Prolonged time to alarm in infusion devices operated at low flow rates.
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.
Ilan
Roy
R
Department of Medicine, Queen's University and Kingston General Hospital, Kingston, ON, Canada. ilanr@kgh.kari.net
Fowler
Robert A
RA
Ferguson
Niall D
ND
Parshuram
Christopher S
CS
Friedrich
Jan O
JO
Lapinsky
Stephen E
SE
Biason
Ron
R
Pinto
Ruxandra
R
Etchells
Edward E
EE