Evaluation of the FASTSTART mode for reducing start-up delay in syringe pump infusion systems

Neff, Thomas; Fischer, J.; Fehr, S. B.; Baenziger, Oskar; Weiß, Markus

doi:10.4414/smw.2001.09694

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…In the last two decades researchers have studied different factors which affect the extent of start‐up delays in syringe infusion pumps. These factors include flow rate, syringe size and architecture, syringe pump design, infusion line setup, administration of a purging bolus prior to connection, use of the Faststart mode, use of filters as well as antisiphon and check valves 4–14 …”

Section: Introductionmentioning

confidence: 99%

“…purging bolus prior to connection, use of the Faststart mode, use of filters as well as antisiphon and check valves. [4][5][6][7][8][9][10][11][12][13][14] Data on start-up performance of infusion pumps have been mainly obtained from experimental in vitro setups with the syringe pump assembly equilibrated to atmospheric pressure or to simulated central venous pressures (CVP) before starting the pump (File S1).…”

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confidence: 99%

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Effect of central venous pressure on fluid delivery during start‐up of syringe infusion pumps for microinfusion

Weiß

Wendel‐Garcia

Cannizzaro

et al. 2023

Pediatric Anesthesia

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BackgroundIntravenous administration of highly concentrated and potent drugs at low flow rates is common practice, particularly in critically ill children. Drug delivery during infusion start‐up can be considerably delayed by intrinsic factors of syringe infusion pump assemblies. The impact of central venous pressures on the course of start‐up fluid delivery of such microinfusions remains unknown.MethodsInfusion volumes delivered after activation of the start button in a conventional 50 mL syringe infusion pump assembly equilibrated (representing classical in vitro testing) and not equilibrated (representing real clinical conditions) to central venous pressure levels of 0, 10 and 20 mmHg at a set infusion flow rate of 1 mL/h were measured using a fluidic flow sensor.ResultsThe experimental setup mimicking real life conditions demonstrated considerable differences in fluid delivery during pump start‐up depending on central venous pressure. A central venous pressure of 0 mmHg resulted in massive fluid delivery at infusion start‐up, while central venous pressure levels of 10 and 20 mmHg resulted in retrograde flows with related mean (95% CI) zero‐drug delivery times of 3.22 (2.98–3.46) min and 4.51 (4.33–4.69) min, respectively (p < .0001).ConclusionDepending on central venous pressure level, connection and starting a new syringe pump can result in significant antegrade or retrograde fluid volumes. In clinical practice, this can lead to hemodynamic instability and hence requires clinical alertness. Further research and methods to improve start‐up performance in syringe infusion pump systems are desirable.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Effect of central venous pressure on fluid delivery during start‐up of syringe infusion pumps for microinfusion

Weiß

Wendel‐Garcia

Cannizzaro

et al. 2023

Pediatric Anesthesia

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Types and Frequency of Infusion Pump Alarms and Infusion-Interruption to Infusion-Recovery Times for Critical Short Half-Life Infusions: Retrospective Data Analysis

Waterson¹,

Bedner²

2019

JMIR Hum Factors

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BackgroundAlarm fatigue commonly leads to a reduced response to alarms. Appropriate and timely response to intravenous pump alarms is crucial to infusion continuity. The difficulty of filtering out critical short half-life infusion alarms from nonurgent alarms is a key challenge for risk management for clinicians. Critical care areas provide ample opportunities for intravenous medication error with the frequent administration of high-alert, critical short half-life infusions that require rigorous maintenance for continuity of delivery. Most serious medication errors in critical care occur during the execution of treatment, with performance-level failures outweighing rule-based or knowledge-based mistakes.ObjectiveOne objective of this study was to establish baseline data for the types and frequency of alarms that critical care clinicians are exposed to from a variety of infusion devices, including both large volume pumps and syringe drivers. Another objective was to identify the volume of these alarms that specifically relate to critical short half-life infusions and to evaluate user response times to alarms from infusion devices delivering these particular infusions.MethodsThe event logs of 1183 infusion pumps used in critical care environments and in general care areas within the European region were mined for a range of alarm states. The study then focused on a selection of infusion alarms from devices delivering critical short half-life infusions that would warrant rapid attention from clinicians in order to avoid potentially harmful prolonged infusion interruption. The reaction time of clinicians to infusion-interruption states and alarms for the selected critical short half-life infusions was then calculated.ResultsInitial analysis showed a mean average of 4.50 alarms per infusion in the general critical care pump population as opposed to the whole hospital rate of 1.39. In the pediatric intensive care unit (PICU) group, the alarms per infusion value was significantly above the mean average for all critical care areas, with 8.61 alarms per infusion. Infusion-interruption of critical short half-life infusions was found to be a significant problem in all areas of the general critical care pump population, with a significant number of downstream (ie, vein and access) occlusion events noted. While the mean and median response times to critical short half-life infusion interruptions were generally within the half-lives of the selected medications, there was a high prevalence of outliers in terms of reaction times for all the critical short half-life infusions studied.ConclusionsThis study gives an indication of what might be expected in critical care environments in terms of the volume of general infusion alarms and critical short half-life infusion alarms, as well as for clinician reaction times to critical short half-life infusion-interruption events. This study also identifies potentially problematic areas of the hospital for alarm fatigue and for particular issues of infusion and infusion-line management. App...

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Problems Inherent to Syringe Pumps

Kubo

Kondo

Nakajima

et al. 2011

Iryou kikigaku (The Japanese journal of medical instrumentation

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Evaluation of the FASTSTART mode for reducing start-up delay in syringe pump infusion systems

Cited by 3 publications

References 6 publications

Effect of central venous pressure on fluid delivery during start‐up of syringe infusion pumps for microinfusion

Effect of central venous pressure on fluid delivery during start‐up of syringe infusion pumps for microinfusion

Types and Frequency of Infusion Pump Alarms and Infusion-Interruption to Infusion-Recovery Times for Critical Short Half-Life Infusions: Retrospective Data Analysis

Problems Inherent to Syringe Pumps

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