Overview
This transcript details the step-by-step setup and programming of a patient-controlled analgesia (PCA) pump, including preparation, priming, and infusion configuration.
Preparation of Equipment
- Gather primary fluids (LR) primed through primary tubing, PCA key, PCA syringe, monoject syringe, and PCA tubing.
- Attach the monoject syringe to the long end of the PCA tubing, ensuring all clamps are engaged before connecting to the PCA module.
Loading and Securing the Syringe
- Turn on the pump and unlock the PCA syringe enclosure using the PCA key.
- Insert the syringe by pulling out and repositioning the glass and plastic pieces to secure it in place.
- Adjust and close the top clamp onto the syringe and secure the enclosure.
Programming the PCA Pump
- Confirm the correct time on the pump and select the appropriate syringe type (monoject 35).
- Enter medication details: morphine, PCA under 65, ordered dose of 5 mg in 1 ml.
- Await a second RN sign-off for verification as required.
- Confirm drug amount and proceed to select infusion mode.
Priming the Tubing
- Access the options menu and select “Prime set with syringe.”
- Unclamp all tubing and hold the prime button until 2 ml are dispensed, ensuring the analgesia reaches the Y port.
- If needed, prime further until medication is visible at the appropriate location.
- Prime the remainder of the tubing using primary fluids by gravity, attaching and releasing clamps as necessary.
Final Setup and Infusion Start
- Attach and start the primary fluids infusion (e.g., 125 ml/hr with 950 ml to be infused).
- Program the PCA dose (1 mg with a 10-minute lockout, 15 mg max, 5 mg/ml concentration).
- Ensure all doors are closed, lock the enclosure, and initiate both PCA and primary fluids infusions.
Key Steps and Safety Checks
- Verify infusion settings and concentrations throughout the process.
- Ensure second nurse verification for controlled substances.
- Confirm readiness for the patient to use the PCA button, ensuring analgesia will be delivered through the primary fluids line.