EBME Forums Forums Maintenance Technical Assistance Infusion pump

We were looking at the VP7000 for tpn, initial signs look good.

Bill, as far as putting it in your pocket, its a bit big. For pain relief the MS16 in a lockbox is more suitable.

I worry about confusion between MS16 and 26! Within in this DGH it has been decreed that all MS26 will run at 48mm/day or 8ml in 24 hours (and we don't have any MS16, at least not on wards). So I have had some overprinted aluminium foil labels made which cover the control twiddlers but have a window to allow the set rate to be seen/confirmed.

The idea is they can't change the rate and so we only need to check the pump at these switch settings.

Our community people use MS16 exclusively so I hope to fit the same label on these things which will be set to 2mm/hour. Only problem seems to be our local hospice who might want to use 4mm/hr (ie 8ml in 12 hours).

Going back to the Graseby 9000 series, in particular the 9300 PCA. Has anyone experience problems with the users damaging the locks? We are getting quite a number in and are having to return them to Graseby for repair. Cost is approx £130.00 a time.

We scrapped all MS16's years ago as there was a real chance they could get confused with MS26's. You really don't want to run an MS16 at the usual MS26 rate of 50mm/24hrs. I swapped them all out for MS26's.

Eden Medical In Edinburgh are touting a similar device called a MICROPUMP MP-100. Anyone got views on this?

Why can't we post jpg's with our replies here? I can do this on other forums.

Due to our bandwidth usage currently being twice that agreed by our webhost, I stopped the ability to link to images just a few weeks ago.

I might start it up again now though.

One thing to bear in mind though, if you link to an image on someone else's site (known as hotlinking) they may get upset at this website sucking up their bandwidth allowance.

Usually the webmaster will do one of two things - send me a email (polite or otherwise) to remove the link, or, replace the image with one of a particularly unsavoury nature.

I'll see if I can restore the function this weekend.

We use both MS16 and MS26's in our Trust and have had little problem with them. Infact, we have only recently scrapped some MS27's we had in service.

I have heard of other trusts removing either all MS16's or MS26's from service due to mix-up's with which one to use.

If there have been mix-up's in this Trust, I have never encountered one being reported to us.

I'm not sure what rate is used in other areas but in our area the MS16 is set to 2mm/hr and the MS26 set to 48mm/24hr. There is no variance to this setting. It is therefore logical to remove the MS16 and replace with MS26 thereby reducing the risk of either an overinfusion or an underinfusion since protocols will be standardised on one device. This is an issued still to be addressed.

We had a situation recently where nursing staff had recorded on the drug sheet that the MS16 was set to 0.2mm/hr, clearly a training problem, and reported that the unit was running to fast. Theis drug record had been running for a few days and the error had been carried over by several nurses before being reported. The unit incidentally was running ok.

Has anyone seen the Micrel Device from Micrel Medical http://www.micrelmed.com/Micropump.htm
It appears to be a very nice device and a good replacement for the Graseby range of ambulatorys.

A few thoughts on the use of MS Drivers.

Ambulatory Syringe Drivers: Graseby MS16A and MS26, Enhanced Operational Safety
Patient mishaps due to infusions delivered via syringe drivers has been highlighted by the MDA as a major cause for concern. This particularly applies to the continued use of Graseby MS16A and MS26.

Operational concerns:-
1. Confusion between the MS16A and MS24 has led to large drug overdose.
2. Complex rate setting, vulnerable to delivery error.
3. Inadequate syringe barrel and plunger securing, vulnerable to free-flow / siphoning/ downloading overdose.
4. Uncontrolled access to the syringe, bolus and rate controls, vulnerable to tampering.
5. Exposure to physical damage, fluid ingress and electromagnetic interference.
6. Minimal alarms, 15 seconds audible for occlusion and syringe empty, indicator lamp stops flashing when battery needs replacing.
7. High operating / occlusion pressure (up to 1000mmHg)

Most NHS Trusts and associated community services currently have many hundreds of these light, compact, versatile, inexpensive drug delivery pumps in routine service.
The recent introduction of the Graseby MS-Driver Locking box (£75), prohibition of pump operation without a Lure Locking Anti-Siphon extension line ( £1.50) and the introduction of a laminated ready-reckon table would reduce risks identified in 2, 3, 4 and 5 above. The reduced risks could extend the operational life of our current units until safer pumps can be phased into use.

Would welcome any comments on above.
Bill

I agree with what you are saying Bill but the Graseby units have been around for at least 22 years with no real alternative. If a new device comes on the market using new technology to meet the challenge then it should be considered as a suitable replacement for the MS range.

Despite training on the Graseby's and all the incidents with these devices accident do still occur, confusion still arises. Sticking the thing in a box is not going to prevent these incidents occurring.

It's time to move on, all we need is the money or moolah as some people put it.

Allan
There are now a variety of better ( safer, although maybe not so flexible) units available. As far as I can see they all require an approximately £10 single use disposable, a considerable increased revenue cost. The Micrel Medical drivers look to have some better safety features but similarly require a locking box and prohibition of pump operation without a Lure Locking Anti-Siphon extension line and the introduction of a laminated ready-reckon table. What I'm suggesting is the reduce risk could extend the operational life of our current units (many thousands in the UK) until safer pumps ( hopefully with a £2ish disposable) can be phased into use.
Bill