Not all brands of infusion pumps allow for any changes at the bedside in the pressure settings. A few allow this, but most would require this change be made by the biomedical engineers in each facility. I am curious to know why you want to make this change. Actually you would not be changing the pressure at which the pump infuses. You would be changing the amount of backpressure the pump detects in the normal pumping mode. Once it senses backpressure in excess of the setting it causes the alarms to sound. The actual infusion pressure is slightly less than the backpressure that causes the occlusion alarm. For infusion through a peripheral vein, this should be less than 3 to 4 psi or 150 to 200 mm Hg because venous pressure is ~35 mm Hg in the hand. As you move up the arm, the pressure decreases. For superior vena cava, the pressure is zero, so this low pump pressure, or even lower would work. If you are talking about arterial infusion, of course the pressure settings must be higher. Lynn
Thanks. We are investigating lowering the occlusion alarm pressure because we had an unrecognized arterial placement of a CVC. Among other actions (namely the competency of the operator) we are trying to determine if lower the occlusion pressure of the alarm setting would have triggered nursing to note that something was wrong with the catheter. The pumps we use (Alaris) are easily changed at the bedside (which I'm not sure I think is a good thing). They have a range of 50mm/Hg to 525mm/Hg, and were all preset to 350mm/Hg. That seems excessively high to us. We would like to have the pumps set to an occlusion pressure that results in a minimum number of occlusion alarms, but also alarms appropriately during infiltrations (and arterial misadventures).
We are gradually lowering the occlusion alarm pressure each week in one small unit to see where we start getting a lot of alarms. So far we are down to 150mm/Hg with no problems.
I have to make one huge correction. There is no pump on the market that will produce alarms to detect an infiltration/extravasation. This has been published several times in the literature and is included in the Infusion Nursing Standards of Practice in both the one on Flow-Control Devices and Infiltration/Extravasation. I have testified to this fact numerous times in court. Please correct this mis-information with your staff immediately to reduce their misunderstanding and their liability! Lynn
We have Hospira pumps and we are able to change the infusion pressure. I am not comfortable with this feature because a bit of education needs to happen so the pump pressure is not increased to overcome infiltrates and such. The Hospira trainers did discuss some scenarios where the feature would be useful during our install training. If memory serves, the pump pressure is set at 8psi. I could be wrong on that, don't shoot me.
Not all brands of infusion pumps allow for any changes at the bedside in the pressure settings. A few allow this, but most would require this change be made by the biomedical engineers in each facility. I am curious to know why you want to make this change. Actually you would not be changing the pressure at which the pump infuses. You would be changing the amount of backpressure the pump detects in the normal pumping mode. Once it senses backpressure in excess of the setting it causes the alarms to sound. The actual infusion pressure is slightly less than the backpressure that causes the occlusion alarm. For infusion through a peripheral vein, this should be less than 3 to 4 psi or 150 to 200 mm Hg because venous pressure is ~35 mm Hg in the hand. As you move up the arm, the pressure decreases. For superior vena cava, the pressure is zero, so this low pump pressure, or even lower would work. If you are talking about arterial infusion, of course the pressure settings must be higher. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks. We are investigating lowering the occlusion alarm pressure because we had an unrecognized arterial placement of a CVC. Among other actions (namely the competency of the operator) we are trying to determine if lower the occlusion pressure of the alarm setting would have triggered nursing to note that something was wrong with the catheter. The pumps we use (Alaris) are easily changed at the bedside (which I'm not sure I think is a good thing). They have a range of 50mm/Hg to 525mm/Hg, and were all preset to 350mm/Hg. That seems excessively high to us. We would like to have the pumps set to an occlusion pressure that results in a minimum number of occlusion alarms, but also alarms appropriately during infiltrations (and arterial misadventures).
We are gradually lowering the occlusion alarm pressure each week in one small unit to see where we start getting a lot of alarms. So far we are down to 150mm/Hg with no problems.
Tim
I have to make one huge correction. There is no pump on the market that will produce alarms to detect an infiltration/extravasation. This has been published several times in the literature and is included in the Infusion Nursing Standards of Practice in both the one on Flow-Control Devices and Infiltration/Extravasation. I have testified to this fact numerous times in court. Please correct this mis-information with your staff immediately to reduce their misunderstanding and their liability! Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We have Hospira pumps and we are able to change the infusion pressure. I am not comfortable with this feature because a bit of education needs to happen so the pump pressure is not increased to overcome infiltrates and such. The Hospira trainers did discuss some scenarios where the feature would be useful during our install training. If memory serves, the pump pressure is set at 8psi. I could be wrong on that, don't shoot me.