[Potential advantages a new syringe pump system]. / Avantages potentiels d'un nouveau système de pousse-seringues.

OBJECTIVES: To evaluate what could be the benefit in terms of alarm suppression, of a new syringe pumps system, which allows automatic relay without alarms. PATIENTS AND METHODS: We have prospectively recorded the nature and the mode of relay of all syringe pumps for administration of drugs to patients in two ICU. The perfusion regimen was studied in 61 patients over the complete duration of their stay in two ICU. Alarms were also recorded in one ICU room, over 13 days consecutive. The records were processed off-line with an automatic detection-recognition system in order to assess the origin of each alarm. Accordingly, the amount of alarm corresponding to monitor, ventilator and syringe pumps was computed. RESULTS: We found that syringe pumps, which would provide automatic relays without alarm, would suppress 17% of alarms in ICU and automatize 65% of the relay procedures, which are usually performed often in emergency, on response to the end of perfusion alarm. CONCLUSION: New syringe pumps allow both reduction of alarms in ICU and a better management of nurse workload. Indeed syringe relay can be planned in advance.

[Perfusion instruments: analysis of product surveillance in 1998 and its on-the-job training. Subcommittee 4b for Product Surveillance]. / Matériels de perfusion: le bilan de la matériovigilance en 1998 et ses enseignements pour la pratique. Sous-commission 4b de matériovigilance.

OBJECTIVES: To analyze retrospectively the data base of the French national vigilance reporting system concerning infusion devices during the year 1998. METHODS: Each report has been reviewed and classified, except implantable catheter ports. RESULTS: The study included 309 reports. Among them, 28% concerned infusion pumps and 72% single use devices, i.e. catheters, infusion lines, taps, connectors, etc. We observed six deaths and 23 severe incidents. Only 25% of devices could be formally investigated by manufacturers. The origins of incidents were very different between infusion pumps and single use devices. The first showed simple failures, software errors, maintenance omissions or errors, and problems related to obsolescence of the device. The second revealed manufacturer quality insurance failures, design and utilization errors, and problems related to the technique itself rather than device. DISCUSSION: Our findings are similar to the few data available in international literature. They address the need to obtain an adequacy between the performances of devices which vary with generations of devices and the clinical risks: newest and safest devices should be preferred for the infusion of the most critical drugs.