Name of the Procedure:

Ambulatory infusion pump, single or multiple channels, electric or battery-operated, with administrative equipment, worn by the patient (HCPCS Code E0781)

Summary

An ambulatory infusion pump is a portable device that delivers continuous or intermittent medication doses directly into the bloodstream. The pump can be worn by the patient, allowing them to move freely while receiving treatment.

Purpose

This procedure is used for patients requiring long-term infusion therapy, such as those undergoing chemotherapy, pain management, or treatment for chronic infections. The goal is to maintain consistent medication levels in the bloodstream, improve patient mobility, and enhance the overall quality of life.

Indications

• Chronic pain management
• Chemotherapy for cancer treatment
• Long-term antibiotic administration
• Treatment for conditions like HIV/AIDS
• Nutritional support (parenteral nutrition)

Preparation

• Review medical history and current medications.
• Complete necessary diagnostic tests (e.g., blood tests, imaging).
• Ensure proper education on pump operation and maintenance.
• Fasting or medication adjustments typically not required for this procedure.

Procedure Description

1. A healthcare professional inserts an intravenous (IV) line or a subcutaneous catheter.
2. The ambulatory infusion pump is programmed with specific medication dosages and schedules.
3. The pump is connected to the IV line or catheter.
4. The patient is instructed on how to wear and operate the pump, including how to address alarms or errors.
5. Continuous or scheduled doses of medication are administered as programmed.

Duration

The procedure to set up the ambulatory infusion pump typically takes about 30 minutes to an hour. The duration of therapy varies depending on the patient's medical condition and treatment plan.

Setting

This procedure can be performed in various settings, including hospitals, outpatient clinics, or at the patient's home under the supervision of a visiting nurse.

Personnel

• Nurses
• Physicians
• Pharmacists (for medication preparation)
• Technicians (for device setup and maintenance)

Risks and Complications

• Infection at the catheter insertion site
• Mechanical malfunction of the pump
• Incorrect medication dosage due to programming errors
• Possible allergic reactions to the medication
• Phlebitis (inflammation of the vein)

Benefits

• Improved quality of life with the ability to move freely
• Consistent and controlled medication administration
• Reduced need for hospital stays
• Enhanced efficacy of treatment due to stable drug levels

Recovery

• Patients can resume most daily activities while wearing the pump.
• Regular monitoring and follow-up appointments are necessary.
• Instruction on pump maintenance and troubleshooting should be adhered to.
• Limited restrictions, mostly related to pump care and catheter site maintenance.

Alternatives

• Traditional IV infusion therapy requiring hospitalization.
• Oral medications (if applicable).
• Subcutaneous or intramuscular injections.
• Each alternative has its pros and cons, such as reduced mobility with traditional IV therapy or reduced efficacy with oral medications.

Patient Experience

• The insertion of the IV line or catheter might cause minor discomfort.
• Once in place, the patient should feel minimal impact from the pump.
• Regular activities can be continued with little interference.
• Pain management and comfort measures should be discussed with healthcare providers to address any discomfort related to the procedure.