CA1319068C - Clinical configuration of multimode medication infusion system - Google Patents

Clinical configuration of multimode medication infusion system

Info

Publication number
CA1319068C
CA1319068C CA000584387A CA584387A CA1319068C CA 1319068 C CA1319068 C CA 1319068C CA 000584387 A CA000584387 A CA 000584387A CA 584387 A CA584387 A CA 584387A CA 1319068 C CA1319068 C CA 1319068C
Authority
CA
Canada
Prior art keywords
pump
clinical
infusion
page
device type
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
CA000584387A
Other languages
French (fr)
Inventor
Paul A. Koenig
John B. Slate
O. Rey Rule, Iii
Fredric C. Colman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
CareFusion 303 Inc
Original Assignee
Pacesetter Infusion Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Pacesetter Infusion Ltd filed Critical Pacesetter Infusion Ltd
Application granted granted Critical
Publication of CA1319068C publication Critical patent/CA1319068C/en
Anticipated expiration legal-status Critical
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/50General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502User interfaces, e.g. screens or keyboards
    • A61M2205/505Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16804Flow controllers
    • A61M5/16827Flow controllers controlling delivery of multiple fluids, e.g. sequencing, mixing or via separate flow-paths
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/13Infusion monitoring

Abstract

CLINICAL CONFIGURATION OF A MEDICAL INFUSION SYSTEM
Abstract of the Disclosure A medication infusion system may be selectively configured to perform an emulation of any one of a plurality of Device Types corresponding to the environment of use. The particular parameters which relate to a given Device Type are set into the system either at the factory or by biomedical engineers at the hospital or other medical institution by resort to an intercoupled computer driven by appropriate software. With the system set up in this fashion, a clinical user can select a given Device Type and can view but cannot change the critical operating parameters thereof. Substantial economies and improvement of device operation are realized by the provision of one switchable system in place of the plurality of different types of devices now required in a given institution.

Description

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~3~9 41This application iA related to nine other co-pending patent 51 applications. $hese patent applications are U.S. Patent No. 4,872,813 61 entitled "Disposable Casqette for a Medication Infusion System," U.S.
7¦ Patent No. 4,940,399 entitled "Piston Cap and Boot Seal for a Medication ~¦ Infusion System," U.S. Patent No. 4,856,340 entitled "Pressure Diaphragm 9¦ for a Medication Infusion System," U.S. Patent No. 4,878,896 entitled 10¦ "Cassette Optical Identification Apparatus for a Medication Infusion 11¦ System~ ~.S.Patent No. 5,006,110 entitled "Air-In-Line Detector for a 2¦ Medication Infusion System," U.S. Patent No. 4,818,190 entitled "Cassette 3¦ Loading and Latching Apparatus for a Medication Infusion System," U.S.
4¦ Patent No. 4,850,817 entitled "Mechanical Drive System for a Medication 15¦ Infusion System," all of which were filed December 1, 1987, and U.S.
16¦ Patent No. 4,919,596 entitled "Fluid ~livery Control and Monitoring 17¦ Apparatus for a Medication Infusion System~ and Canadian Serial No 18 ¦ 584,375 entitled "User Interfacè for Multimode Medication Infusion 19 ¦ System," filed concurrently herewith. All of these applications are 20 ¦ assigned to the assignee of this application.
21 l 22 ¦ BACKGROUND OF THE INVENTION
23 ¦ The present invention relates generally to systems for 24 ¦ continuously infusing medication into a patient and, more particularly, 25 ¦ to apparatus for the configuration of such a system for automatic 26 ¦ operation in a selected mode.
27 ¦ ~ntil recently there were two major techniq-les available for 28 ¦ delivering drugs to a patient when the drugs cannot be orally 29 ¦ administered. The first technique is to inject the drug into the patient with a ~yringe and needle to deliver an appreciable dose at 31 relatively infrequent intervals. This technique i9 not always 131906~

1¦ satisfactory, particularly when the drug being injected is potentially 2 lethal, possibly has undesirable side effects when given in a large 3 dosage, or must be delivered more or less continuously to arrive at a 4 desired therapeutic result. This technique leaves rnuch to be desired.
The risks of overdosage or harmful side effects may be reduced by giving 6 smaller injections at more frequent intervals, an inconvenient and not 7 altogether satisfactory alternative.
8 The need for delivering a drug more or less continuously to 9 achieve a desired therapeutic effect gives rise to the second technique, which involves a continucus delivery of medication to the patient, 11 typically through an intravenous drip. Medication may also be 12 administered using an intravenous system with an injection into a 13 complicated and cumbersome interconnection of IV tubes, hoses, and other 14 components. Drop counters are used to measure the amount of fluid delivered, and medications are often delivered in a large dose through 16 injection into the IV lines, with the medication being somewhat diluted 17 by the fluid.
18 A relatively recent alternative to these two techniques of ~9 administering medication to a patient is the medication infusion pump.
A valuable and much needed development, the medication infusion pump can 21 be used to administer drugs to a patient in small, carefully measured 22 doses at frequent intervals or, with some devices, slowly but 23 uninterruptedly. A therapeutic regimen with an infusion pump can be 24 controlled electronically to administer precisely measured quantities of a drug at precisely planned intervals to give a gradual infusion of 26 medication into the patient. The infusion pump makes possible a closer 27 approximation to the natural maintenance of biochemical balances in the 28 body because of its operation in a repetitive small do æ mode.
29 Disposability is an important consideration in the design of medication infusion systems. Parts of the system through which 331 medication is pumped must be sterile, so that in most applications some 13190~

1 11 of the equipment is used and then discarded. The disposable parts are 2 typically replaced at regular intervals, typically on a daily basis.
3 Disposability of the fluid pump portion of the infusion device is a 4 highly desirable feature. It would be very convenient to design a fluid pump in the form of an attachable cassette of economical design which 6 could easily be installed onto a main pumping unit. A cassette which 7 u~es a small number of parts, is easily mass productible, and is capable 8 of delivering liquid medication or other therapeutic fluids with a high 9 degree of precision is described in U. S. Patent No. 4,872,813 issued 10/10/89, entitled "Disposable Cassette for a Medication 11 Infusion System".

13 The disposable casqette which is referred to above includes a 14 fluid pump affording a high degree of accuracy in fluid delivery, with the degree of accuracy being maintained throughout the life of the 16 product. The cassette also provides means for conveniently and easily 17 priming the pump, and includes a bubble trap to prevent the frequent 18 shutdowns and alarms which are a problem with presently available pumps.
19 The cas~ette also includes additional devices such as pressure sensing means and bubble detecting means which in conventional medication 21 infusion systems constitute ~eparate assemblies.
Z A fluid monitoring and control system for use with disposable 23 cassettes is needed to en~ure accurate and safe delivery of therapeutic 24 fluids. The design of such a system requires careful attention to factors involved in the accuracy of fluid delivery, and instrument 226 monitoring functions are necessary to insure safe operation of the 28 ~ystem.
29 There has been a long-felt but unresolved need for the development of a medication infusion management system that can be used for patient care in both hospitals and home health care applications. A
31 desirable system would provide a reliable and improved product for l3l9a~8 11 current applications to encourage the use of new therapeutic techniques, 21 reduce the cost of hospitalization by improving care and decreasing 31 labor and inventory costs, and would be versatile enough to allow 41 intra-arterial and subcutaneous infusions. Primary requirements of such 51 a system would be volumetric accuracy, state-of-the-art safety 6¦ functions, and a capacity for independently controlling more than one 71 pumping channel, each with a separate line to the patient.
81 Ideally the pump of the improved medication infusion system would 9¦ be substantially smaller and lighter than current hospital pumps while 10¦ at the same time incorporating multiple pumping channels. Moreover, it 11¦ is desirable to be able to configure selected system parameters and to l monitor displayed information related to the needs and performance of a 13¦ given system, thereby optimizing system operation. Together with the 14¦ possibility of extended battery-powered operation, these features may be 15¦ incorporated in a device that is particularly well suited to ambulatory 161 care, intensive care, emergency transport, emergency care, or operating l room use, as needed.
18¦ A system with the capacity for multiple pumping channels, a 19 variety of disposable configurations, a maintenance mode, and a library 2211 f software functions could combine the capabilities of several 221 currently available devices into one single unit. For example, the need l in a hospital for separate syringe pumps, PCA pumps, neonatal pumps, 231 general purpose pumps, and computer communications pumps could be 251 eliminated in favor of one system that could satisfy the requirements l for all these devices on a selective basis~
26¦ The capability of a medication infusion system to operate 271 interchangeably on a selective basis in the emulation of the different 291 types of pumps listed above would represent a significant cost savings l for hospital administration with the elimination or substantial 30¦ reduction o~ some of the costs associated with the use of medication 31¦ infusion systems. A major reduction in inventory costs associated with 1'~ 068 1l infusion systems is possible if one pump apparatus can replace a 2 plurality of different specific types. Also, the capability of a single 3 medication infusion system to operate with a plurality of channels 4 reduces equipment cost~ Other cost benefits may result from a reduction in the number of different disposable peripherals which are required for 6 the infusion system, a reduction in cost of required maintenance and an 7 easing of personnel training requirements.

In brief, arrangements in accordance with the present invention 11 provide for the clinical configuration of a multimode medication 12 infu-~ion system having the desirable characteristics listed above.
13 Various aspects of the multimode medication infusion system with 14 which the present invention is associated are set forth in the co-pending patent applications and patents which are identified 16 on page 1 of this specification.

18 The clinical configuration concept of the present invention is 19 particularly related to the user interface for the multimode medication infusion system which, briefly described, includes apparatus that is 21 designed for use with a disposable fluid pathway that incorporates a 22 sterile cassette containing pumping elements and sensor interfaces in a 23 multi-channel configuration. The hardware portion of the user interface 24 compris2s an audio signal generator, status light emitting diodes (LEDs), a liquid crystal display (LCD), and user inputs. A programmed 26 microprocessor allows the user to control the system through the user 27 inputs. The audio signal generator is used to get the attention of the 28 operator, the status LEDs allow the operator to make a quick visual 29 check of the s~ tus of the instrument at a distance or in a darkened room, and the LCD presents all the detailed information about the system 31 Atatus and operation.
l 3 l 9 a ~

1¦ The user interface is designed to be a flexible mechanism to 2¦ allow use of the system by relatively untrained personnel without 31 sacrificing the capability for use by better trained personnel to 41 control more complex infusion regimens which are possible with the 51 system. Since the system has more than one pumping channel, the user 61 interface allows simultaneous display of data pertaining to multiple 71 infusion requirements. A variety of complex infusion regimens are 81 possible on each pump, making the system potentially very complex, and 9¦ for this reason the design of the user interface has been kept as simple 10¦ and intuitive as possible.
11¦ While setting up an infusion regimen, the operator deals with 12¦ only one pump at a time. When monitoring one or more regimens, the 13¦ operator is able to view the most important information from each pump 14¦ at a glance. Information is grouped in a clinically useful way and 15~ displayed on the LCD in specific formats referred to as "pages." Using 16¦ the interface consists mainly of selecting the correct pages to view 17¦ and, if necessary, changing informal:ion, responding to alarms, and so lô¦ forth. The most significant information for each pump is displayed on 19¦ the LCD in a ormat known as the "standard page." sasic infusion 20 ¦ parameters such as in~usion rate and volume remaining, as well as 21¦ information about alarms and overall status can be viewed from this 22¦ display. The standard page is the default display which appears 231 initially without operator intervention.
24 ¦ The user interface imitates a single-pump infusion device for 25 ¦ purposes of setting up an infusion regimen. Information relating to 26 ¦ only one pump, the "selected" pump, is displayed at one time. The 27 ¦ operator has the option of changing the "selected" pump at any time.
28 The individual pump modes, or clinical device types, are established for 29 ¦ the system by the setting of various parameters by qualified personnel, 30 ¦ either at the factory by establishing fixed values of selected 31 ~ parameters or by ~ualified biomedical technicians at the hospital who . !

1 determine the parameter values to be fixed as defaults. rrhis latter 2 ¦ default selection is referred to as an "instrument configuration," since 31 it involves setting up the instrument in preparation for use at the 41 clinical level.
51 Currently, different infusion devices are used in different B¦ areas of a hospital because of the specific needs of a particular 71 area--intensive care units, operating room, neonatal and pediatric ~¦ intensive care, to name a few examples. The different infusion devices 9¦ have different infusion parameter ranges or settings (rate and volume 10¦ remaining ranges, patient side occlusion and air-in-line alarm 11¦ thresholds, etc.) They may also use different fluid containers le.g., 12¦ syringes, bottles, bags, etc.) and may have software for special 13¦ applications (e.g., patient controlled analgesia, piggybacking, dosage 1~¦ calculation, etc.) 15 ¦ Specifically, hospitals currently use the following types of 16 ~ devices:
17 I General Purpose - This type is used in intensive care units, the general I ~
18 ¦ floor, emergency rooms, labor and delivery. Its flow rate range is from 19 ¦ 1 to 999 ml/hr, its alarm sensitivities are medium.
20 l ~1 ! Neonatal - This type is used in neonatal and pediatric intensive care 22 units. Its flow rate range is one-tenth that of the general purpo~e 23 ¦ type (0.1 to 99.9 ml/hr); too high a rate can cause death. Its alarm 24 ¦ sensitivity is established at the highest level.
25 l 26 ¦ ~l = - These are used at the present time for cancer 27 ¦ chemotherapy. They may also be used on the general floor. The flow 2~ ¦ rate range is from 1 to 299 ml/hr. As for alarms, occlusion pressure is 29 ¦ the most sensitive of all, since it is determined by the fluid head 30 ¦ height, which is low. This is important for infusing cancer 31 chemotherapy drugs which can cause serious tissue damage during an 131~6~
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31 operating Room - The flow rate range is from 1 to 999 ml/hr (same as 41 General Purpose). Alarm sensitivity i5 defaulted to the lowest value, 51 since an anesthesiologist is always present and numerous, particularly ~¦ unnecessary, alarms are to be avoided since they may interrupt the flow ~¦ of an important drug and may distract operating room personnel.

9¦ Home Health Care - Two flow rate ranges are provided: 0.1 to 99.9 ml/hr 10¦ and 100 to 999 ml/hr. Alarm sensitivity is medium. Home health care 11¦ units are usually battery powered.
12¦ In addition to the above-listed general device types, hospitals 13¦ may purchase special devices because of the need for special functions, 14 ¦ such as the delivery of fluids Erom a syringe, patient controlled 15 ¦ analgesia (PCA) and piggybacking.
16 ¦ These various clinical device types and their respective 17 ~ parameter settings are set forth in Table I (belowj which shows a lô ¦ comparison of the clinical device types to which the individual pump 19 ¦ modes correspond and the different parameter values that are conventionally set at the factory as default settings. A given 21 institution may have requasted different default values from those shown 22 in Table I in purchased equipment.
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1l It will be noted that the settings for Occlusion Detection Method 2~ and Very Low Power Mode cannot be changed. The baseline method of 31 occlusion detection involves the pump channel recognizing a certain 41 level of pressure when the infusion starts, and by overcoming that 51 pressure to maintain fluid flow up to the specified increment above the 61 baseline, at which point the occlusion alarm will sound. For example, a 7~ General Purpose Device set at baseline symbol +5 psi will alarm when it 81 exceeds its baseline pressure by 5 psi.
91 Absolute threshold occlusion detection means that the occlusion 10¦ pressure alarm is fixed at a certain ~alue, and the pump channel will 11¦ alarm whenever the occlusion pressure reaches that point. For example, 12¦ a Controller Pressure Device will alarm at the equivalent of three feet 13 of head height (pump to patient), regardless of the initial pressure 14¦ required to overcome back pressure in the IV line. The maximum pressure 15¦ that the rnedication infusion system with which the present invention is 16 ¦ associated is capable of is 15 psi, regardless of baseline pressure.
17 ~ In accordance with the present invention, the trained clinician 18 ¦ can select a particular device type from among those shown on Table I, 19 ¦ based on the immediate need. With the present invention, the clinician 20 ¦ can make certain limited choices with respect to the parameters for a 21 ¦ given device type and~may visually check the default settings for those 22 ¦ parameters which are not accessible to change at the clinician level.
23 l 24 ¦ BRIEF DESCRIPTION OF THE DRAWINGS
25 ¦ A better understanding of the present invention may be realized 26 ¦ from a consideration of the following detailed description, taken in 27 ¦ conjunction with the accompanying drawing in which:
28 FIG. 1 is a schematic block diagram of the user interface in 29 relation to a multimode medical infusion system;
FIG. 2 is a front view of the user interface display device;
31 FIG. 3 is a schematic flow diagram of the overall structure of _g_ 13191~

1 ¦ the user interface. a portion of which represents the clinical configuration feature of the present invention; and 3 FIGS. 4-7 are a seguence of page displays in the clinical 4 configuration mo-Je of the present invention as they appear on the device of FIG. 2.

7 DESCRIPTIO'`l _F THE PREFERRED EM~ODIMENT
8 In accordan-e with the present invention, FIG. 1 is a schematic 9 block diagram of a user interface for clinical configuration of a multimode medication infusion system as described in the related patent 11 applications listed in ~Identification of Related Patent Application~"
12 above, which are hereby incorporated herein by referen.x . Referring to 13 FIG. 1, user interface 10 i~ able to communicate with an off-line 14 digital computer 12 via communications interface 14. When user interface 10 is connected to computer 12 in this way, specialized 16 software 16 is run on computer 12 ~o enable selected qualified personnel 17 to change default values for various parameters associated with 18 operation of the medication infusion system. This mode of operation of 19 user interface 10 i~ called the "instrument config~ration modeO"
Normally user interfa oe 10 is not connected to computer 12. Uær 21 interface 10 controls the functioning of a medication infusion system 22 employing a di~posable fluid pathway that incorporates a sterile 23 cassette containing pumping elements 18 and sensor interfaces in a multi 24 channel configuration, a~ de~cribed in u.s.Patent No. 4,919,596 issued 04/24/90 entitled "Fluid Delivery Controland Monit.~ring Apparat~ s 26 for a Medication Infusion System" assigned to ~he assignee of this application.
27 User interface 10 compriqes user input controls 20, a 28 microprocessor 22, status indicators 24, an audio generator 26, and 29 display means 28.
In a preferred embodiment the user interfa.~e 10 has four basic 31 elements: an audio signal generator, status light-emitting diodes S f !'`\ ll 1319~68 1 1 (LEDs), a liquid crystal display (LCD), and a plurality of user inputs.
2 ¦ FIG. 2 i9 a front view of user interface hardware in the preferred 3 ~ embodiment. A user interface chassis 30 houses a liquid crystal display 4 32, above which are four user input controls 20a-20d, and below which are user input controls 20e-20k.
6 Input controls 20a-20d are momentary-contact switches labelled 7 "on/off," "standard display," "More Options," and "start/stop,"
8 respectively. Switches 20e-20h are so-called softkeys, whose functions 9 depend on what is being displayed on the LCD 32. Switches 20i-20k are 10 used to select a pump for infusion. Switch 201 is a patient-controlled 11 analgesia switch.
12 The face of each pump select switch contains two status LEDS.
13 Thus, pump select switch 20i has status LEDs 24a and 24a', pump select 14 switch 20j has status LEDs 24b and 24b', and pump select switch 20k has 15 status LEDs 24c and 24c'. The status LEDS 24 allow the user to make a 16 quick visual check of the status of the instrument from a distance or in 17 a darkened room, and the LCD 32 presents all detailed information about 18 instrument status and operation. The user inputs 20a-20k allow the 19 operator to control instrument operation.
Normally a user wants to deal with only one pump at a time when 21 setting up an infusion regimen. User interface 10 is designed to 22 facilitate this by grouping information in a clinically useful way on 23 LCD 32 in a specific format referred to as a "page." Many different 24 types of pages are defined for the instrument. Reference is made to the 25 co-pending application enti tled "User Interface for Multimode Medication 26 Infusion System" for specific details of the various pages which are 27 available for display on the display device 32. However, details of the 28 clinical configuration pages will be described hereinbelow.
29 FIG. 3 indicates the overall operational structure of the user 30 interface . Boxes wi th rounded corners denote liquid crystal display 31 pages. The transitions from one LCD page to another are shown. The l3~ G~ ~

1 event which triggers a transition is shown in a rectangle stlperimposed 2~ on the transition tan operator activation of a control) or a label next 3 ¦ to the transition (an instrument-triggered change). All transitions 41 operate from top to bottom or left to right. For example, to move ~rom 51 the standard page to a pump status page, the operator activates a pump 61 select key "A," "s," or "c."
71 Many pages have "More Options" softkey functions defined. Note 81 that a "More Options" activation without any corresponding display 9¦ change denotes that the primary set of softkey options is re-displayed.
If no secondary sets of softkeys are defined, the "More Options" softkey 11 has no effect.
12 All pages subordinate to the standard display have a transition 13 to the standard display after 60 seconds of front panel keyhoard 14 inactivity. In addition, there is an implied transition from all LCD
pages to the standard page, using the "standard display" key. An 16 implied transition from all clinical operations display pages to a pump 17 status page exists, by activation of the appropriate pump select key 18 "A," "B," or "C."
19 Some boxes in FIG. 3 show more than one softkey function. Only one of the functions in a box is available at any time, depending on 21 conditions not shown on the chart.
22 LCD 32 is used for all data entry and display for t~ system.
23 Four types of information are presented:
24 a) General status information for each pump;
b) Prompts and other information to assist in setting up and 26 using the pump;
27 c) Softkey labels; and 28 d) Detailed information about the instrument status and status 29 for each of the pumps.
There are four clinical configuration pages which may be 31 displayed individually on the LCD device 32. These are indicated in the 131906~

left-~nd side of FIG. 3 and are shown respectively in FIGS. 4-7. The ~¦ relationship of Clinical Configuration to Instrument Conflguration and 3¦ Maintenance is described in detail in the co-pending Canadian 4 ¦ Serial No. 584,375 entitled "User Interface for Multimode 5 ¦~ Medication Infusion System".
6 ¦ Clinical configuration page 1 (FIG. 4) appears on the display 7 ¦ when the operator uqes the interface device to access the clinical 8 ¦ configuration settings. The clinical configuration settings mode 9¦ provides a special feature t~t allows the u~er to enter the time and 10¦ date, to select the device type, to set t~ volume level of the audio 11¦ alarm, and to review certain default settings.

13¦ Time And Date Settings (Page l/FIG. 4):
I ._ _ 14¦ The fir4t page of the clinical configuration display shows the 15¦ time, month, day and year. Each of these parameters can be changed by 171 the clinician as needed. The time can also be displayed as am/pm or 18¦ 24-hour military time.

19 ¦ Clinical Device Type (Page 2/FIG. 5):
20¦ The Clinical Device Type affects all three pump c~nnels~ It is 211 not possible to set different clinical device types for different pump l channels; all three channels will always be the same device type, 231 corresponding to a selected one of the available types shown in Table I
24~ above.

271 Audio_Alarm Volume (Page 3/FIG. 6):
28¦ The Audio Alarm Volume can be set to highest, high, medium, or 291 low, and t~ setting determines the initial volume of the alarm tone.
311 If an alarm is ignored, its volume will increase over time to the 32 highest level.

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2 Default Settings (Page 4/FIG. 7):
3 This page (and any succeeding clinical configuration pages which 4 may be needed for the purpose) shows the default settings for the Device Type to which the instrument has been preset. Changes to these settings 6 are possible, but not at the clinician level. These changes can only be 7 made with the use of specialized equipment by biomedical engineers using 8 the instrument configuration mode, or by the manufacturer at the 9 institution's request. Because it is recommended that any changes in the default settings be standardized throughout an institution, it is 11 likely that all instruments used by the clinician will have the same 12 default settings within each Device Type. The clinician can review the 13 settings but cannot change them.

_ 2~ /

131~
3¦ Supplying Power to the System:
_ , _ 4 Power to the system is supplied by operator activation of the on/off switch. Pressing this control while the instrument is "off"

6 supplies power to the electronics (assuming that the internal batteries 7 are charged or an external power supply is attached) and causes an ô instrument reset. The instrument then:
9 a) Performs a "power-on self test" (POST);

b) Displays the current instrument configuration:
11 c) Determines whether to operate in a non-clinical operating 12 mode: and 13 d) If clinical operation is entered, the standard page is 14 displayed. Otherwise, the first clinical configuration page is displayed.
16 Details of clinical operation, including the initial display of 17 the current configuration, the entry into clinical operation, pump 18 selection, setup and review of infusion regimen, and t~ like may be 19 found in co~pending Canadian Serial No. 584,375 entitled "User 2~ Interface for Multimode Medication Infusion System".
22 Home-Health Care Instrument:
23 When the pump is configured as a home-health care instrument, 24 certain functions of the instrument are altered to prevent accidental control activation and to maximize t~ operational life of the battery 26 packs. The instrument operates in low-power mode. When the instrument 27 is "on," the "on/off" and "start/stop" controls must be held down for 28 one second before the instrument powers down or the infusion regimen 29 starts or stops. A general feedback signal is given by the instrument.

If the control is released in less than one second, the control 32 activation is ignored.

13190~

1l Non-Clinical Operation:
2 Because the instrument is capable of operating in a wide range of 3 environments, performing extremely ophisticated functions, it is 4 necessary to configure the operation of the instrument to the environment to which it i9 to be used. Without this configuration 6 ability the user interface would become much more complicated. In 7 addition, it is necessary to be able to test and maintain the operation 8 of the instrument.
9 Configurability and maintenance functions must be performed when the instrument is not being used to infuse fluids into a patient.
11 Therefore, these functions are not available during normal operation and 12 require special procedures in order to be acce~sed.
13 Configuration procedures are of two types: instrument 14 configuration and clinical configuration. The basis for this division is the level of security reguired for the two configuration modes.
16 Instrument configuration involves chan~in~ fairly sensitive information 17 in the instrument, and is expected to be performed only in the 18 biomedical engineering departments. ~rhe settings done in this mode are 19 not to be changed by clinical personnel. Clinical configuration mode co~ers those parameters that may be changed by a knowledgeable clinical 21 operator, based on the requirements of the patient and the environment.
22 Maintenance functions should be confined to the biomedical engineering 23 departments. To ensure that maintenance and instrument configuration 24 functions are only performed outside of the clinical environment, these functions can be accessed only by using the communications capability of 26 the instrument. The details of instrument configuration and maintenance 27 may be found in Canadian Serial No. 584,375 entitled "User 28 Interface for Multimode Infusion System", referenced above.

13191)68 1 Clinical Configuration Pages:
l ~
2¦ The clinical configuration page 1 is acces.sed by holding the 3¦ "More Options" key before releasing the "on/off" control at instrument 41 p~wer on. This page displays a time display format which includes time, 51 month, day, and year, as shown in FIG. 4. These settings may be entered 6¦ or changed by using the Select softkey to choose the particular setting 71 to be changed. Then the up or down error softkeys are used to change 81 the value of the selected settin~. Pressing the Accept softkey confirms 91 the change, while the Recall softkey returns the setting to the old 10¦ value. Each of the remaining settings on page 1 is selected and changed 11¦ in the same manner. Page 2 displays the device type. Page 3 displays 12¦ audio alarm volume. Page 4 displays the default values of the selected 13¦ device type.
1~¦ ~hen the desired settings have been established on page 1, the 15¦ clinician presses the STANDARD DISPLAY button to advance to page 2 (FIG.
16¦ 5). This involves the selection of the Clinical Device Type. The 17¦ clinician uses the Select softkey to select desired Clinical Device 18¦ Type. Pressing the Accept softXey confirms the new Device Type.
19¦ Pressing the Recall softkey returns to the old Levice Type.
20~ Depending on the institution's policy, it may not be possible to 21~ change the Clinical Device Type from the display of clinical 22¦ con~iguration page 2. If the Clinical Device Type is locked out in the 231 Instrument Configuration Mode, it is possible to review the Clinical 241 Device Typ~ but the type may not be changed through Clinical 251 Configuration.
26¦ Changing the Device Type results in all previous infusion 271 settings being cleared. Thus, after a change of Device Type, the 28¦ clinical operation mode must be entered to establish proper infusion 29¦ settings for that type of instrument.
~ol Pressing the STANDARD DISPLAY button advances the display to 31¦ clinical configuration page 3 (FIG. 6). This is the Audio Alarm Volume 321 page which permits setting the initial volume levels for the audio ¦ alarm. The up or down arrow softkeys are pressed to adjust the audio 131!~b~

1l volume to the desired level. Thereafter, the Accept softkey is pressed 2¦ to accept the new setting. Pressing RECALL returns the display to the 31 old setting.
41 Pressing the STANDARD DISPLAY button from the display of page 3 51 advances the display to clinical configuration page 4 (FIG. 7). The 61 settings which are displayed on clinical configuration page ~ can be 71 reviewed but cannot be changed by the clinician. Pressing the STANDARD
81 DISPLAY button from the page for display returns to clinical 9¦ con~iguration page 1.
10¦ To exit the Clinical Configuration Mode, the apparatus must be 11¦ turned off by pressing the ON/OFF button. When the apparatus is powered 12¦ on again, all new Clinical Configuration Settings will be in effect. If 13¦ the Device Type was changed, all previous infusion settings will have lg~ been cleared.
15 ¦ There have thus been disclosed the pertinent details of a 16 ¦ particular aspect of a medication infusion system in accordance with the 17 ¦ invention which permits the clinical user to configure the device for 18 ¦ operation as any one of a plurality of device types which are preset for 19 I operation in different infusion system environments. Providing for 20 ¦ operation of the system in this manner vastly simplifies the task of the 21 ¦ clinician in setting up a medication infusion system for a particular 22 ¦ selected use. Moreover, it improves the safety and efficiency of 23 ¦ utilization of the system by eliminating the possibility of critical 2~ ¦ parameter settings being changed or improperly used by mistake, whether 25 ¦ by the clinician or by unauthorized personnel who might have access to 26 the system. At the same time, however, the clinical configuration mode 27 of the present invention permits the clinical operator to view various 28 parameter settings for the Device Type selected so that any erroneous 29 parameter settings may be detected before the system is used. The main benefit of the present invention, however, is the assurance which is 31 provided that selection of a particular Device Type automatically 32 establishes the proper operating parameter settings for that type of device.

131906~

l ¦ A secondary but still very important benefit resulting from the 21 clinical configuration aspect of the present invention i~ the 31 substantial economies which may be realized from the elimination of the ~¦ hardware duplication of the different Device Types which are currently 51 employed, required to be stocked in inventory, maintained, etc.
61 Although there have been described above specific arrangements of 71 a clinical configuration of a medical infusion system in accordance with 81 the invention for the purpose of illustrating the manner in which the 9¦ invention may be used to advantage, it will be appreciated that the 10¦ invention is not limited thereto. Accordingly, any and all ll¦ modifications, variations or equivalent arrangements which may occur to 12¦ those skilled in the art should be considered to be within the scope of 13 the inventicn as defined in the annexed claims.

l9 ~6

Claims (9)

1. A medication infusion system comprising:
at least one infusion pump;
pump control means for controlling the operation of said pump;
means for setting selected parameter values in said control means to cause said pump to emulate a plurality of device types for infusing medication;
display means for displaying information corresponding to said parameter values and to the different device types related thereto; and means associated with the display means for determining the display thereon, said associated means including input means for selecting the particular device type to be emulated by said pump.
2. The system of claim 1 wherein said display means comprise a sequence of pages, and wherein said input means include means for selecting a particular one of said pages for viewing on said display means and means for changing information displayed on the selected page.
3. The system of claim 2 wherein the information displayed on the selected page comprises time and date information, and the input means include means for setting the time and date displayed on the selected page.
4. The system of claim 2 wherein the information displayed on the selected page comprises names of a plurality of device types, and wherein the input means include means for designating a particular device type on said page to be selected for emulation.
5. The system of claim 4 wherein the information displayed on a selected page comprises a first settable parameter for the infusion system and wherein the input means includes means for changing said settable parameter to correspond to a selected value for the particular device type which is selected for emulation.
6. The system of claim 5 wherein said settable parameter comprises an alarm volume level and said input means includes means for setting said volume level to determine initial alarm sensitivity of the system.
7. The system of claim 4 wherein the information displayed on a selected page comprises parameter values for a selected device type which the input means is incapable of changing, said input means including means for viewing the respective parameter types displayed on said page to check the correctness thereof.
8. The system of claim 4 wherein the device types which are selected for emulation comprise: General Purpose, Neonatal, Controller Pressure, Operating Room, and Home Health Care.
9. The system of claim 1 including a plurality of infusion pumps, all of said pumps being controlled to emulate the particular device type selected by said input means.
CA000584387A 1987-12-04 1988-11-29 Clinical configuration of multimode medication infusion system Expired - Lifetime CA1319068C (en)

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US07/128,966 US5041086A (en) 1987-12-04 1987-12-04 Clinical configuration of multimode medication infusion system
US128,966 1987-12-04

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EP0319268A2 (en) 1989-06-07
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US5041086A (en) 1991-08-20

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