Clinical skills: Patient controlled analgesia

As with any procedure. Don't forget to wash your hands, introduce yourself to the client, explain the procedure and receive consent.

Hello, this video will talk about how to use a patient controlled analgesia pump also called PCA pump. Normally you do everything on this list, but to keep things concise, we'll focus on the steps in blue and we'll also include a summary.

Now, perform any necessary history and physical exam such as a history of opiate use or dependence, the quality and characteristic of the patient's pain, history of drug allergies or any relative contraindications such as respiratory depression start by making sure the patient controlled analgesia pump also called PCA pump is working properly.

Consult your equipment guidelines to make sure it's working right. Some PC pumps are standalone while others will need to be attached appropriately to a computer that controls the PCA pump.

Next double check the medication label to ensure that you're using the right medication and the right dose. It's also important to confirm the frequency, continuous on demand or both and verify any lockout period.

Now, let's set up the tubing. The PC kit should include a Y connector attach that to the long arm of the medication syringe and the short arm to the existing saline infusion.

Be sure not to contaminate any end of the connection, practicing aseptic technique while preparing the tubing and syringe, then load the syringe into the PCA pump to do so, insert the key into the pump and turn it to the unlocked position, open the door and raise the piston to its highest position by twisting the control switch and lifting it upwards.

Open the clamp and insert the syringe, seeing the flange in between the flange grippers, twist the control switch on the piston and bring it down to the height of the plunger, then close the clamp to secure the syringe in place.

Turn on the pump and follow the prompts on the display. Enter the patient ID, the type and size of the syringe and the chosen medication.

When asked to choose the infusion mode, look for the prime button. Double check, the tubing is not yet attached to the patient before pressing and holding the prime button until the medication fills the long arm of the wide connector.

With some devices, you may only need to press the prime button once and then again when fully primed other devices do not have prime buttons.

But we'll ask you if you want to prime the tubing after entering the other information requested, then manually prime the rest of the tubing with the existing Saline infusion.

Always be sure to prime the tubing, we want to minimize air emboli delivered to the patient. Great.

Now attach the bottom of the Y connector to the saline lock or the IV infusion. Once the tubing is primed, select the desired infusion mode, enter the PCA dose, the lockout period, the continuous dose loading dose and the limit be sure to enter any other parameters as per the health care provider's orders, then close the door on the pump before twisting the key to the lock position and removing it at long lasts.

Press start. Many institutions have policies requiring multiple staff members to check the medication order and the PCA pump settings before initiating the infusion.

Be sure to check your institution's policies when putting the syringe into the PCA pump, make sure that the label on the syringe is easily visible through the pump casing.

This will make it easier for you and others to verify the medication. While the pump is running.

In summary, we need to connect the tubing load the syringe, enter the medication details, prime the tubing using the pump program, the infusion mode and then start the infusion.