Thank you for coming along until our very last week of the internship! These 8 weeks have flown by, and It’s been an incredibly rich and rewarding experience.
From Saturday through Wednesday, I dedicated my time to working on a report for the reusable feeding syringe. I spent these days diving deep into research into understanding the background context and problem, as well as developing a methodology to test various reusable syringe models and cleaning protocols. This paper outlined the context and a methodology for studying and developing the syringe project.
Thursday and Friday, however, were quite different, as I shifted from research to hands-on shadowing at Circuimed in Santiago.
Thursday began early with an 8:30 AM Caribe bus ride from 27 de Febrero in Santo Domingo to Los Jardines in Santiago. Upon arriving, we took an Uber to Circuimed, where we spent the day immersed in medical equipment repair and maintenance. We worked with Bleidy George, who was fixing an electrocardiograph (ECG).
An ECG records the electrical activity of the heart by using electrodes placed on a patient’s skin. These electrodes capture electrical signals produced by the heart and send them to the machine, which amplifies and displays them as waveforms on a screen or prints them on paper. These waveforms are crucial for healthcare professionals to assess heart rhythms and monitor overall cardiac health.
The ECG we worked on had stopped functioning due to humidity getting inside the device and causing a short circuit. The source of the issue was the blown fuse, two small glass cylinders responsible for carrying electrical current, which we confirmed with a voltmeter. Testing across the fuse showed no current flow, indicating it needed to be replaced.
After restoring the ECG, Bleidy shifted his attention to a System 5000 Electrosurgical System, a device commonly used in operating rooms to cut tissue and stop bleeding during surgeries. This machine operates in two modes: cut and coagulation. The cut mode uses continuous, high-frequency current at higher voltage levels to vaporize cells quickly and make precise incisions. The coagulation mode employs pulsed current at lower voltage to slowly heat tissue, causing blood to clot and sealing blood vessels. We got to experiment with these modes by testing different voltages on a bar of soap, which was a great way to observe how the device functions practically.
The main issue with this electrosurgical device was that it often turned off unexpectedly during use, forcing doctors to pause procedures while waiting for it to restart. This instability clearly impacts workflow and patient care.
Later, we visited a private hospital clinic where Bleidy was installing pulse oximeters at patient bedsides. I noticed that each pulse oximeter was only compatible with monitors of the same brand, a business strategy that restricts cross-brand equipment use. While understandable from a commercial perspective, this practice unfortunately makes equipment access more complicated and costly for healthcare providers.
Friday’s day at Circuimed started with meeting Vladimir, who introduced us again to Anthony, who specializes in fixing ventilators. Anthony was working on a ventilator with a malfunctioning internal compressor. This component is responsible for filtering ambient air to produce medical air, which typically contains about 20% oxygen. For patients requiring higher oxygen levels, the ventilator mixes this medical air with pure oxygen using a blender, ensuring the delivered mixture meets the specific clinical needs.
Many hospitals in the Dominican Republic lack centralized medical air supplies through wall outlets, so ventilators must rely on these internal compressors. However, these compressors represent older technology and are mechanical in nature. More modern ventilators use turbines, which are smaller, quieter, more durable, and regulate airflow in real-time.
Anthony explained that when an internal compressor breaks, repairing it is often not cost-effective because the price of a new compressor is comparable to that of an entire ventilator. Instead, Circuimed salvages functional components from these incubators to keep other machines running.
Watching Anthony troubleshoot the ventilator was a great learning experience, offering insights extending into my personal project. For instance, to calibrate pressure sensors, he modified a syringe to have two tubing outputs, one connected to a pressure measuring device and the other to the sensor. By pulling back the syringe plunger, the pressure readings on both devices should match, allowing precise calibration. I saw the applications of this kind of procedure for calibrating the pressure sensor that would be used for my breastfeeding monitoring device.
Anthony also shared an important story about visiting a hospital that owned Comen incubators but continued using gooseneck lamps to keep newborns warm. The staff were unaware that the incubators had thermal mattresses capable of safely warming infants. This highlighted a critical need for educating hospital staff on the proper use of equipment to improve neonatal care and reduce risks associated with outdated practices.
