JP6285369B2 - Infusion pump - Google Patents

Description

  The present invention relates to an infusion pump for delivering a drug to a patient.

  As an example of a medical pump, an infusion pump is used in, for example, an intensive care unit (ICU) or the like, and is used for performing a liquid feeding treatment of a patient on a patient with high accuracy for a relatively long time. A predetermined drug bag (infusion bag) is arranged on the infusion pump, and an infusion tube lowered from the drug bag is sandwiched between the main body and the door, and the infusion tube is accommodated in the main body. The door is held by closing the door. In the main body of the infusion pump, the outer peripheral surface of the infusion tube set at a fixed position is sandwiched between a plurality of fingers in the main body and the inner surface of the door. This infusion pump is a peristaltic infusion pump in which a plurality of fingers are sequentially pressed along the length of the outer peripheral surface of an infusion tube to deliver a drug to a patient through an indwelling needle or an indwelling catheter (patent) Reference 1).

  In the infusion pump described in Patent Document 1, the infusion tube is held vertically through the body of the infusion pump from top to bottom. On the other hand, an infusion pump that holds an infusion tube in a horizontal direction in the body of the infusion pump has been proposed. In this way, the infusion pump has a structure in which the infusion tube is held in the horizontal direction in the main body of the infusion pump so that the infusion tube passes vertically through the main body of the infusion pump from top to bottom. This is because the infusion tube does not get in the way even if a plurality of infusion pumps are stacked and held in a stacked state in the vertical position. For example, the upstream side of the infusion tube is disposed on the right side of the infusion pump main body, and the downstream side of the infusion tube is disposed on the left side of the infusion pump main body. In this case, if the upstream side of the infusion tube is arranged on the right side portion of the main body of the infusion pump and the downstream side of the infusion tube is arranged on the left side portion of the main body of the infusion pump, the drug is directed from the upstream side to the downstream side. Liquid can be fed along a predetermined liquid feeding direction, and liquid can be fed correctly to the patient.

JP 2010-200775 A

By the way, when using such an infusion pump to deliver a drug to a patient, the tip opening of the indwelling needle or the indwelling catheter is inserted into a vein. In the middle of this, there is a possibility that the tip opening of the indwelling needle or the indwelling catheter is detached from the vein and remains in the tissue under the skin due to some cause, for example, the patient moving.
If the infusion needle or indwelling catheter tip opening part is removed from the vein and stays in the tissue under the skin, the medicine is delivered into the tissue with the same amount of liquid delivered, May affect the organization.
Therefore, the present invention can reliably warn a medical worker even if the distal end of the indwelling needle or indwelling catheter is detached from the vein and stays in the tissue under the skin, and the medicine is given to the tissue under the skin. It aims at providing the infusion pump which can reduce an influence.

The infusion pump of the present invention is an infusion pump for delivering a drug registered from a drug library into a patient's vein through an infusion tube and a distal opening of an indwelling needle or an indwelling catheter attached to the tip of the infusion tube. A driving motor for feeding the drug through the infusion tube and the needle, an upstream blockage sensor and a downstream blockage sensor for detecting a blockage pressure of the infusion tube when feeding the drug, and the downstream A controller that determines that the tip of the needle is positioned in the subcutaneous tissue outside the vein when the occlusion pressure rapidly increases due to the occlusion pressure of the infusion tube obtained from an occlusion sensor; If the occlusion pressure increases rapidly, and a warning means for issuing a warning in response to a command of the control unit, lower the drug high drug and risk-risk drugs Wherein the said control unit operates the occlusion圧急increase detection processing program, the closure pressure detected in the previous SL Downstream occlusion sensor, defined the criteria vary depending on the type of pre-drug, it is tabulated closed based on the detection reference value of the occlusive圧急rise against the set pressure, when it is determined that jumped, by controlling the operation of the drive motor in response to the patient, when the low risk of drug, the The amount of the medicine delivered from the infusion tube to the patient is decreased, and when the risk of the medicine is high, the medicine delivery is temporarily stopped.
According to the above configuration, when the occlusion pressure suddenly increases, it is determined that the tip of the needle is out of the vein and is located in the subcutaneous tissue, and the amount of the drug delivered is reduced according to the patient. Therefore, it is possible to reduce the amount of drug delivered at a stage where it is not confirmed whether the tip of the needle is really located in the subcutaneous tissue. Thereby, even if the tip of the needle is removed from the vein and stays in the tissue under the skin, it is possible to reliably warn the medical staff and reduce the influence of the medicine on the tissue under the skin. In other words, it is detected that the tip of the needle has come out of the vein (needle detachment), and a low-risk medicine, such as a nutrient, is delivered in the subcutaneous tissue in a large amount with the same amount. This can be avoided and can reliably warn the medical staff of needle removal.

Preferably, when reducing the amount of the drug delivered to the patient, the amount of decrease is changed according to the age of the patient, and the control unit operates an occlusion pressure rapid decrease detection processing program to the closing pressure detected by the downstream occlusion sensor out is determined is different criteria depending on the type of pre-drug, based on the detected reference value of the occlusive圧急downward against the tabled occlusion set pressure was abruptly lowered When it is determined that the tip of the needle is out of the vein, it is determined that the needle is positioned outside the skin.
According to the above configuration, when the occlusion pressure suddenly drops, it can be determined that the tip of the needle is out of the vein and located outside the skin. Can be surely warned.

Preferably, even when the case of the spike is determined or the control unit of the control unit the occlusion pressure has determined the rapid lowering of the closing pressure, the control unit may stop the operation of the drive motor Without being carried out, the liquid feeding operation of the medicine is continued.
According to the above configuration, since the liquid supply of the medicine is continued without immediately stopping the operation of the drive motor, after the medical worker confirms the state of the needle, the liquid supply of the medicine is made at the judgment of the medical worker. The operation can be stopped.

Preferably, the warning means includes a display unit for displaying the contents of warning, a speaker to warn the warning contents by voice, Ri least 1 Tsudea buzzer for alarm warning, said warning means, said infusion pump When, characterized that you have been arranged in the terminal disposed nurse center.
According to the said structure, the medical worker can notify reliably needle | hook removal by a warning means.
In addition, according to the above configuration, not only a medical worker around the infusion pump but also a medical worker packed in the nurse center can be surely warned. Can be stopped.
Preferably, whether or not the occlusion pressure detected by the downstream occlusion sensor has risen rapidly is determined based on the difference between the occlusion value acquired at a predetermined interval and the current occlusion value by Whether or not the occlusion pressure detected by the downstream occlusion sensor has suddenly decreased is determined by comparing the detection reference value with the difference between the current occlusion value and the latest minimum value. It is judged by comparing with the detection reference value of the closing pressure sudden drop.

Preferably, the display unit and an operation panel unit having operation buttons are disposed on an upper part of the main body of the infusion pump, and a lower part of the main body of the infusion pump is used for supplying the medicine. It is a region where members are arranged.
According to the said structure, the medical worker can perform the liquid feeding operation | work of the chemical | medical agent by an infusion pump, confirming the information of the display part of the upper part of a main body. Then, the medical worker can operate the operation buttons on the operation panel unit while confirming the information on the display unit on the upper part of the main body.

  The present invention provides an infusion pump that can reliably warn a medical worker even if the tip of a needle is detached from a vein and stays in tissue under the skin, and can reduce the influence of the medicine on the tissue under the skin. Can be provided.

The perspective view which shows the infusion pump which is preferable embodiment of the medical pump of this invention. The figure which looked at the infusion pump shown in FIG. 1 from the W direction. The perspective view which shows the state which opened the opening-and-closing cover of the infusion pump. The figure which shows the electrical structural example of an infusion pump. FIG. 5 is a block diagram showing a part of the electrical configuration example of the infusion pump shown in FIG. 4 in more detail. The disassembled perspective view which shows the structural example of an upstream obstruction | occlusion sensor and a downstream obstruction | occlusion sensor. The figure which shows the example of a state in which the indwelling needle or indwelling catheter shown in FIG. The figure which shows an example of the obstruction | occlusion precaution reference value table TB. The flowchart which shows the example of monitoring in case occlusion pressure rises rapidly. The flowchart which shows the example of monitoring in case obstruction | occlusion pressure falls rapidly.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the drawings.
The embodiments described below are preferred specific examples of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.
FIG. 1 is a perspective view showing an infusion pump which is a preferred embodiment of the infusion pump of the present invention. FIG. 2 is a view of the infusion pump shown in FIG. 1 as viewed from the W direction.

The infusion pump 1 shown in FIGS. 1 and 2 is an example of a medical pump. The infusion pump 1 is used, for example, in an intensive care unit (ICU, CCU, NICU) or the like, and for a patient, for example, an anticancer agent, an anesthetic agent, a chemotherapeutic agent, a blood transfusion or the like, a drug (chemical solution) This is a micro continuous infusion pump used for performing microinjection treatment (also referred to as)) for a relatively long time with high accuracy.
This infusion pump 1 is used, for example, for selecting a drug to be used from a drug library and feeding the selected drug. This drug library is drug information which is a drug administration setting group including drug names registered in advance in the drug library database (DB). By using this drug library, a medical worker does not have to perform complicated administration settings each time, and can select a drug and set a drug.

As shown in FIG. 2, the infusion pump 1 is configured such that a vein of a patient P is supplied from a drug bag 170 filled with a drug 171 through an infusion tube 200 including clamps (clamps) 179 a and 179 b and an indwelling needle or an indwelling catheter 172. The liquid can be accurately fed into the inside. The drug is also called an infusion. An infusion tube is also called an infusion line.
The infusion pump 1 has a main body cover 2 and a handle 2T, and the handle 2T can be extended in the N direction or stored in the T direction. The main body cover 2 is also called a main body, and is integrally formed of a molded resin material having chemical resistance, so that even if a drug or the like is applied, it can be prevented from entering the infusion pump 1. have. As described above, the main body cover 2 has the splash-proof treatment structure because the medicine 171 in the medicine bag 170 disposed above is spilled or disinfecting liquid used in the vicinity is scattered and attached. Because there is.

First, the elements disposed on the main body cover 2 of the infusion pump 1 will be described.
As shown in FIGS. 1 and 2, a display unit 3 and an operation panel unit 4 are arranged on the upper portion 2 </ b> A of the main body cover 2. The display unit 3 is an image display device, and uses, for example, a color liquid crystal display device. This display unit 3 can display not only information notation in Japanese but also information in a plurality of foreign languages as required. The display unit 3 is disposed on the upper left side of the upper portion 2 </ b> A of the main body cover 2 and above the opening / closing cover 5. The upper portion 2 </ b> A of the main body cover 2 is an upper half portion of the main body cover 2. The lower part 2 </ b> B of the main body cover 2 is a lower half part of the main body cover 2.
A display portion 3 for displaying information and an operation panel portion 4 having a plurality of operation buttons are arranged on the upper portion 2A of the body cover 2 of the infusion pump 1, and a lower portion 2B of the body cover 2 of the infusion pump 1 is This is a region where an infusion tube 200 which is a liquid feeding member for feeding a medicine is arranged. Thereby, the medical worker can perform the liquid feeding operation of the medicine by the infusion pump 1 while confirming the information on the display unit 3 of the upper portion 2A of the main body cover 2. Then, the medical staff can operate the operation buttons on the operation panel unit 4 while checking the information on the display unit 3 of the upper portion 2A of the main body cover 2. For this reason, the operability of the infusion pump 1 is good.

In FIG. 2, for example, the display unit 3 includes a display column 3B for a scheduled dose (mL) of drug administration, a display column 3C for an accumulated dose (mL) of drug administration, a display column 3D for a charge history, and a flow rate (mL / h). In the display section 3 shown in FIG. 1, illustration of these display contents is omitted for simplification of the drawing. The display unit 3 can also display a warning message. In addition, the display unit 3 can change the display from, for example, a “yellow display screen” to a “white display screen” that is a warning screen for medical workers by turning on the backlight of an LED (light emitting diode). it can.
The operation panel unit 4 is disposed on the right side of the display unit 3 in the upper part 2A of the main body cover 2, and the operation panel unit 4 includes, for example, a pilot lamp 4A, a fast-forward switch button 4B, and a start button as illustrated in FIG. A switch button 4C, a stop switch button 4D, a menu selection button 4E, a power switch 4F, and the like are arranged.

As shown in FIG. 1, an opening / closing cover 5 serving as a lid member is provided on the lower portion 2B of the main body cover 2 so as to be openable and closable in the R direction around a rotating shaft 5A. The open / close cover 5 is a plate-like lid member that is formed long along the X direction. The tube mounting part 50 and the liquid feeding drive part 60 are disposed inside the opening / closing cover 5. An infusion tube 200 made of a flexible thermoplastic resin such as soft vinyl chloride is set in the tube mounting portion 50, and the infusion tube 200 is connected to the tube mounting portion 50 by closing the open / close cover 5. , And can be mounted horizontally along the X direction (T direction).
Note that the X direction, the Y direction, and the Z direction in FIGS. 1 and 2 are orthogonal to each other, and the Z direction is the vertical direction. The X direction is parallel to the T direction, which is the liquid feeding direction, and is the left-right direction of the infusion pump 1. The Y direction is the front-rear direction of the infusion pump 1.

FIG. 3 is a perspective view showing a tube mounting portion 50 for opening the opening / closing cover 5 of the infusion pump 1 shown in FIGS. 1 and 2 and mounting the infusion tube 200.
As shown in FIG. 3, the tube mounting part 50 and the liquid feeding drive part 60 are provided on the main body lower part 1B side of the infusion pump 1, and the tube mounting part 50 and the liquid feeding drive part 60 are operated with the display part 3. A lower portion of the panel portion 4 is provided along the X direction. As shown in FIG. 2, the tube mounting portion 50 can cover the open / close cover 5 with the open / close cover 5 when the open / close cover 5 is closed in the CR direction around the rotation shaft 5A.

A medical worker can close the open / close cover 5 by attaching the infusion tube 200 to the tube attachment portion 50 while confirming information on the display portion 3 of the upper portion 2 </ b> A of the main body cover 2. Then, the medical staff can operate the operation buttons on the operation panel unit 4 while checking the information on the display unit 3 of the upper portion 2A of the main body cover 2. Thereby, in the medical field, the operativity of the infusion pump 1 can be improved.
As shown in FIG. 3, the tube mounting portion 50 includes a bubble sensor 51, an upstream blockage sensor 52, a downstream blockage sensor 53, a tube clamp portion 270, a first infusion tube guide portion 54 at the right side position, and a left side position. A second infusion tube guide portion 55 is provided.

As shown in FIG. 3, an infusion tube setting direction display unit 150 for clearly displaying the T direction that is the correct liquid feeding direction when the infusion tube 200 is set is provided in the vicinity of the tube mounting unit 50. ing. The infusion tube setting direction display unit 150 includes, for example, a plurality of arrows 151. The infusion tube setting direction display unit 150 may be printed directly on the lower part of the tube mounting part 50, for example, or may be printed on a seal-like member and attached to the lower part of the tube mounting part 50. The infusion tube setting direction display unit 150 is arranged to clearly indicate the liquid feeding direction (T direction) in the correct direction of the medicine 171 by the infusion tube 200 set inside the opening / closing cover 5.
Accordingly, when the medical staff opens the opening / closing cover 5 of FIG. 3 in the CS direction, opens the tube mounting portion 50, and mounts the infusion tube 200 on the tube mounting portion 50, the infusion tube 200 It is possible to clearly indicate the T direction, which is the direction of drug delivery. For this reason, it can prevent reliably that a medical worker will attach the infusion tube 200 by the reverse direction accidentally.

Next, a structural example of the opening / closing cover 5 shown in FIG. 3 will be described.
As shown in FIG. 3, the open / close cover 5 is a plate-like member made of a thin molded resin member in order to reduce the weight of the infusion pump 1. Thereby, the weight of the opening / closing cover 5 can be reduced, and the structure can be simplified. The opening / closing cover 5 has two hinge portions 2H and 2H that allow the tube mounting portion 50 to be covered so as to be openable and closable along the CS direction and the CR direction about the rotation shaft 5A. It is supported with respect to the main body lower part 2B. The two hinge portions 2H and 2H are arranged corresponding to the first hook member 5D and the second hook member 5E, respectively.

As shown in FIGS. 2 and 3, an opening / closing operation lever 260 is provided at the upper right portion on the surface side of the opening / closing cover 5. On the inner surface side of the opening / closing cover 5, an infusion tube pressing member 500, a first hook member 5D, and a second hook member 5E are provided. The infusion tube pressing member 500 is disposed as a long rectangular and planar protrusion along the X direction, and the infusion tube pressing member 500 is in a position facing the liquid feeding drive unit 60. The infusion tube pressing member 500 has a flat surface in the X direction along the liquid feeding drive unit 60, and the infusion tube pressing member 500 closes the opening / closing cover 5 in the CR direction, A part of the infusion tube 200 is pressed between them.
The medical worker can set the infusion tube 200 on the lower half of the body of the infusion pump 1 along the horizontal direction while confirming the display content displayed on the display unit 3, and the infusion tube 200 is connected to the tube mounting portion. After being set to 50, the opening / closing cover 5 can cover the infusion tube 200.

  As shown in FIG. 3, the first hook member 5D and the second hook member 5E are mechanically simultaneously engaged with the fixing portions 1D and 1E on the lower body 1B side, so that the open / close cover 5 is As shown, the tube mounting part 50 of the main body lower part 1B is held in a closed state. The first hook member 5D, the second hook member 5E, and the fixing portions 1D, 1E on the main body lower part 1B side constitute a double hook structure portion 300 of the opening / closing cover 5.

  The tube clamp part 270 shown in FIG. 3 closes the open / close cover 5 to clamp and close the middle part of the infusion tube 200. The tube clamp portion 270 is disposed in the vicinity of the left fixed portion 1E and at a position corresponding to the left second hook member 5E. When the medical worker sets the infusion tube 200 horizontally in the X direction and the medical worker closes the opening / closing cover 5 in the CR direction, the tube clamp portion 270 can block a part of the infusion tube 200 in the middle.

  As shown in FIG. 3, the first infusion tube guide portion 54 is provided on the right side of the main body lower portion 1B, and the second infusion tube guide portion 55 is provided on the left side of the main body lower portion 1B. Yes. The first infusion tube guide portion 54 can be held by fitting the upstream side 200A of the infusion tube 200, and the second infusion tube guide portion 55 can be held by fitting the downstream side 200B of the infusion tube 200, and the infusion tube 200 can be held. It is held in the horizontal direction along the X direction. Thus, the infusion tube 200 held in the horizontal direction is in the T direction along the bubble sensor 51, the upstream block sensor 52, the liquid feed drive unit 60, the downstream block sensor 53, and the tube clamp unit 270. It is fixed by fitting along.

  As shown in FIG. 3, the second infusion tube guide portion 55 is a groove portion formed in the side surface portion 1 </ b> S of the main body lower portion 1 </ b> B in order to detachably hold a part of the downstream side 200 </ b> B of the infusion tube 200. is there. The first infusion tube guide portion 54 and the second infusion tube guide portion 55 are provided in the tube attachment portion 50 so that the infusion tube 200 is not sandwiched between the opening / closing cover 5 and the tube attachment portion 50 and crushed. Can be installed securely.

  The bubble sensor 51 shown in FIG. 3 is a sensor that detects bubbles (air) generated in the infusion tube 200. For example, the bubble sensor 51 flows into the infusion tube 200 from the outside of the infusion tube 200 such as soft vinyl chloride. It is an ultrasonic sensor that monitors bubbles contained in a medicine. By applying ultrasonic waves generated from the ultrasonic wave transmitter of the ultrasonic sensor to the drug flowing in the infusion tube 200, the ultrasonic wave transmittance in the drug and the ultrasonic wave transmittance in the bubbles are different. The receiving unit monitors the presence or absence of bubbles by detecting the difference in transmittance. The bubble sensor 51 has a pressing member 320 and a receiving member 330. The ultrasonic oscillator is disposed on the pressing member 320. The ultrasonic wave receiver is disposed on the receiving member 330.

  The upstream blockage sensor 52 shown in FIG. 3 is a sensor that detects whether or not the inside of the infusion tube 200 is blocked on the upstream side 200A of the infusion tube 200, and the downstream blockage sensor 53 is an infusion solution on the downstream side 200B of the infusion tube 200. It is a sensor that detects whether or not the inside of the tube 200 is closed. The upstream blockage sensor 52 and the downstream blockage sensor 53 have the same configuration. The case where the infusion tube 200 is blocked is, for example, a case where the viscosity of the medicine to be delivered is high or the concentration of the medicine is high.

  As shown in FIG. 3, pressing members 452 and 453 are provided on the inner surface side of the opening / closing cover 5 at positions corresponding to the upstream closing sensor 52 and the downstream closing sensor 53, respectively. When the medical worker sets the infusion tube 200 in the tube mounting portion 50 as shown in FIG. 3 and then closes the opening and closing cover 5 as shown in FIG. 2, the pressing member 452 and the pressing member 453 on the opening and closing cover 5 side A part of the infusion tube 200 can be pressed against the upstream blockage sensor 52 and the downstream blockage sensor 53 side, respectively. For this reason, even if the infusion tube 200 of any size among the plural types of infusion tubes 200 having different diameters is attached to the infusion pump 1, when the open / close cover 5 is closed, the upstream side occlusion sensor 52 and the downstream side occlusion sensor 53 are The occlusion state of the infusion tube 200 can be detected.

FIG. 4 shows an electrical configuration example of the infusion pump 1.
As shown in FIG. 4, the infusion pump 1 has a control unit 100. The liquid feeding drive unit 60 includes a drive motor 61, a cam structure 62 having a plurality of cams driven to rotate by the drive motor 61, and a plurality of fingers moved by the cams of the cam structure 62. A finger structure 63 is provided.
The cam structure 62 has a plurality of cams, for example, a plurality of cams 62A to 62F, and the finger structure 63 has a plurality of fingers 63A to 63F corresponding to the plurality of cams 62A to 62F. . The plurality of cams 62 </ b> A to 62 </ b> F are arranged with a phase difference from each other, and the cam structure 62 is connected to the output shaft 61 </ b> A of the drive motor 61.

  When the output shaft 61A of the drive motor 61 rotates according to a command from the control unit 100 shown in FIG. 4, the plurality of fingers 63A to 63F sequentially advance and retract in the Y direction by a predetermined stroke, so that the infusion tube 200 extends along the T direction. Then, it is pressed against the infusion tube pressing member 500 of the opening / closing cover 5. For this reason, the medicine in infusion tube 200 can be sent in the T direction. That is, when the plurality of fingers 63A to 63F are individually driven, the plurality of fingers 63A to 63F sequentially press the outer peripheral surface of the infusion tube 200 along the T direction to feed the medicine in the infusion tube 200. . In this way, the control unit 100 controls the peristaltic motion of the plurality of fingers 63A to 63F, thereby causing the fingers 63A to 63F to move forward and backward in sequence, so that the wave is advanced, so that the complete pressure of the infusion tube 200 is reached. By repeating the movement of the closed portion in the T direction, the infusion tube 200 is squeezed and the medicine is delivered into the vein of the patient P through the indwelling needle or the indwelling catheter 172.

  The control unit 100 of the infusion pump 1 employs a CPU (central control unit) chip. The control unit 100 uses, for example, a one-chip microcomputer to control the overall operation, and includes a ROM (read only memory) 101, a RAM (random access memory) 102, a nonvolatile memory 103, and a clock. 104. The clock 104 can correct the current time by a predetermined operation, and can acquire the current time, measure the elapsed time of a predetermined liquid feeding operation, measure the reference time of liquid feeding speed control, and the like.

  4 includes a power switch button 4F, a power switch 111, a display driver 130 and a display 3, a drive motor 61, a speaker 131, a buzzer 132, a lamp 3W, a bubble sensor 51, and an upstream occlusion sensor. 52, the downstream blockage sensor 53, the communication port 140, the operation panel (operation button) 4, and the information terminal 600 on the nurse center side, and manage and control these peripheral elements. At least one or all of the display unit 3, the speaker 131, the buzzer 132, and the lamp 3 </ b> W are provided to the medical staff in response to a command from the control unit 100 when the occlusion pressure in the infusion tube 200 increases or decreases rapidly. This is a warning means for issuing a warning.

The switch 111 supplies power to the control unit 100 from one of the power converter unit 112 and the battery 113 by switching between the power converter unit 112 and the battery 113. The power converter unit 112 is connected to a commercial AC power source 115 via an outlet 114. The battery 113 is a rechargeable secondary battery such as a lithium ion battery.
The control unit 100 is also connected to the upstream block sensor 52 and the downstream block sensor 53. Thereby, the control part 100 can also monitor the obstruction | occlusion state in the infusion tube 200. FIG. When the infusion pump 1 is placed in a ward, for example, the nurse center side information terminal 600 is placed in the nurse center 650 distant from the infusion pump 1, and the display unit 3, the lamp 3W, the speaker 131, The display unit 3T, the lamp 3WT, the speaker 131T, and the buzzer 132T are the same as the buzzer 132.

The display unit driver 130 in FIG. 4 drives the display unit 3 in response to a command from the control unit 100, displays the information content and warning message illustrated in FIG. 2, and turns on the LED (light emitting diode) backlight. For example, the display can be changed from a “yellow display screen” to a “white display screen” that is a warning screen for a medical worker. Thereby, the possibility that a medical worker can visually recognize is increased. The error display lamp 3 </ b> W is turned on according to a command from the control unit 100. The speaker 131 can notify various warning contents instructed by the control unit 100 by voice. The buzzer 132 can warn various warnings by sound according to a command from the control unit 100.
Similarly, the display unit 3T is driven by a command from the control unit 100 to display the information content and warning message illustrated in FIG. 2 and to turn on the backlight of the LED (light emitting diode). The display can be changed from the “display screen” to a “white display screen” which is a warning screen for the medical staff. Thereby, the possibility that a medical worker can visually recognize is increased. The error display lamp 3WT is turned on according to a command from the control unit 100. The speaker 131T can notify various warning contents instructed by the control unit 100 by voice. The buzzer 132T can warn various warnings by sound according to a command from the control unit 100.

In FIG. 4, the bubble detection signal S <b> 1 from the bubble sensor 51, the upstream block signal S <b> 2 indicating that the upstream side of the infusion tube 200 from the upstream block sensor 52 is blocked, and the downstream of the infusion tube 200 from the downstream block sensor 53. A downstream block signal S3 indicating that the side is blocked is supplied to the control unit 100.
The upstream blockage sensor 52 and the downstream blockage sensor 53 can detect a state in which the internal pressure of the infusion circuit exceeds the set pressure in the infusion pump 1 and the medicine cannot be delivered. The reason why the internal pressure of the infusion circuit exceeds the set pressure in the infusion pump 1 is that a so-called “needle detachment” occurs in which the tip of the infusion needle or the infusion catheter 172 shown in FIG. In addition, there are cases where the inside of the infusion tube 200 is clogged, a part of the infusion tube 200 is crushed or broken, a case where a high-viscosity drug is used, and the like.

  In FIG. 4, the control unit 100 can communicate bidirectionally with a computer 141 such as a desktop computer through a communication port 140. The computer 141 is connected to a drug database (DB) 160, and the drug library MF stored in the drug database 160 is acquired by the control unit 100 via the computer 141 as necessary, and the control unit 100 100 nonvolatile memories 103 can be stored. The control unit 100 can display the drug library MF and the like on the display unit 3 shown in FIG. 2, for example, based on the stored drug library MF.

Referring to FIG. 4, the upstream occlusion sensor 52 shown in FIG. 4 detects whether the infusion tube 200 is occluded on the upstream side 200 </ b> A of the infusion tube 200, and the control unit 100 detects the infusion tube 200. This is a sensor for sending an upstream block signal S2 indicating that the upstream side is blocked.
The downstream blockage sensor 53 is a sensor for detecting whether or not the inside of the infusion tube 200 is blocked on the downstream side 200B of the infusion tube 200 and sending a downstream blockage signal S3 indicating that the downstream side of the infusion tube 200 is blocked. is there. The upstream blockage sensor 52 and the downstream blockage sensor 53 have the same configuration. In the embodiment of the present invention, when the downstream side of the infusion tube 200 is blocked, the infusion needle shown in FIG. 2 or the distal end of the indwelling catheter 172 is out of the vein of the patient P. An example in which the downstream occlusion sensor 53 is used to detect this “needle loss” phenomenon will be described later.

FIG. 5 is a block diagram showing a part of the electrical configuration example of the infusion pump 1 shown in FIG. 4 in more detail.
For example, the non-volatile memory 103 of the control unit 100 shown in FIG. 5 includes an occlusion precaution reference value table TB, an occlusion pressure rapid increase detection processing program PIP for the infusion tube 200, and an occlusion pressure rapid decrease detection processing program PDP for the infusion tube 200. The patient personal data PRD is stored. The patient personal data PRD includes various personal data regarding each patient. The patient personal data PRD includes, for example, data on the age of each patient individual and data on past blood pressure values of each patient individual.
The control unit 100 can acquire the occlusion precaution reference value table TB from the medicine database (DB) 160 on the computer 141 side through the communication port 140. This occlusion precaution is a preventive function of “detecting needle dislodgement at the distal end of the indwelling needle or indwelling catheter 172” using a change in the occlusion pressure in the infusion tube 200.
Specific examples of the blockage precaution reference value table TB, the blockage pressure rapid increase detection processing program PIP of the infusion tube 200, and the blockage pressure rapid decrease detection process program PDP of the infusion tube 200 will be described later.

FIG. 6 is an exploded perspective view showing a structural example of the upstream blockage sensor 52 and the downstream blockage sensor 53.
As illustrated in FIG. 6, the upstream blockage sensor 52 and the downstream blockage sensor 53 have the same structure. A hole 400 is provided in the surface 50 </ b> S of the tube mounting portion 50. A plastic frame member 401 is fitted into the hole 400, and the frame member 401 has a rectangular opening 402. The plastic slider 403 is inserted into the accommodation hole 404 in the hole 400, and the slider 403 has a base 405, a tip 406, and a spring 407.

  The front end 406 of the slider 403 is fitted in the opening 402. One end of the spring 407 is attached to the base 405, and the other end of the spring 407 is attached to the protrusion 409 in the accommodation hole 404. A Hall element 410 is disposed on the inner surface of the accommodation hole 404. Two magnets 411 and 412 are arranged on the base 405.

By adopting such a structure, the upstream blockage sensor 52 is simply installed by inserting the frame member 401 into the hole 400 and inserting the base 405 into the opening 402 and the accommodation hole 404 while holding the spring 407. The downstream blockage sensor 53 can be easily mounted on the surface 50S of the tube mounting portion 50, and the assembly workability of the upstream blockage sensor 52 and the downstream blockage sensor 53 can be improved.
On the other hand, as shown in FIG. 4, pressing members 452 and 453 are provided on the inner surface side of the opening / closing cover 5 at positions corresponding to the upstream closing sensor 52 and the downstream closing sensor 53, respectively. The pressing members 452 and 453 have a structure that is pressed to the facing frame member side via a spring 441. The pressing member 452 is a first pressing member, and the pressing member 453 is a second pressing member.

  For this reason, when a medical worker sets the infusion tube 200 in the tube mounting portion 50 as shown in FIG. 3 and then closes the opening and closing cover 5 as shown in FIG. 2, the first pressing member 452 on the opening and closing cover 5 side. And the second pressing member 453 can press a part of the infusion tube 200 against the upstream blockage sensor 52 and the downstream blockage sensor 53 side, respectively. Therefore, even when the outer diameter of the infusion tube 200 varies slightly due to manufacturing tolerances, or when the manufacturer of the infusion tube 200 is different, the infusion tube 200 can be The upstream occlusion sensor 52 and the downstream occlusion sensor 53 are pressed against the infusion tube 200 so that the occlusion state of the infusion tube 200 can be accurately detected.

The structures of the upstream blockage sensor 52 and the downstream blockage sensor 53 will be described more specifically. As shown in FIG. 2, when the open / close cover 5 is closed, the infusion tube 200 is moved between the pressing member 452 (453) and the tip 406 of the slider 403 as shown in FIG. It is sandwiched and held by each urging force 441. If the diameter of the infusion tube 200 is changed due to the blockage of the infusion tube 200, the tip 406 moves in the Y direction following the change in the diameter of the infusion tube 200. For this reason, when the magnets 411 and 412 move relative to the Hall element 410, the Hall element 410 detects a change in the magnetic flux and sends the movement amount to the control unit 100 as a signal of the change in the magnetic flux. Can do.
As shown in FIG. 6, the central axis direction of the spring 441 and the central axis direction of the spring 407 coincide with each other, and the springs 441 and 407 sandwich the infusion tube 200 between the pressing member 452 (453) and the distal end portion 406. Thus, it is possible to apply pressure to the infusion tube 200 along the diameter direction of the infusion tube 200. For this reason, the occlusion state of the infusion tube 200 can be detected with high accuracy by detecting the movement amount of the slider 403 forming the occlusion sensors 52 and 53.

  FIG. 7 shows an example of a state in which the indwelling needle or indwelling catheter 172 shown in FIG. In FIG. 7A, the distal end opening 197 of the indwelling needle or indwelling catheter 172 shows the inserted state of the normal indwelling needle or indwelling catheter 172 inserted into the vein (blood vessel) 198 of the patient. FIGS. 7B and 7C show an abnormal “needle out” condition of the indwelling needle or indwelling catheter 172. In FIG. 7 (B), the distal opening 197 of the indwelling needle or indwelling catheter 172 is removed from the vein (blood vessel) 198 of the patient P and is positioned in the subcutaneous tissue 199 of the patient P. The abnormal insertion state of the indwelling catheter 172 is shown. In FIG. 7 (C), the distal end 197 of the indwelling needle or indwelling catheter 172 is disengaged from within the vein (blood vessel) 198 of the patient P, and is not completely within the subcutaneous tissue 199 of the patient P, but completely of the subcutaneous tissue 199 and the skin 196. The abnormal state of the indwelling needle or the indwelling catheter 172 which has come off outside is shown.

In the abnormal “needle removal” state of the indwelling needle or indwelling catheter 172 shown in FIG. 7B, so-called extravasation occurs in which the drug leaks through the indwelling needle or indwelling catheter 172 and into the subcutaneous tissue 199. Therefore, in the abnormal “needle removal” state of the indwelling needle or indwelling catheter 172 shown in FIG. 7B, the drug leaks into the subcutaneous tissue 199, so that the normal indwelling needle or indwelling catheter shown in FIG. Compared to the insertion state of 172, the pressure increases, and the occlusion pressure (precaution pressure) in the infusion tube 200 increases rapidly.
In contrast, in the abnormal “needle removal” state of the indwelling needle or indwelling catheter 172 shown in FIG. 7C, the drug leaks out of the skin 196 through the indwelling needle or indwelling catheter 172, so that the pressure is increased. Since it rapidly decreases, the occlusion pressure (precaution pressure) in the infusion tube 200 rapidly decreases as compared with the insertion state of the normal indwelling needle or indwelling catheter 172 shown in FIG.

Here, an example of the blocking precaution reference value table TB will be described with reference to FIG. FIG. 8 shows an example of the blocking precaution reference value table TB.
The block precaution reference value table TB illustrated in FIG. 8 is stored in the nonvolatile memory 103 as shown in FIG. In the blockage precaution reference value table TB, the column 1001 of the type of drug in the drug library, the column 1002 of the detection setting level of the blockage state of the infusion tube 200, the column 1003 of the detection standard value of the blockage pressure sudden increase, and the blockage pressure rapid drop A detection reference value column 1004 is displayed.
In the drug type column 1001 in the drug library, drug types such as (A) nutrient, (B) antibiotic, (C) antihypertensive, (D) anesthetic, and (E) anticancer drug are listed. Are illustrated. In FIG. 4, the control unit 100 communicates with a computer 141 such as a desktop computer through the communication port 140, thereby allowing the medicine library MF stored in the medicine database 160 to be used. It can be acquired by the control unit 100. The types and order of drugs described in the occlusion precaution reference value table TB are merely examples, and the types of drugs and the order of description are not particularly limited.

  In the detection setting level column 1002 of the closed state of the infusion tube 200 in FIG. 8, the detection setting level 1 on the low sensitivity side to the detection setting level 5 on the high sensitivity side are illustrated. As the detection setting level 1 increases to the detection setting level 5, the detection capability of the occlusion pressure is highly sensitive. Detection setting level 1 is (A) nutrient, detection setting level 2 is (B) antibiotic, detection setting level 3 is (C) antihypertensive, detection setting level 4 is (D) anesthetic, and detection setting level 5 is (E) an anticancer agent.

In the detection reference value column 1003 of the occlusion pressure rapid increase (in this case, the occlusion AD value decreases) of the infusion tube 200 (200B) on the downstream side of the infusion pump 1 in FIG. 8, the detection setting level 1 to the detection setting level 5 In the detection reference value column 1004 for the blockage pressure sudden decrease (in this case, the blockage AD value increases), the detection setting level 1 corresponds to the detection setting level 5. A detection reference value N for the sudden decrease in the blocking pressure is shown. The detection reference value M for the sudden increase in the blocking pressure and the detection reference value N for the sudden decrease in the blocking pressure are expressed as a percentage (%) with respect to the predetermined blocking set pressure PP. The predetermined blockage setting pressure PP is a blockage pressure when the infusion tube 200 is completely blocked.
In FIG. 8, for example, in the detection reference value column 1003 for the blockage pressure sudden rise, the blockage pressure rapid rise detection reference value M is 90% of the blockage setting pressure PP at the detection setting level 1, and the blockage setting pressure PP at the detection setting level 2. The detection setting level 3 is set to 70% of the blockage setting pressure PP, the detection setting level 4 is set to 60% of the blockage setting pressure PP, and the detection setting level 5 is set to 50% of the blockage setting pressure PP.
In FIG. 8, for example, in the detection reference value column 1004 for the closing pressure sudden drop, the detection reference value N for the closing pressure sudden drop is 100% of the closing setting pressure PP at the detection setting level 1 and is closed at the detection setting level 2. 80% of the set pressure PP, 60% of the blockage set pressure PP at the detection set level 3, 40% of the blockage set pressure PP at the detection set level 4, and 20% of the blockage set pressure PP at the detection set level 5. ing.

  In order to monitor the sudden increase in the occlusion pressure that does not lead to the detection of the occlusion pressure in the occlusion state of the infusion tube 200 and the sudden decrease in the occlusion pressure, that is, the change in the occlusion pressure, “needle removal detection (occlusion precaution) When the flag “)” is “ON”, the control unit 100 monitors “detecting needle removal (blocking precaution)”. As illustrated in FIG. 8, the detection setting level of “needle detachment detection (occlusion precaution)” is set in five steps from detection setting level 1 (low sensitivity) to detection setting level 5 (high sensitivity). The detection setting level is designated according to the type of medicine from one of the five detection setting levels. This “needle detachment detection (occlusion precaution)” is effective only while the medicine is being delivered by the infusion tube 200.

In the determination of the detection of the sudden increase in the obstruction pressure shown in FIG. 8, the control unit 100 in FIG. 5 performs the obstruction AD (for example, acquired every 2 minutes according to the obstruction pressure sudden increase detection processing program PIP of the infusion tube 200 shown in FIG. The difference between the analog-to-digital conversion value and the current occlusion AD value is a certain value, that is,
<Occlusion AD value every 2 minutes−Current occlusion AD value ≧ Detection reference value M of occlusion pressure sudden increase>
Then, the control unit 100 in FIG. 5 displays “needle detachment detection (occlusion precaution)” on the display unit 3 shown in FIG. 5, sounds the buzzer 132, sounds by the speaker 131, and medical, for example. The practitioner can be warned that the indwelling needle or indwelling catheter 172 may be out of needle. Since the blockage AD value every 2 minutes uses the latest blockage AD value acquired every 2 minutes for the trend graph, the blockage AD value every 2 minutes is the blockage 2 minutes before the maximum. It becomes AD value. As already described, the detection reference value M for the blockage sudden rise shown in FIG. 8 is obtained by multiplying the blockage set pressure PP at that time by a ratio selected from five levels.

On the other hand, in the determination of the detection of the sudden decrease in the occlusion pressure shown in FIG. 8, the control unit 100 in FIG. 5 indicates that the occlusion pressure has rapidly decreased in accordance with the occlusion pressure rapid decrease detection processing program PDP in the infusion tube 200 shown in FIG. If the occlusion pressure is reduced above a certain level to detect
<Current blockage AD value−latest minimum AD value ≧ detection reference value N of blockage pressure sudden drop>
If so, for example, “needle removal detection (blocking precaution)” is displayed on the display unit 3 shown in FIG. 5, the buzzer 132 is sounded, or the speaker 131 is audibly voiced to the medical staff. It can be warned that the indwelling catheter 172 may be out of needle. If the same specification is used for the detection of the sudden decrease in the obstruction pressure, if the obstruction pressure AD value two minutes ago is in the process of sudden decrease, there is a possibility that “needle removal detection (occlusion precaution)” cannot be performed. There is no way to detect sudden changes. In the case of detecting the sudden decrease in the occlusion pressure, there is no time limit of 2 minutes from the latest minimum AD value to the current occlusion AD value.
As the latest minimum AD value, the latest AD value at the time when the AD value starts to increase from the decrease after the infusion pump 1 starts the liquid delivery operation is used (the occlusion pressure is increased). The latest minimum AD value is calculated as follows.

(1) At the start of liquid feeding, the latest minimum AD value is unconfirmed. If it has not been determined, the determination of sudden drop detection is not performed.
(2) Start AD value—Current occlusion AD value ≧ 5 points When the current occlusion AD value is the latest minimum AD value, the latest minimum AD value is determined. After the confirmation, a determination of sudden drop detection is performed.
(3) When the latest minimum AD value ≧ current occlusion AD value, the current minimum AD value is updated with the current occlusion AD value as the latest minimum AD value.
(4) When the medicine delivery is stopped, the latest minimum AD value is reset. When liquid feeding is started again, the latest minimum AD value of (1) starts from indefinite.
As the detection reference value N for the sudden decrease in the closing pressure shown in FIG. 8, a value obtained by multiplying the closing setting pressure at that time by a ratio selected from five levels is adopted.

Next, referring to FIG. 9 and FIG. 10, in the infusion pump 1, the tip 197 of the indwelling needle or the indwelling catheter 172 as shown in FIG. 7 (A) and FIG. A precaution (preventive measure) function for monitoring a sudden change in the occlusion pressure is explained, although the occlusion state in which the infusion tube 200 is occluded in order to detect a so-called “needle detachment” phenomenon is described. To do. FIG. 9 is a flowchart showing an example of monitoring when the occlusion pressure rapidly rises during the delivery of the drug through the infusion tube 200, and FIG. 10 shows the occlusion pressure suddenly during the delivery of the drug through the infusion tube 200. It is a flowchart which shows the example of monitoring in the case of falling.
In step ST1 of FIG. 9, the medical staff inserts the indwelling needle or indwelling catheter 172 into the vein (blood vessel) 198 of the patient P as shown in FIG. And when a medical worker pushes on the power switch 4F shown in FIG. 4 and switches on, the control part 100 will operate the drive motor 61 of the liquid feeding drive part 60, and the cam structure 62 will press the infusion tube 200. Then, the drug is fed into the vein (blood vessel) 198 of the patient P through the infusion tube 200 and the indwelling needle or indwelling catheter 172 as shown in FIG.

In step ST1 of FIG. 9, when the medicine is being delivered to the patient P through the infusion tube 200 and the indwelling needle or indwelling catheter 172 of FIG. 2, in step ST2, the downstream occlusion sensor of FIG. 53 sends the downstream blocking signal S3 to the control unit 100, and in step ST3 and step ST4, the control unit 100 determines whether or not the blocking pressure in the infusion tube 200 of FIG. to decide.
In step ST3, the control unit 100 determines that the occlusion pressure in the infusion tube 200 in FIG. 2 is rapidly increased by the downstream occlusion signal S3. In step ST4, the control unit 100 The detection sensitivity 1 to the detection sensitivity 5 is specified according to the magnitude of the percentage (%). For example, when the type of drug in the drug library MF shown in FIG. 5 is (E) an anticancer drug, the detection standard level M for the increase in the occlusion pressure is 50 because it is the detection setting level 5 for the occlusion state. Specified in%. Here, as the highest risk (E) anticancer drug, hypersensitivity requires A rank attention (caution), L-asparakinase, paclitaxel, bleomycin, etc. Note: Enocitabine, carboplatin, gemcitabine, budcetaxel, etc., such as cyclophosamide, melphalan, etc. that require C-rank attention to hypersensitivity (somewhat attention).

  Therefore, if <obstruction AD value every 2 minutes−current occlusion AD value ≧ detection reference value M of occlusion pressure rapid increase>, the control unit 100 inserts the normal indwelling needle or indwelling catheter 172 of FIG. From the state, the distal end 197 of the indwelling needle or the indwelling catheter 172 of FIG. 7B has been removed from the vein (blood vessel) 198 of the patient P and has been inserted into the subcutaneous tissue 199 of the patient P. It is determined that the indwelling needle or indwelling catheter 172 has been inserted. Thereby, in step ST5-1, the control part 100 warns that the indwelling needle or the indwelling catheter 172 may have taken out needle | hook with respect to the medical worker by sounding the buzzer 132 of FIG. To do. At the same time, in step ST5-2, the control unit 100 displays a warning on the display unit 3 in FIG. 5 to warn the medical staff that the indwelling needle or indwelling catheter 172 may be dislodged. At step ST5-3, the control unit 100 warns the medical staff that the indwelling needle or the indwelling catheter 172 may be dislodged by voice guidance through the speaker 131 of FIG. One of these warning means may be used, or a plurality of warning means may be combined.

As described above, in addition to notifying the medical staff by the control unit 100, the control unit 100 shown in FIG. 5 notifies the information terminal 600 on the nurse center side and rings the buzzer 132 T as necessary in step ST 6. This alerts the health care professional that the indwelling needle or indwelling catheter 172 may be dislodged from the vein. In step ST6-1, on the condition that the medicine is not an anticancer drug, the liquid feeding amount (mL / h) of the medicine is corrected and decreased, and the liquid feeding operation is continued (step ST20).
In addition, when a chemical | medical agent is an anticancer agent, it moves to step ST20-1 and stops liquid feeding operation automatically. Further, the control unit 100 warns the medical staff that the indwelling needle or the indwelling catheter 172 may be dislodged by displaying the icon or animation on the display unit 3T in FIG. At the same time, the control unit 100 warns the medical staff that there is a possibility that the indwelling needle or the indwelling catheter 172 is dislodged by voice guidance through the speaker 131T of FIG. In addition, the lamp 3WT is turned on to warn that the indwelling needle or the indwelling catheter 172 may be dislodged. One of these warning means may be used, or a plurality of warning means may be combined.
As described above, the control unit 100 moves the distal end 197 of the indwelling needle or indwelling catheter 172 in FIG. 7B from the normal indwelling needle or indwelling catheter 172 in FIG. When the blood vessel 198 is removed from the inside of the subcutaneous tissue 199 of the patient P, the medical staff is warned using a warning means. In step ST7, the liquid delivery operation of the drug in the infusion pump 1 is performed. Continue without interruption. Thereafter, after the medical worker confirms the state of the needle, the medical worker confirms the state of the needle, and then, according to the judgment of the medical worker, the liquid feeding operation of the medicine is stopped if necessary.

In the infusion operation of the medicine in the infusion pump 1 described so far, as an example of the medicine, an anticancer agent which is a medicine with a high risk is described as an example. In FIG. 8, in the drug type column 1001 in the drug library, the drug type, for example, (A) nutrient, (B) antibiotic, (C) antihypertensive, (D) anesthetic, and (E) anti-antigen. Cancer agents are exemplified. For example, damage is given to the subcutaneous tissue 199 shown in FIG. 7 in the order of (A) nutrient, (B) antibiotic, (C) antihypertensive, (D) anesthetic, and (E) anticancer agent. High risk.
Thus, when continuing the liquid feeding operation of the medicine in the infusion pump 1 without stopping, when the kind of medicine used is a medicine with a low risk, for example, the medicine is not an anticancer agent. In the case of (A) nutrient or (B) antibiotic, after performing steps ST1 to ST20 in FIG. 9, after a predetermined time (for example, in minutes), the process proceeds to step ST20-1, and the liquid feeding operation is performed. Pause automatically. Thereafter, the distal end opening 197 of the indwelling needle or indwelling catheter 172 is placed in the vein again, or it is confirmed that the distal end opening 197 of the indwelling needle or indwelling catheter 172 is placed in the vein. Thereafter, the start switch button 4C is manually pressed to restart the liquid feeding operation (step ST20-2), thereby returning to step ST1 and performing the normal liquid feeding operation.
In addition, when all the prepared infusion solutions are administered, or when the infusion pump has finished sending the set flow rate, the operation is terminated.
Hereinafter, in step ST20, the case where (A) a nutrient is used as a low risk medicine will be described in detail.

In step ST20, the control unit 100 shown in FIG. 5 extracts, for example, patient individual age data from the patient individual data PRD, and determines the amount of the liquid medicine that is a nutrient according to the age of the patient individual. cut back. In this way, depending on the age of the individual patient, the amount of the low-risk nutrient solution to be delivered is reduced when the individual age of the patient increases the pressure in the subcutaneous tissue compared to the case of the younger age. Therefore, the control unit 100 controls the rotation of the drive motor 61 to correct the amount of medicine delivered to reduce the amount of medicine delivered, and exits from the distal end of the indwelling needle or indwelling catheter into the subcutaneous tissue. This is because it is desirable to reduce the cumulative amount of medicine.
To explain an example of reducing the amount of medicine delivered, the control unit 100 assumes that the amount of medicine delivered is 100%, and if the individual patient's age is 20, the medicine delivery to 80%. Rotation control of the drive motor 61 in FIG. 5 is performed so as to reduce the liquid amount. Further, if the age of the individual patient is 30, the control unit 100 controls the rotation of the drive motor 61 shown in FIG. 5 so as to reduce the amount of the drug delivered to 70%. If the age is 40 years old, the rotation control of the drive motor 61 in FIG. 5 is performed so as to reduce the amount of the drug delivered to 60%.

If the age of the individual patient is 50 years old, the control unit 100 controls the rotation of the drive motor 61 shown in FIG. 5 so as to reduce the amount of the drug delivered to 50%. If the age is 60 years old, the rotation control of the drive motor 61 in FIG. 5 is performed so as to reduce the amount of the drug delivered to 40%. If the age of the individual patient is 70 years old, the control unit 100 controls the rotation of the drive motor 61 shown in FIG. 5 so as to reduce the amount of the drug delivered to 30%. Thus, reducing the amount of medicine delivered is merely an example, and the ratio of reducing the amount of medicine delivered can be arbitrarily set according to the age of the individual patient.
In this way, when the type of drug used is a low risk drug, for example, if the drug is not an anticancer drug, for example, a nutrient or antibiotic, the amount of drug delivered is the individual patient By temporarily reducing the age of the drug, the amount of drug that can be administered to the patient's subcutaneous tissue can be reduced and can be shaken more safely.

  Next, returning to step ST3 in FIG. 9, in step ST3, when the control unit 100 determines that the occlusion pressure in the infusion tube 200 in FIG. The process proceeds to step ST8. In step ST8, the control unit 100 determines that the occlusion pressure in the infusion tube 200 of FIG. 2 is suddenly lowered based on the downstream occlusion signal S3. In step ST9, the control unit 100 detects the occlusion set pressure. The detection sensitivity 1 to the detection sensitivity 5 is specified according to the value of the percentage (%) with respect to. For example, when the type of drug in the drug library MF shown in FIG. 5 is (E) an anticancer drug, the detection standard level N for the increase in the occlusion pressure is 20 because it is the detection setting level 5 for the occlusion state. Specified in%.

Therefore, in step ST9 of FIG. 10, if <current occlusion AD value−latest minimum AD value ≧ detection reference value N of occlusion pressure sudden drop>, a normal indwelling needle or indwelling catheter 172 shown in FIG. 7C, the distal opening 197 of the indwelling needle or indwelling catheter 172 shown in FIG. 7C is not inside the subcutaneous tissue 199 of the patient P, but completely removed from the subcutaneous tissue 199 and the skin 196. It has become “an abnormal indwelling needle or indwelling catheter 172 state”.
Thereby, in step ST10-1, the control part 100 rings the buzzer 132 of FIG. 5, and the indwelling needle or the indwelling catheter 172 remove | excludes needle | hook from a medical worker (state where the front-end | tip opening part 197 remove | deviated from the vein). ) Warn you that you may have At the same time, in step ST10-2, the control unit 100 displays a warning on the display unit 3 in FIG. 5 to warn the medical staff that the indwelling needle or indwelling catheter 172 may be dislodged. At the same time, in step ST10-3, the control unit 100 warns the medical staff that there is a possibility that the indwelling needle or the indwelling catheter 172 has come off the needle through the speaker 131 of FIG. One of these warning means may be selected, or a plurality of means may be combined.

In this way, in addition to the control unit 100 notifying the medical staff as described above, the control unit 100 shown in FIG. 5 notifies the information terminal 600 on the nurse center side and rings the buzzer 132T as necessary in step ST11. To warn healthcare professionals. At the same time, the control unit 100 displays the information on the display unit 3T of FIG. 5 to warn the medical staff that the indwelling needle or the indwelling catheter 172 may be dislodged, and to control the control unit 100. Warns the medical staff by voice through the speaker 131T of FIG. 5 that the indwelling needle or indwelling catheter 172 may be dislodged. In addition, the lamp 3WT is turned on to warn that the indwelling needle or the indwelling catheter 172 may be dislodged. One of these warning means may be selected, or a plurality of means may be combined.
As described above, the control unit 100 starts from the insertion state of the normal indwelling needle or indwelling catheter 172 in FIG. 7A, and the distal end opening 197 of the indwelling needle or indwelling catheter 172 in FIG. If it is outside the vein (blood vessel) 198 and outside the skin of the patient P, the medical staff is warned using the warning means, but in step ST12, the liquid feeding operation of the drug in the infusion pump 1 is stopped. Continue without. However, if necessary, the medicine supply operation is stopped by manual operation by pressing the stop switch button 4D according to the judgment of the medical staff.
In step ST8, when the occlusion pressure does not drop rapidly, the process returns to step ST3 in FIG. 9 and the subsequent steps are executed from step ST3.

  As an example of a drug, the most effective anticancer drug is among the drugs. If the tip of the indwelling needle or catheter goes out of the blood vessel and enters the subcutaneous tissue, the anticancer drug leaks out of the blood vessel. Resulting in. For this reason, some anticancer agents have a risk of necrosis of the subcutaneous tissue, some have a risk of causing inflammation, but do not easily cause inflammation, until the subcutaneous tissue becomes necrotic. For example, an anticancer drug is delivered into a patient's vein by infusion over about 3 to 4 hours. For this reason, it is impossible for health care workers to monitor the state of infusions at all times, so even if an anticancer drug is injected outside the blood vessel, the health care workers may not be able to detect it immediately. is there. In such a case, the anticancer agent spreads to the subcutaneous tissue, and in the worst case, the affected area may be necrotic. In addition, anesthetic drugs may cause pain associated with surgery if this drug does not work.

An infusion pump 1 according to an embodiment of the present invention is an infusion pump for feeding a drug into a patient's vein through a tube and a tip of a needle attached to the tube, and driving for feeding the drug through the tube and the needle. A motor, an occlusion sensor that detects the occlusion pressure of the tube when the medicine is delivered, and the occlusion pressure of the tube obtained from the occlusion sensor causes the tip of the needle to be removed from the vein and subcutaneously A control unit for determining that it is located in the tissue, and a warning means for issuing a warning in response to a command from the control unit when the occlusion pressure suddenly increases. An infusion pump characterized in that the amount of medicine delivered from the tube to the patient is reduced by controlling the operation of the drive motor according to the above.
According to the above configuration, when the occlusion pressure suddenly increases, it is possible to determine that the tip of the needle is out of the vein and is positioned in the subcutaneous tissue, and to reduce the amount of medicine delivered depending on the patient. Since it is possible, it is possible to reduce the amount of the drug delivered at a stage where it is not confirmed whether the tip of the needle is really located in the subcutaneous tissue. Thereby, even if the tip of the needle is removed from the vein and stays in the tissue under the skin, it is possible to reliably warn the medical staff and reduce the influence of the medicine on the tissue under the skin. In other words, it is detected that the tip of the needle has come out of the vein (needle detachment), and a low-risk medicine, such as a nutrient, is delivered in the subcutaneous tissue in a large amount with the same amount. This can be avoided and can reliably warn the medical staff of needle removal.

The control unit determines that the tip of the needle is out of the vein and positioned outside the skin when the occlusion pressure rapidly decreases due to the occlusion pressure of the tube obtained from the occlusion sensor. As a result, when the occlusion pressure drops rapidly, it can be determined that the tip of the needle is out of the vein and is located outside the skin. can do.
Even if the control unit determines that the occlusion pressure suddenly increases or the control unit determines that the occlusion pressure suddenly decreases, the control unit continues the liquid feeding operation without stopping the operation of the drive motor. Let As a result, the liquid supply of the medicine is continued without immediately stopping the operation of the drive motor. Therefore, after the medical worker confirms the state of the needle, the liquid supply operation of the medicine is stopped at the judgment of the medical worker. Can be made.

The warning means is at least one of a display unit that displays warning contents, a speaker that warns the warning contents by voice, and a buzzer that issues warnings. I can inform you.
Since the warning means is arranged at the infusion pump and the terminal arranged at the nurse center, not only the medical staff around the infusion pump but also the medical staff packed in the nurse center can be surely warned. Therefore, the liquid feeding operation of the medicine can be stopped by stopping the drive motor.

  On the upper part of the main body of the infusion pump, an operation panel part having a display unit and operation buttons is arranged, and the lower part of the main body of the infusion pump is an area in which a liquid feeding member for feeding a medicine is arranged. . Thereby, the medical worker can perform the liquid feeding operation of the medicine by the infusion pump while confirming the information on the display unit on the upper part of the main body. Then, the medical worker can operate the operation buttons on the operation panel unit while confirming the information on the display unit on the upper part of the main body.

The present invention is not limited to the above embodiment, and various modifications can be made without departing from the scope of the claims. The detection output is such that the occlusion AD value increases in response to the sudden increase in the occlusion pressure of the infusion tube 200 (200B) on the downstream side of the infusion pump 1, and the detection output is such that the occlusion AD value decreases in response to the sudden decrease in the occlusion pressure. Also good.
A part of each configuration of the above embodiment can be omitted, or can be arbitrarily combined so as to be different from the above.

  DESCRIPTION OF SYMBOLS 1 ... Infusion pump, 3 ... Display part, 50 ... Tube mounting part, 53 ... Downstream blockage sensor, 60 ... Liquid feeding drive part, 61 ... Drive motor, 100 ... Control unit, 3 ... display unit (warning means), 131 ... speaker (warning means), 132 ... buzzer (warning means), 172 ... indwelling needle or indwelling catheter, 200 ... infusion tube

Claims (6)

An infusion pump for delivering a drug registered from a drug library into a patient's vein through a tip opening of an infusion needle or an indwelling catheter attached to the tip of the infusion tube and the infusion tube,
A drive motor for feeding the drug through the infusion tube and the needle;
An upstream occlusion sensor and a downstream occlusion sensor for detecting the occlusion pressure of the infusion tube when the drug is delivered;
A control unit that determines that the tip of the needle is positioned in the subcutaneous tissue outside the vein when the occlusion pressure suddenly increases due to the occlusion pressure of the infusion tube obtained from the downstream occlusion sensor; ,
Warning means for issuing a warning in response to a command from the control unit when the occlusion pressure rises rapidly,
The drug includes a high risk drug and a low risk drug,
Wherein the control unit operates the occlusion圧急increase detection processing program, the closure pressure detected in the previous SL Downstream occlusion sensor, defined the criteria vary depending on the type of pre-drug, the tabled occlusion set pressure based on the detection reference value of the occlusive圧急rise against, when it is determined that the said spike, by controlling the operation of the drive motor in response to the patient, when the low risk of drug, the infusion tube An infusion pump characterized in that the amount of the drug delivered from the patient to the patient is decreased, and when the risk of the drug is high, the medicine delivery is temporarily stopped. When decreasing the amount of the drug delivered to the patient, the amount of decrease is changed according to the age of the patient,
Wherein the control unit operates the occlusion圧急falling detection processing program, the closure pressure detected by the downstream occlusion sensor of the occlusion sensor is determined is different criteria depending on the type of pre-drug, it is tabulated based on the detected reference value against occlusion圧急descends occlusion set pressure, that is when it is determined that the rapid lowering is determined that the tip of the needle is located outside the skin off from the intravenous The infusion pump according to claim 1, wherein the pump is an infusion pump. Even when the controller determines the sudden increase in the blocking pressure or when the controller determines the sudden decrease in the blocking pressure, the controller does not stop the operation of the drive motor. The infusion pump according to claim 2, wherein the liquid feeding operation of the medicine is continued. Said warning means includes a display unit for displaying the contents of warning, a speaker to warn the warning contents by voice, Ri least 1 Tsudea buzzer for alarm warning, said warning means, said infusion pump, the nurse infusion pump according to claim 1, characterized that they are being placed on the terminal which is disposed to the center. Whether or not the occlusion pressure detected by the downstream occlusion sensor has risen rapidly is determined based on the difference between the occlusion value acquired at a predetermined interval and the current occlusion value, the detection reference value for the occlusion pressure sudden increase. Is judged by comparing with
Whether or not the blockage pressure detected by the downstream blockage sensor has suddenly decreased is determined by comparing the difference between the current blockage value and the latest minimum value with the detection reference value for the blockage pressure drop. The infusion pump according to claim 2, wherein the infusion pump is determined. On the upper part of the main body of the infusion pump, the display unit and an operation panel part having operation buttons are arranged, and on the lower part of the main body of the infusion pump, a liquid feeding member for feeding the medicine is arranged. The infusion pump according to claim 4, wherein the infusion pump is a region to be operated.

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