Syringe Pumps; Pca Pumps - Fluke Biomedical IDA-4 Plus Operator's Manual

automatic alarm and shut down if air enters the system; pre-set control of total volume to
be infused with digital readout of volume infused; automatic switching to keep vein open
(KVO) rate at the end of the infusion; comprehensive alarm systems; automatic switch
over to internal battery operation on failure of mains supply, with the facility to use the
device on internal battery power only, if no mains power is available (for example during
transportation); other features often available are micro and macro delivery modes,
computer interface, operator-call alarm, primary and secondary ('piggyback') infusion
capability and a technical memory log, which can record the last few hundred operations
for incident analysis. Typically, most volumetric pumps will perform satisfactorily at rates
down to 5 ml/h. If you wish to infuse at lower rates, you should check the trumpet graph.
Below 1 ml/h, the performance should be checked by referring to the manufacturer.

Syringe Pumps

These are low volume, high accuracy devices designed to infuse at low flow rates and are
typically calibrated for delivery in milliliters per hour, typically 0.1 to 99 ml/h. Many
pumps will accept different sizes and different brands of syringe (up to 50/60 or even 100
ml), but the pumps must be set up for a particular type and size of syringe in use, unless the
pump detects the syringe size and type automatically. Total dose volume (without
refilling) is limited to the size of the syringe used. They are mains and/or battery powered
and tend to cost less than volumetric pumps.
Programming in units other than milliliters per hour may be possible, with some having a
bolus facility whereby a given volume may be infused in a short time. In the past, syringe
pumps had few alarms, but the trend has moved towards a comprehensive alarm system
which guards against unsafe operation.
At low flow rates, delivery from a syringe pump is likely to be more uniform than that
from a volumetric pump and the resultant short-term fluctuations are of much smaller
magnitude. There have been problems with backlash (slackness which causes start-up and
alarm delays) in the pump overcome by careful attention at the design stage. Following the
manufacturer's instructions for priming the pump will reduce such problems. Features
available vary so widely that each model must be separately assessed, but the more recent
and more expensive models have much to offer, including delivery pressure displays.
Important points and advice for safe operation: the syringe barrel and plunger must be
located securely in accordance with the manufacturer's instructions. Only by doing this
will the instrument's safety features be fully operational and free-flow (syphonage) be
avoided. Use the smallest syringe the pump will accept, and which is able to hold the
required volume of drug. As in general, occlusion response times are decreased when using
small syringes. Also, small syringes improve the consistency of the flow and reduce bolus
volume when the occlusion is removed.

PCA Pumps

Most of these pumps have the capability of mains or battery operation and are designed
specifically for this application. They are typically syringe pumps, as the total volume of
drug to be infused can usually be contained in a single-use syringe. Some PCA pumps are
based on volumetric designs. The difference between a PCA pump and a normal syringe
pump is the provision of a facility to enable patients to deliver a bolus dose themselves. A
PCA pump may be programmed by clinical staff, to deliver a pre-set bolus on demand,
with a pre-set lock-out time between boluses. In addition to the bolus delivered on patient
demand, PCA pumps may also be programmed to deliver a basal rate (continuous low rate
infusion). Examples of programming options are:
Loading dose; continuous infusion; continuous infusion with bolus on demand;
Bolus on demand only, with choice of units (ml or µg/ml, etc) and variable lockout time;
drug concentration;
Once programmed, access to the control of the pump is usually only permitted by a key or
software code but in some cases, limited patient access is allowed in order to change some
parameters.
Infusion Pump Analyzer
Infusion Devices Delivery Methods
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