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///2017 Abstract Details
2017 Abstract Details2019-08-02T15:54:53-05:00

Alkaline Battery vs. A/C Power for PIEB Infusion Epidural Pump

Abstract Number: F-09
Abstract Type: Original Research

Emily Dinges MD1 ; Jake Heier MD2; Carlos Delgado MD3; Laurent Bollag MD4

Background:

Alkaline battery powered epidural PIEB (programmed intermittent epidural bolus) pumps are common among the major training institutions in the country for obstetric anesthesia, and drain batteries much faster than non-PIEB pumps (88 hours vs 113 hours)1. The batteries represent a recurrent consumable product use that conveys little benefit to the patient, and could cause harm given the low battery alarm starts at 25% capacity. This could disrupt the labor experience and be a concern for the patient and family that something is going wrong. Additionally many partially-used batteries are disposed of, something that runs counter to our institution’s commitment to environmental sustainability and the Greening the OR initiatives2,3. The use of alkaline batteries in the CADD®-Solis pump is likely very common since it is sold without an A/C adapter4. This makes sense for pumps used as PCAs and PCEAs for mobile non-laboring patients, but laboring patients with epidural catheters are generally non-ambulatory. In addition to the logistical and environmental considerations3, medicine is increasingly moving toward cost savings given declining reimbursements, making efficiency ever more important.

Methods: Our cost analysis took into account the major factors involved including alkaline battery acquisition cost ($0.64 per pack of 4 AA batteries with a CADD®-Solis PIEB pump requiring one pack), and cost of A/C adaptor per room ($145).

Results:

$0.64 per pack x 484 packs used per year = $310 yearly acquisition cost of batteries

$145 per A/C adaptor x 9 L&D rooms = $1305 one-time acquisition cost of adaptors

$1305 ÷ $310 = 4.2 years to recover initial investment cost

Discussion:

A/C power adapters for the CADD®-Solis pump while having a large initial cost, proved effective in decreasing variable costs and staff time in a high-risk low volume academic center providing approximately 1400 labor analgesics per year. The disposal of nearly 2000 AA batteries per year is prevented. An added and unquantifiable benefit of A/C power was the removal of the frequent stress-inducing low-battery alarm. The benefits and time to recoup the initial investment cost would be even faster in an L&D unit with higher bed utilization.

1: CADD®-Solis Ambulatory Infusion Pump Technical Manual. https://www.infusystem.com/images/manuals/CADD Solis VIP.pdf"images/manuals/CADD%20Solis%20VIP.pdf [accessed 2/2/17]

2: Greening the operating room. https://practicegreenhealth.org/initiatives/greening-operating-room [accessed 2/2/17]

3: American Society of Anesthesiologists. Greening the Operating Room and Perioperative Arena, Environmental Sustainability for Anesthesia Practice. Consensus Statement of the Task Force on Environmental Sustainability. January 2017.

4: CADD-Solis Ambulatory Infusion Pump. https://www.smiths-medical.com/products/infusion/ambulatory-infusion/ambulatory-infusion-pumps/caddsolis-ambulatory-infusion-pump [accessed 2/2/17]

SOAP 2017