Clinical assessment and diagnostic tool for use with peristaltic pump
Contents
1. 0026 FIG 10 is a graph illustrating line pressure for a pump over a given period of time 0027 FIG 11 is an excerpt of a history file used to generate the graph shown in FIG 10 0028 FIG 12 is a graph illustrating bolus requested vs bolus received over a given period of time and 0029 FIG 13 is an excerpt of a history file used to generate the graph shown in FIG 12 DETAILED DESCRIPTION OF THE INVENTION 0030 Referring now to the drawings wherein the show ings are for purposes of illustrating preferred embodiments of the present invention only and not for purposes of limiting the same FIGS 1A and 1B illustrate a peristaltic pump in communication with a computer capable of pro gramming the pump The particular pump shown in the Figures is marketed by Curlin Medical of Huntington Beach Calif and is described in U S Letters Pat No 6 164 921 the disclosure of which is expressly incorporated Apr 1 2004 herein by reference However use of other ambulatory pumps is contemplated herein Pumps such as the one shown in FIGS 1A and 1B are typically stand alone devices used to administer medication to a patient The pump 10 shown in FIGS 1A and 1B can be used as a stand alone pump Additionally the pump shown in FIGS 1A and 1B can communicate with a computer such as a laptop computer 20 shown in FIG 1A or a handheld computer such as a personal digital assistant PDA 30 shown in FIG 1B 00312. Apr 1 2004 can be automatically generated For example the exemplary screen display 100 shown in FIG 2 may include a control not shown for generating reports Such a report could be printed or displayed In exemplary embodiments the reports are in a format that can be viewed using external off the shelf programs such as Microsoft amp Excel amp 0057 One example clinical assessment and diagnostic that can be performed is the monitoring and analysis of patient side administration set line pressure For example a pump such as the Curlin Medical 4000 pump manufac tured by Curlin Technology of Huntington Beach Calif may be capable of monitoring patient side administration set line pressure The monitored line pressure may be stored in a history file The line pressure information can be retrieved from the history file and used to perform trend analysis 0058 Various catheters may be used with the pump For example the catheter may be a peripherally inserted central line catheter inserted up through the patient S arm or a subcutaneous port catheter used with a Huber needle The pump infuses medication into the patient via the catheter 0059 The internal pressure in millimeters of mercury mmHg is the infusion pressure leaving the pump and going into the patient In exemplary embodiments line pressure is continuously taken and is recorded every twenty minutes in the history file An exemplary history file is in
3. 0 5 nl 19 OFF 0 0 ng YES NO Fig 8 Patent Application Publication Apr 1 2004 Sheet 9 of 13 US 2004 0064435 A1 dos ln wiodirali MS Seleer ingle INeeopy Madr 250 Cunt cuu 15 LuteruillsuL Vanrenls This UG de puls tle pom uy u 274 SINGL TEZPAPY ICI 2 ugruumud by Cuzll2n Medical Cus Medical 03 22 2002 23 05 12 2002 Curio ledival 03 22 2002 03 12 2002 12197 a klitsonel posjgrem sent tc this pwup will RINCVI this weds i i 1 i i Freceut una al A neu program sent ill re enable all to the pump via the MN proqram ather modes new program sent to the pump via the CMS program will ro onabla all other modes Sed Re In 2 m US 2004 0064435 A1 Apr 1 2004 Sheet 10 of 13 Patent Application Publication OL 64 oul 9 ejeq 00 0 2002 21 20 00 0Z00Z 11 Z0 00 0 Z003 01 Z0 00 0 Z00z 6 Z0 00 0 ZOOZ 8O ZO 00 0Z00Z 40 Z0 O0 0z002 90 20 00 0 ZOOZ SO ZO 0 do i SE plis ei A RS it A O ERN lalo Mb eli lt E 3 o o 0 c TENE OL 3 psp e p H vi a CERE E 91 fate cane ODORE SERERE donee RS UE A SG Pa MRO SH R y apatites E gi eui 1 eeyeq SA JYNSSIYd INIT Patent Application Publication 19 42 19 42 19 42 19 27 19 27 19 27 19 27 19 27 19 27 19 27 19 27 06FEBO2 O6FEBO2 O6F
4. In addition to a keyboard the computing device 20 preferably includes a pointing device such as a mouse 0033 The pump shown in FIGS 1A and 1B like prior art pumps includes logic software for managing the pump 0034 In exemplary embodiments of the present inven tion the computer 20 stores a drug library and a patient library The drug library stores protocols classified by drug name programmer name person who stored the protocol and creation date A prescription or protocol can be selected from those stored in the drug library The prescription can then be sent to the pump attached to the computer The protocol is then uploaded to the pump 0035 FIG 2 illustrates an example screen display show ing the major functions of one embodiment of the present invention Preferably upon starting the program the user is asked to enter a password Details in setting up passwords and entering and validating password is not explained in further detail herein as techniques known in the art can be used for security aspects of the present invention including a user login function 0036 The exemplary screen display 100 shown in FIG 2 includes controls to access the major functions of the present invention In the illustrated example graphical depictions of the function are selected to invoke the various functions It will be appreciated that other user interface US 2004 0064435 A1 controls such as menus could be used to access
5. The exported protocol information may be imported to the patient library The protocol information in the patient library may be edited 0012 The protocol information for the drug may include associated warnings and precautions 0013 The remote storage device is a personal computer such as a laptop computer The remote storage device may be a handheld storage device such as a Personal Digital Assistant PDA 0014 A current date time and or maintenance date may be entered 0015 Pump calibration functions may be invoked 0016 Another aspect of the present invention may be regarded as a method for receiving history information from a peristaltic pump A user request is received requesting retrieval of history information from the peristaltic pump A pump request is formatted to retrieve history information The pump request to receive history information is trans mitted to the peristaltic pump The history information is received from the peristaltic pump The history information is displayed US 2004 0064435 A1 0017 The history information may be all of the history information stored in the peristaltic pump The history information may be the latest prescription The history information may be a predefined amount of history infor mation e g four kilobytes The history information may be printed or exported for e mail to others 0018 Another aspect of the present invention is clinical assessment and diagnostic
6. The present invention helps reduce the risk of prescription programming errors and thus medication errors reduces staff costs by providing time efficient pro gramming of the pump facilitates remote monitoring of the infusion process provides an audit trail for billing valida tion and archival purposes and easily integrates into exist ing systems The data management functions allow the clinician the ability to create select and use protocols and prescriptions select and transfer personalized prescriptions to a PDA Palm device provide a Drug Precautions page for warnings indications and instructions compile data for further analysis retrieve patient history files and generate customized reports from a PC or Palm device 0032 Preferably the computing device 20 is a personal computer PC with at least a 486 Intel amp processor with a system speed of at least 90 MHz megahertz In preferred embodiments the computing device 20 uses a Windows operating system such as Windows 95 98 ME 2000 or NT The computing device 20 should have at least thirty two 32 MB megabytes of random access memory RAM and at least eight 8 MB of available storage space The com puting device 20 preferably includes a compact disc read only memory CD ROM drive Preferably the computing device 20 includes a graphics card that is capable of a pixel resolution of 800x600 or better e g super video graphics array SVGA or better
7. claimed is 1 A method for extracting data from history information received from a peristaltic pump the method comprising receiving the history information from the peristaltic pump receiving a request for information to extract from the history file and extracting the requested information from the history file 2 The method of claim 1 further comprising displaying the extracted information 3 The method of claim 1 wherein the extracted infor mation is displayed in a graphical format 4 The method of claim 1 further comprising saving the extracted information in a file 5 The method of claim 4 wherein the extracted infor mation is saved in a graphical format Apr 1 2004 6 The method of claim 4 further comprising receiving a request to delete the file and deleting the file 7 The method of claim 4 further comprising receiving a request to rename the file and renaming the file 8 The method of claim 1 further comprising printing the extracted information 9 The method of claim 8 wherein the extracted infor mation is printed in a graphical format 10 The method of claim 1 further comprising transmit ting the extracted information 11 The method of claim 10 wherein the extracted infor mation is transmitted in a graphical format 12 The method of claim 10 wherein the extracted infor mation is transmitted via e mail 13 The method of claim 1 wherein the requested infor mation is
8. example a file named Patient pdb This file is then transferred to the Palm device In exemplary embodi ments if there is an existing Patient pdb file it will be written over by the new file Thus the user must transfer all desired protocols to the Palm device as the previous protocols in an existing Patient pdb file will be overwritten 0045 If the user presses the Patient Library button 104 a patient library display 160 is displayed In exemplary embodiments such as the one shown in FIG 4 the patient library display 160 and functions invoked by controls such as buttons are similar to those for the drug library As with the drug library the user can import export or edit entries in the patient library The user can send a prescription to the pump or transfer prescriptions to the Palm device 0046 Creating a prescription allows the user to store prescription information in the drug library or the patient library This information is uploaded from the pump The user presses the Create Prescription button 106 from the main display window 100 A create prescription window 180 such as the one shown in FIG 5 is displayed The exemplary screen display shown in FIG 5 provides the user with an instruction window 182 which tells the user to 1 connect and turn on the pump 2 select library and fill in fields and 3 program the pump 0047 A cable is used to connect the pump for example Curlin Medical 4000 CMS pump 1
9. patient side administration set line pressure infor mation 14 The method of claim 1 wherein the requested infor mation is bolus request information 15 The method of claim 14 wherein the bolus request information includes volume of medication administered in response to bolus requests 16 A method for extracting bolus request data from history information received from a peristaltic pump the method comprising receiving the history information from the peristaltic pump receiving a request to extract bolus request information from the history file and extracting the requested bolus request information from the history file 17 The method of claim 16 further comprising display ing the extracted bolus request information 18 The method of claim 16 wherein the extracted bolus request information is displayed in a graphical format 19 The method of claim 16 wherein the bolus request information includes volume of medication administered in response to bolus requests 20 A method for extracting patient side administration set line pressure data from history information received from a peristaltic pump the method comprising receiving the history information from the peristaltic pump receiving a request for the patient side administration set line pressure information and extracting the requested patient side administration set line pressure information from the history file 21 The method of claim 20 furth
10. the func tions The selections available from the main menu shown in FIG 2 include Drug Library 102 Patient Library 104 Create Prescription 106 Manage History 108 Peace of Mind 110 and Single Therapy 112 Each of theses functions is briefly summarized next and described in more detail later 0037 Pressing the Drug Library button 102 invokes the drug library function which allows the user to store and access protocols Pressing the Patient Library button 102 invokes the patient library function which allows the user to store and access e g copy and export patient specific prescriptions Pressing the Create Rx button 104 invokes the create prescription function which allows the user to enter and store information in the drug library or the patient library Pressing the Manage History button 106 invokes the manage history function which allows the user to download the pump history for archiving documentation review or analysis Pressing the Peace of Mind button 108 invokes the peace of mind function which downloads a recently pro grammed therapy for documentation validation or verifica tion Pressing the Single Therapy button 110 invokes the single therapy function which converts the pump into a PCA TPN continuous intermittent or variable therapy only pump for manual programming 0038 If the user presses the Drug Library button 102 an exemplary Drug Library Display 120 such as the one shown in FIG 3 is displayed so that th
11. 0 is connected to the PC 20 by inserting the cable in the serial port of the PC The user selects the desired library 184 i e the drug library or the patient library for storing the protocol to be uploaded from the pump The user also enters a drug name 186 a patient ID 188 comments 190 and precautions 192 0048 The user then presses a Begin Programming button 194 and begins programming the pump The pump is programmed the same as during stand alone operation of the pump For example if the pump is a Curlin Medical 4000 Plus pump the pump is programmed according to the directions for that particular pump The user s manual for the Curlin Medical 4000 Plus pump is included as a compact disc appendix and is incorporated herein by refer ence 0049 Inexemplary embodiments such as the one shown in FIG 6 protocol information including keystrokes that are used when programming the pump is stored For example when a menu is displayed and the user scrolls US 2004 0064435 A1 down DOWN is stored in the protocol file Thus when the information is uploaded to the pump it is as if a user were using the keypad to enter the information directly into the pump except that the information is actually transmitted from the computer via the cable that connects the pump to the computer 0050 The computer stores history files Peace of mind files include the latest programmed prescription 0051 If the user presses the Man
12. 02 IOAPRO2 15 25 STARTPUMP 2 7 ml IOAPRO2 15 25 STOP PUMP 2 7 ml 10APR02 15 25 BOLUS REQUEST 006 10APR02 15 22 BOLUS REQUEST 005 10APR02 15 18 BOLUS REQUEST 004 IOAPRO2 15 15 BOLUS REQUEST 003 IOAPRO2 15 14 BOLUS REQUEST 002 1OAPRO2 15 13 START PUMP 2 0 ml IOAPRO2 15 13 BOLUS GIVEN 2 0 ml IOAPRO2 15 13STOPPUMP 2 0 ml IDAPRO2 15 12 BOLUS STARTED 001 10APR02 15 12 START PUMP 0 0 ml 10APR02 15 12 STOPPUMP 0 0 ml 10APR02 15 12 BOLUS REQUEST 001 IOAPRO2 15 12 m VINT PSI 0 0 3 1 0 0 IOAPRO2 15 12 STARTPUMP 0 0 ml 10APR02 15 12 START THERAPY IOAPRO2 15 12 RUN PAUSE KEY IOAPRO2 15 07 PCARUN OPTION Options LockOFF Lock OFF Cln Dose OFF Shift Tot OFF Hourly Tot OFF Clear Hrly OFF DnOcclu HIGH ArSens 2 0ml Audio 9 PWRCK OFF AcceptOPT YES NO IOAPRO2 15 07 PCARx Bag Vol 250 0ml BasalRate 4 0 ml hr Bolus 2 0 ml US 2004 0064435 A1 Fig 13 US 2004 0064435 A1 CLINICAL ASSESSMENT AND DIAGNOSTIC TOOL FOR USE WITH PERISTALTIC PUMP CROSS REFERENCE TO RELATED APPLICATIONS 0001 This application is a continuation in part of U S application Ser No 10 205 965 filed Jul 26 2002 the entire contents of which are incorporated by reference herein STATEMENT RE FEDERALLY SPONSORED RESEARCH DEVELOPMENT 0002 Not Applicable COMPACT DISK APPENDIX 0003 The specification of the present application includes a compact disc appendix which is submitted here with and incorporated by reference
13. 20M 102089 LL 0S 2CCL ACCS AX 100822 1102 2001 11 22 AX 101306 LL 02 20C L 11 51 AX Low Bate ALexz 1C c 2 11702 2061 t ed prie TARA Te Hams n V end icing 11 11 31 13 11711721 1 11711221 2 1173721 2 1173721 11 3721 gt 1177721 11 5 31 2 1173721 12 1173721 11 11 3 31 11 11 3 31 11 pw Hair ndo 57 Apr 1 2004 Sheet 7 of 13 220 US 2004 0064435 A1 EM OSMO70_ IMUNI ra en n Pil JUSUUVU_ 5 a Yu 0 TOURY LUR Rey ul Dale OSBOTO_ SENCAL UUDBER MAHIKA TIKI DATUTEDANCE DOE Dat Da U ESTORT ETEU LOG hin SVOM IV OsMOTOL 15 52 u_SYIGT PSI 25 32 n 7v 07 P57 YS na ul TOPS n U P5 AG fe D Vs Win von vv u 7 07 3 ST Iso HA n DAS Ron WP ul IOT PSS o Pat nen u PLOT PSE u gal y god de 29 START POUP 1 22 RAUL VALISE 20 20 B UU PAUSC ELT 20 23 370 POP 20 28 ALARM KEY PU SrA 1101406 f HALE 063EPO2 DM 62 9 2 6 0 169 2 6 0 3 66 972 670 0 66 n 2 196 7 02 TA 230 aired 6 0 0 O fM a YANN 6 0 0 20 2 2 BANU 64 2 Patent Application Publication Apr 1 2004 Sheet 8 of 13 US 2004 0064435 A1 240 Options Lock Shift Tot Hourly Tot Clear Hrly Dn Occlu Air Sens Audio PUR CK Clin Dose Accept 28N0V01 14 25 PCA Rx Lock 2 2o OFF 0FF 0FF LOU
14. 31 Soderquist et al and U S Pat No 3 172 367 Kling or curvilinear such as is described in U S Pat No 6 164 921 Moubayed et al 0006 The pump is normally programmed by a clinician based on a specific patient prescription The pump is tradi tionally programmed through a user interface keypad on the pump 0007 There have been some efforts in the past to estab lish capabilities of remotely programming the pump through a modem and transferring data through telephone lines For example Mediview which is currently owned by Baxter provides remote programming capabilities of the Homerun 6060 pump through a modem and telephone line It allows the clinician to view at a remote location the 6060 pump simulated on a computer monitor with its display and keypad The clinician can view the display of the remote pump on a computer monitor and can interact with the pump Apr 1 2004 using a mouse and keyboard Remote programming sys tems such as those described above may be difficult to program and do not reduce infusion errors 0008 Thus there is a need for a system and method for programming a peristaltic pump which reduces prescription programming errors and subsequently infusion errors The system should also be easy to program ie should not require significant training by the clinician Preferably the system and method also provide for clinical assessment and diagnosis of the pump as it is being used for a particul
15. Comments and Drug Precautions windows Patent Application Publication Apr 1 2004 Sheet 5 of 13 US 2004 0064435 A1 180 Curlin Medical CMS Create Presciption 1 Connect and tum on pump Cancel i 2 Select Library and fill in fields 182 3 Press BEGIN PROGRAMMING Click here to store in designated Libra Select Library Patient Library AD rug Library Paa ii Enter Drug Name Here Alphanumeric 186 Patient ID Enter Patient Name Here Alphanumeric 188 Comments Enter Therapy Information Here Mode Amount To Be Infused Rate Enter Drug Precautions Here These Precautions Will Appear in the Precaution Window Before the Program Is Uploaded Into the 4000 CMS Pump E BEGIN PROGRAMMING Fig 5 Precautions Patent Application Publication Apr 1 2004 Sheet 6 of 13 200 ENDURE the Yes Enter Fig 6 US 2004 0064435 A1 Patent Application Publication 222 224 Cuba Medes LMS Maray Palena Histuiy Te Prion divny Fi Fron 2 ims Der exe Ta en Liao Xx Ret cv thor Czer Paic Helon Es dio des ate Name 226 resp nis 4 Poll 100205 LL L1 2CCl 1C 100203 LL LL 20Cl 1 100203 2 Puyu Kiza 11 11 2001 LOLI0G 7 Days LLI CE ZCCLl 5 51 M 101303 DIT LL O zCCl C LOL336 TIN LL CE CCI C LULIZU HCI LL U zLl LI HAT Wn Urn PEEL EE d san qu LOLAOG 1140342001 C 1C 100022 LL 02720 1 C 17 FK
16. EBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 O6FEBO2 19 27 06FEBO2 19 27 06FEBO2 19 27 06FEBO2 19 16 Apr 1 2004 Sheet 11 of 13 STOP THERAPY REPEAT Rx ON PUMP OFF PUMP STOP PUMP ALARM ml VINT PSI START PUMP START THERAPY RUN PAUSE KEY US 2004 0064435 A1 0 0 ml 0 0 ml REPLACE SET4 0 0 2 6 17 6 0 0 ml TPN RUN OPTION Options Lock Hourly Tot Clear Hrly DN Ramp Dn Occlu Air Sens Audio PWR CK Accept TPN RX Bag Vol Vol TBI Rate UP Ramp DN Ramp Tot Time KVO Rate Done TPN PRE Rx Delay Next REPEAT Rx EXIT PRIME Fig 11 Lock 2 2 OFF OFF OFF HIGH 2 0 ml 5 SOBRE YES NO 2070 ml 2050 ml 136 7 ml hr 1 00 HH MM 1 00 HH MM 16 00 HH MM 0 1 ml hr YES OFF YES 0 0 ml ZL Ol US 2004 0064435 A1 Apr 1 2004 Sheet 12 of 13 Patent Application Publication jsanbay sniog UaAID snjog u Tea19ju sajnuiy OL zo1d oL eun 6 8 AA QU RIS L c diu rmm i TI ol ig e N wo N a m wu e y SP Ja nua iiam 06 paaladay snjog SA pajsaNbay snjog AdeJay jeainpidaz sjsanbay jo Jaquiny Patent Application Publication Apr 1 2004 Sheet 13 of 13 IOAPRO2 15 26 STARTPUMP 47ml IOAPRO2 15 26 BOLUS GIVEN 2 0 ml IOAPRO2 15 26 STOP PUMP 4 7 ml 10APR02 15 25 BOLUS REQUEST 007 IOAPRO2 15 25 BOLUS STARTED 0
17. US 20040064435A1 a2 Patent Application Publication co Pub No US 2004 0064435 A1 as United States Moubayed et al 43 Pub Date Apr 1 2004 54 CLINICAL ASSESSMENT AND DIAGNOSTIC TOOL FOR USE WITH PERISTALTIC PUMP 76 Inventors Ahmad Maher Moubayed Mission Viejo CA US David Norman White San Juan Capistrano CA US Linda Thomas Laguna Niguel CA US Chuck Grey Irvine CA US Mehryar Michael Parsee Los Angeles CA US Correspondence Address Kit M Stetina STETINA BRUNDA GARRED amp BRUCKER Suite 250 75 Enterprise Aliso Viejo CA 92656 US 21 Appl No 10 459 079 22 Filed Jun 11 2003 Related U S Application Data 63 Continuation in part of application No 10 205 965 filed on Jul 26 2002 Publication Classification Gi S ita ase G06F 7 00 52 A GU AD bee ON MIME 707 1 57 ABSTRACT A method of storing on a remote storage device protocol information for a drug for administration via a peristaltic pump is disclosed A communications path between the peristaltic pump and the remote storage device is provided The protocol information for the drug is entered into the peristaltic pump The protocol information is transferred from the peristaltic pump to the remote storage device The protocol information for the drug is stored on the remote storage device History information may be retrieved from the peristaltic pump A user request is received requesting retrieval of h
18. age History button 108 the manage history function is invoked and all of the information stored in the pump 10 is downloaded to the computer 20 A manage patient history display 220 such as the one shown in FIG 7 is displayed The user can either choose to retrieve the patient history 222 or to retrieve and then clear the patient history 224 If clear the patient history is selected the history file will be deleted from the pump 10 after it is downloaded to the computer 20 After selecting one of these options the user presses a Retrieve Now button 226 to retrieve the data from the pump The names and creation dates of the downloaded history files are displayed in an existing history files window 228 The user can select a history file from the existing history file window 228 The data in the selected file is then displayed in a view history window 230 There are also controls e g buttons that allow the user to rename 232 export 234 delete 236 or print 238 a selected history file 0052 If the user presses the Peace of Mind button 112 a peace of mind function is invoked The peace of mind function downloads and displays the most recently pro grammed therapy This provides the clinician with proof or peace of mind that the therapy was uploaded into the pump In exemplary embodiments this feature downloads the most recent four 4 kilobytes of data from the pump history An exemplary screen display 240 showing peace of mind data is s
19. ar patient BRIEF SUMMARY OF THE INVENTION 0009 An aspect of the present invention may be regarded as a method of storing on a remote storage device protocol information for a drug for administration via a peristaltic pump The method provides a communications path between the peristaltic pump and the remote storage device The protocol information for the drug is entered into the peristaltic pump The protocol information is transferred from the peristaltic pump to the remote storage device The protocol information for the drug is stored on the remote storage device 0010 The protocol information may be stored in a drug library on the remote storage device The protocol informa tion may be selected from the drug library and sent to the peristaltic pump for administration to a patient The protocol information may be copied from the drug library to a patient library The protocol information may be exported from the drug library The exported protocol information may be sent to another user for example via e mail The exported protocol information may be imported to the drug library The protocol information in the drug library may be edited 0011 The protocol information may be stored in a patient library on the remote storage device The protocol informa tion may be selected from the patient library and sent to the peristaltic pump for administration to a patient The protocol information may be exported from the patient library
20. cluded in the CD appendix and is titled History File TPN Pressure SN102243 A portion of this history file is shown in FIG 11 The volume infused voltage of the internal battery and internal line pressure are recorded in the history file every twenty minutes 0060 The data can be extracted from the history file to be analyzed The data may be plotted For example FIG 10 illustrates history data plotted from the file included in the CD appendix This information can be displayed printed and or saved in a file In exemplary embodiments the data can be transmitted for example via email The saved files can be renamed and or deleted 0061 The plot can be used to perform trend analysis This trend analysis can be used to determine if pressure is building up This build up of pressure indicates that there is a restriction of the flow of the medication into the patient The analysis can also be used to assist in predicting when the catheter needs to be flushed or replaced 0062 In FIG 10 after starting the infusion the average pressure started to slowly increase on the third and fourth days The pressure then dropped This increase is likely due to gross sedimentation from the bag occluding the admin istration set filter The pressure drop was likely because the bag was replaced 0063 Anomalies may also be seen in the graph For example there is a large spike in the pressure This spike occurred immediately after starting in
21. e user can view or edit information for the prescription that was entered during create Rx In the example shown there is a list of stored protocols 122 which are identified by a drug name pro grammer and creation date One of the stored protocols can be selected Detailed information is then shown for the selected protocol The detailed information includes com ments 124 and drug precautions 126 The display includes controls such as buttons that allow the user to manipulate the data in the drug library 0039 In the exemplary embodiment the user can press a Copy button 130 which allows the user to copy a protocol from the drug library to the patient library When the copy button 130 1s pressed a window is displayed prompting for a patient s name Entry and acceptance of a valid patient name causes the selected protocol to be copied to the patient library and stored under the entered patient s name 0040 Pressing an Import button 132 allows the user to import a protocol This allows the user to store appropriately formatted files into the drug library The files may be sent by another user 0041 Pressing an Export button 134 allows the user to export a selected protocol The user can export the protocol to another user In exemplary embodiments the protocol is exported by sending it to the desired user via e mail 0042 Pressing an Edit button 136 allows the user to edit an existing protocol In exemplary embodiments selectio
22. ed above the basal amount The patient has a mechanism such as a button which is pressed to request additional medication Medica tion is not automatically administered for each request The system is programmed to allow only a certain amount of additional medication within a given time period 0066 Bolus requests are recorded in the history file Additional medication administered in request to the bolus request s is also stored in the history file The bolus requests and medication administered in response to the bolus requests can be extracted from the history file An exemplary history file is in the CD Appendix in a file entitled History File PCA Boluses UCLA SN102436 FIG 13 shows an excerpt of this history file The extracted information can be put in a graphical format such as that shown in FIG 12 Trend analysis can be performed in order to determine a patient s tolerance for pain This information can be dis played printed and or saved in a file In exemplary embodi ments the data can be transmitted for example via e mail The saved files can be renamed and or deleted 0067 While an illustrative and presently preferred embodiment of the invention has been described in detail herein it is to be understood that the inventive concepts may be otherwise variously embodied and employed and that the appended claims are intended to be construed to include such variations except insofar as limited by the prior art What is
23. er comprising display ing the extracted patient side administration set line pressure information 22 The method of claim 20 wherein the extracted patient side administration set line pressure information is displayed in a graphical format
24. fusa 500 mq 14 4 n1 per day for 7 days ino nat refriqerate medication mo nat use filtered sets 126 Protect Tv bag from light Mon tor far signs and symptoms of infection gt Sorted by Comments and Drug Precautions windows 140 7 Curlin Medical CMS Precautions let Gle the Tullowiu preci TM SOT Uhr Isis sty EA ade a id x DAR Infusc 600 mg 14 4 mi per day for 7 days Do not refrigerate medication Do not uso filtered sets Protect IV bag from light th Jp Us Monitor for signs and symptoms of infection ata dao Replace battery every 3 days window will appear hen a Protocol is uploaded to Ncted Patent Application Publication Apr 1 2004 Sheet 4 of 13 US 2004 0064435 A1 160 Einin Medical MN Patient i henry Suluu u Prucuipliun Sule b Reverie rpulCido y Cieulida Dato srl Centen 5412 2002 08 wait j 1 Psccenc Nas Puga ed Yy Tack Cosy Dalai d Vest Coust X Pusit Coust X Purl a beli Edi a Farena iode CAL owes Fam Lick Adin Rus TV Sen Fs irr Patr Fares el jUni zs wl Bag Vol C ml anf pnr tH ow i bord ito Hun Fo da Cuq gt ecauicne Infuse 500 mq 14 4 nl per day for daya Mo nat refriqerate medication Mmo not nae filtered seta Prot eat TY baq from light Monitor for signs and symptoma of infection z Sorted by
25. fusion and then dropped prior to the next pressure reading This indicates a problem that was quickly corrected For example a slide clamp may have been left in place which caused the spike When the slide clamp was removed the spike drop i e the pressure returned to a normal or expected range value 0064 Total Parenteral Nutrition TPN patients are con cerned about occlusion of the catheter Such an occlusion can indicate the presence of an infection Catheter pressure US 2004 0064435 A1 trend analysis as described above can be used to predict catheter performance and useful life It can help to determine when a catheter needs to be flushed or replaced This reduces the risk of infection to the patient due to catheter inclusion A home healthcare professional can typically flush or replace a catheter Trend analysis for determining when a catheter should be flushed or replaced may prevent unnec essary trips to the emergency room 0065 Another example of a diagnostic is the analysis of bolus requests Hospitals typically configure a pump based on a single protocol However patients have different tol erances to pain Patient Controlled Analgesia PCA therapy allows a patient to have some control over the amount of medication received A prescription includes a basal amount The patient may also be able to receive additional medica tion a bolus upon request The bolus allows for a certain amount of medication to be administer
26. herein The compact disc was created on Oct 25 2002 and includes a total of four 4 files The first file 350 9008B CMS User Manual is a User s Manual for the Curlin Medical Clinical Manage ment System and has a size of 891 Kbytes The second file Curlin Medical 4000 Peristaltic Pump is a User s Manual for the Curlin Medical 4000 Peristaltic Pump and has a size of 2 243 Kbytes The third file History File PCA Boluses UCLA SN102436 an exemplary history file used to gen erate the bolus requested vs bolus received graph over a given period of time shown in FIG 12 and has a size of 55 Kbytes The fourth file History File TPN Pressure SN102243 is an exemplary history file that was used to generate the line pressure graph of FIG 10 and has a size of 33 Kbytes BACKGROUND OF THE INVENTION 0004 The present invention relates generally to medical infusion pumps and more particularly to a system and method for remotely controlling a peristaltic pump 0005 Traditionally infusion pumps have been used to deliver medications and fluids to patients by intravenous subcutaneous or Epidural methods according to a controlled rate and dose schedule Such infusion or peristaltic pumps are known in the art Peristaltic pumps may be linear such as those described in U S Pat No 2 877 714 Sorg et al U S Pat No 4 671 792 Borsannyi U S Pat No 4 893 991 Canon rotary such as those described in U S Pat No 4 886 4
27. hown in FIG 8 0053 The present invention also allows the pump to be utilized as a single therapy device When the user presses the Single Therapy button 112 all but one therapeutic mode on the pump are disabled For example some hospitals only need a single mode such as PCA This feature can be used when the pump is being manually programmed In exem plary embodiments the user can select any available thera peutic mode as the single mode therapy for example Continuous Intermittent PCA TPN or Variable The pump can be removed from single therapy mode manually or by selecting Multi therapy 0054 Various maintenance activities may be performed on the pump using the present invention For example a current date time may be entered and or a maintenance date may be entered The present invention may also be used to invoke calibration functions on the pump 0055 In exemplary embodiments a palm computing device 30 may be used to perform a subset of the operations that can be performed by larger computing devices such as a laptop computer 20 The Palm system can be used to program a pump 10 or to retrieve information from the pump Protocols or prescriptions can be transferred to the PDA 30 from the PC 20 for bedside pump programming Infusion information gathered by the pump 10 can be downloaded for later analysis 0056 In exemplary embodiments clinical assessments and diagnostics can be performed Preferably these reports
28. istory information from the peristaltic pump A pump request is formatted to retrieve history information The pump request to receive history information is trans mitted to the peristaltic pump The history information is received from the peristaltic pump The history information can be displayed and or stored 10 Patent Application Publication Apr 1 2004 Sheet 1 of 13 US 2004 0064435 A1 Patent Application Publication Apr 1 2004 Sheet 2 of 13 US 2004 0064435 A1 Ele Users setup Hee Clinical Management System Curlin Medical LLC CURLIN MEDICAL Pa dahang thes Line on fisco Corr KA S HA Single Therapy 102 106 110 Fig 2 Patent Application Publication Apr 1 2004 Sheet 3 of 13 US 2004 0064435 A1 120 ain Modra MIS Drag they Sulu u Precuaipliun Lawa Tuler Ut Porac rout Cide Der Hun Prvscatizi Ly CieuLis 22 Fencany1 3 2cicicuine Curlin Xadicul 3341172002 0 MEA S z 32 Dopauirue East Mas Kedicul Center 3341172002 0530 v t ung Fiawavurasil 3701 Bust 33411 2C02 05 78 PI DU gau 34 122 _ Puepicios 3alynai e 2341142002 05 23 136 1_p ds 33 11 5002 05 1 Edt D luulid Kedicul Cerler 33 11 2002 05 09 P henerol Kedical Center 3341142002 04 49 A Zla peun 12 17tCOL 08 20 2 face ms jFamLick 150 ode CLA UY Kawin Re IV iUnizs wl ng Bag VILI Com 124 ikot TENG SHD I Sean Fx ice Pate Lua gt ecauicre in
29. n of the edit function causes two additional controls e g buttons to be displayed namely Delete and Save The user can then edit the comments and or precautions fields and save them by pressing the save button if desired In exem plary embodiments the drug name programmed by and creation date fields cannot be edited The user may delete a protocol if desired by pressing the Delete button 0043 The user may also send the prescription to the pump by pressing a Send Rx to Pump button 140 Sending Apr 1 2004 a prescription to the pump programs the pump with the prescription Pressing the Send Rx to Pump button 140 causes the precaution window to display the precaution information for the protocol The administrator of the pre scription must review the precautions and indicate that the precautions have been reviewed by pressing the Noted button 0044 The user may also Send a Prescription to the Palm by pressing the Select Rx for Palm button 150 In exemplary embodiments selection of this function saves selected protocols into a directory for transfer to a Palm device A cable is connected from the computer to the Palm device In exemplary embodiments the user selects the prescription to be sent to a HotSync folder The files in the HotSync folder can then be selected for transfer to the Palm device In exemplary embodiments all of the pro tocols being transferred to the Palm device are stored in one file for
30. s History information received from a peristaltic pump may be extracted The information is extracted in response to a request for information The requested information is then extracted from the history file 0019 In exemplary embodiments the requested informa tion may be patient side administration set line pressure information or bolus request information In the case of bolus request information the extracted information may include bolus requests and medication administered in response to bolus requests 0020 The extracted information may be displayed saved to a file printed and or transmitted e g via e mail Saved files can be renamed The extracted information may be in a graphical format BRIEF DESCRIPTION OF THE DRAWINGS 0021 These as well as other features of the present invention will become more apparent upon reference to the drawings wherein 0022 FIG 1A illustrates a first embodiment of the present invention wherein a peristaltic pump is in commu nication with a laptop computer 0023 FIG 1B illustrates a second embodiment of the present invention wherein the peristaltic pump of FIG 1A is in communication with a handheld computing device 0024 FIG 2 illustrates an example screen display show ing the major functions of one embodiment of the present invention 0025 FIGS 3 9 illustrate exemplary screen displays for performing the various functions available from the display shown in FIG 2
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