PROMETRA® II PROGRAMMABLE PUMP
Page 14 of 38
bolused to the patient. This could result in drug overdose that could lead to serious patient injury or
death. To determine the volume of drug in the Reservoir, inquire the pump with a Prometra
®
Programmer. The Reservoir volume is shown on the inquiry screens.
If a Programmer is not available,
then all drug must be removed from the Drug Reservoir prior to the Emergency MRI scan.
The Flow Activated Valve (FAV) of the Prometra
®
II Pump is intended to shut off drug flow when
exposed to strong magnetic fields. When this occurs a small amount of drug, ≤10 μL, will be delivered
to the patient.
The physician must determine if the patient can safely receive this 10 μL bolus dose
during the Emergency MRI procedure
(1)
.
If not, then all drug must be
completely emptied from the
Drug Reservoir prior to the Emergency MRI procedure.
NOTE:
For a pump containing Infumorph
®
at a concentration of 25 mg/mL, a bolus dose of <
0.25 mg would be delivered to the patient during an Emergency MRI procedure if the drug was
not removed from the Drug Reservoir prior to the MRI.
Following an MRI, the FAV will be closed, and will prevent further drug delivery to occur until the pump
is manually reset after the completion of the MRI procedure.
The physician must determine if the
patient can safely be deprived of medication until the FAV is reset after the MRI procedure.
If
medication is needed, then alternate means of drug delivery (such as I.V. administration or analgesic
patch) should be employed keeping in mind that the patient will be receiving up to a 10 μL bolus of drug
during the Emergency MRI if drug was not removed from the Reservoir prior to the MRI procedure.
In the event that an Emergency MRI scan was performed on a patient with a Prometra
®
II pump in which
the drug was NOT removed due to a medical emergency situation, the Prometra II FAV must be reset by
performing a reset procedure.
1
Per Deer et al., Polyanalygesic Consensus Conference 2012: Recommendation for the Management of Pain by
Intrathecal (Intraspinal) Drug Delivery: Report of an Interdisciplinary Expert Panel, bolus doses of 5%-20% of the daily
dose are typical, but cautions that doses are additive to baseline infusion and cumulative side effects could occur.
