Exploring the clinical effects of height elevation and depression on syringe pumps

Research has shown that the positioning of syringe pumps can have a significant effect on the amount of drug delivered t opatients. This article explains the effects of raising and lowering syringe pumps in relation to the entry site, and its impact on drug delivery. It also discusses drugs which are particularly associated with risks to patients when the device height is changed, and measures to reduce the clinical impact of height elevation and depression of infusion lines, including training.     

Design flaw can convert commercially available continuous syringe pumps to intermittent bolus injectors

Objective: To investigate if unexpected behaviour of neonatal and paediatric patients connected to syringe pumps could be explained by transient elevation of these devices. Design: Five different commercially available syringe pumps were set at an infusion rate of 1 ml/h and then subjected to a vertical displacement manoeuvre (height 1 m). The actual delivered infusion volumes in association with the displacement manoeuvre were measured by a high precision weight scale connected to a computer. Setting: A medical technology laboratory in a university hospital. Measurements and results: Elevation of the devices resulted in a rapid bolus injection of 0.19–2.28 ml. Returning the devices to their original positions resulted in an aspiration into the system of 0.06–0.34 ml. The times both for bolus injection and for aspiration into the system were less than 1 min in all cases. The up-down manoeuvre was followed by a period with zero infusion ranging from 8 to 105 min. Conclusions: Design flaws in the construction of syringe pumps can expose patients to substantial danger following vertical displacemet if potent drugs are being infused. If potent drugs are infused, care should be taken not to change the vertical position of the syringe pump even for short periods of time. Before buying new equipment, the authors recommend that the delivery characteristics of these devices should not only be tested during ordinary bench testing but should also include the reaction to a vertical displacement manoeuvre. Received: 6 June 1997 Accepted: 8 July 1997     

微量注射泵垂直移动后注出率改变最小的安全移动高度的实验室研究

目的 找出微量注射泵垂直移动后注出率改变最小的安全垂直移动高度,作为临床泵体垂直移动安全措施的理论依据.方法 使用Micorinfusion Pump WZ-50C、WZ-50C2、BRAUN Perfusor compact 3台微量注射泵在10 ml/min的运转速率下,分别用电子天平测定在平面未移动时以及分别垂直移动15,25,35,50 cm高度后1 min的注出量并进行比较. 结果 垂直移动注射泵各不同高度间的流量比较有显著差异;垂直移动15,25,35,50 cm与未移动时的1 min的平均注出流量的差值分别为0.004,0.017,0.033,0.046 ml,差值最小的是垂直移动15 cm高度;流出量剖面图显示水平面与垂直移动15 cm高度的流出量线条呈稍有抬高而接近水平线状态,而后此高度流出量的点成为了一个拐点,线条随着垂直移动高度的增大变得越来越陡直,显示注出量比较的改变随着移动高度的增加而急剧增加.结论 垂直移动15 cm高度注出量的变化最小,成为不同高度的增加使流出量急剧增加的拐点,此垂直移动高度是安全的移动高度.     

肝素浓度,一次性注射器气密性对血气,电解质测定结果的影响

目的：探讨肝素浓度、一次性注射器气密性对血气、电解质测定结果的影响。方法：用一次性注射器及两种肝素浓度检测同一患者动脉血标本，比较血气、电解质测定结果及即时测定和１５ｍｉｎ后测定的血气结果。结果：抗凝肝素浓度高时（每ｍｌ血标本含肝素５１２Ｕ），ｐＨ、ＰａＯ２、Ｎａ＾＋、Ｃｌ、Ｃａ＾２＋、ｎＣａ＾２＋均较低（Ｐ〈０．０１），而Ｋ＾＋偏高（Ｐ〈０．０１）；标本放置１５ｍｉｎ后测定ＰａＯ２明显上升（Ｐ〈     

Placement of syringe infusion pumps and solution density can impact infusion performance: An experimental study

AimTo verify how variations in the height and solution density can influence syringe infusion pumps accuracy.MethodsThree syringe infusion pumps were studied in two infusion rates 0.5 ml/h and 10.0 ml/h. The solutions studied were saline solution and parenteral nutrition. The syringe infusion pumps were placed at the level of the distal exit of the infusion line, 30 cm above and 30 cm below.ResultsAfter 2 h of infusion, loss of accuracy was verified mainly at 0.5 ml/h with a significant influence of infusion pump placement (p < 0.001). At 10.0 ml/h there were differences between saline solution and parenteral nutrition at the same level (p < 0.004) and 30 cm above (p < 0.001). After 2 h of infusion the higher error rate identified was 20.1%.ConclusionThe placement of the syringe infusion pump and the infusion rate influence accuracy mainly at 30 cm below and 0,5 ml/h.     

Administering heparin subcutaneously: an evaluation of techniques used and bruising at the injection site

This experimental study tested the effects of four different subcutaneous injection techniques on bruising at the injection site. The independent variables of aspiration of the syringe prior to injecting heparin and pressure on the site following injection, and the dependent variable of size of bruising were studied. Aspiration of the syringe had little effect on bruising. After the first injection, fewer subjects who received pressure following the injection had bruising, the difference being significant for females. However analysis of subsequent injections did not support the conclusion that pressure reduces the probability of bruising.     

Administering drugs to patients with swallowing difficulties

Dysphagia is common among older patients. Its impact can be profound can swallowing difficulties can not only undermine the quality of life and exacerbate malnutrition but also complicate medication administration. Tablet crushing and capsule opening are widespread, yet few health care professionals are aware of the pharmacological or legal aspects of these practices. This article examines some of the causes of dysphagia in older patients, its impact on medication management and practical ways for nurses to meet this challenge.     

Administering eye medications

This article discusses eye medications and considerations for their use in ophthalmic patient care. It is aimed at all healthcare practitioners who are involved directly or indirectly in the care of patients with eye problems. The issues discussed are indications for the instillation of eye medications, legal aspects, patient assessment, concordance, classification of ophthalmic medications, drug interactions and the nursing procedure.