As demanding as emergency medicine can be in a hospital or clinic setting, the paramedic’s role can be made more complex by the uncontrolled scenarios and factors they face each day. They must be able to rely on their medical equipment, and that equipment must correspondingly be robust, compact, and efficient.
Infusion pumps, one of the lifesaving devices within the paramedic’s arsenal, are used to administer medications and fluids accurately and reliably into patients. Advanced infusion pumps allow for defined dosing and flow rates that providers can depend upon to deliver medications quickly, accurately, and safely.
The period from 2005–2009 saw significant safety concerns arise around infusion pumps, with about 56,000 reports of adverse effects resulting in numerous injuries and deaths and 87 pump recalls.1 In response the FDA established the Infusion Pump Improvement Initiative to help speed improvements and create new guidance for the industry.2
The initiative had three components: new requirements for pump manufacturers; proactively facilitating device improvements; and increasing user awareness. It led to new safety guidance for industry and FDA staff, a safety assurance case pilot program, and a letter to manufacturers outlining design deficiencies and resulting problems.
The infusion pump industry has advanced considerably since then, especially with the advance of smart pumps—which, among other features, have built-in drug libraries and dose error reduction software (DERS) to ensure the exact prescribed dose of medication is administered, and can alert healthcare providers of suspected drug interaction risks. Other smart advances include data monitoring systems, field maintenance software, longer battery life, and a more compact design.
With regards to prehospital medicine, paramedics need infusion pumps that are tailored to emergency scenarios, specifically to ambulatory care. When in transit and under unstable conditions, EMS providers require a pump that is not only compact and mobile but easy to use and highly reliable. EMS equipment must be suitable for fluctuating and possibly drastic temperatures that can occur in the uncontrolled prehospital environment.
Despite all the advances in smart pump technology over the years, there are still older, less-advanced pumps on the market. A particular issue with which EMS providers should be concerned is secondary medical devices: Once resold, these risk the potential of losing manufacturer involvement in maintenance and support. Additionally, these pumps may be outdated and no longer manufactured, making maintenance and servicing difficult.
These often-compromised pumps may lead to over- or under infusions or other unforeseen errors that may occur with an aging pump fleet.