Small Volume Parenterals and Medfusion® Pumps

NATIONAL SHORTAGE OF 50 ML AND 100 ML MINI-BAGS OF SALINE

For medications with critical delivery parameters SMITHS MEDICAL CAN HELP FACILITIES DURING THE NATIONAL SHORTAGE OF 50 ML AND 100 ML MINI-BAGS OF SALINE

CURRENT PROCESS OF INTERMITTENT MEDICATION ADMINISTRATION Many hospitals and health-system pharmacies routinely use small volume parenterals (SVPs) to compound mostly intermittent medications but also continuous infusions in preparation for administration. Intermittent medications are common in all types of hospitalized patients, and range in drug class as well as in their administration requirements. For centers focused on adult care, SVPs may be used extensively and could already be in short supply.

Is consistent drug delivery Is drug delivery time > Can drug be concentrated Yes 5 minutes critical? (e.g. No rate critical? (e.g. electrolytes, to <20 mL? chemotherapy) electrolytes, chemotherapy, aminoglycosides)

Yes

Is proper dilution (volume Yes and/or compatibility) of the medication critical? Medfusion® Syringe Infusion Pump

Note: syringe delivery may also be used for continuous medications compounded as small volume parenterals.

BENEFITS TO USING THE MEDFUSION® SYRINGE PUMP THE MEDFUSION® PUMP SOLUTION • +/- 2% accuracy • Pumps readily available from • Reduced dependence on SVPs • Out-of-the-box use option: Smiths Medical or our licensed • Decreased costs: non-proprietary Volume or Dose over time rental distributors tubing and syringes, less drug programming • Direct conversion for 50 mL waste due to decreased priming • Medication Safety Software available parenterals to syringe pump use volume, and less medical waste in 60 mL syringes compared to bulky large volume • Dose Error Reduction System (DERS) parenterals limits available for dose and time to • Simple delivery programming using help prevent programming errors dose or volume over time • Potential decreased risk of fluid overload to patients1 • Rapid Occlusion Detection • Online product training accessible 24/7 at no cost with additional • Flow rates: professional services available for 0.01 mL/hr – 1130 mL/hr purchase • Syringe compatibility: • Medication Safety Software with ® ® ® BD , Covidien /Monoject , and DERS functionality to reduce ® Terumo in 1 mL – 60 mL sizes programming errors • Trusted technology in use for years on the smallest patients

Source: IN193703GL-032015 - Medfusion 4000 Pump and PharmGuard Software Brochure Practical considerations for implementing a syringe delivery system

PHARMACY / COMPOUNDING • Are appropriate Policies and Procedures in place for syringe compounding? • Medication compounding needs - is staff trained on syringe prep? Are clean room space and equipment adequate? Is drug stability and compatibility information available? IT / INFORMATICS • Are necessary supplies available, including syringes, transport caps, drugs, and diluents? • What is the impact to EMR and department applications – CPOE, • Is outsourcing from a registered 503B pharmacy systems, medication compounder available? cabinets? • Are pharmacy labels and barcodes compatible • Can devices be added to the with syringe administration? ® PHYSICIAN ORDERING existing PharmGuard Server • Is the pharmacy medication distribution ® software if using the Medfusion and storage process appropriate for syringe • Are changes to order sets 4000 pump? administration? needed? • Is a drug library desired or will nursing use • Will there be an impact to CPOE? generic delivery modes? • Will physicians need training on the changes in medication NURSING / DELIVERING administration to ensure proper • Are appropriate Policies and patient care? E.g. maintenance Procedures in place for syringe IVF needs may change as a result? medication administration? • Are internal super-users available from pediatric, neonatal, or surgical areas available to assist with internal training? Have nurses used syringe pumps in previous practice? Syringe Delivery Model • What non-proprietary tubing syringes and connectors would be BIOMED / SERVICING required based on the impact to SOURCING / SUPPLY • Is staff trained on the new IV line configuration - y-site into equipment? mainline vs. direct connection to • Review pricing and par volumes the patient? needed for syringe infusion • Is the process for pump check-in and calibration understood? • Will there be changes to flushing tubing, connectors, syringes. practices before and after • Will new flush syringes be needed • Is any medication safety software medication delivery? for this workflow change? needed within Biomed? • Will there be an impact to • Can syringe pumps be rented or • Are there any new cleaning charting/EMR documentation? purchased? supplies or training needs? OPTIONS FOR ACQUIRING MEDFUSION® PUMPS

Direct Purchase of Medfusion® 3500 & 4000 Syringe Infusion Pumps Contact Smiths Medical .• Please contact your local Infusion Account Manager .• Call: 1-800-258-5361 .• https://smiths-medical.custhelp.com/app/whos_my_sales_rep

Capital or Operating Lease of Medfusion® 3500 & 4000 Syringe Infusion Pumps Work directly with your local Smiths Medical Infusion Account Manager. They will coordinate with one of our authorized Leasing Partners: US Bank MedOne Chris Jepson www.medonecapital.com Account Executive Tim Loftis (612) 492 2634 Director of Strategic Development [email protected] (800) 248-5882 (801) 619 6764 [email protected]

Rental or Asset Management of Medfusion® 3500 & 4000 Syringe Infusion Pumps Work directly with your local Smiths Medical Infusion Account Manager. They will coordinate with one of our authorized Renting Partners or with their respective office • UHS - https://www.uhs.com Toll Free: 1-800-847-7368 • Freedom Medical - http://www.freedommedical.com Toll Free: 1-800-784-8849

1. Child, D.L., Cao, Z., Seiberlich, L.E., Brown, H., Greenberg, J., Swanson, A., Sewall, M.R., Robinson, S.B., The costs of fluid overload in the adult intensive care unit: is a small volume infusion model a proactive solution? ClinicoEconomics and Outcomes Research. 2015;7:1-8.

PRODUCT(S) DESCRIBED MAY NOT BE LICENSED OR AVAILABLE FOR SALE IN CANADA AND OTHER COUNTRIES MMSPCA-0038 Smiths Medical ASD, Inc. 6000 Nathan Lane North Minneapolis, MN 55442, USA Tel: 1-614-210-7300 Toll-Free USA: 1-800-258-5361 Find your local contact information at: www.smiths-medical.com/customer-support Smiths Medical is part of the global technology business Smiths Group plc. Please see the Instructions for Use/Operator’s Manual for a complete listing of the indications, contraindications, warnings and precautions. Medfusion and the Smiths Medical design mark are trademarks of Smiths Medical. The symbol ® indicates the trademark is registered in the U.S. Patent and Trademark Office and certain other countries. All other names and marks mentioned are the trademarks or service marks of their respective owners. ©2017 Smiths Medical. All rights reserved. IN193746EN-112017