Choosing the Right Infusion Pump

Infusion pumps can be classified according to their volume, form of administration, and mobility.

According to volume

Two types:

• Large volume infusion pumps, also known as volumetric infusion pumps: Are suitable for administering large volumes of infusion over a long period. The flow rate can be regulated by medical staff.

• Small-volume infusion pumps: These are ideal for administering small infusion volumes. The operator programs the number of drops to be administered per unit of time (e.g. drops/min). These are mainly syringe infusion pumps. The advantage of this type of infusion pump is that it offers greater precision.

There are also various operating mechanisms for these infusion pumps:

• Peristaltic infusion pumps: A set of rollers compresses a part of the flexible tube through which the solution passes, forcing it to flow. These pumps are best suited to administering large volumes of fluids.
• Piston infusion pumps: The piston pushes the plunger of the syringe containing the solution.
• Osmotic infusion pumps: This type of pump uses osmotic pressure to administer solutions at a constant rate for periods not exceeding four weeks.
• Elastomeric infusion pumps: The solution is contained in an elastic balloon. The pressure exerted by the walls of the balloon causes the fluid to move.

Medcaptain volumetric infusion pump

Assut Europe elastomeric infusion pump

RWD osmotic infusion pump

According to how the infusion is administered

Three types:

• Continuous infusion pumps: These are usually volumetric pumps, used to administer high volumes of solutions.

• Intermittent infusion pumps: This type of pump is mainly used to infuse solutions that can irritate blood vessels. Intermittent administration helps to minimize these effects.
• Patient-controlled infusion pumps: These are mainly used for pain management. The most common are Patient-Controlled Analgesia pumps, known as PCA pumps.

Angel PCA pump

CME PCA pump

According to mobility

Two main types:

• Ambulatory infusion pumps: The advantage of these pumps is that they are light and portable, enabling the patient to take it with them when they move around. However, ambulatory pumps are not suitable for all situations.

• Stationary infusion pumps: These are used for bedridden patients who cannot move or who are hospitalized for a long period of time. They are particularly suitable for intensive care units.

Infusion pumps are mostly used in hospital settings for bedridden patients, except for ambulatory pumps, which are used for people who can move around. Infusion pumps are used in a wide variety of environments and departments, from intensive care units to geriatric clinics. Here are some of the main ones:

• Resuscitation/intensive care
• Anesthesia
• Surgery
• Internal medicine
• Gastroenterology
• Palliative care (for pain relief, for example)
• Emergency care
• At home care
• Geriatric clinics

The infusion pump must be operated by a healthcare professional with specific training in handling these devices. In general, a nursing professional is responsible for putting the infusions into the patient.

Various types of drugs and nutrients can be administered to a patient using an infusion pump.

Medications

Several types of medications can be infused:

• Chemotherapy drugs (chemotherapy infusion pumps)
• Insulin for diabetes treatment
• Antibiotics for treating infections
• Analgesics (pain management infusion pumps)

Nutrients

Infusion pumps are also used to administer various nutrients, either parenterally (intravenously), to replace or supplement nutritional intake via the gastrointestinal tract, or enterally (with a tube). The following nutrients are often administered:

• Glucose solutions
• Amino acid solutions
• Lipid solutions
• Vitamin solutions

To ensure the correct use and operation of an infusion pump and not put the patient’s health at risk, it is important to respect certain safety requirements by ensuring the following are installed:

• Alarms to detect any problems in the infusion flow or incorrect pump settings.
• A battery for uninterrupted operation in the event of a mains power failure.
• A free-flow prevention system to avoid uncontrolled infusion of the solution.
• A pressure sensor to detect low pressures.
• An air bubble sensor.
• A droplet sensor.

The use of an infusion pump can entail a number of risks to a patient’s health, which must be taken into account.

• Risk of infection through venous lines
• Software-related errors, particularly when setting infusion rates
• Power outages, hence the need for a battery
• Risk of medication errors or drug interactions
• Drug dosing errors when programming the pump
• Errors caused by the patient when using patient-controlled pumps (PCA pumps)
• Errors made when using the interface