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ICO Foundation Assessment Poster 2013 Final 2:Layout 1 26/3/13 17:01 Page 1 EXCHANGE E T International Examinations h Keep on operating: x e I a n how to deal with power cuts t m e r n The new On-Line i at Brian Savage Figure 1. UPS, front and rear views Figure 2. Inverter, attached to lead acid battery n i showing power outlets (chargeable by solar or mains electricity) o Ophthalmologist, Mvumi a n Hospital, Dodoma, Tanzania. age age a [email protected] av av Foundation Formative ti lC Icto ism teh aatn tdim geo noef ,y iet aisr dagrya, iann: dra iitn sse heamves the Brian S Brian S o o electricity generating industry is coming to u n another crisis. We are 90 minutes into our Assessment n c main operating list and doing well. i s l Unexpectedly, the music from the radio o cuts, and so do the lights from the micro- f f O scopes. In the sudden silence we realise This new online assessment is mostly for first year trainees.It is available 24/7 and candidates o there is another power cut and the hospital p generator is not working. Do we tell the can use books or search engines to answer the 84 questions (336 options) in up to 20 r h people waiting to come back another day? Figure 3. 12v 7amp-hour battery for Figure 4. Small petrol generator t direct current minutes each. A compulsory“confidence indicator”which rewards those justifiably confident h a of their knowledge. O lm FOiunri fsirhsitn pgri othritey pisr teos feinnisth o tpheer parteisoennt age age Questions are a statement,a scenario,many with a picture,diagram or video. When the p ol operation. A good halogen torch (or other an Sav an Sav examination is completed,candidates will be issued instant results,A*,A,B,C,D or F and a o bright, focused light), held by a nurse, Bri Bri h g may help; however, we have found the detailed analysis. y following two options even more useful. t 1 Uninterruptible power supply (UPS). h A UPS (Figure 1), similar to that used Subjects a for a desktop computer, allows our two microscopes another 30 minutes or so l A GeneralMedicinerelatedtoOphthalmology B Ophthalmicpathologyandintraoculartumours m of power so we can conclude the enough power to finish the present having several operating sets that can CommunityMedicineandPublicHealth Intraocularinflammationanduveitis present operation with illumination of operation and to perform additional be pre-sterilised and double-wrapped InternationalMedicalEthicsandGoodPractice Retinaandvitreous better quality than a torch. EpidemiologyandStatistics o 2 Inverter. The inverter is connected to operations. Alternatives include the in sterile drapes. Provided the packs Genetics battery from the car you arrived in, or remain dry, they can be kept for up to 1 the mains and charges a lead acid l a specially-purchased dry cell battery week. o battery connected to it (Figure 2). As similar to that found in many UPS 2 Use a domestic pressure cooker soon as the mains power cuts, power devices. We have completed many (costing around US $70) on top of a g from the battery – direct current (DC) – operating lists using this method, but gas burner that screws into the top of a C TGrlaauumcoam,eaxternaldiseaseandcornea D AEmnabtroymolyoogyftahnedEDyee,vtehloepOmrebnittandrelatedstructures is fbloewcosm therso u2g2h0 tvh ael tienrvneartteinr,g a cnudrr ent only when we have two or more gas cylinder (Figure 5). The burner gives Lensandcataract Neuro-Anatomy t (AC). It can now power a microscope charged batteries available (suitable quick and effective heat and using a PrinciplesofGeneralPhysiology requiring AC current. UPS batteries cost around US $30). pressure cooker is better and quicker s Vision,OcularPhysiology,Biochemistry,CellBiology than boiling instruments in a pan. The We have had no significant problems PathologyandMicro-biology Continuing an operating list gas burner with cylinder is readily using our basic Scan Optics microscope available locally for around US $100. In a setting where patients have travelled with either the generator or the 12v long distances, often at high cost, battery for a list lasting several hours. These suggestions do not work for all E Pharmacology F Neuro-ophthalmology cancelling an operating list due to a power situations. If you have a sophisticated OBapsticicdseasnidgnR,ceofrnascttriuocntionanduseofinstruments OParebdiita,teryiceloidpahnthdallamcorilmogayldainsdeaSsterabismus failure is something to avoid if at all Sterilisation microscope, then a standard UPS will not possible. If the hospital generator is not Problem solved? Well, not quite: Commonlyusedtestsinophthalmology have the power to give a consistent, reliable, we strongly recommend that you the nurses have run out of sterile instru- steady illumination. Also, invest in one of the following. ments, which they usually Figure 5. Cylinder- you may not have sufficient 1 A small generator. A small petrol sterilise during the list in mounted gas burner with operating instruments to generator, such as the one in Figure 4, autoclaves requiring large domestic pressure cooker pre-pack and sterilise. quantities of electricity. Our should be adequate to run your micro- However, if you want The emphasis of the questions will be on basic and practical ophthalmology batteries and alternators scope. If you are buying one specifically your operating to go well cannot provide this load. We that is essential knowledge to be gained in the first year of training. for this purpose, it is important to know through a period of power have developed two different the total amount of electricity needed shortage, and are prepared approaches to providing by the microscope, vitrector and any to plan for this in advance, sterile instruments during a Applications can be made online by logging into the other equipment using a small amount you might like to give these power cut. ICO Examinations website www.icoexams.org electricity, then you can be sure the suggestions a try. It is generator will produce enough. 1 Use pre-packed, pre-steri- possible to continue 2 A 12v battery. We have a microscope lised instruments, just as operating during a power e The International Council of Ophthalmology that has the option of running on 220v one uses pre-sterilised avag cut and the equipment to 11-43 Bath Street,London,EC1V 9EL,England AcaCn o lra 1st2 fvo Dr sCe.v Ae r1a2l hv obuartste, rpyr (oFviigduinreg 3) dadravpaensc.e T phliasn rneqinugi raensd Brian S eanvaaiblaleb lteh ilso cisa lulys.ually Tel + 44 (0) 207 6086949/6959 Email:[email protected] © The author/s and Community Eye Health Journal 2013. This is an Open Access article distributed under the Creative Commons Attribution Non-Commercial License. CCEEHHJJ8833__FFIINNAALL..iinndddd 99 0044//1111//22001133 1111::5489 CEHJ84_OA.indd 15 16/12/2013 16:20