to the system. Quality and Function Tests Learn about quality and function tests. Checklist TitleChecklist TypeChecklist ContentOverall SystemHTMLReason: To ensure optimum operation on the basis of the specifications listed in the data sheet What is checked: Interaction of all system components according to the assured characteristics  Powerline ConnectionHTMLReason: To ensure unrestricted power input from the line power source for the purpose of maximum system load. Sometimes the power input can be limited by oxidation and corrosion, which can result in exposure fluctuations and system shutdowns. What is checked: Internal line impedanceVacuum Components: X-ray Tube AssemblyHTMLReason: To assure system specification since vacuum components are subject to aging What is checked:  Image QualityBeam Geometry, Centering, Beam CollimationHTMLReason: To observe the specifications and legal regulations that are required to minimize radiation exposure of the patient and personnel What is checked: Centering the central beam onto the center of the image receptor, as well as coincidence of radiation field size and image receptor size or light field size and radiation field sizeRadiation DoseHTMLReason: Compliance with specifications and legal requirements to minimize radiation exposure of patient and personnel What is checked: Check of dose rate and cutoff dose during acquisition in all operating modesDetail RecognitionHTMLReason: To ensure compliance with specifications and legal requirements and to ensure image quality What is checked: Resolution during acquisition in all operating modesImage ContrastHTMLReason: To ensure compliance with specifications and legal requirements and to ensure image quality What is checked: Minimum contrast and dynamic range during acquisition in all operating modesImage DisplayHTMLReason: To ensure compliance with specifications and legal requirements as well as image quality What is checked: The brightness, focus and geometry of the configured monitorsImage ArtifactsHTMLReason: To ensure compliance with specifications and legal requirements and to ensure image quality What is checked: The image display for intolerable image artifacts in all existing application techniquesDose Measurement DeviceHTMLReason: To ensure maintenance of specifications What is checked: Accuracy of the displayImage Documentation SystemsHTMLReason: To ensure compliance with specifications and legal requirements and ensure image quality What is checked: Gray scale reproduction, geometric imaging characteristics, resolution, optical density, artifacts