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Alkaline Battery vs. A/C Power for PIEB Infusion Epidural Pump
Abstract Number: F-09
Abstract Type: Original Research
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).
$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
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]