Title: Managing Patients on Continuous Home Infusion Medications<br/>Author: Ashley Martinelli<br/><a href='mailto:1912'>[Click to email author]</a><hr/><p>
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.</p>
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Is the pump working correctly?
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Check the infusion lines for leaks or holes</li>
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Is the screen on, and does it show the correct dose information</li>
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How long will the current battery last?</li>
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How long will the current infusion bag last or expire?
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Also consider the half-life of the medication. Infusions for pulmonary hypertension have a very short half-life and cannot be stopped abruptly.</li>
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Is the medication carried by the hospital or will the patient need to provide their own medication for pump refills?</li>
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What is the current dose?
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Look for doses in weight based increments (i.e. mcg/kg/min, or ng/kg/min)</li>
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Insulin may have a basal rate and a bolus dose.</li>
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What is the patient's "dosing weight"?
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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.</li>
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What is the current bag concentration?</li>
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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. </p>
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