Baxter PCA Pump Questions

**canoehead, BSN, RN** · Oct 29, 2004

If you press during the lockout period no dose is given and none will be given after the lockout is over. Makes sense because somepeople press 5-6 times in 5 minutes, and they can't be getting ALL those doses.

The lockout time is from the last time a dose was administered, not the last time a button was pressed.

General E. Speaking, RN, RN · Oct 29, 2004

Hi All,
Use this pump all the time, know how to program etc, but still have questions patients need answers to and can't find much info on the web. If you press for a dose during the lockout period, does the pump deliver a dose when the lockouts over without a second push? If you repeatedly push the button do you reset the lockout time; ie, does it delay the next dose. Any imput or links would be appreciated,
thanks.[/quote

say the patient has MS04 set at:
dose- 1ml
lockout- 10 min
hourly max- 6ml
no basal
they can push the button a zillion times in 10 minutes but still will only get 1 ml. No catch-up doses are spontaneously given by the PCA. After 10 min. it starts over again.

annmariern · Oct 29, 2004

Hi, thanks for the replies; those answers are what I always give patients and they look at me like Huh? "How am I supposed to know when to hit it then?" I am finding them really not very effective for post op pain, it seems a push or even 2 percocet last longer. Anyone else find this?

begalli · Oct 29, 2004

There's also a feature on those pumps that tell you how many hits (successful or not) the patient has taken.

So say the patient has the same example dose as posted above:

MS04 set at:

dose- 1ml

lockout- 10 min

hourly max- 6ml

no basal

You can go in and see how many attempts of delivering a dose the patient has tried:

12 attempts

6 successful (the max dose)

This would be an indication to me that the pain relief is not adequate...if the patient has tried 12 times, obviously they have pain beyond what the pump is delivering.

purplemania, BSN, RN · Oct 29, 2004

if they ask when to press button, just tell them press whenever you are in pain. The machine will give them a dose if it is time. If it is not time, just press again later. If you can't wait, call the nurse for a booster.

plumrn, BSN, RN · Oct 30, 2004

I always tell them to press it when they begin to feel pain. If they don't hear the beep, (the pump we use beeps with a successful push of the button), then wait a few minutes and push again. If they are having to push the button real frequently, perhaps they need a basal rate added, so that they can rest/sleep some instead of having to stay awake all night to stay ahead of the pain.

Trauma-tizedRN · Oct 30, 2004

I really dislike Baxter PCA pumps....very user unfriendly number one....and at the mercy of the pump as to how much drug is REALLY left...no way to measure it in a bag. I love it when the bag goes empty but the pump says there should still be X amount left. Like playing hot potato. How do you track for pump error, programmer error or nurse diversion. I am so used to being able to visually verify remaining amounts at end of shift count before I sign my Jane Henry. Baxter oughta throw these pumps in the garbage. Nearly impossible to change out a bag with air in the tubing and subsequent alarming to drive you crazy. Icky. I don't believe diversion was a problem in the unit where I worked....but the management were eyeballing all the obvious discrepancies on the narc flowsheet as if we had that issue. Pretty unnerving. We complained over and over about these pumps...to no avail. We finally boycotted and refused to sign for an end of shift narc count we couldn't measure. Fixed that problem. New pumps ordered.