Fluke Biomedical IDA-4 Plus - Manual (Page 66)

IDA-4 Plus
Operators Manual
A-6
A feature of most PCA pumps is a memory log, which can be accessed either through the
display, or downloaded via a printer or computer. This enables the clinician to determine
when and how often, a demand has been made by the patient and what total volume of
drug has been infused over a given time.
There is a range of miniature battery powered volumetric pumps designed for PCA
applications and having disposable internal fluid reservoirs.
With PCA pumps, protection against free-flow is important, particularly as the patient may
be unsupervised for some of the time.
Pumps for Ambulatory Use
are of two types, miniature syringe drivers and miniature volumetric pumps. Because of
the size of the devices, the available battery capacity is low and continuous pumping is not
feasible. Most ambulatory pumps, therefore, give an output in the form of a small bolus
delivered every few minutes. For the same reason, and because space is at a premium, very
few alarms are provided. Usually, warning indicators are restricted to flashing light to
show pump running and an audible alarm to indicate occlusion, or end of infusion.
Some non-electrically powered ambulatory pumps for PCA applications are appearing on
the market, using, for example, elastomeric balloons as the energy source.
Miniature Syringe Pumps
can easily be carried in a pocket or handbag, or worn by the patient. Most are battery
powered (a few are spring-driven), have few controls and the minimum of alarms. They
were developed from early syringe pumps accepting small volume syringes for intermittent
bolus delivery via routes other than IV, typically subcutaneous infusion of insulin.
However, pumps are now available that are specifically designed for IV infusions, and are
useful in cytotoxic chemotherapy, pain relief and other applications where very small
volumes are to be infused over periods of days, rather than hours, and where the patient is
at home rather than in a hospital ward.
They can typically accept syringes between 2 and 10 ml and are able to achieve very low
rates of delivery. Because of this ability to accept various sizes of syringe, these pumps
may require the rate to be set in millimeters per day, that is, linear travel of syringe plunger
against time. They will be able to achieve the linear rate with considerable accuracy.
Calculations, which depend on the syringe used, may be required to convert from flow rate
to linear travel per unit time.
The volumetric accuracy, however, can be variable, depending on the rate set, the fluid and
syringe used and the type of tubing employed. At the very low infusion rates which can be
selected (a few microliters per hour), some of the infusate may migrate through the walls
of the tubing and never actually reach the patient.
Miniature Volumetric Pumps
use removable reservoirs which contain the solution within the pump. Some may offer a
large variety of programming options. Those pumps having bolus on demand, as well as
basal rate, are also suitable for PCA pumps.
Anesthesia Pumps
These are syringe pumps designed for use in anesthesia or sedation and must be used only
for this purpose. They should be clearly labeled ANESTHESIA PUMP and should be
restricted to operating and high dependency areas. They are designed so that the rate may
be changed and other functions accessed immediately, whilst infusing. They need to infuse
over a higher flow rate range than normal syringe pumps and have a high bolus rate
facility, so that the induction dose may be delivered quickly, with a single operation.
Because of their application, these pumps may have a number of specific features such as:
Programming for body weight and drug concentration; drug specific
smart-card system which automatically calibrates the pump for the drug