The Effects of Multiple Infusion Line Extensions on Occlusion Alarm Function of an Infusion Pump

Deckert, D.; Buerkle, C. Alex; Neurauter, Andreas; Hamm, Peter; Lindner, Karl H.; Wenzel, Volker

doi:10.1213/ane.0b013e31819237ae

Cited by 12 publications

(9 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Testing to maintain PPP within a safe range is also required, where PPP high enough to cause fluid leakage or rupture should not be generated. If a single large volume is injected in the patient as bolus or infusion is blocked, an alarm should sound immediately [ 11 ]. Continuous backflow under normal operating conditions or even with a simple defect can be dangerous, and the device must not allow this to happen under any circumstance.…”

Section: Discussionmentioning

confidence: 99%

Efficacy evaluation of syringe pump developed for continuous drug infusion

Jung

Seo

Kwon

et al. 2016

J Dent Anesth Pain Med

View full text Add to dashboard Cite

BackgroundIn dental intravenous sedation, continuous intravenous infusion of a low-dose drug requires an infusion pump such as a syringe pump. To develop a new syringe pump for clinical use, the functions of the pump must meet certain international standards. Various safety and efficacy tests must be performed on the syringe pump, as stipulated by these standards, and an approval must be received from the approving agency based on such test results.MethodsThe authors of the present study developed a novel syringe pump and performed efficacy evaluation by testing its infusion speed at 1 and 25 ml/h, and infusion performance testing at 2 and 24 h. Moreover, performance evaluation was conducted by comparing the novel pump to an existing pump with the infusion speed varied from 1 to 5 ml/h.ResultsIn the efficacy testing on the newly developed syringe pump, infusion with the infusion speed initially set to 1 ml/h resulted in infusion speeds of 1.00 and 0.99 ml/h in the 2- and 24-h assessment, respectively. Changing the infusion speed setting to 25 ml/h resulted in an infusion speed of 25.09 and 23.92 ml/h in the 2- and 24-h assessment, respectively. These results show no significant differences when compared with other commercially available pumps.Conclusions The efficacy testing of the newly developed syringe pump showed the accuracy to be within tolerance. Based on these findings, we believe that the newly developed syringe pump is suitable for clinical use.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy evaluation of syringe pump developed for continuous drug infusion

Jung

Seo

Kwon

et al. 2016

J Dent Anesth Pain Med

View full text Add to dashboard Cite

show abstract

“…As reported previously, highest possible infusion rate and smaller sized syringes are useful in decreasing alarm delays [7,8,9]. Routine use of a less compliant syringe and syringe extension line might be recommended to reduce the alarm delay [6,10]. During the infusion of drugs requiring a smaller amount of initial bolus, such as remifentanil, lowering the setting of occlusion alarm threshold (P set ) could decrease the alarm delay.…”

Section: Discussionmentioning

confidence: 99%

Arrangements of the intravenous parallel infusions with anti-reflux valves decreasing occlusion alarm delay

Joe

Moon

Lee

et al. 2014

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundThe methods of arrangement of combined intravenous parallel infusions using anti-reflux valve (ARV), with and without anti-syphon valve (ASV) that could decrease occlusion alarm delay were investigated.MethodsOcclusion challenge tests were mainly performed as bench experiments of four kinds of multiple parallel infusions (10 ml/h and 50 ml/h infusions), which were connected at the proximal or distal portion of ARV, with or without ASV. Alarm threshold was set to 1000 mmHg. Occlusion alarm delays and the compliances of the infusion systems were compared among groups.ResultsWithout ASV, compared to 10 ml/h infusion alone distal to anti-reflux valve, 50 ml/h infusion distal to anti-reflux valve reduced the mean alarm delay from 416 ± 7 s to 81 ± 3 s (P < 0.001). Compared to 50 ml/h infusion alone, combined 10 ml/h and 50 ml/h infusion distal to ARV prolonged the alarm delay from 81 ± 3 s to 133 ± 6 s (P < 0.001). However, combined infusions distal to ARV with ASV significantly reduced the alarm delay from 133 ± 6 s to 74 ± 5 s (P < 0.001), and also reduced the compliance of the infusion system from 2.31 ± 0.12 to 1.20 ± 0.08 µl/mmHg (P < 0.001).ConclusionsThe infusion setup of faster infusion rate, lower compliant system using ASV could effectively decrease occlusion alarm delay during multiple intravenous parallel infusions using ARV.

show abstract

“…Detection of occlusion is complicated by a prolonged time to alarm using low flow rates, longer infusion lines, larger syringe size, and varying pump models. 33,34 Other alarms were documented 25 as a warning for low battery (2.9%), a relatively easy fix if pump batteries are kept charged, and proximal air (2.52%).…”

Section: Prevalence and Causes Of Smart Pump Alerts And Alarmsmentioning

confidence: 99%

Strategies for Managing Smart Pump Alarm and Alert Fatigue: A Narrative Review

2018

View full text Add to dashboard Cite

Although smart infusion pumps are intended to prevent medication errors by alerting users about doses that exceed set thresholds, a large number of clinically insignificant alarms and alerts create the potential for alert and alarm fatigue. We searched the PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for peer-reviewed literature (January 1, 2004-August 31, 2017) on managing smart pump alerts, alarms, and related fatigue. Twenty-nine articles that met the inclusion criteria were reviewed and organized into themes. Smart pumps give users two types of signals: alarms that indicate mechanical issues such as occlusion, air in the line, or low battery; and clinical alerts that indicate that a programmed dose exceeds a predefined safety limit. Mechanical alarms occur with greater frequency than clinical alerts, but alarms and alerts vary widely by pump model, patient population, time of day, month, and type of drug. Several causes of clinically insignificant alerts and alarms may be actionable, and strategies proposed in the literature include development of a multidisciplinary team to oversee the quality improvement effort with involvement of end users, standardization of medication administration practices, widening of drug limit library thresholds when clinically appropriate, maintaining up-to-date drug limit libraries, and interoperability. Whereas many strategies have been proposed, and case studies have been reported, none have been rigorously evaluated. In addition, more research is needed related to managing occlusion and air-in-line alarms, especially for complicated infusions. Future work should focus on the evaluation of specific and replicable alert and alarm reduction strategies with a greater emphasis on quantitative metrics.

show abstract

The Effects of Multiple Infusion Line Extensions on Occlusion Alarm Function of an Infusion Pump

Abstract: When simulating low flow rate infusions (5 mL/h) as for vasopressor support, occlusion alarm time was critically prolonged, especially with an increased length of infusion lines.

Cited by 12 publications

References 9 publications

Efficacy evaluation of syringe pump developed for continuous drug infusion

Efficacy evaluation of syringe pump developed for continuous drug infusion

Arrangements of the intravenous parallel infusions with anti-reflux valves decreasing occlusion alarm delay

Strategies for Managing Smart Pump Alarm and Alert Fatigue: A Narrative Review

Contact Info

Product

Resources

About