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

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 5 th 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