Pressure sensitive IVpumps

  1. The two hospitals I have worked for most recently use IV pumps (I don't remember what brand) that do NOT have pressure sensors that trigger an alarm to indicate that the infusion is infiltrating. I have seen infiltrations the likes of which I hadn't seen since the early 1980's. I was told "this happens all the time with IV pumps, and I could not convince them otherwise.

    I would like to hear opinions and I formation from knowledgeable nurses about this.
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    About bd2rn

    Joined: Jun '18; Posts: 36; Likes: 29

    8 Comments

  3. by   MunoRN
    There are no IV pumps in existence "that trigger an alarm to indicate the infusion is infiltrating". IV pumps have sensors to measure the amount of resistance the pump is working against, but increased resistance is not limited to an infiltration, where resistance does not typically increase above normal variations until long after the infusion infiltrates.
  4. by   bd2rn
    No, of course the pump can't know what is causing the increased resistance, and I don't think I implied that. What I am getting at is that there are pumps that detect increased resistance and that they alarm and stop when they meet the trigger. I have cared for thousands of patients since the mid-80s, when I first used pressure-sensitive pumps. Over the last couple of years, however, I have seen enormous infiltrations-200 to 500ccs or so-that I never saw in previous decades. I'm trying to understand why these newer pumps allow that. Obviously, we need to monitor the sites frequently, as always. That's a given. I'm trying to understand why we're getting pumps that don't do their job.
  5. by   iluvivt
    The nurse is the infiltration detector.You already have the solution and that is more frequent and accurate assesment.As Muno already,stated an infusion pumps have downstream occlusion sensor circuitry that detects elevated pressure between the pump and the patient. When the pump reaches the preset limit for the occlusion pressure ...it will alarm..The nurse can then go in and assess and figure out why there is resistance between the pump and the patient.This does NOT indicate that infiltration or extravasation is occuring because infiltration/extravasation pressures are much lower than the pumps downstream occlusion alarm limit settings and will not trigger the occlusion alarm .If you think setting the pump to the maximal downstream occlusion alarm will help by making it more senstive and thus with a lower value...Think Again.....what happens then is the patient and nurse are driven nuts with nuisance alarms and it still will not detect an infiltration.The alarm will tell you if there is resistance...that could be caused by a variery of things such as a pinched cannula....pinched IV tubing....IV tubing that has become pinched in the pump....(sometimes these are upstream occlusions)...even a pinched slide clamp ..Your premise that the pump is not doing its job is incorrect. Pumps do not detect infiltrations and the feature you are referring to is only to detect resistance as I explained.If you were told this...it is incorrect and I can refer you to more information if needed.I have had many a nurse think this and I politely correct them and tell them they are the infiltation detectives.
    Last edit by iluvivt on Oct 23
  6. by   bd2rn
    I'm obviously not explaining my concern well. What I am finding is that the newer pumps I've come across the past several years DO NOT ALARM when there is increased pressure due to an extravasation. They just keep quietly pumping away. I hadn't seen such indurations sonde the early 1980s. By 1985, we DID have pumps that would alarm and stop when the preyis high d/t extravasation. I'm just trying to figure out why the newest pumps don't do their jobs as well as the older ones. (At this point, I'm guessing nobody here knows, either.)
  7. by   MunoRN
    I think your premise may be faulty; when an IV infiltrates the pressure the pump is working against does not necessarily increase, and often it decreases. The pressure will eventually increase once the infiltration has filled the compartment it has infiltrated into, but this may be long after the infiltration occurred.
  8. by   bd2rn
    Quote from MunoRN
    I think your premise may be faulty; when an IV infiltrates the pressure the pump is working against does not necessarily increase, and often it decreases. The pressure will eventually increase once the infiltration has filled the compartment it has infiltrated into, but this may be long after the infiltration occurred.
    You've misunderstood my question. What I am saying is that the newer pumps are allowing HUGE infiltrations that the older pumps did not allow. I am wondering why TPTB are allowing this situation.
  9. by   MunoRN
    Quote from bd2rn
    You've misunderstood my question. What I am saying is that the newer pumps are allowing HUGE infiltrations that the older pumps did not allow. I am wondering why TPTB are allowing this situation.
    The problem with that claim is that the newer pumps aren't allowing HUGE infiltrations that the older pumps did not allow.
  10. by   bd2rn
    Quote from MunoRN
    The problem with that claim is that the newer pumps aren't allowing HUGE infiltrations that the older pumps did not allow.
    . Okay, so you have not seen this. That is somewhat useful information. I actually HAVE seen it numerous times, but it's good to know that it is not as common as I feared.

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