ELECTRONICS

IN
THERAPY & DISABILITY
(BMB 42204)

Surgical, Intensive Care and Operating Theatre

Assistance -------- Infusion Devices

Naszariah Hj Mohd Noor

Lecturer
Medical Engineering Technology Section
Sem2015/1P
Introduction to Infusion Therapy.

 Infusion therapy involves the administration of medication through

a needle or catheter.

 It is prescribed when a patient’s condition is so severe that it cannot

be treated effectively by oral medications.
• Typically, “infusion therapy” means that a drug is administered
intravenously, but the term also may refer to situations where
drugs are provided through other non-oral routes’

• Traditional” prescription drug therapies commonly

administered via infusion include
 antibiotic

 antifungal

 antiviral

 chemotherapy

 hydration, pain management

 parenteral nutrition
 Also provided to patients for treating a wide assortment of often
chronic and sometimes rare diseases for which “specialty” infusion
medications are effective. While some have been available for
many years, others are newer drugs and biologics.

 For example, they can administer as little as 0.1 mL per hour

injections (too small for a drip), injections every minute, injections
with repeated boluses requested by the patient, up to maximum
number per hour (e.g. in patient-controlled analgesia), or fluids
whose volumes vary by the time of day.
 Because they can also produce quite high but controlled
pressures, they can inject controlled amounts of fluids
subcutaneously (beneath the skin), or epidurally (just
within the surface of the central nervous system - a very
popular local spinal anaesthesia for childbirth).
Types of infusion

1.Continuous infusion usually consists of small pulses of infusion, usually

between 500 nanoliters and 10000 microliters, depending on the pump's
design, with the rate of these pulses depending on the programmed
infusion speed.

2.Intermittent infusion has a "high" infusion rate, alternating with a low

programmable infusion rate to keep the cannula open. The timings are
programmable. This mode is often used to administer antibiotics, or
other drugs that can irritate a blood vessel.
3.Patient-controlled is infusion on-demand, usually with a
preprogrammed ceiling to avoid intoxication. The rate is controlled
by a pressure pad or button that can be activated by the patient. It is
the method of choice for patient-controlled analgesia (PCA), in which
repeated small doses of opioid analgesics are delivered, with the
device coded to stop administration before a dose that may cause
hazardous respiratory depression is reached.

4.Total parental nutrition usually requires an infusion curve similar to

normal mealtimes.
Type of Pumps

Several different types of infusion pumps exist:-

1. Piston Pumps

2. Diaphragmatic pumps

3. Syringe pumps

4. Peristaltic Pumps
1. Piston Pumps

Works when a piston moves back, allowing fluid into a chamber

through a one way valve. When the piston moves forward, fluid is
pushed out of the chamber and into the IV line.
2. Diaphragm Pumps

Have a thin spring loaded diagram that moves up and down. The pressure
changes cause fluid to rush into the negative space created by the
diaphragm (just like the thoracic cavity).
3. Syringe Pumps

Have a turning shaft that causes the syringe cylinder to move in as the
shaft is turning
 In syringe pumps a motor, through a gear-reducing mechanism and
a lead screw, applies force to the plunger of a syringe containing
the drug.

 The device is mainly convenient for applications that require the

delivery of volumes limited by the syringe size.

 Syringe pumps are usually of a reciprocating type (positive

displacement). A plunger or piston delivers a fixed volume of fluid
on each stroke.
4. Peristaltic Pumps

Have a rotating head that pushes fluid along in a tube. Because the
turning is continuous, fluid can’t go backwards. The rate of
administration is controlled by the speed of rotation.
Infusion Pumps - Volumetric
Abbreviation / other names
Peristaltic Pump

What does it do?

It is used to pump fluids (drugs, liquid food, glucose, saline) into the body.

How it works?
These pumps squeeze tube to produce movement of the liquid inside the
compressed container. Linear peristaltic pumps have a row of fingers that
compress the tube in a wave-like motion, squeezing in the liquid as the wave
progress.
 The more often used rotary
peristaltic pumps are a rotor
that pushes rollers against a
tube along a semicircular
path.

 Peristaltic pumps have the

advantage that the fluid
does not come into contact
with the pump, avoiding
contamination.
 The various means for achieving peristaltic action are:
i. Cam-operated fingers pressing the tubing in succession.

ii. A rotor on an eccentric shaft which squeezing action to plastic tubing.

 They are self-priming, as no valves or seals are required, and the accuracy
rate is high. Peristaltic pumps use speed control of the device motor,
which may be a synchronous motor.
 Volume infused,
volume limit and rate
displays

Pump Mechanism
Air detection Air detection
components circuitry

Visual indicators and

alarms
Door open
detection
Motor drive
circuits
Display drivers
Empty bag External input
detection multiplexing circuitry

Occlusion Malfunction alarm Audio alarm

detection circuitry circuitry

Elect/Mech
detection
(interrupt)

Nurse call (option)

Power supply battery Memory circuitry

(RAM)
Microprocessor and
EPROM

Membrane switch
 The microprocessor controls all operator programmable functions
and alarm condition sensors.

 A synchronous stepping motor is used to operate the volume and

the rate at which the dose is delivered.

 The key component of the disposable administration set is a

flexible, three chambered cassette. The administration sets may
also be used for gravity administration independent of the pump
due to their valve-less design.
 Precise control over delivery rate and volume infused is provided
by the mechanical manipulation of the flexible cassette.

 The pumping system results in continuous, non pulsalite delivery

to the patient. The pump provides for patient safety by monitoring
several alarm situations.

 In such situations, the pumps stops fluid delivery, sounds an

audible alarm and displays a visual alarm indicator.
 The unit has 3 types of displays:-

i) Volume infused which indicates

the cumulative volume (ml)
which the pump has delivered

ii) Volume limit indicating the

volume limit (dose) in ml, which
the operator has selected

iii) Rate indicating the rate (ml/hr)

which the operator has selected.
 The motor is operated according to the control programme in
microprocessor memory. A four-phase stepping motor is used,
with a step angle of 7.5° and a gearbox reduction ratio of 20:1.

 Due to this reduction, 1920 pulses yield one full revolution of

the cam shaft in the pumping mechanism.
 Each cam shaft revolution and the resulting cycle of the
pumping mechanism delivers approximately 2ml of fluid.

 The delivery of fluid to the patient is non-pulsatile and nearly

continuous since each ml is delivered in approximately 960
increments.