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IV Infusion Pump- Working, Applications, Cleaning, Maintenance

An IV infusion pump is a machine that infuses the drugs, or nutrients into the body of the patient in a precise volume for a fixed period of time. The nutrients or the medications are stored in the IV bag or bottles. Since it can deliver a large volume of fluid (about 500 ml), it belongs to one of the types of ‘Large Volume Pump’.

Working Principle of IV Infusion Pump

Working Principle of IV Infusion Pump
Working Principle of IV Infusion Pump

The peristaltic pump or the peristaltic finger draws the fluid from the IV bag/bottle and delivers it to the patient. Peristaltic fingers are the arrays of the finger-like structure, that presses the tube in sequence causing the movement of the internal fluid.

The tubing connects from the IV bag/bottle and goes through the machine. Inside the machine, there can different kinds of detectors to check the condition of the tubing and the fluid flowing through it. Some of the fundamental sensors are the occlusion detection sensor, bubble detection sensor, door sensor, etc. Based on different companies, there can be many more variations.

If the sensors detect any abnormalities, they send the signal to the control unit. Then the machine sends reports to the user via alarm and display the message on the screen.

Modes of Operation

Different machines can have different modes of operation. Here we will be discussing a few of them.

1. Volume Mode (ml/hr)

(Rate Mode)

This is the most popular and commonly used mode in hospitals. Here you will be able to get few parameters such as Volume to be Infused (VTBI), rate of flow, and the total time to infuse the set volume of the drugs.

2. Bolus Mode

An IV bolus is the rapid injection of the drug into the patient for a short period of time. In bolus mode, you can set parameters such as Volume to be Infused (VTBI) and infusion rate. In most of the machines, you can set bolus in two ways. One of them is the auto mode while the other mode is the manual mode.

3. Drop Mode (drops/min)

Drop mode can be an optional mode. Thus, it may not be available in all the machines. It measures the number of drops. Some of the parameters of drop mode are infusion rate, infusion volume (VTBI), time period, etc.

4. Weight Mode

You can set the parameters such as dose and the weight of the drug. Similarly, other parameters such as dose unit, dose rate, etc, are also possible.

4. Program Mode

Instead of manually setting the parameters for the drug infusion, you may even be able to preset the values in the form of programming. You can set a number of programs and select the programming according to your need. This will make the process of operation easier and reliable.

How to use IV Infusion Pump?

How to use IV Infusion Pump?
Flow chart showing the procedure of using IV Infusion Pump

Once you have fixed the machine on a stable IV stand, turn on the machine. The machine will undergo a self-test. During this time, it will check for the condition of the pressure sensor, batteries, etc.

Then install the IV set into the machine. Then set the parameters of the machine as per your requirement.

Make sure that there is no air bubble in the tubing, and the tube is set properly in the machine. You may have the option of purge/bolus in the machine. Press on it and allow the air bubbles to escape from the tubing.

Now, puncture the vein of the patient. Then, start the process of infusion. During the set time period, the machine will infuse the drugs or nutrients into the patient. Once the set time period has been reached, the machine will stop.

If you need to stop the machine in the middle, then you can use the stop button. You may be able to continue the process or even reset the machine.

If you want to know the rate for the given nutrient volume you may use the formula for calculation. However, you can even use an IV Infusion Calculator.

Infusion Set Calibration

Different companies can manufacture different types and sizes of infusion sets. For example, the normal diameter of the infusion tube can range from 3.4 mm to 4.5 mm. Thus, for every new tubing system, I personally suggest you do the calibration.

For this connect the upper end of the infusion set to the infusion bag or bottle. Then properly fix the tubing within the iv infusion pump. Then, dip the other end of the tube to the measuring cylinder such as a 10 ml syringe.

Now, manually purge the tubing system. This will allow the tubing system to be completely filled up with the liquid solution. After that, in the setting menu choose the brand of the infusion set that you are using. Else, you can even enter the brand name manually. Then set the total volume (for example 10 ml). The higher volume can refer to the better result from the machine.

Now, begin the process of the infusion. The measuring cylinder will slowly begin to fill up. Once the set volume of liquid has been observed in the measuring cylinder, stop the machine. The calibration process will be over.

You can follow the same steps of calibration 2 to 3 times.

Cleaning of IV Infusion Pump

The iv infusion pump should be cleaned regularly. For this, you can use collins or semi-wet tissue paper to get rid of the dust. You may even use 75% alcohol for disinfection. But do not use chemicals such as xylene and acetone. 

Maintenance of IV Infusion Pump

For any one of the given errors, the machine will give you an alarm.

1. Battery

The problem can arise when the battery has not been adjusted properly. Also, there can be a low charge in the battery. In such a case, you need to charge it up.

After long usage of the machine, the battery may deteriorate. So, it will not be able to hold the charge for a longer period of time. In such a case, you need to replace the battery with a new one.

To check the performance of the battery, follow the following steps.

  • Supply AC power to the IV infusion pump.
  • Once the battery has been fully charged, remove the power supply.
  • Set the time for about 2 hrs.
  • Turn on the pump for infusion.
  • Now measure the time period needed for the machine to shut down.
The time period from start to stop Remark
More than 90 minutes Battery is good
From 45 to 90 minutes The battery is reaching its end life
Less than 45 minutes It is better to replace the battery

2. Door Open

Make sure that the infusion set has been set properly and has been mounted on the bubble detector. Similarly, make sure to close the door properly

3. Bubble

There should not be any obstruction in the infusion set. So, make sure that there is no breakage in the tubing system and all the parts of the infusion set are fixed properly. After that, place the infusion tubing in the slot of the bubble detection sensor. Else, the sensor will not be able to detect the infusion tubing. You may also need to clean the slot of the bubble detector sensor with the help of a clean semi-dry tissue paper. After that,  press the bolus key or the purge key to get rid of the existing bubbles from the tube.

Due to the continuous use of the machine, the infusion set can undergo pipeline fatigue. In such a case, shift the position of the pipeline within the machine.

If the display shows the error of bubble even when there is no bubble in the infusion set, the problem can be with the bubble detector. In that case, replace the bubble detector with a new one.

4. Occlusion

If there is any jam or occlusion in the infusion set, the machine will give you an error with an alarm signal. The occlusion can be due to the presence of foreign particles within the tubing system. Similarly, the clamp may be blocked.

The needle of the syringe can be blocked due to the flow of highly viscous liquid or nutrient solution.

Also, the tubing may be folded. It may be too hard or too soft. In such a case, it is better to replace the infusion set with a new one.

5. Pressure Error

The strong electromagnetic interference around the infusion pump can alter the performance of the pressure sensors. In that case, you can re-start the machine after the removal of the source of interference.

The occlusion within the infusion set can cause an increase in the pressure. Similarly, the pressure sensors might be defective. You can verify it, by doing a cross-check with a new piece of the pressure sensor.

Finally, if the set value of the pressure is low, the infusion pump will give you an alarm. For this problem, go through the settings and adjust the pressure level.

6. Drop Error

The drop sensor might be loosely connected. Similarly, the drop sensor may not have been properly chipped to Murphy’s dropper.  Even after checking for these, if you are getting an error, then cross-check the drop sensor with a new one. If the sensor is damaged, then replace it with a new one.

 

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