Applications for Anaesthesia. arcomed syringe and infusion pumps

Transcription

1 Applications for Anaesthesia arcomed syringe and infusion pumps

2 TIVA TCI PCA PCEA PCS PIEB Anaesthesia programs and applications for arcomed Infusion Devices TIVA TCI PCA PCEA PCS PIEB (Total Intravenous Anaesthesia) Classic TIVA with dose calculated Induction bolus of Propofol, Remifentanil and other drugs (Target Controlled Infusion) algorithm controlled, intravenous anaesthesia Current TCI protocols include Schnider, Minto, Marsh and Paedfusor (Patient Controlled Analgesia) Individual programming of various parameters and security levels (Patient Controlled Epidural Analgesia) patient-specific programming and adaptable pressure limits (Patient Controlled Sedation) for Sedoanalgesia for example in Gastroenterology (Programmed Intermittent Epidural Bolus) specific program for advanced epidural anaesthesia with intermittent bolus, PCA dose and automatic Lock-outtime

3 TIVA / TCI protocols and applications TIVA Individual TIVA programming (dose calculation, mg/kg/h, mcg / kg / min) for Propofol, Remifentanil, and other anaesthetic drugs, such as Lidocaine Individual and pre-set induction boluses Graphic display of the infusion process and the relevant parameters at a glance or via touchscreen Adjustable bolus speed up to a maximum of 1500ml/h TIVA / TCI TCI models and protocols including Schnider, Marsh 1.6, 4.0, Minto and Paedfusor (Paediatric Anaesthesia) Specific TCI protocols for Dexmedetomidine, Ketamine, Fentanyl and Sufentanil Special Propofol programs for patients with high BMI Simply input the awake concentration via touchscreen BMI and LBM display Display of patient parameters (weight, height, age, etc.) Permanent display of the volume infused (for example mg for Propofol) Drug-based colour coding and display of medicines in accordance with ISO / DIVI Standard or hospital internal medicine labels to increase patient safety and help prevent medication errors Secure wireless transfer of patient data from one pump to another (IR) Graphic display of infusion history (TCI time graph) Target Controlled Infusion (TCI) calculates the target concentration of the infused drug using microprocessor-controlled syringe - or infusion pumps. The aim is to reach and maintain a particular effect site level (Analgesia, Anaesthesia) based on a defined plasma level (in the blood or brain). Depending on the model it is plasma (cp) or effect site concentration (ce) controlled.

4 PCA / PCEA / PCS Applications PCA / PCEA (intravenous and epidural analgesia) Individual PCA programming for all PCA-based applications such as Morphine, Fentanyl, Sufentanil, Remifentanil (obstetrics), etc. For each drug, all relevant parameters can be programmed individually and adapted to ensure the highest level of security Graphic display of the administered, rejected and physician boluses Different passwords can be enabled for individual departments Individually adjustable bolus speed and pressure limit for each drug Mechanical and / or electronic door lock Programs specifically for regional, local, epidural anesthesia Special Applications PCA (ArcoAir PCA Switch) PCS arcomed provides a modified PCA button which is activated by patients breath (indicated for multiple trauma, severely burnt or paraplegic patients) Patient Controlled Sedation for Sedoanalgesia for example gastroenterology (colonoscopy) Special Programs Remifentanil-PCA during childbirth is a relatively new analgesic method, though becoming more popular. Clinical studies have shown efficiency in this procedure, for both routine analgesic and emergency treatment. PCA activated via the patients breath (ArcoAir PCA Switch). arcomed provides a specific, modified bolus button with a mouthpiece for triggering the patient bolus via the patients breath (pressure sensor). This supports both pre-set and patient activated pain therapy for patients unable to use their upper limbs such as multiple trauma, severely burnt or paraplegic patients). The PCS (patient-controlled sedation) is a monitored anaesthesia method (Sedoanalgesia) used for minimally invasive surgical and radiological procedures. For this application, Propofol together with short-acting opioids are used. Fundamentals of PCS: a) small boluses b) fast delivery of a bolus c) no lock out time between boluses

5 Solutions for simple and highly specialised applications in infusion therapy ml TCI / TIVA PCA / PCEA / PCS / PIEB Bolustokolyses DDC (Drug-Dose-Calculation) Sequences Ramping time Time

6 PIEB Programmed Intermittent Epidural Bolus PIEB Program for advanced epidural infusion with intermittent bolus, PCA patient bolus and automatic lockout time limit An infusion model for epidural anaesthesia based on the latest clinical and scientific evidence Combination of patient controlled analgesia, lockout time secured bolus delivery and automated intermittent bolus with intelligent lockout time calculation The option for physician boluses within the lockout time may also be enabled Better distribution of the local anaesthesia in the epidural space means higher bolus effect in the labour ward Example of a classic PIEB scheme ml Manual intitial bolus 10-20ml e.g.: PCA bolus after 55 min PCA Bolus 5ml 20 min. lock time 20 min. lock time PCA Bolus 5ml PCA Bolus 5ml Initial Blous (manual) PIEB bolus and interval rejected PIEB bolus PCA Bolus and lock time rejected PCA bolus PIEB versus traditional epidural anaesthesia: arcomed provides PCA pumps for modern regional anaesthesia and pain therapy. Rather than conventional manual boluses we provide a new function of patient-controlled epidural analgesia with Syramed μsp6000 and Volumed μvp7000 syringes and infusion pumps. Advantages of the programmed, intermittent, epidural bolus (PIEB) against classical continuous PEA: a) Reduction of local anaesthetic during childbirth b) Less manual bolus requests c) Better patient compliance Time d) Less side effects 1 hour interval 1 hour interval 1 hour interval

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