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ECRI

Publications and source records attributed to ECRI.

10 recordsLinked to original sources

Patient-controlled analgesic infusion pumps.

Patient-controlled analgesic (PCA) infusion pumps allow patients to self-administer doses of pain-relieving medication as needed, rather than having to summon a caregiver. The most significant risk when using these pumps is overmedication leading to narcotic-induced respiratory depression. Several current PCA pumps offer advanced error-reduction features designed to minimize the odds of an accidental overdose: dose error reduction systems, bar-code readers, and computer-based pump-programming systems that entail downloading infusion protocols via a hardwired connection to a PC. The availability of these features plays a dominant role in our ratings. We tested 11 pumps from seven suppliers. Two pumps are rated Preferred because they offer easy-to-use advanced error-reduction features that have been proven effective in a hospital setting. Two other pumps offer computer-based programming and are rated Acceptable, although we note that not all facilities may be able to accommodate the workflow necessary to use the computer-based programming. The remaining pumps are rated Not Recommended because they lack advanced error-reduction features; although most of these pumps perform acceptably, better choices are available.

Analgesia, Patient-Controlled↗

Safety technologies for laparoscopic monopolar electrosurgery; devices for managing burn risks.

The use of monopolar electrosurgery during laparoscopy has many benefits. But it also creates the risk that high-frequency leakage currents could travel from the active electrode to patient tissue, causing burns. In some cases, these burns can be serious and even lead to life-threatening complications. In this Evaluation, we review four products designed to reduce the risk of leakage-current burns during these procedures. One of the products is an active-electrode shaft with a brightly colored inner layer of insulation, making it easier to spot insulation breaks that could allow leakage currents. Two of the products use high DC voltage to detect full-thickness breaks in electrode insulation. The other product is an active-electrode shielding system that provides protection during a procedure by conducting potentially dangerous leakage current away from the patient. We rate one product Preferred and the others Acceptable. However, we don't believe that any of these technologies are essential to safe monopolar laparoscopic electrosurgery. If these technologies are used, they should be viewed only as supplemental safety measures, not as a substitute for the general safe practices required during these procedures.

Burns, Electric↗

Higher currents, greater risks: preventing patient burns at the return-electrode site during high-current electrosurgical procedures.

Patient burns at the site of the return electrode are a well-known, and generally well-managed, risk of electrosurgery. However, the use of newer electrosurgical devices and techniques that apply higher currents to the patient for longer periods of time has created a new set of burn risks. And the safety measures that have proven effective during conventional electrosurgery can not necessarily be relied on to prevent return-electrode-site burns during these high-current, long-activation-time electrosurgical procedures. In this article, we explain the hazards and detail the factors that can increase the risks of return-electrode-site injuries for a given procedure. We also provide recommendations to help facilities and clinicians minimize those risks.

Burns, Electric↗