Feeding pump
A feeding pump is an electrically operated dosing device that conveys tube feeding through a feeding tube into the gastrointestinal tract of a patient at the set speed . It is an active medical product and may therefore only be used by people who have demonstrably been instructed in its functions and operation .
indication
The use of such a pump is only indicated if enteral feeding is to be carried out continuously, for example in a patient whose feeding tube leads through the nose or the abdominal wall directly into the small intestine (nasointestinal or nasojejunal tube, percutaneous endoscopic jejunostomy ). Otherwise, tube feeding can be administered in portions via gravity systems or in boluses .
functionality
A feeding pump works on the principle of a hose pump . Tube feeding container and feeding tube are connected to one another by a special hose system that is similar to an infusion system , but with different connections. This prevents accidental connection with an intravenous access.
The transparent tube of the transfer device is attached to a drip chamber, which, depending on the product, is either inserted into the tube feeding container or screwed onto the neck of the bottle. The drip chamber is filled approximately halfway by squeezing it several times. With the mechanical roller clamp on the hose, this is opened and initially completely filled with the liquid that is to be administered. Then the flow is stopped again with the roller clamp. The integrated intermediate piece, which must be compatible with the respective pump make, is inserted into the device. The free end of the tube is connected to the feeding tube, which is closed with a clamp. The device is now switched on and the delivery rate is set. After all clamp fasteners have been opened, the program is started.
When the tube feed container is empty, the device gives an alarm, as well as if the conveyor stops, for example if the hose system is kinked.
Advantages and disadvantages
One advantage of the feeding pump is that the patient is less restricted in his mobility than with a gravity system. The pump, which has a rechargeable battery , can be carried in a special carrying bag or backpack , while the gravity system has to be above the stomach level and is therefore usually attached to an IV pole. When changing location, the IV pole must be carried or the food supply interrupted.
However, the delivery accuracy of many nutrition pumps is only about ten percent; possible alarm sizes and their tolerances are not comparable with those of infusion pumps. Particular caution is required if insulin is administered via an infusion pump at the same time as continuous tube feeding . Since the feeding of food can go unnoticed, there is a risk of metabolic imbalances and even hypoglycemic shock .
According to the Federal Institute for Drugs and Medical Devices (BfArM), there have also been incidents in the past in connection with the use of feeding pumps, in some cases life-threatening aspiration pneumonia due to uncontrolled excessive pumping or free-flowing tube feeding. Large amounts of tube feeding were fed in in a very short time because, for example, the line system was not correctly inserted into the device. The excessive conveyance was not noticed by the staff or the supervisor immediately or even only after the food container was completely emptied when the alarm occurred. The affected patients vomited from overfilling, and in some cases the fluid was aspirated . As a result, pneumonia and, indirectly, some deaths occurred.
supporting documents
- ↑ Medical devices, risk assessment, recommendations (2013) at www.bfarm.de , accessed on May 9, 2014
- ^ Dietrich Schröder: Problems caused by over- and under-funding. at www.bfarm.de , accessed on May 9, 2014