RL - in answer to your questions:
No - there is no loss of delivery at startup as they follow the correct priming procedures. From our tests the pump does not fluctuate excessively - we've run tests (over 3 days!!) but it is close to the limit of what we can measure reliably.
As far as I am aware there are no undesirable effects to the patient.
John's initial problem was a misunderstanding regarding KVO rates at the end of infusion. Generally these are to allow the pump to run at a lower rate than the initial infusion to keep the vein patent. But, due to this extremely low rate of infusion being below the KVO rate there was concern that the pump would actually INCREASE in rate when reverting to KVO mode.
My concern is that this rate is so low that all sorts of other problems may occur:
- slow start up if not primed.
- movement of line may cause bolus to be delivered
- how accurate is such a low rate? (actually in tests there is no problem)
- Time to alarm occlusion will be long
- if they are using this rate & want to go lower, they can't
- etc
I hope that this clarifies the issue.
(I shall see if I can clarify why the users are using such low rates).
Mark
