SPRINGFUSOR® DATA SHEET
See also: Pain Mangement; Pumps
Contents of this sheet:
The springfusor is a spring driven syringe pump. It consists of a re-useable spring unit available in 2 volumes - 10mL and 30mL. Infusion rates are controlled by the Flow Control Tubing. Extension tubing can also be connected directly to the Flow Control Tubing ( FCT ) and the FCT to the cannula. Flow Control Tubing is available in a range of different flow rates.
The Springfusor is suitable for intermittent or continuous parenteral infusion of small volumes. It can be used for ambulatory or immobile inpatients and patients at home.
Not recommended for use where operating parameters better than those specified for the device are necessary (eg: accurate infusion of a toxic drug). Not where the low flow rate could have serious clinical consequences (because of the potential risk of tubing occlusion from particulates). Nor is it recommended where frequent flow rate adjustment is necessary (eg: dose titration).
Flow is continuous and non-pulsatile. Flow rate decreased during infusion (as the spring is released) as illustrated for the Springfusor 10 in the figure below.
Deviation from Mean Flow rate %
Syringe Volume
Nominal flow rate is calibrated for intravenous infusion of normal saline (unless otherwise stated) at 25 C to a supine patient. Accuracy of the device is within +/- 20% using the recommended Braun syringes.
Drug, drug concentration and diluent affect flow rate. For example the flow rate of concentrated solutions of antibiotics (2g/10ml) is approximately double that of saline. Refer "Viscosity Correction Factor" table for more detail.
External factors which could affect infusion rate accuracy include:
 | Temperature Each 1 C (1.8 F) above or below 25 C (77 F) increases or decreases flow rate, respectively, by approximately 2.5%. |
| Height of the Springfusor in relation to the injection site. For every 30 cm elevation difference, flow rate varies by approximately +/- 2.4%. |
| Venous and arterial back pressure. Nominal flow rate assumes a venous back pressure of 5 mmHg. Flow rate will be reduced approximately 2.2% for every 20 mmHg increase in blood pressure at the site of injection. |
Pressure generated by the Springfusor 10 during use is nominally 914 mmHg.
Flow control tubing is non-kink. Purge volume is approximately 0.2mL.
The Springfusor can be strapped or bandaged to the arm, over the spring unit, not the syringe. Alternatively ,extension tubing can be added, and the Springfusor placed in a bag hung around the neck, put in a pocket or in pouch and pinned to the clothes.
READ INSTRUCTIONS THOROUGHLY PRIOR TO USE
The Springfusor must NEVER be used without Go Medical Flow Control Tubing. Should be used with specified syringe brand - Braun..
Do not disconnect Flow Control Tubing from the syringe while it is still in the Springfusor as contents of the syringe will be expelled.
For accurate flow rate :
- Use only specified syringe brands. Do not fill beyond nominal capacity.
- Select correct Flow Control Tubing for infusion rate required.
- Do not infuse solutions containing particulates. Prefilter solutions containing particulates with a 5 micron filter prior to loading into Springfusor.
- Ensure temperature of infuscate approximately 25 C (refer accuracy above).
- Position syringe nozzle height within 30cm of injection site height (refer accuracy above).
- Protect Springfusor from extremes of temperature and environmental conditions, direct sunlight, moisture and solvents during storage and use.
Exterior of Springfusor can be wiped with detergent and/or disinfectant. Do not clean interior, if contaminated discard. Do not use solvents or immerse in any liquid. Do not attempt to disassemble.
| Weight (g) | Length (mm) | |
| Springfusor 10 | 86 | 161 |
| Springfusor 30 Short | 133 | 245 |
| Springfusor 30 Long | 226 | 288 |
REDUCED INFUSION TIME |
ACTION |
| 1. Temperature of infusate too high. | Maintain temperature at approximately 25 C (refer accuracy above). |
| 2. Wrong Flow Control Tubing selected. | Change tubing. |
| 3. Incorrect viscosity correction factor, ie: incorrect drug concentration. |
Change tubing or re-dispense dose in different volume. |
| 4. Syringe not filled to nominal volume. | Allow for priming of extension tubing. |
| 5. Springfusor too high. | Relocate so that syringe nozzle height within +/- 30cm of injection site height. |
PROLONGED INFUSION TIME |
ACTION |
| 1. Temperature of infusate too low. | Maintain temperature at approximately 25 C (refer accuracy above). |
| 2. Wrong Flow Control Tubing selected. | Change tubing. |
| 3. Incorrect viscosity correction factor, ie: incorrect drug concentration. |
Change tubing or re-dispense dose in different volume. |
| 4. Flow Control Tubing blocked. | Change tubing and if due to particulate contamination filter infusion solution. |
| 5. Wrong syringe brand. | Use only recommended syringe brands. |
| 6. Springfusor too low. | Relocate so that syringe nozzle height within +/- 30 cm of injection site height. |
APPLICATIONS FOR THE SPRINGFUSOR SYRINGE PUMP
The Springfusor can be used to replace bolus injections, minibags and burettes, or in certain situations gravity lines and electronic pumps.
It is suitable for continuous or intermittent therapy and is ideal when fluid restriction or slow controlled infusion is required. The following are some potential applications for the Springfusor.
| Antibiotics |
| Anticoagulants |
| Analgesics |
| Parenteral anaesthetics |
| Cytotoxics |
| Anti-emetics |
| Muscle relaxants |
| Others such as Ranitidine, Phenytoin, Digoxin, Desferrioxamine |
| Intravenous eg. access maintenance instead of gravity infusion. |
| Subcutaneous eg. opioids. |
| Where a lot of antibiotics are given : orthopaedic respiratory and general wards |
| Renal, paediatric and neonatal units where low volumes are required |
| Theatres |
| Intensive care units |
| Oncology |
| Emergency departments due to ease of set up |
| Inter and intra hospital transfers |
| Patient retrievals |
| Outpatients |
| Home environment for patient mobility and ease of use |
WHY?
The Springfusor offers a solution to the problems of manual injection over 3-5 minutes:
| Once primed and activated it does not require a doctor or nurse for the duration of the injection. |
| Infusion time controlled to a minimum of 5 minutes where as manual injections are often given faster, because of time pressures. Rate of infusion is related to pain and phlebitis. |
| Flow Control Tubing is less expensive than minibags and about the same price as burettes, but require less time to operate and monitor. |
HOW?
| The Flow Control Tubing can be left connected to the cannula or infusion set for the recommended set change time (commonly 72 hours). Simply cap the end of the tubing. When a dose is to be given, remove the cap and store safely, connect the Springfusor . |
| There is no need to flush after administration, unless incompatible drugs are to be given, because the volume remaining in the tubing is only 0.2ml (2% of 10ml dose). |
| If access is required for other fluids or drugs then a V-Set or 3 way tap can be connected between the Flow Control Tubing and cannula. The Flow Control Tubing can be left attached to one of the ports leaving one (or more in the case of V-Sets ) port available for an infusion set or bolus injections. |
WHY?
| Phenytoin should be given undiluted at a rate not greater than 50mg/min . |
| If given manually, a 300mg dose requires at least 6 minutes of someone’s time. If a Springfusor is used this time can be used more productively. |
| If diluted in a mining or burette it must be diluted in specific vehicles and concentrations and given promptly, to prevent precipitation . |
- Refer to Phenytoin packed insert.
- Australian Journal of Hospital Pharmacy 1988 ; 18:322-6
HOW?
| Draw up required dose, undiluted and infuse through 10ml/5min Flow Control Tubing . |
| Since the viscosity of Dilantinâ is 6.4 times that of saline, 10ml of Dilantinâ will be infused over approximately 32 minutes with 5 min Flow Control Tubingâ 300mg (6ml) will be infused over approximately 19 minutes. Since the concentration of undiluted Dilantinâ premix is 50mg/ml, the infusion rate will be acceptable 50mg/3min. |
| If flushed afterwards the 5 minute Flow Control Tubingâ can be used for antibiotics, it required. |
WHY?
| All have cardiovascular toxicity related to related injection, so infusion rate should be slow. |
| If given by a burette then there are concerns about labelling the burette and the potential for inadvertent drug mixing in the burette. |
| Minibags are time consuming, high waste factors and cost more. |
| Continuous infusion of Cimetidine and Ranitidine, rather intermittent doses, may be indicated in patients at high risk of GI bleeding* . |
*Ballesteros MA, Hogan DI, Koss MA, Isenburg JI, Bolus or intravenous infusion of ranitidine: effects on gastric acid secretion; a comparison of relative efficiency and cost. Ann Int Med 1990; 112(5): 334.9.
HOW?
| Draw up required dose and dilute to 10ml with saline. |
| Select required Flow Control Tubing® - 5, 15 and 30 minute are the most appropriate. For continuos cimetidine and ranitidine, 8 hour tubing can be used and the syringe refilled every 8 hours. |
| If digitalising with higher doses of digoxin, then the viscosity will increase infusion time (eg 1000 mcg/10ml will take twice the labelled time). |
Opioid analgesics, anti-coagulants, anti-emetics.
WHY?
| Many drugs, particularly for certain indications, do not require the accuracy and expense of electronic pumps. |
| If Springfusors are used for those drugs which do not require the accuracy of electronic pumps, then the electronic pumps can be freed up for other specific uses. |
| Springfusor® is light and compact allowing the patient mobility. |
HOW?
| Connect 8, 12 or 24 hour Flow Control Tubing® to cannula. If access is required for other fluids and drugs the a V-Set® or 3 way tap can be connected between the Flow Control Tubing® and the cannula. |
| Connect refill port (with one way valve and extension set ) and Springfusor® to Flow Control Tubing®. |
| Provide continuous infusion by refilling every 8, 12 or 24 hours through refill port: |
| When infusion time is nearly up, connect a pre-filled syringe to the one way valve and refill Springfusor® reservoir syringe. Remove re-fill syringe. |
WHY?
| For convenience, because it saves having to give frequent small boluses. Instead, a constant back ground infusion is provided which can be supplemented with boluses, as indicated from monitoring. |
HOW?
| Choose the appropriate Flow Control Tubing® to cover the anticipated duration of the operation (1, 2, 4 and 8 hour tubing available). Calculate the appropriate dilution to give the anticipated required rate. |
| If calculated dilution gives too high dose disconnect syringe, remove some of the syringe contents and dilute. If dilution too weak then increase the drug concentration. |
| Boluses can be given when required if a V-Set® or 3 way tap is connected between the cannula and Flow Control Tubing®. |
1. Eagle CCP, Capes DF, use of a new syringe pump (Springfusor®) for muscle relaxant infusion. Anaesthe Intense Care 1993; 21:444-6.
WHY?
| Electronic pumps for desferrioxamine infusion are expensive, bulky and have the disadvantages associated with a power source. |
| The Springfusor provides a low cost, east to use alternative. |
HOW?
| Dilute desferrioxamine to the desired concentration. Select appropriate Flow Control Tubing. |
FOR EXAMPLE
| Four hour Flow Control Tubing with 2g/10ml desferrioxamine (viscosity correction factor
of 2.6) will give a 10.5 hour infusion. Connect syringe and Flow Control Tubing to extension set/needle and attach Springfusor to start infusion. |
SPRINGFUSOR VISCOSITY CORRECTION FACTORS
DRUG SOLUTION VISCOSITY
The infusion time of Flow Control Tubing has been calibrated with normal saline, unless otherwise labelled. However, drug solution viscosity affects the accuracy of the infusion time achieved. Viscosity is dependent upon the drug, concentration, diluent and temperature. The viscosity correction factor is the drug solution viscosity relative to normal saline, which can be measured according to the method of the European pharmacopoeia. The effect of temperature is discussed in the Springfusor Date Sheet".
WHAT IS THE PURPOSE OF THE TABLE?
| The table below provides a viscosity correction factor for drug solutions commonly used with Springfusor®. |
HOW TO USE THE TABLE
| Simply find the drug, concentration and diluent you want to use and read off the viscosity correction factor. Then, multiply the saline infusion time labelled on the Flow Control Tubing, by the viscosity correction factor, to give the infusion time with the drug solution. If necessary, correction should also be made for temperature. |
EXAMPLES
VISCOSITY CORRECTION
| Amoxycillin 1g/10ml of water for injection via 10ml/15min Flow Control Tubing. |
| From table, viscosity correction factor for Amoxycillin 1g/10ml WFI = 1.6. |
| Expected infusion time: 15 minutes x 1.6 = 24 minutes. |
VISOCSITY CORRECTION FACTOR TABLE
DRUG |
CONCENTRATION |
DILUENT |
CORRECTION FACTOR |
Aminophylline (DBL) |
250mg/10ml |
U |
1.1 |
Amoxycillin (Amoxil®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
3.0 1.6 1.2 |
Ampicillin (Austrapen®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.2 1.4 1.2 |
Atracurium (Tracrium®) |
50mg/5ml |
U |
.1 |
Benzylpenicillin (CSL) |
2.4g/10 1.2/10ml 600mg/10ml |
WFI WFI WFI |
3.0 1.5 1.2 |
Cefotaxime (Claforan®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.1 1.4 1.2 |
Ceftazidime (Fortum®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.3 1.4 1.2 |
Ceftriaxone (Rocephin®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.1 1.4 1.2 |
Cephalothin (Keflin®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.0 1.3 1.1 |
DRUG |
CONCENTRATION |
DILUENT |
CORRECTION FACTOR |
Cephamandole (Mandol®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.3 1.4 1.2 |
Cephazolin (Kefzol®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
1.9 1.3 1.1 |
Clindamycin (Dalacin C®) |
1500mg/10ml 1200mg/10ml 600mg/10ml |
U WFI WFI |
2.3 1.9 1.3 |
Cloxacillin (Austrastaph®) |
1g/10ml |
WFI |
1.4 |
Colistin (Coly-Mycin® M Parenteral) |
450mg/10ml 300mg/10ml 150mg/10ml |
NS NS NS |
1.5 1.3 1.1 |
Desferrioxime (Desferal®) |
2.5g/10ml 2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI WFI |
3.3 2.5 1.5 1.2 |
Digoxin (Lanoxin®) |
2,500mcg/10ml 500mcg/10ml 250mcg/10ml |
U WFI WFI |
5.3 1.4 1.2 |
Flucloxacillin (Flopen®) |
2g/10ml 1g/10ml 500mg/10ml |
WFI WFI WFI |
2.4 1.4 1.2 |
Gentamicin (DBL) |
160mg/10ml 80mg/10ml |
NS WFI |
1.1 1.0 |
Glucose |
5% |
-` |
1.1 |
Heparin (DBL) |
25,000U/5ml |
U |
2.0 |
DRUG |
CONCENTRATION |
DILUENT |
CORRECTION FACTOR |
Midazolam (Hypnovel®) |
5mg/ml |
U |
1.0 |
Phenytoin (Dilantin® 250mg IV) |
500mg/10ml |
U |
6.4 |
Piperacillin (Pipril®) |
2g/10ml 1g/10ml |
WFI WFI |
2.4 1.4 |
Propofol (Diprivan®) |
100mg/10ml 50mg/10ml 25mg/10ml |
U G G |
1.6 1.4 1.2 |
Ranitidine (Zantac®) |
50mg/10ml |
U |
1.1 |
Sodium Chloride |
0.9% |
- |
1.0 |
Ticarcillin (Tarcil®) |
3g/10ml 1.g/10ml 500mg/10ml |
WFI WFI WFI |
4.2 1.5 1.2 |
Vancomycin (DBL) |
1g/10ml 500mg/10ml |
WFI WFI |
1.5 1.2 |
Vecuronium (Norcuron®) |
20mg/10ml |
solvent plus NS |
1.0
|
FOOTNOTES: |
|||
WFI - Water for injection NS - Normal Saline U - Undiluted G - 5% Glucose |
|||
| Diluents specified in this table are those used for measurement of the Viscosity Correction Factor and are intended for guidance in calculating expected infusion time, but are not to be taken as the recommended diluent. Refer drug labelling for recommended diluent. |
