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Discussion

Alaris pumps

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 completely unreliable although described as being "safer" with the Guardrails software.

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We use Alris pumps and don't have too much of a problem. I work on a Neuro/Neurosurg floor. The only thing I don't like is the fact that I can set a max rate of 270cc/hr. To run boluses or fast piggybacks, I usually use a gravity set. I have tried using the Alaris pumps for blood, but again prefer to use gravity. Because of the 270/hr limit, I can get my blood in quicker through gravity.

Elizabeth LPN

RN to be in July

I can't address the Channel Error, though I do know what you mean...frustrating!

As for Air in Line, I've found that after you load the tubing, if you make sure the bottom part (where the electronic eye actually is) is fully shoved in, you get fewer Air in Line alarms. Air in Line alarms make us want to chuck the darn things through the window because, of course, there's no visible air! And I work NICU, so I think our air alarms are probably set to highest sensitivity. One time an anesthesiologist told us that if you put a dollop of KY jelly over the electronic eye, it won't alarm Air in Line at you... though I wouldn't necessarily try it myself...

Oh, FYI...

I'm referring to the Alaris IV pumps, not the syringe pumps. Did you mean the IV pumps?

  • Author

Either really. I swear they will kill someone. If they don't want to flow they won't. The other day I had a "Check IV Tubing" error on my citrate for dialysis. Reset wouldn't work. Changing the tubing wouldn't work. I ended up changing the tubing twice, and the module twice before my whole dialysis clotted off in the interim. If it had been vital pressors it could have been catastrophic. And I swear as I watch his blood pressure tidal up and down, that its pump related. As he does have his norepi and vasopressin on the Alaris. We never had these issues with the AVI's. We have had lists of errors with these things and managment keeps saying there is nothing wrong with them.

Oh, FYI...

I'm referring to the Alaris IV pumps, not the syringe pumps. Did you mean the IV pumps?

  • Expert

We use the double-channel Alaris Signature volumetric pumps and I HATE THEM!!!!!!!!!! They were not designed for intensive care purposes, I don't care what anyone says. And inotropes should never be run through them: they have a pulse and pause delivery system which makes for huge swings in BP caused by this tidal effect. :eek: The other night I spent a full 20 minutes trying to get a transfusion going on a kiddie with a Hgb of 55... the pump refused to sense the set. The good old "air in line" alarm is a common occurence, particularly with TPN and blood products. I may just try the K-Y Jelly tip!! And then there's the tubing itself. Takes forever to set up an infusion because of having to fool around with the cassette to make sure no microscopic air is in it, and to manually purge air out of all those ridiculous needle-less ports. Volume of the set... nearly 25 mL. What a waste!! When we change the concentration of KCl in our infusions, we have to disconnect, run at least 25 mL through then reattach. How safe is that? To say nothing of the time expended! And no such thing as a vented blood set for albumin. :banghead: Do they not infuse large volume of albumin in their world? We do one of three things... spike the bottle with an unvented blood set then vent the bottle with an 18 gauge needle (surest way to an albumin shower there is, never mind the risk to the patient :no: ), spike the bottle with an unvented set then push the spike over to one side every ten minutes or so to let air into the bottle, or we draw it up into syringes and push it in that way. Money and time down the drain. Please give me back my Baxter triple channels!! :bowingpur

but when I prime the tubing, I hold the chamber upside down - it pushes all of the air up and out so that when you flip it over there isn't any to get stuck in the chamber... I work in NICU, so I only use these Alaris pumps for HAL and regular fluids - the syringe pumps for critical drips, blood, etc. Have to say, however, that I don't have issues with air in the line.

Rainbows

Ok I need some advice. I was under the impression that if there are air bubbles in a giving-set line after a bag of fluids is finished you can flush the air bubbles out by priming the line by running a new bag of fluids through it until the line is clear. Can anyone clarify this for me?? And if so is there any resource that says so in writing???

We use the Alaris in our PICU and while we have had a few problems it is not many. Air in line is a pain but usually resolves once we thump out the air. Channel error rarely occurs. I am assuming you were running the Citrate in prefilter. Where exactly in the dialysis tubing were you giving the Citrate? One thing we have found with SLED is that the pump doesn't like the "drag" of pre-filter administration. The same pump that pulls the blood from the pt attempts to pull fluid from the pump and sets off alarms. The pump needs a little resistance to infuse against. The Alaris tubing has a small blue slide clamp under the pump. Partially close the clamp until the bar that designates pressure on the front screen appears. This simple step eliminated our dialysis related channel errors. Hope this helps.

I had "Channel Error" maybe three times last year? I can switch out the module in about a minute and haven't noticed a problem.

agree with 100%!! the company has been sending all kinds of memos to us about problems that could occur. i don't know why the hospital does not send them back

Another trick I learned to fix the Air in Line issue was to clean the 'eye' part of the alaris pump with alcohol. When it's dirty is also senses air in line. :)

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