The electric syringe pump is used, as its name suggests, to push a syringe, continuously, slowly and without human intervention. It is an electronic device, making it possible to inject a quantity of product continuously and at a certain rate. It is used in hospitals and care centers for patients requiring continuous injections. It is widely used for the administration of anticancer drugs, insulin, antibiotics, analgesics or even vasopressor amines in many medical specialties: anesthesia-intensive care, surgery, infectious diseases, palliative care, etc.

Electric syringe pumps (EPS), also called self-pushing syringes (SAP), are electrical apparatus for pushing the plunger of a syringe, connected to the patient intravenously. The contents of the syringe are thus administered without the intervention of a nurse. They allow continuous injection and at a certain rate fluids or medication.

The electric syringe pump combines parts:

• mechanical: this serves as a support for the different types of syringes. It includes a cradle and a piston which will receive the body of the syringe. The cradle is usually provided with a sensor and a notch to lock the syringe. The plunger flange attaches to the syringe plunger carriage by means of claws. It also includes a system of sensors which will make it possible to check the correct fixing position of the piston. The piston moves thanks to a worm screw system which will literally push the contents of the syringe towards the patient circuit;
• electric: the mechanical part is driven by an electric motor powered either by the sector or by a battery. The use of a battery is essential to ensure patient safety, since it allows continuous administration, even in the event of a power failure or patient transport ;
• electronic: this manages all the other elements. This part works like a real small computer capable not only of checking the flow rates and pressures, but also of performing numerous dose calculations according to various protocols.

Easy to use, the programming of an electric syringe pump allows the nursing staff to start an infusion in a few seconds, in a completely secure manner, and thus to allow good medication adherence for patients, under infusion, in particular:

• when oral drug administration is impossible: disturbances of consciousness, frequent vomiting;
• in the event of fasting recommended while waiting for a surgical intervention;
• in serious pathologies where the venous route is necessary: ​​states of shock, hydroelectrolytic disorders, etc. ;
• when the drugs are to be prescribed only by infusion: filling fluids, certain antibiotics, etc. ;
• in the event of therapies requiring a precise and constant flow, such as catecholamines, nicardipine, antiarrhythmics, etc.

The electric syringe pump is used in all departments of a hospital establishment, in particular in:

• resuscitation and intensive care;
• anesthesia;
• surgery;
• chemotherapy;
• internal Medicine ;
• gastroenterology;
• emergency room ;
• gynecology;
• pediatrics;
• home hospitalization, etc.

The use of a electric syringe pump helps prevent periods when the level of drugs in the blood is too high or too low, as well as clotting preventing the product from flowing into the vein.

The electric syringe pump requires prior training.

Precautions for use

• the material should be revised periodically;
• a fall, even without visible breakage from the outside, requires a passage in revision. Many internal components are fragile and their alteration can seriously affect the functioning of the electric syringe pump;
• the batteries must also be regularly maintained and replaced when the autonomy is no longer sufficient;
• the electric syringe pump is calibrated to operate at more or less one meter above the patient’s heart. The reliability of measurement of the administration pressures depends on it;
• the electric syringe pump should not be placed in an upright position, to prevent the passage of residual bubbles into the infusion system;
• the equipment used must be suitable for the syringe pump.

The main criteria for choosing an electric syringe pump include:

• the mode of use;
• ease of adjustment;
• the capabilities of the device with respect to injection dose and rate.

Operating modes

There are several operating modes, which can be indifferently chosen on the same electric syringe pumps, based on patient profile and therapist preferences :

• mode «perfusion continue» : mode the simplest, the most basic and the most used, allows you to adjust the quantity to be injected as well as the flow rate;
• “AIVT” mode for “Total Intravenous Anesthesia”: allows the flow rate as well as the dosage to be adjusted according to the age, weight and sex of the patient. The syringe pump itself calculates the quantity to be injected. More often used in anesthesia, more rarely in intensive care, this mode makes it possible, for example, to deliver an induction dose (the dose to put the patient to sleep at the start of a procedure), then a constant flow rate according to the desired dosage;
• “TCI” mode for “Intravenous Anesthesia with Concentration Target”, the dose of which is calculated as a function of either the desired plasma concentration, that is to say in the amount of drug in the blood plasma, either concentration at the site of action (the brain for a hypnotic for example). This mode works with pharmacokinetic models determined according to the chosen molecule and patient data ;
• “PCA” mode for “Patient Controlled Analgesia”, thanks to a protective cover and locked by key or code, thus limiting single access to nursing staff.

There are syringe pumps with several (usually two) channels which allow different sites to be injected with different drugs into the same patient.

Finally, whatever the operating modes, a certain number of electric syringe pumps are designed so that they can be plugged into a docking station. A source of energy to keep the batteries charged and operate the device, they can offer remote control or servo functions, to remotely control or monitor the batteries. electric syringe pumps, or even carry out a drug relay when a syringe expires.