Clinical Engineering & Non-Ionising Radiation Physics

Clinical Engineering & Non-Ionising Radiation Physics section provides scientific and technical support to a wide range of clinical departments in Lothian and Fife, and also to the other services in Medical Physics.
 
Examples of the services provided are:
 

Clinical Engineering

Clinical Computing 

The Clinical Computing group in NHS Lothian exists to provide a comprehensive, cost-effective and cutting-edge administration, support and clinical development service covering the clinical computing aspects of medical devices and clinical systems across NHS Lothian.
 
Clinical Computing - Support Service
Provides ‘always available’ support to clinical critical systems and medical devices across a range of departments at the RIE / WGH / SJH and Primary Care. The support service ensures high availability and reliability of clinical critical systems and medical devices, enabling an efficient and comfortable patient experience. This includes:
 
  • Joint working with Radiotherapy and Oncology Physics Support
  • Joint working with medical staff to determine the clinical consequences of technical issues
  • Diagnostic Imaging Physics Support (MRI / PET / CT / Ultrasound / SPECT)
  • Nuclear Medicine Physics Support
  • Rheumatology Systems Support
  • CTR Image Vault and Echo Archive Support
  • Respiratory Physiology Support
  • Cardiac Physiology Support
  • Neurophysiology Support
  • Intensive Care Unit Device Support
  • Physiological Measurement Support
  • Clinical Acquisition and Scientific Calculation System Support
  • Treatment planning / recommendation support
 
Clinical Computing - Administration
Administration work relating to departmental and job activities:
 
  • Disaster Recovery and Business Continuity Planning
  • Compliance with Medical Device legislation and policy at local and national levels
  • Departmental policies, standards and operating procedures
  • Staff Training
  • Configuration Management
  • Systems Administration
 
Clinical Computing - Development Service
Clinical service development that provides a patient centred approach to facilitating the introduction of new technology into medicine. The service develops specialised software and electronics that reduces patient time to treatment, improves the patient experience, improves the usage, efficiency, safety and security of medical devices, and improves availability with a reduction in the cost of medical equipment.
 
  • Medical Imaging Quality Assurance System
  • Respiratory Physiology Test and Report System
  • Medical Physics and the 18 Week RTT
  • Nuclear Medicine Physics Re-Engineering of DEXA, GFR, Thyroid Uptake and Co60 contamination software
  • Medical Image Processing for MRI and PET
  • DERIC (Endoscopy Reporting) System Development
- design, development and manufacturing services for new software applications
- technical support for existing clinical software applications and devices.

Instrumentation and Mechanical Engineering

The development of custom solutions to clinical problems that cannot be resolved using the standard equipment available to clinicians. This may include
 
  • The development of novel medical instrumentation e.g. low cost device for vein imaging in neonates; a nurse call system for spinal injury patients; user-friendly vitrectomy equipment for ophthalmic surgery; an alert button for patient use during eye surgery under local anaesthetic; a device for rapid extraction of kidney stone fragments during percutaneous nephrostomy; a thermostatic chamber for diabetic hyperinsulinaemic clamp studies.
  • The development of novel mechanical apparatus, e.g. ultrasound power measurement system for monitoring therapeutic ultrasound patient safety levels; calibration system for a device used to measure vein thickness; versatile mounting brackets for patient monitors in an intensive care setting.
  • The manufacture of test objects for quality assurance in X-ray, MRI and ultrasound imaging.
Electronic design, development and manufacturing services and the repair & modification of existing medical equipment.

Mechanical Engineering Workshop:
Our mechanical workshops undertake the design, construction and modification of scientific and clinical equipment. For example: custom & prototype devices for surgery, therapy, physiological measurement, patient monitoring, and test equipment for various imaging modalities. Medical Physics has mechanical workshop facility at RIE, Little France.
These undertake:
 
  • Machining - turning, and milling.
  • Welding - ferrous and non-ferrous metals.
  • Fabrication - in a wide range of materials, including metals, plastics and wood.
 
 

Non-Ionising Radiations

This Service also provides scientific support to clinical users of non-ionising radiations, including ultrasound (diagnostic, therapeutic and surgical ultrasound, lithotripsy and shock waves) and optical radiations (ultraviolet, visible & infra-red light, lasers). The interactions of ultrasound and optical radiations with the body are poorly understood, and many clinical procedures benefit from scientific and technical support. Principal clinical areas are: radiology, cardiology, obstetrics and gynaecology, neonatology, neurology, GI, urology, general surgery, dermatology, ophthalmology, physiotherapy. The work incorporates components of radiation protection, patient dosimetry, equipment specification, evaluation and commissioning. Services are summarised within the modalities listed below:
 

Ultrasound

Performance assessment; dosimetry; quality assurance; analysis of image data. The clinical base is broad, and encompasses a wide range of diagnostic and therapeutic techniques:
 
  • Diagnostic Ultrasound: 100+ scanners in various clinical departments within NHS Lothian and NHS Fife. The Head of Service acts as Lead for the NHSL ultrasound equipment replacement programme (capital equipment value £6.5M). This delivers saving that are re-invested in better quality equipment, enabling more effective and efficient diagnostic procedures and supporting to 18 Week RTT target for imaging departments. The pan-Lothian replacement programme led by Medical Physics has also enabled the standardisation of a substantial amount of ultrasound equipment, benefitting user training, and lowering clinical risk and maintenance costs. Medical Physics staff also carry out a programme of equipment evaluation and quality assurance.
  • Therapeutic Ultrasound: 50 machines at 30 sites within NHS Lothian (acute and primary). Performance testing of equipment with emphasis on evaluation, acceptance and delivery of controlled patient dose.
  • Lithotripsy: The main clinical base is in Urology at WGH, which houses an extracorporeal shock wave lithotriptor, a laser lithotriptor, and several invasive surgical devices. Approximately 1000 patients p.a. receive lithotripsy treatment.
  • Endoscopic Ultrasound (EUS): A clinical system has been developed to capture and analyse 3D patient scans for staging cancer of the oesophagus (200 patient studies p.a.).
 
Diagnostic, therapeutic & surgical ultrasound (including lithotripsy).
 

Optical Radiation

Including Lasers and UV Phototherapy  
 
  • Laser Protection Adviser: There are 25 Class 4 medical lasers within Lothian and Fife, and the Service provides the Laser Protection Adviser for NHS Lothian and NHS Fife. SLAs are in place with the Spire Murrayfield Hospital and Laserase. From April 2010, the Control of Artificial Optical Radiation at Work Regulations places a requirement on employers to risk assess all sources of optical radiation from the most trivial to the most dangerous. The Service has taken the lead role in ensuring that NHS Lothian and Fife are compliant with the new Regulations.
  • UV Phototherapy: Dosimetry: optimisation of patient treatment regimes  
The main clinical base is in Dermatology, currently at the Lauriston Building. This is Scotland’s largest psoriasis phototherapy centre, with approximately 15,000 patient visits for phototherapy annually, the majority for psoriasis. The Service also has a SLA with the phototherapy centre at Queen Margaret Hospital, Dunfermline. Medical Physics staff are closely involved in the delivery of clinical services, including the planning of individual patient treatments.
 
Lasers (including Laser Protection Adviser); ultraviolet, visible & infrared light; RF radiation & microwaves.
 
 
 
 
 

Last Reviewed: 06/02/2015