electronic pumps complete their treatment, they can mail the pumps
back to their providers.
In either case, one of the big determining factors in which type you
purchase is likely to be how much control you want your patients to
have. Many providers and facilities set a certain infusion rate and liter-
ally take away the key. They won't even let nurses, let alone patients,
change the rates. But if you take that approach, you limit your ability
to customize care for each particular patient.
Does the pump have a bolus option? I prefer to use programmable
pumps and allow patients the option to adjust infusion rates within
certain parameters and also to give themselves boluses when they
feel the need. In addition to helping with breakthrough pain, the
bolus provides more spread in the tissue plane, so the pump can do
a better job of saturating a larger area. That's really useful for any
block where the catheter isn't right next to the nerve, such as an
adductor canal or an infraclavicular block, where you have 3 cords
of the brachial plexus bundled around the axillary artery. With elas-
tomeric pumps, the extra push provided by the bolus may be a little
slower and weaker, so it may not provide the same spread as their
electronic alternatives.
"Is it working?"
Educating patients and their caregivers helps immensely. You'll be
sending a patient home with a small plastic catheter coming out of
their body. The more the patient knows about it and what it's doing,
the better chance of limiting complications.
Electronic pumps are a little more complicated with their various
dials and alarms, so they require a more detailed tutorial. On the plus
side, if there's an occlusion with an electronic pump, or for some rea-
Thinking of Buying …
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