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Continuous home infusion therapies of medications such as insulin, milrinone, dobutamine, and pulmonary hypertension medication such as treprostinil are becoming more common. As a result, you may see these patients present to the emergency room and need to know the basics for checking the pump.
- Is the pump working correctly?
- Check the infusion lines for leaks or holes
- Is the screen on, and does it show the correct dose information
- How long will the current battery last?
- How long will the current infusion bag last or expire?
- Also consider the half-life of the medication. Infusions for pulmonary hypertension have a very short half-life and cannot be stopped abruptly.
- Is the medication carried by the hospital or will the patient need to provide their own medication for pump refills?
- What is the current dose?
- Look for doses in weight based increments (i.e. mcg/kg/min, or ng/kg/min)
- Insulin may have a basal rate and a bolus dose.
- What is the patient's "dosing weight"?
- Ensure that the weight used to program the pump is the same weight used to enter a continuation order in the electronic medical record. This may be different from their current weight and can lead to dose changes if not done properly.
- What is the current bag concentration?
These questions are very important to determine if you will need to order a replacement infusion bag and run it on a hospital infusion pump, or if the patient can safely remain on their pump during the initial medical evaluation.