Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia

1. Infusion Pumps and Indications for Use:Pain Therapy; Anesthesia Infusion Pumps and Related Therapies Sept. 26-28, 2000 Charles H. McLeskey, M.D. Senior Medical Director, Clinical Development Abbott Laboratories

2. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia • Uses in Anesthesiology/OR • Uses in Pain Therapy • Acute In-Hospital Use • Patient-Controlled Analgesia (PCA) • Epidural Analgesia • Chronic Outpatient Use • Patient-Controlled Analgesia (PCA) Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

3. Uses in Anesthesiology/OR • Overall Pump Requirements • Specific Applications Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

4. Uses in Anesthesiology/OR • Overall Pump Requirements • Accurate, Constant Delivery • Rapid, Changeable Delivery • Volume or Timed Delivery • Weight-Based Delivery Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

5. Uses in Anesthesiology/OR • Specific Applications • Hydration • Fluid Restriction • Pediatric Patients • Geriatric Patients Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

6. Uses in Anesthesiology/OR • Specific Applications (cont’d) • Medications • Anesthetics/Sedatives • Propofol • Remifentanil • Muscle Relaxants Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

7. Uses in Anesthesiology/OR • Specific Applications (cont’d) • Medications • Vasopressor Drugs • Dopamine • Dobutamine • Vasodilator Drug • Nitroglycerin • Nitroprusside Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

8. Uses in Anesthesiology/OR • Specific Applications (cont’d) • Medications • Anticoagulants • Heparin • Antithrombolytics Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

9. Pain Management Principles • Pain Assessment • Acute vs. Chronic Indications • Effective Pain Management Outcomes • Stable Analgesia • Minimal Sedation • 5th Vital Sign - JCAHO Standard Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

10. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

11. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

12. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

13. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

14. Overall Pump Requirements • Dosing limits • Lockouts • Security • Accuracy • Documentation • Clinician Interface Prompting Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

15. Uses in Pain Therapy • Acute In-Hospital Use • Patient-Controlled Analgesia (PCA) • Epidural Analgesia • Chronic Outpatient Use • PCA Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

16. Uses in Pain Therapy • Acute In-Hospital Use • PCA • Continuous, PCA, Continuous+PCA • Epidural Analgesia Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

17. Uses in Pain Therapy • Acute In-Hospital Use • PCA • Therapeutic Applications • Post Surgical • Trauma • Orthopedic • Medical Conditions • Pancreatitis • Sickle Cell Disease Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

18. Uses in Pain Therapy • Acute In-Hospital Use • PCA • Medications • Opioids • Optimal Pump Characteristics • Pharmacy Preparation/Prefilled • Dedicated Device • Medication Error Control Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

19. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

20. Uses in Pain Therapy • Acute In-Hospital Use • Epidural Analgesia • Continuous Epidural Infusion • Patient Controlled Epidural Analgesia (PCEA) Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

21. Uses in Pain Therapy • Acute In-Hospital Use • Epidural Analgesia • Therapeutic Applications • Post-Surgical • Thoracic • Abdominal • Back • Lower Extremity • Trauma Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

22. Uses in Pain Therapy • Acute In-Hospital Use • Epidural Analgesia • Therapeutic Applications • Post-Cesarean Section • Opioids/Local Anesthetics • Labor • Local Anesthetics Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

23. Uses in Pain Therapy • Chronic Outpatient Use • PCA • Continuous, PCA, Continuous+PCA • Therapeutic Applications • Oncology • Hospice • Medications: Opioids Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

24. Uses in Pain Therapy • Chronic Outpatient Use • PCA • Optimal Pump Characteristics • Battery Life - Extended/ Rechargeable • Pharmacy Preparation • Multi-Therapy Pumps • Portable/Light-Weight/ Durable Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies

25. Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia • Uses in Anesthesiology/OR • Uses in Pain Therapy • Acute In-Hospital Use • Patient-Controlled Analgesia (PCA) • Epidural Analgesia • Chronic Outpatient Use • Patient-Controlled Analgesia (PCA) Infusion Pumps and Indications for Use: Pain Therapy; Anesthesia Charles H. McLeskey M.D. Abbott Laboratoies