Section 3 • Programming Instructions
37
3.2.3
P+P Mode
P+P stands for patient-intermittent bolus (PIb) combined with patient-controlled analgesia
(PCA). This mode contains dose volumes occurring at set intervals, as well as optional boluses.
It is important to understand how the P+P mode functions. Below is an explanation.
3.2.3.1
P+P Mode Programming Parameters and Definitions
• In the PIB-IL
v1.5
, a maximum interval limit is set. This limits the
maximum dose and maximum bolus that can be programmed.
• A bolus is a volume of medication infused over a relatively short period
of time.
19
The bolus is infused at the bolus flow rate. A bolus is delivered
when a patient requests it by pushing the BOLUS button or the optional
remote BOLUS switch. A bolus is sometime referred to as a PCA bolus.
The bolus has units of milliliters (ml).
•
The bolus/dose flow rate is the flow rate at which a bolus or dose is
delivered. It is a higher flow rate than the basal flow rate. In the ambIT
®
PIB
v1.5
pumps, the bolus flow rate varies from 210 ml/hr to 125 ml/
hr, depending on the energy left in the battery. Flow rate accuracy is not
affected by the bolus flow rate. See Section 1.4.1 for an explanation of how
the bolus flow rate changes. The bolus/dose flow rate is not adjustable.
• The dose is a volume of medication infused over a relatively short period
of time
20
and is programmed to occur at scheduled intervals. Sometimes
a dose is referred to as a programmed intermittent bolus (PIb) or as a
programmed intermittent epidural bolus (PIEb)
21
. In this manual, the term
“dose” will be used when discussing either PIb or PIEb. The dose has
units of milliliters (ml).
• The interval or dose interval is the time between the start of one dose and
the start of the next dose. The dose interval has units of hours and minutes
(hh:mm).
• In general, the lockout time is the time between the end of one after a
bolus or dose and the start of the next bolus or dose. The lockout time has
units of hours and minutes (hh:mm).
•
The volume to be infused is the total amount of fluid in the solution
container or reservoir to be infused. The volume to be infused has units of
milliliters (ml).
See Section 1.4.1 for an explanation of the patterns of flow available in P+P mode: specifically,
bolus-only, dose-only and bolus plus dose (Figures 1-2 and 1.4 through 1-6).
19
The bolus is delivered at a higher flow rate than the basal rate; therefore, for a given volume, the bolus is delivered faster.
20
The dose is delivered at a higher flow rate than the basal rate; therefore, for a given volume, the dose is delivered fast.
21 In some publications, the PIB is referred to as an “automated bolus” or “automated mandatory bolus.” This usage is less
common than PIB or PIEB.
