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introduction :(refer to khandpur 893p-898) INFUSION PUMP An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer fluids in ways that would be impractically expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too small for a drip), injections every minute, injections with repeated boluses requested by the patient, up to maximum number per hour (e.g. in patient-controlled analgesia), or fluids whose volumes vary by the time of day. Because they can also produce quite high but controlled pressures, they can inject controlled amounts of fluids subcutaneously (beneath the skin), or epidurally
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AUTOMATED DRUG DELIVERY SYSTEM
Unit 5
INTRODUCTION :(REFER TO KHANDPUR 893P-898)
INFUSION PUMP An infusion pump infuses fluids, medication or nutrients into
a patient's circulatory system. It is generally used intravenously,
although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer fluids in ways that would be impractically
expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too
small for a drip), injections every minute, injections with repeated boluses requested by the patient, up to maximum number per hour (e.g. in patient-controlled analgesia), or fluids whose volumes vary by the time of day.
Because they can also produce quite high but controlled pressures, they can inject controlled amounts of fluids subcutaneously (beneath the skin), or epidurally
Fluid container
Drip chamber
Roller Clamp
BASIC INFUSION SYSTEM
Flow by gravity
Flow controlled by roller clamp
Difficult to set and control infusion rate
INFUSION PUMPSWhat are they? Usually electrically powered
infusion devices
What do they do? Use pumping action to infuse
fluids, medication or nutrients into patient
Suitable for intravenous, subcutaneous, enteral and epidural infusions
TYPES OF INFUSION Continuous infusion usually consists of small pulses of infusion, usually
between 500 nanol-iters and 10 milliliters, depending on the pump's design, with the rate of these pulses depending on the programmed infusion speed.
Intermittent infusion has a "high" infusion rate, alternating with a low programmable infusion rate to keep the cannula open. The timings are programmable. This mode is often used to administer antibiotics , or other drugs that can irritate a blood vessel.
Patient-controlled is infusion on-demand, usually with a preprogrammed ceiling to avoid intoxication.
The rate is controlled by a pressure pad or button that can be activated by the patient.
It is the method of choice for patient-controlled analgesia (PCA), in which repeated small doses of opioid analgesics are delivered, with the device coded to stop administration before a dose that may cause hazardous respiratory depression is reached.
Total parenteral nutrition: usually requires an infusion curve similar to normal mealtimes.
INFUSION PUMPSWhy are they used? To provide accurate and controllable flow over a
prescribed period or on demand
What are they used for?Wide range of drugs and therapies including Chemotherapy Pain management Total parental nutrition Anaesthesia/sedation Etc. etc.
Application :(refer to khandpur 893p-898)1. Hospital system2. Ambulatory application
COMPONENT OF DRUG INFUSION SYSTEMS :(refer to khandpur 893p-898)
1.DELIVERING THE DRUG
2. SYRINGE PUMP
Definition :A syringe driver or syringe pump is a small infusion pump (some include infuse and withdraw capability), used to gradually administer small amounts of fluid (with or without medication) to a patient or for use in chemical and biomedical research.
PRINCIPLES OF OPERATION Syringe pumps use a series of sensors
and a motor driven plunger head to infuse liquid at a precise rate
Inputs Outputs AC Moving Plunger Full syringe Liquid released at
steady rate
PRINCIPLE OF OPERATION Chassis contains:
LCD screen Alarm to alert user of failures and other
issues that need attention Power supply 2 power distribution boards Memory capabilities
Records doses, rates, and settings
PRINCIPLES OF OPERATION Chassis contains:
Flange clamp sensor Determines if syringe flange is present
Barrel clamp sensor Determines if barrel of syringe is present Determines size of syringe
Position sensor Determines how far plunger head is from
chassis
PRINCIPLES OF OPERATION Chassis contains:
Motor and worm gear Smoothly moves plunger head outwards Unidirectional
Pyramid shaped reflective counter Rotates with motor Counts rotations by reflecting light back at a sensor
PRINCIPLES OF OPERATION Plunger head contains:
Force sensor Syringe plunger pushes
against sensor Springs attached to
plunger flippers and force sensor detect presence of syringe plunger
Clutch & lever to allow and prevent plunger from moving freely
OPERATION Place syringe in three clamps (flange, barrel,
plunger flippers) Designate infusion settings on screen Press “start”
Bolus option: quickly moves plunger head to prime syringe
Always pay attention to alarm warnings Use Biomed option for troubleshooting help
APPLICATIONS
Infuse fluids, medication or nutrients into circulatory system
Administers fluids more reliably than humans Improve patient safety by increasing consistency
and accuracy Assist in investigation of incidents by collecting
data in memory
SAFETY Always use PPE (Personal protective equipment
(PPE))
Read manual before using
3.PERISTALTIC PUMPS :(also refer to khandpur 893p-898)
•t is type of positive displacement pump used for pumping a variety of fluids.
•The fluid is contained within a flexible tube fitted inside a circular pump casing (though linear peristaltic pumps have been made).
•A rotor with a number of "rollers", "shoes", "wipers", or "lobes" attached to the external circumference of the rotor compresses the flexible tube. •As the rotor turns, the part of the tube under compression is pinched closed (or "occludes") thus forcing the fluid to be pumped to move through the tube. Additionally, as the tube opens to its natural state after the passing of the cam ("restitution" or "resilience") fluid flow is induced to the pump. This process is called peristalsis
• Typically, there will be two or more rollers, or wipers, occluding the tube, trapping between them a body of fluid.
•The body of fluid is then transported, at ambient pressure, toward the pump outlet. Peristaltic pumps may run continuously, or they may be indexed through partial revolutions to deliver smaller amounts of fluid.
IMPLANTABLE INFUSION SYSTEM(IIS) :(refer to khandpur 893p-898)
•It is intended to provide long-term continuous or intermittent drug infusion.
•Possible routes of administration include intravenous, intra-arterial, subcutaneous, intra-peritoneal, intrathecal, epidural, and intra-ventricular etc
•The IIS is surgically placed in a subcutaneous pocket under the infraclavicular fossa or in the abdominal wall, and a catheter is threaded into the desired position.
•A drug is infused over an extended period of time, and the drug reservoir may be refilled as needed by an external needle injection through a self-septum in the IIP.
•Bacteriostatic water or physiological saline is often used to dilute drugs.
• A heparinized saline solution may also be used during an interruption of drug therapy to maintain catheter patency.
•The driving mechanisms may include peristalsis, fluorocarbon propellant, osmotic pressure, piezoelectric disk benders, or the combination of osmotic pressure with an oscillating piston.
