title: Prolonged time to alarm in infusion devices operated at low flow rates.
abstract: OBJECTIVE
  To evaluate the time to occlusion alarm for peristaltic infusion devices used in Toronto adult critical care units.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Biomedical engineering departments of four Toronto teaching hospitals.
  
  
  METHODS
  Twenty peristaltic infusion devices (five Sigma 8000-plus, five Graseby 3000, five Baxter Colleague, and five Alaris 7230B).
  
  
  METHODS
  None.
  
  
  METHODS
  Time to occlusion alarm at flow rates of 2, 10, and 100 mL/hr at a full range of available pressure thresholds for occlusion detection, and with commonly used tubing sets.
  
  
  RESULTS
  At default (mid-range) pressure thresholds, mean (SD) time to occlusion alarm was 0.3 (0.1) min at a flow rate of 100 mL/hr, 2.3 (0.5) min at a flow rate of 10 mL/hr, and 11.7 (3.1) min at a flow rate of 2 mL/hr.
  
  
  CONCLUSIONS
  Time to occlusion alarm in peristaltic infusion devices is long at low flow rates. Patients receiving important medications with short half-lives at low flow rates could experience clinically important interruptions in treatment. Time to occlusion alarm at high flow rates is short, which could lead to excessive alarms and "alarm mistrust" by clinical staff.
authors.affiliation: Department of Medicine, Queen's University and Kingston General Hospital, Kingston, ON, Canada. ilanr@kgh.kari.net
authors.forename: Roy
authors.initials: R
authors.lastname: Ilan
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fowler
authors.forename: Niall D
authors.initials: ND
authors.lastname: Ferguson
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parshuram
authors.forename: Jan O
authors.initials: JO
authors.lastname: Friedrich
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Lapinsky
authors.forename: Ron
authors.initials: R
authors.lastname: Biason
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Pinto
authors.forename: Edward E
authors.initials: EE
authors.lastname: Etchells