This information describes the elastomer pump (SMARTeZ®pomp of Easypump®) and explains what to do during continuous pump infusion. It also includes instructions for disconnecting the pump after infusion.
Your pump is connected to a central venous catheter (CVC). There are 3 main types of CVCs: tunneled chest catheters, peripherally inserted central catheters (PICCs), and implantable ports (such as Medi-Ports®). If you are not sure which type of CVC you have, talk to your doctor.
Elastomer pump information
Your pump is a small, lightweight device that pushes chemotherapy into your bloodstream at a constant rate. This is called continuous infusion chemotherapy. Your pump consists of many parts (see Figure 1).
- Ofbalonwhere chemotherapy is given. The balloon has 2 layers. The inner membrane holds the chemotherapy and the outer cover protects the inner membrane.
- Offill the gatehere the chemotherapy is placed in the balloon. The filling opening is fitted with a protective cap.
- Ofdrip linetransfers chemotherapy from the balloon to the CVC tube.
- OfShameused to start and stop the flow of chemotherapy.
- Offilterfilters chemotherapy before it enters the body.
- Ofcurrent limiterhelps to control the rate of chemotherapy infusion.
- Ofpatient connectoris where the infusion set connects to the CVC tubing. The patient connector has a cap that covers the connector when not connected to the CVC tubing. It is removed when the pump is connected to the CVC hose.
With a continuous infusion, chemotherapy flows from the balloon, through the infusion set, and through the CVC tubing into the bloodstream. When this happens, the balloon deflates (shrinks) and wrinkles form.
Start a continuous infusion
Before your continuous infusion, your healthcare provider will provide you with information about the chemotherapy you are receiving and any possible side effects. Read the information and discuss your questions with your doctor.
Your healthcare provider will start the infusion by connecting the pump to the CVC. They will also glue the current limiter to your skin.It is important that the flow limiter is in contact with the skin at all times during the infusion.
After connecting the pump you can go home. Your continuous infusion will continue as long as the pump is connected. Follow the instructions in the "During Continuous Infusion" section with the pump connected to the CVC.
A continuous pump infusion usually lasts about 48 hours. When the continuous infusion is complete, disconnect the pump from the CVC. See 'After continuous infusion' for more information.
During continuous infusion
Carrying an elastomer pump
- Wear the pump in the area between your armpits and hips. Wearing it higher or lower may cause the medicine to flow too fast or too slow.
- The pump is best stored in the sachet provided by your doctor.
- Do not store the pump under a warm coat or blanket. This can cause the pump to overheat and the medication to flow too quickly.
- Keep the pump next to you and over your blankets before going to sleep. Do not hang it from a bedpost or place it on the floor.
- Do not sit or lie directly on the pump.This can cause it to break.
If you have a pet, make sure to keep the pump and hose out of their reach. You can keep pets out of the bedroom at night while infusing continuously.
Activities and exercises
You can do most of your daily activities while on continuous infusion. You can do light exercise, such as walking. You can also engage in sexual activity.
Avoid activities that can raise or lower your body temperature. This can make chemotherapy go too fast or too slow.
- Do not place heating pads, electric blankets or hot water bottles directly on top of the pump.
- Do not take hot or very cold showers or baths.
- Do not swim, go to the sauna or use the hot tub.
- Do not expose yourself or the pump to direct sunlight or very cold temperatures.
- Do nothing else that could cause your body temperature to rise or fall, such as running, jogging, and other strenuous exercise or activity that causes you to sweat.
Do not play contact sports during continuous infusion.
Douche
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When showering, use a handheld shower head (a movable shower head that you can hold). This helps divert water away from the entry or exit and pump system. If you don't have a handheld shower, use a wet sponge or washcloth to give yourself a sponge bath.
Before showering or bathing, cover the implanted port entry site or catheter exit site with a waterproof dressing (such as AquaGuard®). This prevents the entrance or exit area from getting wet. One of the health workers will give you a waterproof bandage. watch the videoDouching if you have a central venous catheter (CVC).for instructions on how to apply the waterproof dressing.
Also place the pump and filter in a plastic bag (such as Zip-Loc®bag) while showering or bathing. Try not to get the plastic bag wet.
Use a 4% solution of chlorhexidine gluconate (CHG) antiseptic skin cleanser (such as Hibiclens®)
Wash daily with 4% CHG, an antiseptic skin cleanser, as long as the needle is on the port or when a tunneled chest catheter or PICC is in place
An antiseptic is something that kills bacteria and other germs. The 4% CHG solution is an antiseptic that kills germs for up to 24 hours after use. Douching with a 4% CHG solution helps reduce the risk of infection. You can buy a 4% CHG antiseptic skin cleanser at any local pharmacy or online.
Do not use 4% CHG solution if you are allergic to chlorhexidine. If you experience irritation or an allergic reaction while using the 4% CHG solution, discontinue use and inform your doctor.
Using an antiseptic skin cleanser with 4% CHG solution:
- Use regular shampoo to wash your hair. Rinse your head well.
- Use regular soap to wash your face and genital area. Rinse the body well with warm water.
- Open the bottle with 4% CHG solution. Pour some onto your hand or a clean cloth.
- Move away from the shower spray or direct the water from the handheld shower head away from your body.
- Gently rub the 4% CHG solution over your body from neck to toes. Do not apply to the face or genital area.
- Rinse the 4% CHG solution with warm water.
- Dry yourself with a clean towel after showering.
- Do not use lotion, cream, deodorant, make-up, powder, perfume or cologne after showering.
watch the videoDouching if you have a central venous catheter (CVC).for instructions on douching with a 4% CHG solution.
Monitor the course of chemotherapy
As the chemotherapy moves from the pump into the bloodstream, the balloon will deflate and wrinkles will appear (see images 2 and 3). Chemotherapy will be very slow. Balloon changes do not become apparent until about 18 hours after the start of the infusion.
Check the pump 24 hours after starting the infusion to make sure the balloon is slightly deflated and wrinkles have formed.This is a way to check that the chemotherapy is going well. Your healthcare provider will teach you how to do this.
If the balloon has not deflated and has formed ripples:
- Verify that the IV tubing or CVC tubing is not pinched in any of the clamps. If this is the case, open the clamp to release the wire and then close the clamp to avoid pinching the wire (see Figure 4).
- Make sure the infusion set is not kinked. If so, straighten the infusion set to remove any kinks.
- Call your doctor to tell them.
Call your doctor if:
- The balloon has not deflated or formed ripples in the last 24 hours.
- The balloon deflates faster than expected.
Check infusion set, CVC tubing, and access to implanted port or catheter exit site
- Check the pump infusion set, CVC tubing, and access to the implant port or catheter outlet daily. To do this:
- Make sure the pump's flow limiter is taped to the skin. If it falls off, keep the tube under your clothes. Make sure it's close to or right next to your skin.
- Make sure the extension set and CVC tubing are out of the clamps and that the clamps are closed. If there is a hose in the clamp: Open the clamp, put the hose aside and close the clamp so that it does not clamp the hose. Then call your doctor.
- Check the skin around the implanted port entry site or catheter exit site for fluid. If you see fluid, it could mean that chemotherapy is leaking. Follow the instructions in the sourceSafe handling of chemotherapy and biotherapy at homeprovided by the doctor.
- Watch for signs of infection, such as redness, pain, swelling, or drainage around the implanted access port or catheter outlet. See your doctor if you notice any of these symptoms.
- If you have a port implanted, make sure the needle is in the access point. To do this, gently press the needle with your index finger. You should feel it touch the back of the implanted port. If the needle feels out of place, call your doctor.
- If your doctor has given you other instructions, follow them.
Removing leaks or leaks
Your healthcare provider will provide you with resourcesSafe handling of chemotherapy and biotherapy at home. If your pump is leaking or chemotherapy is coming out of your pump, follow the instructions in this resource. Then call your doctor.
After continuous infusion
The infusion is complete when the balloon is completely deflated (see Figure 5). A continuous pump infusion usually lasts about 48 hours.The infusion should end around the date and time stated below.
It is possible that the infusion will stop as early as 42 hours (6 hours before the indicated time) or even 50 hours (2 hours after the indicated time). It is normal.
- If the infusion stops less than 42 hours after starting, please contact your doctor.
- If the infusion stops after 48 hours from the start of the infusion, the pump can be disconnected.
- If the infusion is not complete after 48 hours after starting the infusion, wait 2 hours and check the balloon again. When it is now completely empty, you can disconnect the pump.
- If the infusion is not completed after 50 hours, please contact your doctor.
Disconnect the elastomer pump
When the infusion is complete, the pump should be disconnected from the CVC. You can disconnect the pump yourself or make an appointment with MSK to have it disconnected by your doctor.
- If you have an appointment for your doctor to disconnect your pump, try to arrive as close to your scheduled appointment time as possible. This is to make sure you get your full dose of chemotherapy.
- If you are disconnecting the pump yourself and having the port implanted, follow the instructions in the next section.
- If you disconnect the pump yourself and have a tunneled chest catheter or PICC: Your healthcare provider will give you instructions on how to disconnect the pump.
Instructions for disconnecting the pump from the implanted port
Follow the instructions in this section to disconnect the pump from the implanted port and remove the needle from the port.
In this video, we show you how to detach the elastomer chemotherapy bottle from the implanted port.
Videodetails
Get your supplies ready
- Prepare a clean place to put your materials, such as a kitchen table. Do not disconnect the pump in the bathroom.
- Gather your supplies. You need:
- 1 syringe (10 ml) filled with saline.
- 1 pair of non-sterile gloves.
- Alcohol flakes.
- 1 gazik.
- Bandage (such as Band-Aid®).
- A hard plastic container with a lid (such as a Tupperware® container). Call it "chemotherapy."
- Make sure the container is strong enough that the needles cannot pierce the sides.
- Do not use plastic or paper bags.
- Wash your hands thoroughly with soap and water or an alcohol-based hand sanitizer.
- Wear non-sterile gloves.
- Open the gauze and remove it from the packaging. Put it on your clean workspace.
- Prepare a syringe with normal saline. To do this:
- Get a syringe of normal saline. Hold it with the point pointing up.
- Unscrew the cap but do not remove it.
- Pull the plunger back slightly. Then gently push it up to force the air out of the syringe.
- Tighten the nut again.
- Place the syringe in a clean work area.
Flush the implanted port
- Start at the pump and follow the infusion set to the flow restrictor taped to the skin. Carefully remove the tape and current limiter from the skin.
- You will see 2 clips on the CVC wire (See Figure 6). Close the clamp closest to the pump. It is a clamp under clamp (needleless connector) with a green disinfectant cap.
- Make sure the clamp is closed so that it clamps the transparent wire.
- Don't close the second clip (the one above the buckle, closest to your body) yet.
- Remove the green cap from the clave by unscrewing it counterclockwise (to the left). If the green cap has fallen off or is missing, clean the tip with an alcohol swab for 15 seconds. Let dry for 15 seconds.
- Remove the cap from the normal saline syringe. Attach the saline syringe to the buckle by pushing it into the buckle and screwing it clockwise (to the right).
- After connecting the saline syringe to the chopper, use the push/pause method to flush the tubing with saline. Inject ⅓ saline at a time. To do this:
- Push the plunger to quickly inject about ⅓ of the saline into the clave.
- Pause.
- Inject another ⅓ of saline.
- Pause.
- Inject the last ⅓ of saline.
- Close the second clamp (the one above the clamp, closest to the body) so that it clamps the CVC tube.
Remove the needle from the implanted port
- Remove the dressing from the implanted port. Remove the tape from the skin.
- Remove the needle from the implanted port. To do this:
- Hold the Hinged Safety Base against the skin with two fingers of your non-dominant hand (the hand you are not writing with).
- Gently push the base into the port.
- With the other hand, pull the textured handle up firmly until you feel resistance and the needle clicks into the safe position (see images 7 and 8).
- Hold the swab over the needle and apply light pressure for 3 minutes. After 3 minutes, place a bandage on the area.
Your pump is now disconnected.
tidy
- Place the pump needle in the hard plastic container.
- Place all dirty materials in a container with needle and pump. This includes an empty syringe, dirty gloves, and used alcohol wipes and cotton swabs. Close the lid properly.
- Bring the container to your doctor on your next visit. Don't throw it in the trash.
When should you call your healthcare provider?
Call your doctor if:
- You have experienced any of the side effects listed in the information they have given you.
- The balloon deflates and creates wrinkles faster than it should.
- Your pump is emptying sooner than you were told.
- The balloon does not float and does not form wrinkles.
- The pump does not seem to be draining as it should.
- You see fluid on the skin around the implanted port entry site or catheter exit site.
- You have redness, pain, swelling, or drainage near the implanted access port or catheter exit.
- Pump leakage.
FAQs
What is an elastomeric infusion pump? ›
An elastomeric pump, also known as a balloon pump or ball pump, is a medical device used for infusing medication. Depending on the therapy needed, these medications might include antibiotics, chemotherapy, 5FU, cytostatics, analgesics, and local anesthetics.
How do you initiate an infusion using an IV elastomeric pump? ›Remove the cap on the Elastomeric Pump IV tubing. Unclamp the tubing on the medicine ball (Elastomeric Pump) to ensure there is no air in the line and that it works properly. 3. Attach the Elastomeric IV tubing to your IV line and infuse the medication as directed.
What are the disadvantages of elastomeric pumps? ›The disadvantages of using elastomeric pumps are the possibility of inaccurate flow rates and lack of flexibility to change flowrate and fill volume.
What is the infusion rate of elastomeric pump? ›Elastomeric pumps generate a driving pressure of 260–520 mmHg and infuse at rates of 0.5-500 mL/h (1).
In which setting is an elastomeric pump most commonly used? ›The elastomeric pump is typically used in acute or chronic (moderate-severe), oncologic or non-oncologic, post-operative pain, when oral therapy is no longer sufficient.
How does a continuous infusion pump work? ›The pumping function is provided by the continuous contraction of an elastomeric balloon filled with drug. Inside the infusion line connected to the balloon is a flow restrictor, also called a capillary, which limits the flow rate of the elastomeric drug by the pressure difference between its inlet and outlet.
What is a continuous infusion? ›(kon-TIN-yoo-us in-FYOO-zhun) The administration of a fluid into a blood vessel, usually over a prolonged period of time.
What are the three major problems of infusion pumps? ›- Software Defects. Some pumps fail to activate pre-programmed alarms when problems occur, while others activate an alarm in the absence of a problem. ...
- User Interface Issues. ...
- Mechanical or Electrical Failures.
Chemotherapy pumps are also called infusion pumps. When you have chemotherapy through a central line (for example a PICC line) a nurse can attach a pump. This will give a controlled amount of drugs very slowly into your bloodstream.
What are the advantages of elastomeric balloon system? ›Benefits of using an elastomeric pump include: They are portable. They allow the child to be disconnected from IV tubing in between medication doses. They do not require power cords, IV poles, or programming.
What is the use of elastomeric pump? ›
Elastomeric pumps - also called balloon pumps - are usually used in the medical field to administer liquid drugs such as local anesthetics, analgesics, cytostatics or antibiotics (depending on the therapy).
What are the advantages of elastomeric? ›An elastomeric waterproofing material offers advantages over other types of technologies due to its flexibility to expand and contract; its durability, which prevents punctures, indentations, and abrasions; and its ability to withstand high tensile forces.
How long does elastomeric last? ›Elastomeric roof coating typically lasts 10 or 20 years (sometimes longer) depending on how thick the coating is applied and how well it is maintained.
How many mL per hour will you set the infusion pump? ›The answer is that the rate required on the infusion pump is 13 mL/hour.
How often should infusion pump be changed? ›The standard teaching is three days, but the answer is more complicated than that. Several studies using continuous glucose monitoring data have shown that glucose levels start to rise after two and a half to three days when all other factors have been kept the same as much as possible.
What pressure should an infusion pump be? ›Therefore infusion devices must be capable of delivering infusions at pressures between 100 and 750mmHg (2 to 15PSI) to overcome any internal or external resistance to the flow of fluid.
How do you sleep during chemo pump? ›Where do I keep the pump when I am sleeping? Keep the pump at a height similar to where the infusion connects to your intravenous line. This could be on top of the bedcovers, or on a bedside table. Avoid placing the pump beneath the pillow or bedcovers where it may be too warm.
What type of pump produces the smoothest flow? ›With many different configurations available, centrifugal pumps are widely-used because of their design simplicity, high efficiency, wide range of capacity and head, smooth flow rate and ease of operation and maintenance.
Which pump gives more flow rate? ›Centrifugal pumps are best for high-flow, low-viscosity applications, where you can take advantage of their high-volume capabilities. You can also customize them to move more gallons per minute than other types of pumps.
What are the disadvantages of continuous infusion? ›One disadvantage of continuous infusions of opioids is the significant delay in onset of analgesic activity if a bolus dose is not given with the infusion. Another is that the cost, in terms of infusions and the labor needed during setup and monitoring, is considerable.
How long does a continuous infusion last? ›
After Your Continuous Infusion
It's possible that your infusion will finish as early as 42 hours (6 hours before the time written) or as late as 50 hours (2 hours after the time written).
Continuous infusion – the uninterrupted infusion of I.V. fluids with or without added electrolytes or medications over several days, weeks, or months.
What is an example of a continuous infusion? ›Continuous Intravenous (Medication) Infusion
Most IV continuous infusions are given for a short duration. Examples of continuous IV infusion medications include heparin, insulin R, and pantaprazole.
Infusion Drugs & Types of Infusions
Antibiotics. Biologics. Chemotherapy. Fluids.
Answer: IV tubing should be changed according to agency protocols. Generally IV tubing that has an infusion is changed every 96 hours. IV tubing used for intermittent IV infusion (ie. antibiotics) is changed every 24 hours.
Why would you need an infusion pump? ›Infusion pumps may be capable of delivering fluids in large or small amounts, and may be used to deliver nutrients or medications – such as insulin or other hormones, antibiotics, chemotherapy drugs, and pain relievers.
Does using an infusion pump make a difference? ›Infusion pumps provide an additional safeguard by using a pump to provide an exact amount of fluid per hour to prevent medications from being inadvertently administered too slowly or too quickly. While IV pumps are intended to improve patient safety, the nurse is still responsible for safely setting up the pump.
What are two primary reasons for using an IV infusion pump? ›First, it assists in maintaining IV patency and second, it aids in overcoming any potential resistance.
Who needs an infusion pump? ›An infusion pump is primarily used to administer medications to a patient when there is no other way of administering medication.
What are the disadvantages of IV infusion? ›Disadvantages of drugs administered IV include an inability to reverse the actions of all drugs after they have been injected. Although it is possible to reverse the actions of some drugs (e.g., opioids, anticholinergics, and benzodiazepines) through the use of specific drug antagonists, this is not always the case.
What drugs go through infusion pump? ›
The infusion pump is built in a manner to infuse large or small quantities of nutrients and medications. The medications range from infusing antibiotics, insulin and other hormones, chemotherapy drugs, and pain relievers.
What not to do with a PICC line? ›GENERAL PICC LINE CARE:
No strenuous activity or heavy lifting for first 48 hours after line is placed. Never use scissors to remove tape/dressing from around the line. Always tape line to your arm to prevent it from snag- ging on objects. Cover with plastic when showering so the dressing does not get wet.
A PICC line generally isn't recommended if there's a chance you may one day need dialysis for kidney failure, so let your doctor know if you have a history of kidney disease.
How does a Baxter pump work? ›How does the pump work? The balloon gently and continuously pushes the medicine through the IV tubing and into your Venous Access Device or IV. The balloon will slowly empty and get smaller as you get your medicine.
What is a volumetric infusion pump? ›Volumetric infusion pumps (VIP) are medical devices capable of delivering continuous and very specific amounts of fluids at very slow to very fast rates. Infusion pumps are commonly used to control the flow of intravascular drugs, fluids, whole blood, and blood products to patients.
What is an antibiotic ball? ›Your medicine ball pumps medicine into your bloodstream. As the medicine enters your blood (infuses), the ball gets smaller. The device delivers the medicine at the rate that your care team ordered. It uses your body heat and the pressure of the balloon pressing inside the medicine ball.
What is large volume infusion? ›Large-volume pumps (LVPs) are used to accurately deliver liquids through IV or epidural routes for therapeutic and/or diagnostic purposes, normally with rates from 0.1 to 999 mL/hr or higher.
What are the parts of elastomeric pump? ›Three parts include filling port (1), elastomeric balloon (drug- containing reservoir) (2), and outer protective shell (3).
What are the benefits of Alaris pump? ›General Benefits of Alaris Infusion Pumps
They help ensure that infusions go smoothly and reduce instances of incorrect dosing. Patients, clinicians, and healthcare facilities are better protected when medication errors are minimized, and stress is reduced. Alaris pumps help clinicians provide exacting care.
elastomer, any rubbery material composed of long chainlike molecules, or polymers, that are capable of recovering their original shape after being stretched to great extents—hence the name elastomer, from “elastic polymer.” Under normal conditions the long molecules making up an elastomeric material are irregularly ...
What is the unique characteristic of an elastomer? ›
Elastomers are loosely cross-linked polymers. They have the characteristics of rubber in terms of flexibility and elasticity. The long randomly coiled, loosely cross-linked materials can be stretched easily, but return to their original shapes when the force or stress is removed.
What is the best elastomeric? ›| Product | temp | water proof |
|---|---|---|
| Sherwin Williams Conflex Elastomeric | 50 degrees | Yes |
| Ben Moore UltraSpec Masonary Elastomeric | 50 degrees | Yes |
| PPG Perma-Crete Pitt Flex Elastomeric | 50 degrees | Repels water |
Dries to the touch in 4-6 hours. Longer dry time required in cooler temperatures and higher humidity. Allow 24 hours between coats. After two weeks, cured paint film may be cleaned with a mild, non-abrasive liquid detergent.
Do you need to prime before elastomeric? ›A too thin coat of elastomeric paint won't provide the weather-proofing benefits you're using it for. Additionally, primer should be applied and dried fully before the coat of elastomeric paint is done. This gives another layer of protection, and stops the paint from peeling.
Which is better silicone or elastomeric? ›Longevity. Many factors can affect the longevity of an elastomeric coating, but mil for mil, silicones last longer than acrylics. This is mostly due to the inherently superior UV and moisture resistance of silicone materials.
What is the formula for pump infusion? ›If you need to set this up on an IV infusion pump, use the formula, volume (mL) divided by time (min), multiplied by 60 min over 1 hour. This equals the IV flow rate in mL/hr which is the standard method of setting infusion rates on IV pumps.
How does an infusion pump work? ›In a syringe pump, fluid is held in the reservoir of a syringe, and a moveable piston controls fluid delivery. In an elastomeric pump, fluid is held in a stretchable balloon reservoir, and pressure from the elastic walls of the balloon drives fluid delivery.
How do you sleep with an elastomeric pump? ›Wearing your elastomeric pump
Do not keep your pump under a warm jacket or blanket. This can make the pump too warm and cause the medication to flow too fast. At bedtime, keep your pump next to your side and above your blankets.
| Syringe | Diameter | Minimum |
|---|---|---|
| 500 µl | 3.256 mm | 1.275 nl/min |
| 1000 µl | 4.608 mm | 2.553 nl/min |
| 1 ml | 4.699 mm | 2.655 nl/min |
| 3 ml | 8.585 mm | 8.863 nl/min |
Can I take a shower with my infusion pump? Yes, but avoid submerging the pump or exposing it to a direct stream of water. You could place the pump into a plastic bag and hang this over the shower head or taps. Avoid spending prolonged periods of time in a very warm environment.
What chemo is given in a pump? ›
Not many IV chemotherapies require a take-home pump. One of the most common take-home chemotherapies is 5-fluorouracil, or 5-FU for short. It's an older drug that's often used to treat gastrointestinal cancers, such as colorectal and pancreatic. Normally, 5-FU is given over 46 to 48 hours.