Name of the Procedure:

Common Name: Ambulatory Infusion Pump
Technical Term: Ambulatory Infusion Pump, Mechanical, Reusable, for Infusion 8 Hours or Greater (E0779)

Summary

An ambulatory infusion pump is a medical device used to deliver medication directly into a patient’s bloodstream over an extended period, typically 8 hours or more. This mechanical, reusable pump allows patients to receive continuous treatment while maintaining mobility.

Purpose

This device is used to manage chronic health conditions that require consistent medication administration, such as pain management, chemotherapy, or antibiotic therapy. The goal is to maintain therapeutic levels of medication in the bloodstream, ensuring effective and continuous treatment while allowing patients to continue their daily activities without being confined to a hospital bed.

Indications

Patients with conditions such as:

• Chronic pain needing continuous opioid or pain-relief medication
• Cancer requiring chemotherapy infusions
• Severe infections necessitating prolonged antibiotic infusion
• Other chronic conditions needing continuous medication administration

Patient criteria include:

• Adequate understanding and willingness to comply with device usage
• Suitable for patients who benefit from prolonged and controlled medication delivery
• Not appropriate for acute treatment requiring immediate drug blood-level adjustments

Preparation

• Instructions to maintain consistent hydration
• Adjustments to current medications as advised by the healthcare provider
• No fasting typically required, but follow specific doctor's guidelines
• Prevalent diagnostic tests: Blood tests, renal and liver function tests, to ensure medication safety

Procedure Description

1. Initial Assessment: Patient evaluated for suitability.
2. Device Setup: Medication loaded into the pump.
3. Infusion Start: The pump is connected to an infusion set, usually via a catheter or port.
4. Operation: The pump is programmed to deliver medication at a set rate.
5. Monitoring: Regular checks to ensure correct infusion rate and monitor for possible issues.

Tools and Equipment:

• Mechanical Pump
• Medication reservoir

• Infusion set (tubing, catheter)

  Anesthesia/Sedation: Typically none required unless insertion of intravenous port is necessary.

Duration

Device setup and connection may take about 30 to 60 minutes. The infusion can last 8 hours or longer according to medical needs.

Setting

Commonly used in outpatient settings, patient’s home, or specialty infusion centers.

Personnel

• Registered Nurse (RN) or Infusion Specialist for setup and monitoring
• Pharmacist for preparing and loading medication
• Physician overseeing treatment plan

Risks and Complications

• Common: Local irritation or infection at infusion site, device malfunction, medication side effects.
• Rare: Severe allergic reactions, blood clots, overdose or underdose if pump malfunctions. Management: Immediate medical attention for serious side effects, regular site care, and device maintenance checks.

Benefits

• Continuous and steady medication delivery ensuring effective treatment
• Increased mobility and ability to continue daily life activities
• Enhanced quality of life for patients with chronic conditions Realization Time: Benefits typically observed within days after starting therapy.

Recovery

• Post-setup: Regular monitoring of the infusion site and pump function
• Instructions for self-care include managing infusion site cleanliness and recognizing signs of infection.
• Recovery time varies: minimal disruption to daily activities, continuous use as long as required by the treatment plan.
• Follow-up appointments to assess device efficacy and patient's progress.

Alternatives

• Oral or intravenous medications administered in clinical settings
• Subcutaneous injections
• Alternative medications or therapies Pros and Cons:
• Pros of Pump: Continuous delivery, better management, convenience.
• Cons of Pump: Requires management and understanding of device, risk of infection.

Patient Experience

• During Procedure: Minimal discomfort, mobility maintained.
• Afterwards: Potential site tenderness, need for regular site and device care.
• Pain Management: Localized discomfort managed with topical treatments, analgesics if needed.

Comfort measures include education on device use and 24/7 support for any concerns.