Health devices
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This study focuses on molecular-sieve concentrators that deliver high-content oxygen for continuous, long-term therapy, which improves and extends the quality of life for adult patients who suffer from such illnesses as chronic obstructive pulmonary disease. We did not include membrane concentrators, which produce a maximum concentration of 40% oxygen (compared with 90% or more for molecular-sieve concentrators), because they are not suitable for most long-term oxygen-therapy applications. Although oxygen concentrators are most often used at home, they are also occasionally used in hospitals or nursing homes as an economical method of delivering oxygen when built-in systems are not required or available. ⋯ Readers are cautioned not to base purchasing decisions on our ratings alone, but on a thorough understanding of all issues surrounding the use of oxygen concentrators, which can be gained only by reading this study in its entirety. In the Discussion section, "Issues in Selecting, Purchasing, and Using Oxygen Concentrators," we discuss important factors to consider, such as required flow, oxygen concentration status indicators, high-temperature performance, electrical safety, noise, maintenance, and cost. Manufacturers' specifications for these and other units are available in ECRI's Hospital Product Comparison System.
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A nurse's aide, in transferring a mother in labor to the delivery room, turned off the infusion pump delivering Pitocin, a drug administered intravenously to accelerate contractions. The aide removed the infusion set from the pump without first closing the manual clamp on the line. A free-flow infusion occurred, and the mother received nearly 35 times the prescribed amount of drug. ⋯ We first raised this issue in our 1982 Evaluation "Infusion Controllers" and have emphatically and repeatedly addressed it in Health Devices and other ECRI publications. Yet, hospitals continue to report free-flow infusions, a problem that can be addressed by both hospitals and device manufacturers. In this article, we describe the causes of free-flow--both user error and device design; report numerous incidents, some resulting in death; and provide recommendations for reducing the likelihood that such problems will continue to occur.