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How to titrate Propofol on the Alaris pumps

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This is the elaire’s pump and this is the one that you’re going to be seeing at bristol regional at holston valley and you’ll also be see it in the sim lab this semester and the biggest thing to kind of note on this pump is that it is bigger than the baxter pumps that we’ve been using in the sim lab but it has the basic same features this part of the pump is

Called the brain and this part of the pump are called the channels and you can have multiple channels on each side so that you can run multiple medications at different rates one thing i want to note is that this part of the pump here this channel is a pca and in the hospital you’re only going to see this pca connected if the patient is being prescribed a pca

So for your sim lab specifically you’re not going to have to load the pump for the propofol drip it’s already going to be set and going for you the only thing you’re going to be responsible for is assessing your patient and determining if they do need a titration on their propofol drip but just for the your knowledge i’m going to go ahead and show you how to load

This pump so the alaris pump does have special tubing and in the center of the tubing there’s the stretchy part of the tubing and that goes in the channel that’s the part that you’re going to load up the little blue part is going to go at the top of the channel and then the little slide the little clamp is going to go at the bottom of the channel once i’ve got

It loaded in and i have already had primed it and everything prior to that i’m going to go ahead and program it now for this pump anytime that you want to program it you do have to hit channel select on the channel that you want to work with otherwise the brain doesn’t know which channel you’re wanting to program so channel select is this little button right

Here right below the letter so this is a this is b if you had more on it would be a b c d so i’m going to hit channel select and the screen that’s going to pop up here is asking you do you want to program a drug do you want to program an iv fluid or just a basic infusion and we want to do a drug and then they’re listed in alphabetical order so you can go over here

We’re going to the p’s let’s let the p up here and if you’re not seeing it right here on your first page there’s a button down at the bottom that says page down so you can page down until you find profile so i’ll select propofol with using a little arrow beside of it and it’s going to ask me what’s the concentration of this propofol and here in the sim lab we’re

Always going to use a thousand milligrams to 100 milliliters and it’s asking me if that’s correct i’m going to say yes and then the clinical advisory for this medication is just reminding you that this medication needs to be used for mechanically ventilated patients only and the tubing must be changed every 12 hours so i’m just going to come back one of the things

About this medication is it is based on the patient’s weight so before your simulation it might be a good idea to go ahead and calculate your patient’s weight in kilograms just go ahead and do that conversion because that’ll save you some time in the actual sim i’m just going to make up a kilograms here i’m going to say this person is 75 kilograms i’m going to

Hit next now something that’s different with this than what you’ve been doing with like lactated ringers and ampicillin is for propofol you’re going to program in the dose the micrograms per kilogram per minute you’re not going to do the rate which is a milliliters per hour so dose i’m going to check on that and then i’m going to look over my physician order and

See what did he want me to start this propofol infusion on and my order says i can start it at 5 micrograms per kilogram per minute put in five and then the volume to be infused um this is a hundred milliliters up here so i’m going to go ahead and just put in 100 milliliters and if you make any mistakes like that just clear it out five for micrograms and then

Volume to be infused you do have to click on it and click in 100. and then i’m going to look at it real briefly and make sure that i’ve got it correctly there i do i’m going to hit start and before i walk away there’s a couple of things that i’ve got to check on this pump to make sure that it is infusing so one of those things is this little light over here and

Green tells me that it’s good to go you’re running it’s going through orange tells me something’s wrong and then red of course says it’s not infusing it’s completely stopped and the message that it’s given us is that it’s occluded to the patient so i’m going to look at my lines and make sure that my roller clamp is unclamped make sure that the clamp that’s attached

To the patient is unclamped and once i’ve checked to see what’s going on i can hit restart and that one i intentionally had the roller clamp on just so that i could show you so now we’ve got the green light so green means go that means it is infusing but there’s one more thing that you need to check you need to ensure that this pump is running exactly the way that

You want it to run before you walk away and the way you’re going to verify that is by looking at this little screen here it says 5 micrograms per kilogram per minute you can also look over on the brain and it’ll kind of flash back and forth so that’s going to tell you that your infusion is running how you want it to run now i told you that when you come in here

For your simulation all this is going to be set up for you when you come in so your responsibility is going to be to determine if your patient needs more of this medication so make sure that when you’re at home you’re doing your pre-reading you’re going over propofol you’re looking at why we give propofol you’re looking at indications you’re looking at the side

Effects and that’ll give you a better understanding for when you come in to assess your patient to determine do they need more or are we good at what we’re look at right now so i’m going to say that based on my assessment my patient has given me signs that they do need to be titrated on their propofol so i’m going to check my physician orders and it says that

It’s okay for me to go ahead and titrate that up by fobs as needed until i get my patient sedated so the way that i’m going to do that is remember anytime you want to work with this pump and these channels you need to select which channel you want to work with so i’m going to hit this channel select button and that brings us back to our screen and we are working

With doses when we’re talking about propofol so i’m gonna hit the dose button and we can go by five so i’m going to put it on 10 micrograms per kilogram per minute and i’m gonna hit start and before i walk away from my pump i’m looking for that green light that’s telling us that we’re good to go and then i’m also verifying on the little screen that scrolls by here

That it’s set on 10 micrograms per kilogram per minute and it is so that’s going to be the large part of your responsibility with these pumps um if you want to come in and practice you’re more than welcome to just give us a heads up so i know that you’re coming and that’s pretty much all you’re going to need to know about them if you have any questions feel free to reach out to us

Transcribed from video
How to titrate Propofol on the Alaris pumps By Bethaney Hilt