Alaris pumps - page 2
by deanpicu 22,085 Views | 31 Comments
Has anyone had any trouble with these pumps. We keep having Channel Error and air in line problems. Just shutting down for no reason with inotropes or dialysis causing swings in blood pressure. The pumps just shut down and are... Read More
- 0Oct 16, '06 by dawnglovesOoo! I just found this! Maybe someone can use it. I don't think I've ever vented the buretrol!
- 0Aug 31, '07 by NotReady4PrimeTime Senior ModeratorWe don't have the upgraded version. Our pumps are about 8 years old and will only be replaced when enough of them are dead that we can't function without new ones. We're having a ton of trouble with our Alaris Asena syringe pumps these days, with "excessive plunger deviation" the most common and most problematic. We run our pressors on these pumps and the only solution to that particular problem is to turn the pump off, reset the plunger and turn it back on. I haven't timed it but I'd guess the whole reset takes about 2 1/2 minutes, enough time for baby on norepi to arrest...
- 0Mar 30, '11 by Floyd NightingaleThe system I work for recently went to the Alaris pumps after ditching the ones made by Baxter. If you've used the Baxters you know what a problem they were but as bad as they were, I want them back.
The air in line thing is incredibly frustrating. I've wasted of lot of medicine, sometimes very expensive medicines, trying to clear the lines. Tonight I spent the better of an hour trying to get a potassium infusion going, and that's not the first time. I expect it won't be long before we have a sentinal event because of these pumps.
An does it really have to alarm when I shut the door? Hello?, I'm standing right here. That's how it got closed.
Another thing is they told us that pumps were specifically programmed not only for our system but for specific departments. Ours are set up for the ER and ICUs, I work the ER, but I noticed that at the community satellite ER where I pick up overtime the pumps are set up wrong. At the main campus the potassium piggybacks are 20meq in 250ml and the pumps at the satellite are set up the same way but they use a 10meq in 100cc concentration, so it's wrong.
Otherwise they seem to work pretty well if you can get them going, and they're much easier to program than the Baxters were but they're not much use if it takes an hour to get a drip going. I can't wait until I have to give pressors to a dying pt.
- 0Mar 30, '11 by NotReady4PrimeTime Senior ModeratorThis is a pretty old thread, originally from 2005. In the interim our unit has repalced all the Alaris Signature Gold pumps we had with the Alaris Smart Pump systems that you're describing, Floyd. We have many problems with them too. I'm not sure why they had to program them to require that we scan our IDs before we can do anything, but it creats havoc at certain times, that's for sure. The additional step of having to enter the patient's Universal Lifetime Identifier when first setting it up is a pain in the you-know-what too.
Air-in-line alarms were supposed to be fewer with this pump and they're supposed to have the capability to propel the air through so that it can be caught at the first in-line port, but of course that's not reality. My preferred method for getting rid of air causing alarms is to pull some of the IV fluid out of the bag or buretrol, attaching the syringe on the port below the problem, pulling the impeller tubing out of the pum and gently flushing backward up into the buretrol or bag. Flushing too fast, or pulling fluid down the fluid path creates turbulence and even more air. In a pinch I've just twisted on a prefilled syringe of saline and flushed up with that. We NEVER run pressors or any vasoactive meds on them because this pump too has the pulse-and-pause delivery that causes swings in BP. We don't even run anything into the same lumen as pressors on these pumps, and in smaller babies, not even in the other lumens of the same line. It's just too unpredicable.
- 0Apr 3, '11 by hubcapsCan anyone explain the pressure limit settings? My hospital switched over to them in December and alaris failed to inform us of this option. I had a kid on a heparin drip and the default pressure setting was not able to detect an occlusion in the line. The kid later on got a clot in his shunt. Fortunately, they were able to stent it open. Later on, our unit found out that you can change the pressure limit for the alarm. Are there guidelines as to what the pressure limit should be?
This was actually the second incident. I was quite mad that management did not inform our unit when it first happened (probably because nothing happened).
I too find the air inline frustrating. We have needed our pharmacy to overfill TPN because we keep wasting it when we pull air from the ports. Our old baxter pumps didn't have as much issues with air.
- 0Apr 4, '11 by NotReady4PrimeTime Senior ModeratorThe pumps have a default pressure limit on them. They can be increased or decreased by the user. For example, if you're running TPN through a PICC on a tiny infant, there's going to be a lot of resistance, so you'd want to increase the pressure limit so that it's not alarming all the time. I usually increase it by one increment at a time until the alarms stop... and of course assess the line frequently. Another situation we see is when running heparinized saline into an arterial line (at 1.5 mL.hr) and the baby is hypertensive. It would seem that in your instance, the limit should have been lower so that you could assess back pressure more easily.
As for wasting TPN, see my previous post for a tip on how to reduce that. We run ATGAM and rATGAM on ours and we can't afford to waste a drop of that!
- 0Apr 4, '11 by hubcapsQuote from janfrnUnfortunately that won't work with our setup. There is a disc below the chamber that is connected to the spike which prevents back flow.As for wasting TPN, see my previous post for a tip on how to reduce that. We run ATGAM and rATGAM on ours and we can't afford to waste a drop of that!