EBME Forums Forums Maintenance Technical Assistance B_BRAUN INFUSION PUMPS PROBLEMS

Blood Warmer?

It sounds like the pump is behaving exactly as it should, Richard. Perhaps B.Braun will incorporate an "on the fly" AIL reset button in the next version! Although I'm not so sure that would be a good idea in general, would it? Opinions welcome.

We had a problem at Hereford with air in line during blood infusions using Graseby 500 pumps Link
Hopefully I've put the link in correctly.

Lee

As I say, I believe that the real issue is with the procedure. Shouldn't the blood be pre-warmed? Or am I missing something here?

(which could well be the case, as my own life force is a bit chilled this morning)

Geoff

the ail is reset when a new infusion/therapy starts.
the use of blood warmers for every blood infusion is not practical.

Lee

thanks for the link not familar with the graseby 500 does this pump have an accumalative alarm or is it just air bubble size?

regards

richard

The Graseby giving set has three bubbles which are squeezed in sequence to give the required rate, air detection is by amount of air measured by IR in the top bubble.

Air in the circuit or bubbles produced above the pump accumulates in the top giving set bubble. The problem we had was that micro bubbles were gassing off below the pump then accumulating in the bend above the cannula.

Lee

Hi Lee

the air will be released as the blood warms in the set, one suggestion was to let the blood warm up for approximately 10 mins before primming the line, this did not go down to well with our staff.

it takes approximately 20ml of air to kill somebody,adult that is.the accumalative air alarm is set to 3.8ml on the B-Braun pump because the pump can be used on peads.

even when blood is gravity fed the small bubbles are still there.one thing which can lead to more air in the blood is the wrough handling of the blood before being set up for infusion.

hope this is of some help!

I WOULD STILL LIKE TO HEAR FROM PEOPLE USING PUMPS OTHER THAN B-BRAUN AND HAVE AN ACCUMALATIVE AIR ALARM.I NEED TO KNOW IF YOU DO OR DON'T HAVE PROBLEMS WHILE INFUSING BLOOD.

Richard

From memory I'm pretty sure that the Graseby 500 does not add up the air bubbles to give an accumulated total. As with most contemporary pumps it simply triggers an alarm (and stops pumping) when air bubbles of a certain size are detected. I don't know the size off hand, as I don't have the specs with me.

However ... our old (and much maligned) friend the Baxter Colleague does have an accumulated AIL feature! It also has the (clever) "Advance Air" feature which pumps a bit more to let you inspect the air bubble. Here is an extract from the Colleague manual:-


It would be nice to see a chart showing the AIL characteristics of all the current pumps.

Meanwhile, see here.

OK ... also the Alaris GW.

Single bubble configurable:-

50, 100, 250, 500 microlitres (100 default)

Accumulation:-

Fixed at 500 microlitres (over 15 minutes)

Notice that (like the Colleague) the GW has a horizontal pumping mechanism. Could this be significant here, I wonder?

The design of the Graseby giving set ensures that any air bubbles from above the pump accumulates in the top bubble (I tried very hard to beat this feature but failed)so it does operate as an accumulated alarm.

What it and none of the other pumps I have come across do is to measure the air close to where it goes into the patient.

The maximum amount of air we saw was 0.3mL which according to the figures I’ve seen should not be a problem. What was particularly worrying for us was that when this was occurring no one else appeared to have seen the same problem.

Lee

Hopefully we will be seeing something like this in the next generation of pumps. As I have mentioned before (but I'm still waiting for the Royalties), surely we need a miniature monitoring device (flow, pressure, bubble detection) ... plus a relief valve to release dangerous conditions as necessary ... sitting at the actual infusion site!

OK ... where's my drawing board?