How is an Infusion Pump Used in the ICU?

by Sara Alvarado

Updated December 26, 2023
Go to any ICU, or Intensive Care Unit, in the US, and there are some common pieces of equipment that you are going to see in each of them. One of the most common pieces of equipment is an infusion pump.

That’s because infusion pumps are highly critical to the ICU’s mission. Let me explain:

ICUs are specialized departments within a hospital or medical facility that provide highly specialized care and treatment for critically ill patients.[ WebMD, What is an Intensive Care Unit (ICU)? (online). Accessed 10/21/23.] ICU patients are typically those who require close monitoring, constant medical attention, and advanced life support due to severe illness, injury, or post-operative recovery – and that’s where an infusion pump comes into play.
icu infusion pumps
Infusion pumps are medical devices that are used to deliver fluids, medications, or other solutions into a patient's body in a controlled and precise manner. These devices are essential in healthcare settings like the ICU department, because they provide a means to administer intravenous (IV) medications, fluids, and various therapies with accuracy and safety.

Let’s take a closer look at ICUs and how infusion pumps are used in them.

1. The Modern ICU

icu infusion pumps
Today’s ICUs are staffed with healthcare professionals who have specialized training in critical care, including intensivists (doctors with expertise in critical care), critical care nurses, respiratory therapists, and other specialists.

Patients who are admitted into the ICU are continuously monitored using advanced medical equipment, including cardiac monitors, ventilators, pulse oximeters, and intravenous pumps to closely track vital signs and organ function.

One of the things that separates ICUs from other areas of a hospital is that ICUs are equipped with special life-saving equipment such as mechanical ventilators, hemodialysis machines, and extracorporeal membrane oxygenation (ECMO) devices to support patients with severe respiratory, cardiac, or kidney issues.

In fact, ICUs are equipped to manage a wide range of medical conditions, including post-surgical recovery, severe infections, trauma, heart attacks, strokes, organ failure, and respiratory distress.

Something else that is important to know about ICUs is that they typically have a high nurse-to-patient ratio.[ Penn LDI, What Patient-To-Nurse Ratios Mean for Hospital Patient Health and Outcomes (online). Accessed 10/20/23] ICUs maintain a low nurse-to-patient ratio to ensure close and constant monitoring of patients, as critically ill patients often require frequent interventions and adjustments in their care.

Patients in the ICU are assessed and evaluated frequently to monitor their progress, manage pain and discomfort, and adjust treatment plans as needed.

Infection control is also a critical aspect of ICU care to minimize the risk of hospital-acquired infections, as patients in the ICU are often more susceptible to infections due to their weakened state.[ RT, Infection Control in the ICU (online). Accessed 10/21/23. ]

The level of care and the range of services in an ICU make it a vital component of many hospitals, especially in emergencies and during the post-operative recovery period.

2. How Are Infusion Pumps Typically Used in the ICU?

icu infusion pumps
Here's how infusion pumps are most commonly taken advantage of in the ICU:
Infusion pumps are employed to administer a wide range of medications to ICU patients. This includes antibiotics to treat infections, vasoactive drugs to regulate blood pressure and circulation, sedatives to manage agitation and anxiety, and analgesics for pain control. The precise dosing and controlled delivery are crucial for the safety and effectiveness of these medications.
ICU patients often require intravenous fluids, including saline solutions, dextrose solutions, and electrolyte solutions to maintain hydration and support vital organ function. Infusion pumps are used to control the rate at which these fluids are administered, allowing healthcare providers to tailor the treatment to each patient's specific needs.
In cases where patients are unable to eat or digest food normally, such as those on mechanical ventilation or with gastrointestinal disorders, infusion pumps are used to deliver enteral or parenteral nutrition. [ ASPEN, What is Parenteral Nutrition? (online). Accessed 10/20/23. ] Enteral nutrition pumps deliver nutrition through a feeding tube, while parenteral nutrition pumps provide nutrients intravenously.
icu infusion pumps
Infusion pumps are essential for delivering critical care medications, such as medications to treat sepsis, maintain cardiac function, and support respiratory function in patients with severe lung conditions. These medications require precise control over their administration.
Infusion pumps can be used for a variety of routes of administration, including intravenous, subcutaneous, and epidural, making them suitable for a wide range of clinical scenarios in the ICU.
Infusion pumps play a critical role in the ICU by providing precise and controlled delivery of medications and fluids, allowing healthcare providers to tailor treatment plans to each patient's specific needs, and enhancing patient safety and therapeutic effectiveness. They are indispensable tools for managing critically ill patients in the ICU.

3.What Features Make an Infusion Pump Ideally Suited for the ICU?

IV infusion pump
For one thing, ICU patients are continuously monitored, and their condition may change rapidly. Infusion pumps include alarms and monitoring features to alert healthcare providers to issues like line occlusions, air in the tubing, low battery, or the completion of the infusion. This constant vigilance ensures prompt response to changing patient needs.

For another thing, the programmable nature of infusion pumps allows healthcare providers in the ICU to customize treatment plans for each patient. This includes adjusting infusion rates, bolus doses, and other parameters based on the patient's condition and response to therapy.

Infusion pumps also have built-in data logging and documentation features. This allows healthcare providers to maintain accurate records of medication administration, monitor patient response, and ensure compliance with regulatory requirements.

Additional infusion pump features that come in handy in the ICU include:
Infusion pumps allow healthcare providers to set and control the rate at which fluids or medications are delivered into the patient's bloodstream, ensuring precise dosing.
The pumps can be programmed to deliver specific volumes of fluids or medications over designated periods, enabling tailored treatment plans.
Depending on the model, infusion pumps may offer various modes of operation, including continuous infusion, intermittent infusion, bolus delivery, and patient-controlled analgesia (PCA), which allows patients to self-administer pain medications within prescribed limits.
Infusion pumps are designed to maintain accurate and consistent flow rates, particularly important for medications with narrow therapeutic windows.
Infusion pumps are used for a wide range of medical treatments, including chemotherapy, pain management, antibiotics, enteral and parenteral nutrition, hydration, and more. Their precise and controlled delivery of medications and fluids is critical to patient safety and therapeutic effectiveness.

4. Here’s How to Use an Infusion Pump in the ICU

icu infusion pumps
Using an infusion pump requires proper training and knowledge of the specific pump model and the medication or fluid being administered. Here's a general overview of how to use an infusion pump.

Preparation:
Ensure that you have the correct medication, fluid, or solution for the patient and verify the patient's identity.
Inspect the medication, checking for proper labeling, expiration dates, and any signs of contamination.
Gather all the necessary supplies, including IV tubing, catheters, and connectors.
Programming:
Power on the infusion pump and ensure it's in working order.
Program the pump with the appropriate settings, including:
  • Medication or fluid type and concentration.
  • Infusion rate (mL/hour or similar units).
  • Volume to be infused (if applicable).
  • Any additional parameters specific to the medication or patient's condition.
Double-check the programming to ensure accuracy.
Loading Medication or Fluid:
If using a multi-dose vial, prepare the medication according to aseptic technique.
Prime the IV tubing with the medication or fluid.
Connect the tubing to the pump and the patient's IV catheter.
Ensure there are no air bubbles in the tubing.
Safety Checks:
Perform safety checks to confirm that the medication or fluid is flowing correctly. This includes checking for proper flow rates and monitoring for any alarms or warnings.
Confirm the patency of the IV line and ensure it is securely connected to the patient.
Monitoring:
icu infusion pumps
Continuously monitor the patient's vital signs, as well as the pump's alarms and displays.
Watch for any signs of adverse reactions or complications, and respond promptly.
Documentation:
Maintain thorough documentation of the infusion, including the start time, medication administered, infusion rate, any changes made, and the patient's response.
Record any alarms, issues, or interventions during the infusion.
Completion:
When the infusion is complete, stop the pump and disconnect the tubing.
Properly dispose of any waste and unused medication or fluids following medical waste disposal protocols.
Cleaning and Maintenance:
Clean and disinfect the pump and IV tubing according to hospital or healthcare facility policies.
Ensure that the infusion pump is in proper working condition and ready for the next use.
It's important to note that the specific procedures for using an infusion pump can vary depending on the type of pump, the medication, the route of administration, and the clinical setting. Healthcare professionals, such as nurses and pharmacists, receive specific training on how to use infusion pumps safely and effectively. Patients should not attempt to operate infusion pumps themselves; this task should always be performed by trained healthcare providers.

5. Keys for Best Using Infusion Pumps in the ICU:

ICU staff should receive appropriate training and ongoing education on the safe operation of infusion pumps. Training may include hands-on instruction, understanding the specific features of the pumps in use, and how to respond to alarms and errors.

ICU personnel who are responsible for using infusion pumps should also have a thorough understanding of the medications they are administering, including dosage calculations, potential side effects, and the specific indications for use.

One more thing: ICU staff must know how to program and operate different types of infusion pumps. This includes setting the correct infusion rate, volume, and any special features or modes (e.g., PCA or intermittent infusions).

Something important to keep in mind is that infusion pump technology and best practices evolve over time.[ National Library of Medicine, The Impact of Smart Pump Technology in the Healthcare System (online). Accessed 10/22/23.] ICU personnel should stay up-to-date with the latest developments and participate in ongoing education and training to ensure maximum benefits from continued infusion pump usage.

References

1. WebMD, What is an Intensive Care Unit (ICU)? (online). Accessed 10/21/23.
2. Penn LDI, What Patient-To-Nurse Ratios Mean for Hospital Patient Health and Outcomes (online). Accessed 10/20/23
3. RT, Infection Control in the ICU (online). Accessed 10/21/23.
4. ASPEN, What is Parenteral Nutrition? (online). Accessed 10/20/23.
5. National Library of Medicine, The Impact of Smart Pump Technology in the Healthcare System (online). Accessed 10/22/23.
Article by
Sara Alvarado
Greetings, I'm Sara, a dedicated nurse and a proud contributor to the AutoInfu blog. With my firsthand experience in the world of infusion pumps, I'm here to provide you with the latest insights, expert advice, and essential updates to ensure you stay informed about the infusion pump industry.

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