Infusion Pumps: Precision Delivery

Infusion pumps are essential medical devices used to deliver fluids, medications, and nutrients directly into a patient's bloodstream or other specific sites. This presentation will provide a comprehensive overview of infusion pumps, covering their various types, mechanisms of action, clinical applications, safety considerations, and advancements in technology.

We will begin by exploring the different types of infusion pumps, including:

* **Syringe pumps:** These pumps are designed for small-volume infusions, such as medications administered in critical care settings or during anesthesia. They use a syringe to deliver precise doses at controlled rates.
* **Volumetric pumps:** These pumps are used for larger-volume infusions, such as intravenous fluids, parenteral nutrition, and blood products. They typically use peristaltic or cassette mechanisms to deliver fluids from bags or containers.
* **Ambulatory pumps:** These portable pumps allow patients to receive continuous infusions outside of a hospital setting, improving their quality of life and independence. They are commonly used for pain management, chemotherapy, and other long-term therapies.
* **Patient-controlled analgesia (PCA) pumps:** These pumps allow patients to self-administer pain medication within prescribed limits, providing them with greater control over their pain management.

The presentation will delve into the mechanisms of action of these pumps, explaining how they precisely control the rate and volume of fluid delivery. We will discuss the various technologies used, including peristaltic, syringe, and cassette mechanisms, as well as the importance of accurate flow rate and occlusion management.

Furthermore, we will explore the wide range of clinical applications of infusion pumps across various medical specialties, including:

* **Critical care:** Infusion pumps are crucial for delivering vasoactive medications, fluids, and nutrients to critically ill patients.
* **Oncology:** They are used for administering chemotherapy drugs and managing pain in cancer patients.
* **Pain management:** Infusion pumps provide continuous delivery of analgesics for chronic pain conditions and postoperative pain.
* **Anesthesia:** They are used for delivering anesthetic agents and maintaining stable hemodynamics during surgical procedures.
* **Neonatal care:** Infusion pumps are essential for delivering precise amounts of fluids and medications to premature infants and newborns.

Safety is paramount when using infusion pumps. This presentation will cover key safety considerations, including:

* **Programming accuracy:** Ensuring correct programming of infusion parameters to prevent medication errors.
* **Occlusion management:** Monitoring for and addressing occlusions in the infusion line to maintain consistent delivery.
* **Alarms and alerts:** Understanding and responding to pump alarms to prevent adverse events.

1. INFUSION PUMP Infusion pump is a biomedical device which is capable of delivering fluid in large or small amount and use to deliver nutrients or medications to a patient’s body in a controlled manner.

2. PRINCIPLE It uses the pumping action to infuse fluids , medications, or nutrients into the patient’s body It is suitable for intravenous, subcutaneous,enteral and epidural infusion .

3. TYPES There are two basic types of infusion pumps Syringe pumps Volumetric pumps Others Smart infusion pump Patient controlled analgesia pump Insulin pump Enteral pump

4. SYRINGE PUMP They are programmed to deliver drug through the veins at a determined rate Also known as Micro infusion pump Highly precise while administering small doses

5. PARTS OF SYRINGE PUMP

6. PARTS

7. Backside: IV clamp Power cord socket Machine details (company, model, serial number) Front side: On/off (hold the switch for 1 to 2 min) Charging indicator

8. 4. Battery status (Red indicate battery drain or completely depleted) 5. LCD screen ( infusion rate, total volume infused, time ) 6. Keypad (to adjust the flow rate) 7. Mode button (to select the mode of infusion) 8. Bolus (For fast infusion) 9. Purge (For clearing the air bubbles from tubings )

9. 10. Alarms (occlusion, near empty, empty) 11. Syringe indicator 12. Syringe Push handle 13. Syringe clamp 14. Power button 15. Mute button

10. WORKING MECHANISM A syringe pump generally consists of a drum attached to a piston. A motor operates the piston through a drive screw or worm gear which helps in pushing the plunger of the syringe in or out, resulting in a smooth flow. The syringe is engaged in a clamp on the frame, and the plunger of the syringe is displayed by movement of the drum.

11. Most of the syringe pumps can work with different syringes of different diameters, but the diameter has to be entered in the beginning to make sure the correct volume is dispensed. These guidelines should be read from the manufacturer guidelines & make sure whether syringes with different diameters can be used. The user can set the parameter such as flow rate, dispense volume & syringe diameter.

12. VOLUMETRIC PUMPS This pump has an advantage to deliver high volume of fluid at precise administered rate where other pumps might have limited or no use at all.

13. PARTS

14. WORKING MECHANISM Volumetric pumps are designed for and suited for the delivery of larger volumes of fuild at medium to high flow rate. Almost all volumetric pumps are accurate to well within the specified ±5% when measured over one hour. It is used to accurately deliver intravascular drugs, fluids, whole blood, & blood products to the patient.

15. A linear peristatic or piston cassette pump insert is utilized to control the prescribed infusion volume. They use computer-controlled rollers compressing a silicone which the medicine flows.

16. OTHER TYPES OF PUMPS SMART INFUSION PUMPS: They are preprogrammed with drug libraries & wireless technology, Calculate medication dose & delivery rates to help prevent IV medication errors. INSULIN PUMP: A device that closely mimic the functioning of normal pancrease , by continuously infusing insulin subcutaneously.

17. PATIENT CONTROLLED ANALGESIA PUMP: Used to manage post-operative pain as well as chronic pain. This pump permits the patient to self-administer continuous infusions of medication safely. It can also be programmed to deliver a constant, infusion of medication. ENTERAL PUMP: It can be programmed for continuous or intermittent feeding Generally preferred for bedridden patients.

18. INDICATIONS Prevent fluid overload. Administer a specific amount of pharmacologic agent.

19. USES Chemotherapy Pain management Total parental nutrition Anesthesia / Sedation

20. MAINTENANCE OF PUMPS Always place pump & supplies on a clean surface. Keep food & drinks away from the area around the pump. Before touching the pump wash hands & dry with a papertowel , change tubing according to pump’s instructions, change batteries or recharge the pump as directed by the healthcare providers. Always keep infusion pump away from radio transmitters & strong electromagnetic fields

21. COMMON PROBLEMS IN INFUSION PUMP Software problems Alarm errors Inadequate user interface design Broken components Battery failure Fire, spark, charring or shock

22. CAUTIONS TO BE FOLLOWED Do not operate it in a high pressure oxygen room. Do not install or store pump where the chemicals are stored. Do not expose it to sunlight or any other strong light. Do not expose it to the dust or in the presence of corrosive gas in atmosphere. Do not expose it at hot place or splashing water. Do not store or operate it to the area where the air pressue increase or decreases spontaneously.

23. CONCLUSION Infusion pumps have been a source of multiple patient safety concerns, and problems with such pumps have been linked to more than 56,000 adverse event reports from 2005 to 2009, including at least 500 deaths. As a result U.S Food and Drug Administration (FDA) has launched comprehensive initiative to improve their safety called the Infusion Pump Improvement Initiative.