Imagine you're an older person with osteoporosis. A fall may mean a fracture rather than a bruise. One of the major applications of a system to measure standing balance devised by biomedical engineer Meabh Smith is to identify older people at risk of a sudden fall so that precautions can be put in place.

Her master's research project, in lay terms, consisted of a box with four bags of water inside and a plate sitting on top. It's slightly unstable and can be used to determine where the patient's centre of gravity is, the frequency of sway as well as the distance and amplitude of sway in order to measure standing balance. Posturography brings medicine and engineering together. One of the possible applications, says Smith, is in identification of neurological diseases which have a characteristic frequency of sway.

Smith's journey into biomedical engineering began in Omagh, Co Tyrone, where she took A levels in physics, chemistry and maths. From there, she studied engineering in TCD, specialising in micro-electronics and computers.

A J1 visa, a stint in the US, some teaching work and lots of letters to colleges and hospitals culminated in an offer of a place on a six-month course in the University of Patras in Greece.

She then worked in St James's Hospital, Dublin, where she was involved in equipping new theatres. "When new equipment comes into a hospital it must be recorded, electrical safety testing must be done as well as some level of functional testing. There are often training issues."

In the Meath Hospital, Dublin, Smith worked mostly in dialysis in a maintenance role. She also "got very involved in developing protocols for the management of water quality". Standing by the bedside of a patient whose blood is flowing through plastic tubes, in and out of a dialysis machine, the critical nature of equipment maintenance is obvious. That patient is totally dependent on the machine for four hours, three times a week.

Now working in Beaumont, Dublin, as a senior clinical engineer/ physicist, Smith is the hospital's Y2000 project manager. "In hospitals it's not just IT, there are unknowns in the equipment . . in this hospital, over £2 million worth of equipment had to be replaced to become compliant while over £1 million was spent on IT. There were no problems on the night and only two small equipment problems surfaced later - an ECG recorder reverted to 1900 while an ultrasound machine produced a colon (the two dots variety) in its dateline in place of a zero. There were some IT glitches but nothing critical, says an obviously relieved Smith. In fact, with the possible nightmare scenario averted, Smith can say in retrospect that the Y2000 project was a great boon to the hospital, replacing older equipment and ironing out long-standing problems.

Now, Smith and her colleagues are wrapping up the project, reviewing the major disaster plan of the hospital and developing an internal disaster plan.

WHEN an ER-viewing public visits a hospital they expect to see lots of equipment, she notes. Equipment management involves justification, specification, tendering, purchase, acceptance testing, tracking (regular servicing and repair) and performance review.

"People generally wouldn't drive a car unless it was serviced. They wouldn't get in an aircraft unless they thought it had been serviced but people rarely think about medical equipment, which may be vital for life support. Whether the work is done in-house or on contract, the hospital must manage their equipment."

The vast bulk of biomedical engineering jobs are in industry, with a large concentration in the west of the country. But, biomedical engineering in hospitals is an expanding discipline, particularly with the advent of electronic healthcare records (where Xray images, files etc can be stored in the one electronic file) and the impact of the Internet.