Potential Safety Hazards and Nursing Countermeasures in the Use of Infusion Pumps

As clinical auxiliary infusion equipment, the infusion pump has the advantages of accurately controlling the total amount and flow rate of the liquid medicine and reducing the workload of nursing. At the same time, it also puts forward higher requirements for clinical users. Only by mastering the application, it can effectively avoid clinical risks. The followings are some precautions in the use of the infusion pump.

Perform regular maintenance on batteries in use. Avoid battery fluid overflow caused by not replacing the battery for a long time, corroding the power circuit board, and causing unnecessary losses; regularly check whether the battery contacts are corroded and if there is any problem, use a soft eraser to erase.

When the infusion pump is in use, other machines, such as nutrition pumps and infusion pumps, maybe hang around it. When the liquid discharged from other machines accidentally drips onto the infusion pump, it needs to be wiped clean in time.

Because liquid seeps into the inside of the machine, it may cause damage to the circuit board. In addition, liquids such as glucose can cause adhesion between the pump pieces, resulting in excessive resistance when the pump piece is squeezed, which affects the infusion accuracy, so you need to pay careful attention to keep the surface of the infusion pump clean.

The fixed bracket and locking rod head of the infusion pump are hard plastic products, which are easy to break. Therefore, when storing the infusion pump, please place the infusion pump in a cool place that is not easy to fall. The infusion pump is positioned correctly and keeps the parts in place.

1. The appearance of the equipment should be clean and tidy, the surface of the pump body should be clean, the infusion pump groove should be free of stains, the door of the infusion pump should be free of stains, and the sensor part should be free of stains.

2. The indication should be normal when the external power supply and internal power supply (power supply battery) of the device are powered.

3. All parts of the pump (box body, power cord, pull bolt, frame rod, clamp, infusion pump door, etc.) are in good condition.

4. All switches and buttons should be effective and sensitive.

5. Under daily illumination or lighting, the content displayed on the screen should be clearly identifiable.

6. The warning signs are clear and the alarm function works normally. In addition to the indicator light or screen display, it should be accompanied by a sound alarm.

Some researchers have found that the infusion pump has a delay in starting pump. At a speed of 1 mL/h, the delay time of different infusion pumps ranges from (6.75±4.40) min to (57.20±28.60) min, which is different from the design of the infusion pump. Syringe specifications, injection speed, pump tube compliance, and other factors.

1. Infusion equipment should use special supporting consumables. Different brands of pipelines have different parameters such as hardness and pipeline wall thickness. If they do not match the parameters of the infusion pump, the infusion rate will be inaccurate.

2. When the infusion speed is slow and the puncture site is higher than the pump body, venous backflow often occurs, which is easy to cause needle blockage and affect the treatment; when the injection pipeline is blocked, the micropump will not immediately alarm, only when the pipeline is blocked for a certain period of time to produce a certain resistance alarm will sound.

3. When the input speed of the micropump is lower than 5mL/h, it is easy to block the tube. It is necessary to input normal saline or glucose solution at the same time. Maintaining at a speed of 5 drops/min will neither cause adverse reactions nor increase the load on the heart.

4. The main factor to avoid non-human omissions to generate air bubbles: the liquid medicine is usually stored at low temperature. Due to the high gas solubility of low-temperature liquid, when infusion in the ward, as the temperature of the liquid medicine gradually increases, its gas solubility decreases, and it will resolve out. Microbubbles; medicinal liquid components, such as cardiovascular and cerebrovascular medicines, Chinese medicinal liquids, etc. themselves will also produce bubbles.

5. The distance between the Murphy dropper of the infusion set and the entrance above the door of the infusion pump should be kept >10cm, not too short or too long, otherwise it will affect the accuracy of the infusion. The fatigue degree of the infusion pipeline used by the infusion pump changes with time.

For the infusion pump manufacturer's domestic supporting consumables, from the perspective of accuracy and safety, when using an ordinary infusion set, the extrusion at the same position cannot exceed more than 4 hours, it is recommended that the infusion set should be pulled down for a certain position every 4 hours or so.

6. The drop sensor should be installed at a position 1 cm above the liquid level of the Murphy tube.

7. Beware of drug extravasation. If drug extravasation occurs during the bolus injection, the alarm system of the infusion pump will not respond. If positive and correct measures are not actively taken, serious consequences will occur.

8. Pump speed adjustment error: because the operator is not familiar with the speed setting button, or the speed is not changed in time after changing the drug, or in some cases, the speed setting is accidentally touched by others and the speed is changed, so that the drug enters the body too much or not enough, leading to adverse consequences.

9. Bubble velocity <0.02mL/(kg/min) can be detected after entering the human body, but does not cause physiological disturbance; When the bubble velocity entering the human body is greater than 0.4mL/(kg/min), the pulse pressure may increase; The lethal dose of continuous entry of bubbles is > 2mL/(kg/min); that is, a person weighing 50kg can be killed by inputting 100mL of bubbles within 1 minute.

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