I have been asked to find an infusion pump that can have the rate pre-configured and locked to give to a patient in their home. It must be tamper proof.

Basically, the only thing the patient should be able to do is switch it on and press start, then switch it off when the ifusion is complete.

Suggestions..........??

Hi John

Have recently investigated the market for a safe ( free-flow protection, tamper proof, alarms) low operating cost ( syringe rather than a £10.00 cassette) replacement for the hundreds of Graseby MS 16 & 26s that are in use in our area. With the exception of the SIMS Deltec CADD-Micro 5900 (which appears to have a dedicated £X syringe) there appears not to be any. Would be grateful if anyone knows of one.
I have attempted to get more info on the SIMS Deltec CADD-Micro 5900. It's on www.deltec.com/products_detail.cfm but the UK office inform me it's no longer on the market??!!

Have you looked at the disposable Baxter elastomeric membrane units. The flow accuracy is %10 but for some situations they could at least be an interim option.

On the medical equipment product evaluation subject I agree it's a good idea and that it will require to be done very carefully. I suggest some advice from Which on how they manage their members car-users feedback surveys would be worthwhile.

Bill

Bill
We've got some Deltex CADD Prizms (from Graseby), but I would'nt have Deltex again because they won't allow EBME depts to service them. The Prizms also have a software lockout so when they have been in use for xxx hrs it comes up with a message to return the pump for service (to Graseby). At a cost of £120 ish.

I've just been speaking to Arcomedical infusion, they have a small infusion pump called the VP7000, which will do the job. Consumable costs are low at around 70pence a set, so life costs should be low and we can maintain them.

Gentlemen, Witness the power of shared information. Let the poll begin, my friends, let the poll begin.

Ha Ha Ha Ostentation, my friends, Ostentation

Regards

Louis

John
Looked at the VP 7000 specification on the web. Battery run time 3-5 hrs, weight 2.6Kg!!!!!
Our requirement is to replace Ambulatory pumps, Graseby MS 16A, battery run time weeks, weight 200g. Tamper proof was in your criteria, VP 7000???????

Glasgow punters would require a minder to carry the beast, with a wheelbarrow load of spare charged batteries just to get to the pub. Where they would promptly replace the contents of the (TAMPER PROOF) bag with whisky!!!!!
Could do better!!

Yes dear Louis witness it.

Bill

As an interim measure lock boxes are available from Graseby @ £65 ish. One draw back (or benefit) is that it locks out all controls as well as securing the syringe

We have some of the Graseby 9000 series Infusion pumps, but we are unable to do any work on them as they have to be sent back to Graseby, although we do have software testing cards. Reports from users reasonable.
I immagine there is a pretty large corner of the market waiting to be filled for a cheap, reliable and repairable replacement to the MS16s.
There again if the MS16 is still doing its job OK why fix it if it aint broke.

Maybe a tamperproof solution for the Glasgow punters Bill could be to house the syringe driver in a cuningly converted souvenir England World Cup 2002 biscuit tin
I think most users in your geographical area would avoid opening/touching any such contraption.

I don't know what you could use as a deterent to stop the replacement of the drug with the whiskey, why you would want to do this tho is beyond me, I've self-cured more ailments with a dram than I've ever had with medication.
The side effects are normally more controllable too, alieviated with a fry-up and the occassional talk in the large white telephone.

I suppose if you wanted to deter people replacing medication with whiskey you could always post on the bag the health warning
" Replacement of this solution could mean you are selected as centre half for the next S.F.A. international squad "
Surely that would be enough to frighten anyone off

Hi John,
I might as well have my 2 pence worth. Graseby are distributing & support the Deltec CADD range of products including the replacement for the original CADD 1 products, the Legacy. All have electronic password lock and some have cassette locking too.
All commments noted about local support and forwarded to Graseby Head Office. I know it's being looked in to but no news yet.

I took up Ken Willis's advice and now have a demo lock box.
“As an interim measure lock boxes are available from Graseby @ £65 ish. One draw back (or benefit) is that it locks out all controls as well as securing the syringe ”
First impressions are favourable its light strong and reasonably compact. I'm in the process of attempting to acquire a basic L lock anti-siphon extension set. I think this combination considerably ups the safety of these useful wee devices although there is still the 1 and 24 hour and set-up issues.
Thanks Ken.

Bill

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

Micrel are looking to introduce a ml/hr or/and ml/24hr programmed to take a syringe brand of your choosing eg B-D. If this were to be introduce then consumable cost would be considerable lower.

I find both the MS16 and the MS 26 OK, the problem is that staff aren't concentrating. Its not exactly rocket science to tell the difference between the two!!!