NZ752330B2 - Infusion system, device, and method having advanced infusion features - Google Patents

Abstract

Existing infusion devices might be limited in various ways. As one example, while multi-channel infusion devices might be able to deliver multiple medications to a patient, these infusion devices might be limited in the number of medications they can deliver and in their ability to interoperate with other infusion devices of different types. As a result, existing infusion devices might not be suitable or even capable of providing complex medication therapies involving multiple medications delivered in particular sequences. Therefore a need exists for advanced systems and devices for delivering substances to patients. Disclosed herein is an infusion device comprising: a pump; an input device; an output device; one or more processors; and memory storing instructions that, when executed by one or more of the processors, cause the infusion device to initiate a first infusion of a first type, receive, at the input device while the first infusion is infusing, input indicating a selection of a second infusion of a second type, display, at the output device, a configurable parameter of the second infusion, receive, at the input device, input indicating a value for the configurable parameter, determine whether the second infusion of the second type is duplicate; determine whether the second infusion is compatible with the first infusion; and initiate the second infusion based on the determination of duplication and the determination of compatibility. other infusion devices of different types. As a result, existing infusion devices might not be suitable or even capable of providing complex medication therapies involving multiple medications delivered in particular sequences. Therefore a need exists for advanced systems and devices for delivering substances to patients. Disclosed herein is an infusion device comprising: a pump; an input device; an output device; one or more processors; and memory storing instructions that, when executed by one or more of the processors, cause the infusion device to initiate a first infusion of a first type, receive, at the input device while the first infusion is infusing, input indicating a selection of a second infusion of a second type, display, at the output device, a configurable parameter of the second infusion, receive, at the input device, input indicating a value for the configurable parameter, determine whether the second infusion of the second type is duplicate; determine whether the second infusion is compatible with the first infusion; and initiate the second infusion based on the determination of duplication and the determination of compatibility.

Description

INFUSION SYSTEM, DEVICE, AND METHOD HAVING ADVANCED INFUSION FEATURES TECHNICAL FIELD The present application is generally related to the automated administration of a medication therapy. More particularly, the present application is directed toward uring and ng delivery of medications in systems and methods that include infusion devices.

The entire t of the complete specification of New Zealand Patent Application No. 734829 as originally filed is incorporated herein by reference.

OUND Modern medical devices, including infusion devices, are increasingly being lled by microprocessor based systems to deliver substances such as fluids, solutions, medications, and drugs to patients. A typical control for an infusion device includes a user interface enabling a l practitioner to enter a dosage of fluid to be delivered, the rate of fluid delivery, the duration, and the volume of a fluid to be infused into a patient. To deliver medications to the patient, an infusion device lly includes a pump and a fluid delivery device such as a syringe, tubing, section of tubing, or cassette.

Existing infusion devices, however, might be limited in various ways. As one example, while multi-channel on devices might be able to deliver multiple medications to a patient, these infusion s might be limited in the number of medications they can deliver and in their ability to interoperate with other infusion devices of different types. As a result, existing infusion devices might not be suitable or even capable of providing complex medication therapies involving le medications delivered in particular sequences. Therefore a need exists for advanced systems and devices for delivering substances to patients.

SUMMARY An aspect of the present invention provides an infusion device configured to infuse a fluid to a t, the on device comprising: a first pump; an input device; an output device; one or more sors; and memory storing instructions that, when executed by one or more of the processors, cause the infusion device to initiate a first infusion of a first type, receive, at the input device while the first on is infusing, input indicating a selection of a second infusion of a second type, display, at the output device, a configurable parameter of the second infusion, receive, at the input device, input indicating a value for the configurable ter, determine whether the second on of the second type is duplicated in another step in a current program, request, from a medication management system, a determination that the second on of the second type is duplicated on another line of a second pump that is also connected to the patient; determine whether the second infusion of the second type is duplicate in any ganged infusion pumps, and initiate the second infusion based on the ination that there is no of duplication in the another step the ination from the medication management system, and the determination from any of the ganged infusion pumps.

BRIEF DESCRIPTION OF THE DRAWINGS Aspects of the disclosure may be implemented in certain parts, steps, and embodiments that will be described in detail in the following description and illustrated in the accompanying gs in which like reference ls indicate r elements.

It will be appreciated with the benefit of this disclosure that the steps illustrated in the accompanying figures may be performed in other than the recited order and that one or more of the steps may be optional. It will also be appreciated with the benefit of this disclosure that one or more components illustrated in the anying figures may be positioned in other than the disclosed arrangement and that one or more of the components illustrated may be optional. Furthermore a set of elements is intended to include one or more elements. depicts a schematic m of an example medication management system including an example medical management unit and an example medical device. depicts a tic diagram of an example medical device. depicts an example of a -channel infusion device. depicts an example of a multi-channel infusion device. depicts an example of a medical device including two infusion devices that are associated with one another. depicts an example of a cassette kit for an infusion . s an example user interface of an infusion device having multiple lines. depicts a art of example method steps for programming an infusion to be delivered by an infusion device having multiple lines. depicts an example user interface at which the caregiver selects the substance to be delivered during the continuous infusion. depicts an example user interface at which the caregiver selects the concentration at which the selected substance should be delivered during the continuous infusion. depicts an example user interface at which the caregiver s the dose and unit for the continuous infusion. depicts an example user interface at which the caregiver specifies the value of the dose per unit for the continuous infusion. depicts an example user interface where the caregiver has ed to specify a VTBI. s an example user interface at which the caregiver selects the action the infusion device should perform upon completing the continuous infusion. depicts an example user interface that displays the parameters of the primary infusion tly being delivered by the infusion device. depicts an example user interface at which the caregiver may y the action to perform upon completion of a piggyback infusion. depicts an example user interface that ys the parameters of both the primary and secondary infusions currently being delivered by the infusion device. depicts a flowchart of e method steps for selecting a medication. depicts a flowchart of example method steps for ming a safety check for duplicate on substances. depicts a flowchart of example method steps for performing a safety check for compatible infusion substances. depicts a flowchart of example method steps for ying a dose for the selected substance at the infusion device. depicts a flowchart of example method steps for specifying a VTBI. depicts a flowchart of example method steps for ming an infusion configured at the infusion device. depicts a flowchart of example method steps for converting a current continuous infusion to one of the various advanced on types. depicts an example user interface of an infusion device at which the caregiver may add a step to an infusion sequence at the infusion device. depicts a flowchart of example method steps for adding a new step to a current infusion ce at an infusion device. depicts an example user interface of an infusion device for changing the line for an inter-channel sequencing infusion. depicts a flowchart of example method steps for ganging infusion devices. depicts a flowchart of example method steps for viewing and manipulating the list of infusion steps configured for an infusion sequence. depicts an example user interface displaying a list of infusion ce steps for an infusion to be delivered by an infusion device. depicts an example user interface of an infusion device for displaying the parameters associated with a step the caregiver has selected in the list of infusion steps. depicts the user interface of in which the ver has selected one of the steps (step no. 4) in the list of infusion steps. depicts the user interface of in which the caregiver has dragged the selected step to the right to remove it from the list. depicts a flowchart of e method steps for converting a uous infusion to an intermittent infusion. depicts a flowchart of example method steps for specifying one or more callback options. depicts an e user interface for cloning a current step of an intermittent on. depicts a flowchart of e methods steps for configuring an intermittent on. depicts a flowchart of example method steps for converting a continuous infusion to an "infinite" flow infusion and configuring the ite" flow infusion. depicts a flowchart of example method steps for configuring an "infinite" flow infusion. depicts a flowchart of example method steps for an "infinite" flow infusion.

A depicts an example user interface of an infusion device during an "infinite" infusion flow.

B depicts another example user interface of an infusion device during an "infinite" infusion flow. depicts a flowchart of example method steps for selecting a secondary infusion at infusion device. depicts an example user interface of an infusion device at which a caregiver may select to configure an advanced infusion type. depicts a flowchart of e method steps for selecting an advanced infusion type to configure at an infusion device. depicts a flowchart of example method steps for configuring a TPN infusion at an on device. s a flowchart of example method steps for selecting a TPN protocol at an infusion device. depicts a flowchart of example method steps for configuring a multistep on at an infusion device. s a flowchart of e method steps for configuring an interchannel sequencing infusion. depicts a flowchart of example method steps for selecting a predefined inter-channel sequencing protocol. depicts an example user interface for selecting an channel sequencing protocol at an infusion device. depicts a flowchart of example method steps for performing safety checks based on a selected inter-channel sequencing protocol. depicts an example user interface of an on device for listing and selecting infusion s to be used in an inter-channel sequencing infusion. depicts an example user ace of an infusion device displaying a confirmation request to gang the on device to another infusion device. s a user interface of an infusion device for assigning infusion lines to steps of an inter-channel sequencing infusion. depicts a art of example method steps for configuring the steps of an inter-channel sequencing infusion.

A depicts a user interfaces that include a visual indicator to identify the on device as a master or slave infusion device.

B s another user interfaces that include a visual indicator to identify the infusion device as a master or slave infusion device. depicts an example of a possible inter-channel sequencing infusion that may be implemented utilizing the infusion devices described herein. depicts a flowchart of example method steps for configuring the steps of an inter-channel sequencing infusion manually. s a user interface for configuring the first delivery of the second step of an inter-channel sequencing infusion. depicts a user ace for configuring the second delivery of the sixth step of an inter-channel sequencing infusion. depicts an e user interface of an infusion device for notifying or warning a caregiver regarding a non-delivery condition. depicts a flowchart of example method steps for configuring a piggyback on at an infusion device. depicts a flowchart of e method steps for uring piggyback infusion options including selecting or specifying an action to perform at the end of the piggyback infusion. depicts a art of example method steps for configuring a concurrent on. depicts an example of an implementation of an infusion device. depicts an example of a set of interconnected infusion devices. depicts interconnected infusion devices respectively associated with patients. depicts a flowchart of e method steps for ganging together infusion devices via a medication management system. s a art of example method steps for ganging together infusion devices via direct communications. depicts a flowchart of example method steps for ating a master infusion device for infusion devices ganged together via an interconnecting device. depicts a flowchart of example method steps for designating a master infusion device for infusion devices ganged together via wireless communications. another flowchart of example method steps for ganging together infusion devices that are interconnected via a medication management system. depicts a art of example method steps for configuring an infusion at an infusion device. s a flowchart of example method steps for uring a ce of infusion steps at an infusion device. depicts a flowchart of example method steps for interconnecting multiple infusion devices and controlling the interconnected infusion devices from a master infusion device during an infusion.

DETAILED DESCRIPTION In general the present disclosure provides systems, devices, and methods for delivering substances such as , solutions, medications, and drugs to patients using infusion devices having a set of advanced features. These advanced es include aspects related to the programming of infusion devices, the configuration of on sequences performed by the infusion devices, and the interconnection of multiple infusion devices for interoperation during an infusion having a sequence of infusion steps.

The aspects described herein may be employed using infusion products available from Hospira ide, Inc. ira") headquartered in Lake Forest, Illinois.

Examples of infusion systems that may be utilized include the Plum A+ TM Infusion System and the Plum A+3 TM on System available from Hospira. The on systems may utilize the PlumSet TM cassette also available from Hospira. The cassette may be a dual-input cassette with two input ports from respective delivery sources and one output port to the patient. The deliver source may be, e.g., a bottle, bag, or other type of container suitable for infusion procedures. The dual-input cassette thus provides the ability to deliver two infusions to the patient via the same infusion channel. The dual- input cassette thus provides opportunities to e infusion systems, devices, and methods with advanced infusion features.

As described in r detail below, infusion systems, devices, and methods may include the following ed on es. One advanced infusion feature allows a caregiver to dynamically configure the parameters of a current ongoing infusion as well as add steps to a current ongoing infusion. This advanced infusion feature advantageously allows the caregiver to convert the current infusion type to r type of infusion. This advanced infusion feature also advantageously allows the caregiver to initiate the first step of an infusion while configuring the subsequent steps of the infusion.

As described in further detail below, an infusion device may provide a user interface that allows a ver to select and configure infusion steps, e.g., selecting the on type and infusion parameters, arranging the sequence of infusion steps, and confirming individual on steps and the overall infusion sequence.

Another advanced infusion e interconnects multiple on devices via a network in a master/slave configuration. This feature provides protocols for discovering interconnected infusion devices available for selection, designating an on device as the master infusion device, and selecting one or more slave on devices. As described in further detail below, different techniques may be employed to designate the master infusion device and select the slave infusion devices depending on whether the infusion devices are interconnected via a physical or wireless connection. This feature also provides protocols for designating a new master infusion device if the slave infusion devices lose the connection with the current master infusion device.

The master/slave configuration of the infusion devices allows for advanced infusion es related to inter-channel and inter-device sequencing of infusion steps.

As also described in further detail below, a ver may program infusion steps between different types of infusion devices may program infusion steps with le deliveries via multiple channels per step. In this way, the advanced infusion features allow the caregiver to configure complex sequences of infusion steps involving multiple delivery sources, multiple infusion devices, and multiple channels. onnecting the infusion devices also provides various safety features. As one example, the total infusion rate across all on devices associated with a patient may be limited. As another example, the total amount of air accumulated across all infusion devices associated with the patient may be tracked, and an alarm may be provided to a caregiver if the total amount of accumulated air s a predetermined threshold. In a further example, duplication and compatibility safety checks for multiple infusion s connected to the same access site, and a notification indicating duplicate or incompatible substances may be provided to a caregiver who may have the ability to review and override any conflicts.

These and additional s will be appreciated with the t of the disclosures provided in further detail below.

Medication Management Systems, Medical Management Units, and Medical Devices As a brief introduction to the aspects discussed in further detail below, the following description of medication management systems, medical management units and medical devices is provided. depicts an example medication management system including an example medical management unit and an example medical device. The medication management system (MMS) 10 includes a medication management unit (MMU) 12 and a medical device 14, typically operating in conjunction with one or more information systems or ents of a hospital environment 16. The term hospital environment should be construed broadly herein to mean any medical care facility, including but not limited to a hospital, treatment center, , doctor's office, day surgery , hospice, g home, and any of the above associated with a home care environment. There can be a y of information systems in a hospital environment. As shown in the MMU 12 communicates to a hospital information system (HIS) 18 via a caching mechanism 20 that is part of the hospital environment 16.

The caching mechanism 20 is primarily a pass through device for facilitating communication with the HIS 18 and its functions can be eliminated or incorporated into the MMU 12 and/or the medical device 14 and/or the HIS 18 and/or other ation s or components within the hospital environment 16. The caching mechanism 20 provides temporary storage of al information data separate from the HIS 18, the medication administration record system (MAR) 22, pharmacy information system (PhIS) 24, ian order entry (POE) 26, and/or Lab System 28. The caching mechanism 20 provides information storage ible to the MMS 10 to support scenarios where direct access to data within the hospital environment 16 is not available or not desired. For example, the caching mechanism 20 provides continued flow of information in and out of the MMU 12 in instances where the HIS 18 is down or the connectivity between the MMU 12 and an onic network is down.

The HIS 18 communicates with a MAR 22 for maintaining medication s and a PhIS 24 for delivering drug orders to the HIS. A POE device 26 permits a healthcare provider to deliver a medication order prescribed for a patient to the hospital information system directly or indirectly via the PhIS 24. A medication order can be sent to the MMU 12 directly from the PhIS 24 or POE device 26. As used herein the term medication order is defined as an order to administer something that has a physiological impact on a person or animal, including but not d to liquid or gaseous fluids, drugs or medicines, liquid nutritional products and combinations thereof.

Lab system 28 and monitoring device 30 also icate with the MMU 12 to deliver updated patient-specific information to the MMU 12. As shown, the MMU 12 communicates directly to the lab system 28 and monitoring device 30. However the MMU 12 can communicate to the lab system 28 and monitoring device 30 indirectly via the HIS 18, the caching mechanism 20, the l device 14 or some other intermediary device or system.

Delivery information input device 32 also communicates with the MMU 12 to assist in processing drug orders for delivery through the MMU 12. The delivery information input device 32 can be any sort of data input means, ing those adapted to read machine readable indicia such as barcode labels; for example a personal digital assistant (PDA) with a barcode scanner. Hereinafter the delivery information input device 32 will be ed to as input device 32. Alternatively, the machine readable indicia may be in other known forms, such as radio frequency identification (RFID) tag, two-dimensional bar code, ID matrix, transmitted radio ID code, human biometric data such as fingerprints, etc. and the input device 32 adapted to "read" or recognize such indicia. The input device 32 is shown as a separate device from the medical device 14; atively, the input device 32 icates directly with the medical device 14 or may be integrated wholly or in part with the medical device.

With reference to an electronic network 114 ts the MMU 12, medical device 14, and hospital environment 16 for onic communication. The electronic k 114 can be a completely wireless network, a completely hard wired network, or some combination thereof. is a schematic diagram illustrating several functional components of a medical device 14 for implementing aspects of the present disclosure. The device 14 includes many more ents than those shown in However, it is not necessary that all these components be shown in order to disclose an illustrative embodiment for practicing aspects of the present disclosure.

In the context of the present disclosure, the term "medical " includes without limitation a device that acts upon a cassette, reservoir, vial, syringe, or tubing to convey medication or fluid to or from a patient (for example, an enteral pump, a parenteral infusion pump, a patient controlled sia (PCA) or pain management tion pump, or a suction pump), a monitor for monitoring patient vital signs or other parameters, or a diagnostic, g or sampling device.

For the purpose of exemplary illustration only, the l device 14 is disclosed as an infusion pump. More particularly, the medical device 14 can be a single channel infusion pump, a multi-channel infusion pump (as shown), or some combination thereof.

The l device 14 in is a pump-style medical device and includes a network interface 112 for connecting the medical device 14 to electronic network 114.

Where a wireless connection to the electronic network 114 is desired, network interface 112 operates an antenna for wireless connection to the electronic network 114. The antenna can project e the device 14 or be enclosed within the g of the device.

A processor 118 is included in the medical device 14 and performs various operations described in greater detail below. The input/output device 120 allows the caregiver to receive output from the l device 14 and/or input information into the medical device 14. The input/output device 120 may be provided as a single device such as a touch screen 122, or as a separate display device and a separate input device. The y screen 122 of the medical pump 14 may be a thin film transistor active matrix color liquid crystal display with a multi-wire touch screen. A membrane generally impermeable to fluids may overlay the display screen 122 so the caregiver can press on images of keys or buttons on the underlying screen with wet gloves, dry gloves or without gloves to trigger an input.

A memory 124 communicates with the processor 118 and stores code and data necessary for the processor 118 to perform the functions of the medical device 14. More specifically, the memory 124 stores multiple ms formed in accordance with the present disclosure for s functions of the l device 14 including a graphical user interface program 126 with multiple subparts described in greater detail below.

Infusion and Infusion s on devices may be programmed to carry out various types of infusion sequences. Types of infusion ces include continuous infusion, intermittent infusion, step infusion, inter-channel sequencing infusion, "infinite" (i.e., uninterrupted) flow infusion, and total parenteral nutrition (TPN) infusion.

Continuous infusion refers to infusion that occurs at a defined infusion rate until the infusion device has delivered the Volume-to-be-Infused (VTBI). The infusion device may then perform a user-selectable action which may include, e.g., keeping the vein open (KVO), continuing the infusion rate, or stopping the infusion.

Intermittent infusion refers to infusion that occurs until the infusion device has delivered the VTBI, at which point the on device performs a user-selectable action and then resumes the infusion until on device has again delivered the VTBI. The infusion device may repeat an ittent infusion a user-specified number of times.

Multi-step infusion is similar to intermittent infusion as multi-step infusion involves le sequential infusions of the same medication. In contrast to intermittent infusion, however, subsequent ons in multi-step infusion may be configured to deliver the medication at a different dose, rate, VTBI, or duration. A subsequent infusion in a multistep infusion may also be configured such that a different action is performed when the subsequent infusion is complete.

Inter-channel sequencing infusion refers to infusion that involves multiple sequential infusions that can be delivered via different lines and thus from different sources ning different substances. The infusion devices used for inter-channel sequencing may include a -channel large volume pump (LVP), a dual-channel LVP, a syringe pump, or a patient-controlled analgesia (PCA) pump. Inter-channel sequencing infusion may also be performed using multiple infusion devices in which a l of a first infusion device infuses a first substance and a channel of a second infusion device infuses a second substance. Inter-channel sequencing infusion that uses multiple infusion s may be ed to as device infusion.

"Infinite" flow infusion refers to infusion that utilizes two delivery lines on a single cassette channel wherein the infusion device automatically es to the other line when the current line completes its infusion such that there is no interruption in the delivery. A caregiver may then replace the depleted delivery source without having to stop or otherwise interrupt the t infusion.

Total parenteral nutrition on refers to infusion that delivers nutrition intravenously according to a pre-defined protocol.

As noted above, multi-channel infusion devices may include both a primary and a secondary line. A caregiver may program the infusion device to deliver a y infusion via either the y or the secondary line. When an infusion device has been programmed with a primary infusion, the caregiver may program the other line (either the primary line or the secondary line) to deliver a secondary infusion. The secondary infusion may be a concurrent infusion or a piggyback infusion. A concurrent infusion refers to simultaneous delivery from two delivery sources and ndent infusion rates. Piggyback infusion refers to infusion that will stop infusion on one line, complete infusion on another line, and then restart infusion on the d line.

As also noted above a medical device can be a single channel infusion pump, a multi-channel infusion pump, or some combination thereof. depicts an example of a medical device that is a single channel infusion device. The infusion device may include a display screen that may display error messages, error codes, and suggested actions. The infusion device may comprise a memory, a sor, a clock (real time or otherwise) and other components. The memory may store computer-executable instructions the processor may execute to cause the infusion device to perform one or more steps bed in further detail below. depicts an example of a medical device 14 that is a multi-channel on device having a first channel 132 with first channel machine-readable label 134 and a second channel 136 with a second l machine-readable label 138. A user of the medical device 14 operates the machine-readable input device 130 to select a channel from one or more channels 132 and 136, by scanning in the associated ereadable label 134 or 138.

The caregiver selects the desired channel 132 or 136 by using the machinereadable input device 130 to scan a factory or hospital programmed, unique, machinereadable label 134 or 138 that is electronically ted and presented on the screen 122, which may be juxtapositioned near the tive channel 132 or 136. Alternatively, the machine-readable labels 134 and 138 are physically d to the medical device 14, which may be on or ositioned near the channel 132 and 136, respectively.

Since the machine-readable labels 134 and 138 are generated and/or can be stored in memory 124 by the medical device 14, the medical device 14 can associate the machine-readable labels 134 and 138 to the ls 132 or 136. The medical device 14 then allows the caregiver to m and activate the selected channel 132 or 136.

The caregiver may also manually select the desired channel by touching an appropriate folder tab on the touch screen. The folder tabs are labeled and/or physically arranged on the screen so as to be proximate to the corresponding channel 132 or 136.

In a further aspect of the wireless embodiment, the medical devices can periodically ast a unique wireless device/channel IP address and/or a selfgenerated unique machine-readable label (for example, a barcode) 134 or 138 that can also be presented on the screen 122. atively, the machine-readable labels 134 and 138 are physically affixed to or posted on the medical device 14. Each medical device may correlate such broadcasted or posted device/channel IP addresses and/or es with a particular patient, who is also identified by a unique machine readable label (not shown) or patient IP address. The caregiver associates the desired pump(s) or channel(s) 132, 136 with the patient by using the machine-readable input device 130 to scan the unique machine-readable labels 134, 138 and the patient's machine readable label. This causes the appropriate pump processor(s) 118 to associate the appropriate pump channel(s) 132, 136 with the patient. Then the pumps or channels can associate communicate, and coordinate with each other wirelessly.

The medical device 14 includes a split touch screen 122 having a first channel screen n 140 associated with first channel 132 and a second channel screen portion 142 associated with the second channel 136. Each channel screen portion 140 and 142 presents a subset of the delivery information regarding the respective ls 132 or 136, including without limitation therapeutic agent name, concentration, dose rate, VTBI, and alarm information, in a font size that it is easily readable by a caregiver from a distance such as, for example, from approximately fifteen to twenty feet (4.6-6.2 meters) away. This is what is referred to as a "far view" delivery screen. The far view delivery s display subsets of the information found on the nt "near view" ry screens. The near view delivery screen displays drug name, tration, dose rate, time remaining, VTBI, volume remaining, and alarm name for the highest priority alarm if in an alarm state. The near view delivery screen will switch to the far view delivery screen after a defined period of time that is predetermined by the manufacturer, configurable by the facility via the drug library, and/or set by the caregiver at the device, for example after 20 seconds.

Upon a caregiver touching one of the tabs "A" or "B" or anywhere on the channel screen portions 140 or 142 of the far view delivery screen, a "near view" delivery screen is presented on the screen 122. The channel screen portion 140 or 142 selected or corresponding to the tab ed expands in area but the size of at least some of the text therein is shrunk.

The shrinkage of one of the channel screen portions 140 and 142 and enlargement of its counterpart provides additional space for one or more data display or data entry fields to be placed on screen 122. As discussed below, data displays or data entry fields are placed on screen 122 in space previously ed by portions of the channel screen portion 140 or 142. This reallocation of space on screen 122 permits the caregiver to enter inputs more easily since the data entry field can be large, preferably at least as large or, more preferably, larger in area than the al channel screen portions 140 and 142 were in the delivery screen mode. Additionally, the reallocation of space on screen 122 provides greater space for ting information on the channel being adjusted or monitored.

Referring again to the l device 14 includes dedicated or fixed tactile infuser buttons, and images of buttons on the LCD-touch screen 122. The fixed tactile buttons 133, 135, 137, and 139 provide the following functions: LOAD/EJECT button pens and closes the cassette carriage; ON/OFF button 135--turns power on and off; ALARM SILENCE button 137--silences a silenceable alarm for a specified period of time, for example two minutes; and EMERGENCY STOP button 139--stops all channels.

The LCD color touch screen 122 allows the caregiver to access and use onscreen button , for example 3D button , and data entry fields. The touch screen 122 uses a membrane over the LCD display so a single keypress does not cause significant infusion pole movement nor is it mistaken for a double keypress. The touch screen also accommodates a keypress whether the caregiver is wearing wet gloves, dry , or no gloves. depicts an example medical device 11 that includes a single-channel infusion device 11A and a multi-channel infusion device 11B. The single-channel infusion device 11A has a single channel 51 (i.e., an "A" channel). The multi-channel infusion device has a first channel 33 (i.e., a "B" l) and a second channel 39 (i.e., a "C" l). The single channel infusion device 11A and the multi-channel infusion device 11B are physically and communicatively connected to each other for programming and operation in a coordinated manner. In one example, the single channel on device 11A and the multi-channel infusion device 11B are detachably coupled together. Although rates a single channel medical device 11A associated with a multi-channel medical device 11B, is it noted that this is for illustrative purposes only, and other various ations of various types of infusion devices may be made without departing from the present sure. Additionally, while the infusion devices 11A and 11B are shown as being physically associated, it is contemplated that they may alternatively be wirelessly associated.

The infusion device 11B of the medical device 11 has a first channel 33 and a second channel 39. A first tube set may be operably coupled to the first l 33 to deliver a fluid from the first channel 33 and a second tube set may be operably coupled to the second channel 39 to deliver a fluid from the second channel 39. Each of the channels 33, 39 includes a tive g mechanism 35, 37 for acting upon a tube set to pump fluid. Various pumping mechanisms may be utilized without detracting from the present invention. The tube set may be made of soft, kink-resistant medical grade tubing and may e a medicinal dispensing pump cassette that is acted upon by the pumping mechanism. The first l 33 may also include a first channel machine-readable label (134 in and the second channel 39 may also include a second channel machine-readable label (138 in . A user of the medical device 10 may operate a machine-readable input device (130 in to select a channel from one or more channels 33 and 39, by scanning in the associated machine-readable label.

The user may select the d channel 33 or 39 by using the machine-readable input device to scan a y or hospital mmed, unique, machine-readable label that is electronically generated and presented on the screen 23, which may be juxtapositioned near the respective channel 33 or 39. Alternatively, the machinereadable labels may be physically affixed to the medical device 11, which may be on or juxtapositioned near the channel 33 and 39 respectively. Since the machine-readable labels are generated and/or can be stored in memory by the infusion device 11B, the infusion device 11B can associate the machine-readable labels to the channels 33 or 39.

The infusion device 11B then allows the user to program and activate the selected channel 33 or 39. The user may also manually select the desired channel by touching an appropriate folder tab on the touch screen. The folder tabs are labeled and/or physically arranged on the screen so as to be ate to the corresponding channel 33 or 39.

That is, the "B" tab is juxtapositioned near or adjacent to the "B" channel 33 and the "C" tab is juxtapositioned near or adjacent to the "C" l 39.

A graphical user interface program may cate the screen 23 for one of the infusion devices 11A or 11B of the medical device 11. The infusion device 11B includes a split touch screen 23 having a first channel screen portion 41 associated with first channel 33 and a second channel screen portion 43 associated with the second channel 39. Each channel screen portion 41 and 43 presents a subset of the delivery information regarding the tive channels 33 or 39, including without limitation therapeutic agent name, concentration, dose rate, VTBI, and alarm information, in a font size of at least twenty-eight points so that it is easily le by a user from approximately fifteen to twenty feet (4.6-6.2 meters) away. This is what is referred to as a "far view" delivery screen.

When a user touches one of the tabs "B" or "C," or any part of the l screen portions 41 or 43 of the far view ry screen, a "near view" delivery screen is presented on the screen 23. The channel screen portion 41 or 43 ed or ponding to the tab ed expands in area but the size of at least some of its text is reduced. The font size for rate and VTBI information on the near view delivery screen is substantially less than twenty-eight points. The other channel screen portion 41 or 43 (if present) is reduced in size, hidden or moved to the background to limit its space on the screen 23. Preferably, if the "B" tab of the first channel screen portion 41 is selected, the "C" tab of the second channel screen portion 43 s exposed, but is grayed or colored differently to indicate it is not the channel of interest. Thus, the second l screen portion 43 becomes smaller than the first channel screen portion 41, as the first channel screen portion 41 is currently being viewed and adjusted by the user and is therefore of primary concern. The second or C channel can be selected in a similar manner, whereupon the first channel portion 41 of the screen 23 will become smaller and the second channel portion 43 will become . Since the screens for the respective channels are substantially identical, except for the position of their tabs, features shown in the gs and described below relative to the B channel also apply to the C l, and vice versa.

As described above, the memory stores multiple programs formed in accordance with the present invention, including an infuser program that allows for inter-channel sequencing infusions. Inter-channel sequencing infusions allows for the tial delivery of separate substances from two or more channels. In particular, the infuser program can be programmed by a caregiver to sequence dispensation of substances between channels such that a t can e substances from two or more channels without having to reprogram the infusion device. depicts an example of a te kit that may be used in a single-channel or multi-channel on device. As seen in the cassette kit includes a te connected to a convertible piercing pin with drip chamber via a primary line along which a slide clamp may be positioned. The cassette is also connected to a patient line that includes a Y-site connector along its length and a protective cap with filter at one end. A roller clamp may also be positioned along the length of the patient line. The cassette in also includes a secondary inlet port at which a secondary line may be connected.

The cassette in may advantageously allow two deliver two infusions using the same infusion channel from delivery sources respectively connected to each of its two input ports. The cassette may route the substance received from the delivery sources at the input ports to the output line connected to the patient. As described in further detail below, the use of this type of cassette advantageously presents new opportunities for uring infusions at an infusion .

Dynamic Infusion Programming As noted above, aspects of the disclosure are directed toward ed infusion features that allow a caregiver to dynamically configure the parameters of a current ongoing infusion of add steps to a current ongoing infusion. depicts an example user ace of an infusion device having multiple lines, in this case a y line (Line A) and a secondary line (Line B). As seen in the interface includes input elements for selecting a type of infusion to m for the primary line, in this case a continuous infusion or an advanced infusion. Advanced infusions may e, e.g., an intermittent infusion, a multi-step infusion, an interchannel sequencing infusion, an "infinite" infusion, and a TPN infusion. The interface also includes input elements for selecting a type of infusion to program for the secondary line, in this case a concurrent infusion or a piggyback infusion. depicts a flowchart of example method steps for programming an infusion to be delivered by an infusion device having multiple lines. As seen in if the primary line and the secondary line have not yet been programmed, the caregiver may select either the y line or the secondary line to program for the primary infusion.

For the primary infusion, the caregiver may select either a continuous infusion or an advanced infusion as noted above with reference to If the caregiver selects to provide an ed type of on, the caregiver may select the particular type of advance infusion desired (e.g., intermittent, step, inter-channel sequencing, "infinite," or TPN). The caregiver may ure the parameters of the selected on type, and, once programmed, the infusion device may initiate the primary infusion.

If either the primary line or the secondary line is already programmed, the caregiver may select the ogrammed line for a secondary infusion. As seen in if the primary line has been programmed for the primary infusion, then the caregiver may select the secondary line for the secondary infusion. If, however, the secondary line has been programmed for the primary infusion, the caregiver may select the primary line for the secondary infusion. As also seen in the caregiver may select either a concurrent infusion or a piggyback infusion for the ary infusion. The caregiver may likewise ure the parameters of the selected on type and, once programmed, the infusion device may initiate the secondary infusion.

FIGS. 9-15 depict example user interfaces of an infusion device for uring the parameters of a continuous infusion on the primary line (e.g., Line A). depicts an example user interface at which the caregiver selects the substance to be delivered during the continuous infusion. The user interface includes a list of substances available for selection which is filterable by substance name. depicts an e user interface at which the caregiver selects the concentration at which the selected substance should be delivered during the continuous on. The interface includes a list of concentrations available for selection. depicts an example user interface at which the caregiver selects the dose and unit for the continuous on. This ace includes a list of doses per unit available for selection. depicts an e user interface at which the caregiver specifies the value of the dose per unit for the uous infusion. This interface includes input elements, in this case a keypad and a slider, at which the caregiver may specify the desired value for the dose per unit.

For a continuous infusion, the caregiver may specify a desired VTBI or a desired duration. If the caregiver specifies a VTBI, then the infusion rate and duration may be tically calculated based on the selected concentration, dose per unit, and VTBI. If the caregiver specifies an infusion duration, then the VTBI and infusion rate may be automatically calculated based on the selected concentration, dose per unit and infusion duration. depicts an example user interface where the caregiver has selected to specify a VTBI. This ace likewise includes input elements (e.g., a keypad and slider) at which the caregiver may specify the desired value for the VTBI. Similar input elements may be provided to specify a value for the infusion duration where the caregiver opts to specify the on duration rather than the VTBI. In some circumstances, the caregiver may skip certain configuration steps, e.g., where the ry substance does not have a dose (e.g., saline). depicts an example user interface at which the caregiver selects the action the infusion device should perform upon completing the continuous infusion. This interface includes various actions available for selection including a KVO action, a continue rate action, and a stop action. The interface also includes input elements at which the caregiver may y a KVO rate or a continue rate. This interface further includes input elements at which the caregiver may configure an alarm when the continuous infusion nears completion. The interface includes input elements at which the caregiver may toggle the alarm on and off and specify how soon the alarm should be provided prior to completing the continuous infusion. In addition, this interface includes an input element at which the ver may specify a threshold for an air-in-line alarm.

Having configured the parameters of the continuous infusion, the caregiver may start the infusion by selecting a "START" button at the interface. The caregiver may also select to start the infusion after a specified delay by ing a ED START" button at the interface.

Once the primary infusion has started, the infusion device may display the parameters of the current on. depicts an example user ace that displays the parameters of the primary infusion currently being red by the infusion device. As seen in , the parameters displayed include the substance being delivered, the dose, the rate, and the VTBI. The infusion device may update the interface as the VTBI changes hout the infusion (e.g., from 100 ml remaining to 97 ml remaining). The interface may also include the remaining duration of the current infusion.

During the primary infusion, the caregiver may select and program a secondary infusion to be delivered along with the primary infusion. As seen in , the caregiver may select a secondary infusion type for the secondary line, e.g., a concurrent infusion or a piggyback infusion. The caregiver may navigate h user interfaces similar to those depicted in FIGS. 9-13 to specify the nce, concentration, dose per unit and corresponding value, and VTBI or duration value. Having configured the ters of the secondary infusion, the caregiver may similarly y an action to perform upon completion of the secondary infusion. depicts an example user interface at which the caregiver may specify the action to perform upon completion of a piggyback infusion. As seen in , the actions available for selection include ng infusion at the primary line, a KVO action at the secondary line, and stopping infusion at the secondary line. As also seen in , this interface includes a button to backprime the primary line before starting infusion at the secondary line. The caregiver may then select a button at the interface to start the secondary infusion with or without delay.

Once the secondary on has started, the infusion device may display the parameters of the current infusions. depicts an example user interface that displays the parameters of both the primary and secondary infusions currently being delivered by the infusion . This interface likewise displays the nces being delivered by the primary and secondary lines, as well as the respective concentrations, does, rates, and VTBI values.

In accordance with the screenshots above, FIGS. 18-24 depict arts for creating and configuring a uous infusion procedure. depicts a flowchart of example method steps for selecting a medication.

As seen in , the infusion device may be configured to display the infusion nces available for selection and initiate safety checks to determine whether the selected substance has already been selected for infusion at the current infusion device or another infusion device ated with the patient (i.e., a duplicate check) or if the selected substance is compatible with other substances selected for infusion (i.e., a compatibility check) at the current infusion device or other infusion devices associated with the patient. The infusion device may notify the caregiver of any potential duplicability or compatibility issues, which the caregiver may acknowledge and override if desired. As also seen in , the caregiver may also select or specify, e.g., the desired concentration, VTBI, or indicators. depicts a art of example method steps for performing a safety check for duplicate infusion nces. As seen in , the duplicate safety check may be med with respect to multiple infusion devices associated with a patient (i.e., infusion device no. 1, infusion device no. 2, ... , infusion device no. n). As described in further detail below, the infusion devices associated with the patient may be in signal communication with each other. In some implementations, the infusion devices may be set up in a master/slave configuration. As also seen in , the infusion devices associated with a t may also be in signal communication with a medication ment system having medication safety software. Suitable medication safety software for the medication management system may include the Hospira ™ Safety re available from Hospira.

During the duplicate substance safety check, the on device may determine whether the selected nce has been selected for delivery on r line of the infusion device or during another step of the infusion sequence. The infusion device may also query the medication management system to determine whether the selected substance has been selected for ry via another on device associated with the patient. Similarly, the infusion device may query the other infusion devices associated with the patient for a list of substances selected for delivery via those infusion devices.

In response to the query, the other infusion devices may return a list of substances selected for delivery to the patient. The infusion device may then compare the selected substance to the tive lists of substances received from the other infusion s.

The infusion device may query other infusion devices it is ted to as a master or slave infusion device. The infusion device may also poll any nearby infusion s and provide a unique identifier associated with the patient. If the polled infusion device indicates it is associated with the same patient (i.e., the patient identifiers match), then the infusion device may query from the polled computing device the list of substances selected for ry via the polled computing device. If the infusion device determines that the selected substance matches a substance selected for ry via another infusion device, then the infusion device may provide a notification or warning to the caregiver. depicts a flowchart of example method steps for performing a safety check for compatible infusion substances. The compatibility safety check may be similar to the duplicate safety check discussed above. In particular, the compatibility safety check may likewise involve querying and polling le infusion devices associated with a patient and querying a medication management system to determine whether the selected substance is compatible with the selected substance. If the infusion device determines that the selected substance is (or is potentially) incompatible a substance selected to be delivered via another infusion device associated with the patient, then the infusion device may provide a notification or warning to the caregiver. s a flowchart of example method steps for specifying a dose for the selected substance at the infusion device. As seen in , the caregiver may select from a list of available dosing units for the selected substance displayed by the on device and specify a desired dose. The infusion device may include or be in signal communication with a library that specifies a default dose for the selected substance.

The infusion device may allow the caregiver to specify a body surface area (BSA) dose (e.g., kilograms/kg or square meters/m2) or a patient weight-based dose. For a BSA dose, the on device may allow the caregiver to specify the patient weight and height and tically calculate the patient BSA. The caregiver may also specify the rate of on, or the infusion device may be configured to calculate the rate (e.g., ml/hour) based on the concentration, dose, and weight or BSA. s a flowchart of example method steps for specifying a VTBI. As seen in , the on device may allow the user to specify the desired VTBI value and calculate an infusion duration based on that value. depicts a flowchart of example method steps for confirming an infusion configured at the infusion device. As seen in , the infusion device displays the ters selected for the infusion so that the caregiver may review them. The infusion device may also be configured to wait a user-selectable number of seconds before allowing the caregiver to confirm the parameters to ensure the caregiver has had enough time to review them. If the infusion involves multiple steps, the caregiver may advance to the next step in the infusion sequence to review the parameters configured for that step. If the infusion is an intermittent infusion, the infusion device may be configured to request mation of the parameters of only one of the intermittent infusion as well as the total number of ittent infusions and the time between steps.

Once all steps have been reviewed, the caregiver may start the on or initiate a delayed start for the infusion. At the infusion start time, the infusion device may begin the infusion sequence.

The infusion device described herein is also configured to allow a caregiver to add a step to a current ongoing continuous infusion thus converting the current continuous infusion into one of the advanced infusion types. In other words, the caregiver may convert a current continuous infusion into one of an intermittent, multistep, inter-channel sequencing, or "infinite" flow infusion. The infusion device leverages the recognition that the advanced infusion types may be viewed as a series of continuous infusions red in sequence. In particular, an intermittent on may be recognized as a series of identical uous infusions separated by a delay. A tep on may be recognized as a series of continuous infusions using the same substance at the same concentration and indication, but ing in dose, rate, or both dose and rate. An inter-channel sequencing infusion may be recognized as a series of continuous infusions delivered from different lines via different channels. An "infinite" flow infusion may be recognized as a series of continuous infusions delivered from different lines on the same l. s a flowchart of example method steps for converting a current uous infusion to one of the various advanced on types. As seen in , the caregiver may select a nce for infusion and, if the selected substance permits le infusion steps to be performed, the caregiver may choose to add a step to the t infusion. For the additional step, the caregiver may select or specify a dose and VTBI as bed above. If the desired infusion type is an "infinite" flow infusion (i.e., there is only one step in the infusion sequence), then the caregiver may specify the volume of the delivery source container and configure the parameters for the "infinite" flow infusion. If the desired infusion type is an intermittent infusion (i.e., there is one ed step), then the caregiver may clone the current step and configure the parameters for the intermittent infusion.

After the caregiver has added a step to the current infusion, the caregiver may select to view all steps for the infusion sequence at the infusion device. The caregiver may select one of the steps to view in further detail at the on device or to delete from the infusion sequence. Once the caregiver has configured all the d steps for the infusion sequence, the caregiver may confirm the infusion steps and the infusion sequence as described above. depicts an example user interface of an infusion device at which the caregiver may add a step to an infusion sequence at the infusion device. As seen in , a caregiver may select a substance to be delivered to the patient and the corresponding delivery parameters as discussed above. The user interface also includes a button to add a step to the current infusion sequence as well as a button to clone the current step of the infusion sequence. The user interface may be configured to display in a pop-up menu additional buttons that allow the caregiver to specify whether the new step should be added to the infusion ce either before or after the current step.

The user interface may be configured to display the pop-up menu after a long press (i.e., n number of seconds) on the button to add a new step. The user interface in FIG. also includes a "Mode" button that allows the caregiver to convert or configure the continuous on as an advanced on type (e.g., TPN, intermittent, multi-step, inter-channel sequencing, or "infinite" flow). depicts a flowchart of example method steps for adding a new step to a current infusion sequence at an infusion device. As seen in , the caregiver may select to add a step to the current infusion at the infusion device and specify whether the new step should be before or after the current step of the infusion. The on device may be configured to pulate the new step with the substance selected for the current step. If the caregiver specifies a new concentration for the new step, the infusion device may automatically calculate the VTBI based on the new concentration.

If the new step is added for an inter-channel sequencing infusion, the caregiver may select to change the infusion line for the new step, as well as add new infusion devices for the inter-channel sequencing on. If the caregiver selects to add a new infusion device, then the infusion device may display a list of infusion devices available to add, and the caregiver may select one of the infusion devices listed. If the caregiver has selected to change the line for the infusion during an inter-channel sequencing infusion, the infusion device may clear the substance selected for the current step ng the ver to select a new substance to be delivered during the new step of the channel sequencing infusion. The caregiver may also specify whether the new step for the inter-channel sequencing infusion should be performed concurrently with r step in the sequence. depicts an example user interface of an infusion device for changing the line for an inter-channel cing infusion. As seen in , the ace displays the currently selected infuser, line, and channel. The interface also displays a list of lines available at the infusion device that may be selected for the infusion step tly being configured at the infusion device. In this example, the infusion device includes two channels (e.g., a Left Channel and a Right Channel) and two lines per channel (e.g., Line A and Line B for the Left Channel and Line C and Line D for the Right Channel). As also seen in , the list of lines may also identify one or more on devices in signal communication with the current infusion device with lines available to be selected for the current infusion step.

Selecting additional infusion devices to perform a step of an infusion sequence may be referred to as "ganging" the infusion devices together for coordinated operation of an infusion to a patient. In addition, infusion devices that have each been configured to perform at least one step in an infusion sequence may be referred to as "ganged" infusion devices. depicts a flowchart of example method steps for ganging infusion devices. As seen in , a caregiver may gang infusion devices together via a medication management system that onnects multiple computing devices such that they are in signal ication with each other. As also seen in , a ver may gang infusion devices together by setting up a master/slave configuration between the computing devices without a medication management system. For this alternative approach to ganging infusion devices together, an on device may perform a device discovery operation to locate any nearby infusion devices or any other infusion devices associated with the current patient. As bed in further detail below, infusion devices may be in signal communication with each other via wired, wireless, or both wired and wireless communications.

For step infusion sequences, the infusion device may allow the caregiver to view a list of the steps ured for an infusion sequence. s a flowchart of example method steps for viewing and manipulating the list of infusion steps configured for an infusion ce. As seen in , the caregiver may select to view the list of infusion steps, and the infusion device may display the list with the steps in their current order. The user may select one of the steps (e.g., by tapping the step), and the infusion device may display details for the selected step. The ver may also drag the selected step (e.g., by pressing and holding the step), to move or delete the selected step (e.g., drag and release). The caregiver may drag the step up or down to reposition the step in the list of steps (e.g., drag step no. 3 down to become step no. 5 and drag step. no 4 up. to become step no. 2). The caregiver may also drag the step right or left to delete the step from the list. The infusion device may be ured with an undo function that allows the caregiver to display a list of removed steps and select a d step to add back to the list.

FIGS. 30-33 depict e user aces of an infusion device for displaying and manipulating a list of infusion sequence steps. depicts an example user interface displaying a list of infusion sequence steps for an infusion to be delivered by an infusion . As seen in , the list of infusion steps identifies, for each step, the infusion device, the line, the substance, and the infusion parameters associated with the step (e.g., substance, concentration, dose, rate, VTBI, and time). depicts an example user interface of an infusion device for displaying the parameters associated with a step the caregiver has selected in the list of on steps. Similar to each step displayed in the list, the interface displays the details of the selected step (e.g., substance, concentration, dose, rate, VTBI, and time). depicts the user ace of in which the caregiver has ed one of the steps (step no. 4) in the list of infusion steps. depicts the user interface of in which the caregiver has dragged the selected step to the right to remove it from the list. As noted above, the user interface in may also display a button to undo the removal of the removed step.

As noted above, a caregiver may convert a continuous infusion to an ittent infusion. The uous infusion being converted may be currently ongoing at the infusion device, i.e., the infusion device may currently be delivering a substance to the patient. The continuous infusion being converted may also be an infusion that has been configured but not yet started at the on device. The ability to t a continuous infusion to an intermittent infusion may depend on the substance being infused. Some nces may permit intermittent infusion while other substances may not.

Accordingly the infusion device may query a library of substances (e.g., a drug library) to determine whether intermittent infusion of the current substance is permitted. In addition, the infusion device may not permit a caregiver to convert a continuous infusion to an intermittent infusion until the continuous infusion has been fully configured. depicts a flowchart of example method steps for converting a uous infusion to an ittent on. After a continuous infusion has been configured, the caregiver may select a button at a user interface of the infusion device to display the options for an intermittent infusion. The caregiver may then select or specify the number of infusion steps for the intermittent infusion. The infusion device may limit the total number of infusion steps for the intermittent on based on a permitted range for the selected substance. The infusion device may likewise query a substance library (e.g., a drug library) for the permitted range. The caregiver may also select or specify the time delay between each step of the intermittent infusion as well as callback options for the intermittent infusion. A callback refers to a notification provided to the caregiver at the end of an individual infusion step as well as at the end of the intermittent infusion. depicts a flowchart of example method steps for specifying one or more callback options. The infusion device may display a list of callback options available for selection, and the caregiver may select a ck option to be provided upon completion of one or more dual infusion steps or upon tion of the entire intermittent infusion. The caregiver may also specify that the infusion device should not provide a ck for one or more of the individual infusion steps or the intermittent infusion. depicts an example user interface for cloning a current step of an intermittent infusion. As seen in , the user interface display the current line of the infusion device and the allowable range for the total number of infusion steps that may be performed for the substance in an ittent infusion. The user interface includes a keypad at which the caregiver may specify the total number of infusion steps (i.e., deliveries) that should be performed. The user interface may also allow the caregiver to specify the delay between steps, and options for each step (e.g., callback options). depicts a flowchart of example methods steps for configuring an intermittent infusion. As seen in , the caregiver may select a substance to be delivered to the patient, the intermittent on options, the dose, and the VTBI. With the intermittent infusion configured, the caregiver may confirm the parameters.

As also noted above, a caregiver may also convert a continuous infusion at the infusion device to an "infinite" flow infusion. As noted above, an "infinite" flow infusion refers to an infusion in which an infusion device utilizes two ry lines on a single cassette channel wherein the infusion device tically switches to the other line when the current line completes its infusion such that there is no interruption in the delivery. Each ry line may be connected to a respective delivery source such that the caregiver may replace a depleted ry source with a full ry source while the other delivery source continues to deliver the substance to the patient. The switching between delivery sources allows the caregiver to continually swap out ed delivery sources during the infusion without upting the continuous delivery of the substance to the t. In this way, the infusion may continue while new delivery sources are ted to the on device. Infusion may thus continue without pausing to connect new containers. depicts a flowchart of example method steps for converting a continuous infusion to an "infinite" flow infusion and configuring the "infinite" flow infusion. After a continuous infusion has been ured, the ver may select a button at a user interface of the infusion device to display the options for an "infinite" flow infusion. Like converting to an intermittent infusion, the ability to convert a continuous infusion to an "infinite" flow infusion may be restricted until the continuous flow infusion has been fully configured.

When the caregiver selects to convert and configure an "infinite" flow infusion, the infusion device may display options for the "infinite" flow infusion. As seen in , the caregiver may, if necessary, specify at the infusion device a KVO rate. With the total VTBI having already been configured, the infusion device ts that the caregiver specify the volume of the delivery sources that will be used for the "infinite" flow infusion. The infusion device also requests that the caregiver indicate whether the additional and subsequent delivery sources with be attached to the infusion device before or after the delivery sources are fully ed. If the caregiver indicates the delivery sources will be ed before they are fully depleted, the caregiver may configure a callback such that the caregiver is ed a predetermined amount of time before the delivery source is fully depleted (e.g., x number of s or seconds). If the caregiver indicates that depleted delivery sources will be replaced after they are depleted, the infusion device may prompt the caregiver to attach one or more additional delivery sources to the infusion device before the "infinite" flow infusion begins. s a flowchart of example method steps for configuring an "infinite" flow on. As seen in , the caregiver may select the substance to be delivered to the patient, the dose, and the volume of the delivery s that will be used for the "infinite" flow infusion. Once the volume of the delivery sources has been specified, the caregiver may specify the total VTBI of the total infusion duration. If the caregiver specifies the VTBI, then the infusion device may automatically calculate the total infusion duration. If the caregiver specifies the total infusion on, then the infusion device may automatically calculate the VTBI. The caregiver may then specify s options for the "infinite" flow infusion such as the KVO rate and the ck options as discussed above. As also noted above, the infusion device will prompt the caregiver to connect an addition delivery source to the infusion device prior to starting the infusion if the caregiver opts to be ed when a delivery source is depleted. The caregiver may then connect a new delivery source to the infusion device after each delivery source that empties. As also noted above, the ver may opt to be notified prior to the depletion of a delivery source in which case the caregiver may only connect the subsequent delivery source when the current delivery source is near empty. Waiting to connect a subsequent ry source until receipt of notification may be advantageous where the substances delivered to the patient are in limited supply or need to be refrigerated. In other words, requesting notification of a mpty delivery source allows the caregiver to connect the next delivery source only when it becomes necessary. Having configured the options for the "infinite" flow infusion, the caregiver may confirm and initiate the infusion at the infusion device. depicts a art of example method steps for an "infinite" flow infusion. As seen in , the infusion device may request confirmation from the ver that the subsequent delivery source has been connected to the infusion device. When the caregiver connects the subsequent delivery source, the caregiver may confirm at the infusion device that the subsequent delivery source has been connected.

The infusion device may also provide a notification to the caregiver that the current ry source is near-empty as bed above. The ver may d to the notification by replacing the near-empty delivery source with a new delivery source.

When the current delivery source has been depleted, the infusion device stops infusing on the current line, switches to the next line connected to a full delivery source, and begins infusing on the new line. If the infusion device has reached the VTBI or the total infusion duration, the infusion device may stop the infusion ure or execute any end-of-procedure actions (e.g., infusing at a specified KVO rate). The infusion device may likewise notify the caregiver that the on procedure is complete.

FIGS. 41 A-B depict example user aces of an infusion device during an "infinite" infusion flow. As seen in A, the infusion device is currently infusing the patient via a first line (e.g., Line A) of the infusion device. When the delivery source connected to the first line is depleted, the infusion device switches to infuse the patient via another line of the infusion device. As seen in B, the infusion device has switched to infuse the patient via a second line (e.g., Line B) of the infusion device. A caregiver may thus replace the delivery source ted to the first line with a new delivery source to subsequently use when the delivery source for the second line is depleted.

As noted above, a caregiver may configure various secondary infusions (e.g., concurrent ons and piggyback infusions) during an infusion currently being performed at the infusion device. s a flowchart of example method steps for ing a secondary infusion at infusion device. As seen in , the infusion device may display a user interface with s allowing the caregiver to select a secondary infusion via a selected line at the infusion device. The caregiver may select a secondary on type (e.g., concurrent or piggyback) and the infusion device may determine whether the other line is currently infusing.

If the other line of the infusion device is currently infusing, then the caregiver may proceed with configuring the concurrent or piggyback infusion as bed above. If, however, the other line of the infusion device is not currently infusing, then the on device may assess the status of the other line in order to provide notifications or warnings to the caregiver. As an example, the infusion device may notify or warn the caregiver that the other line is currently in a potential non-delivery condition exists, i.e., that the infusion device might not be able to perform the secondary infusion selected. A non-delivery ion may exist where the other line is delayed, is in standby, or has completed its infusion. If a non-delivery condition exists, the on device may notify the caregiver that the other line must be currently infusing in order to perform the secondary infusion via the selected line. The cations and warnings may advantageously avoid situations where, e.g., the infusion device attempts to switch back to a line that may not resume an infusion upon completion of a ack infusion. The infusion device may prompt the caregiver to initiate or restart an infusion at the other line. Once initiated or restarted, the caregiver may proceed with uring the parameters of the secondary infusion. depicts an example user interface of an infusion device for notifying or warning a caregiver regarding a non-delivery condition. As seen in , the user interface informs the ver that the infusion device cannot initiate a secondary infusion unless the other line is currently infusing. The user interface also includes buttons to cancel the secondary on or view the settings configured for the other line. depicts a flowchart of example method steps for configuring a ack infusion at an infusion device. As seen in , the caregiver may select or specify the substance to be delivered to the patient, the dose, the VTBI, and various piggyback infusion options (e.g., an action to perform at the end of the infusion). Once the ters for the piggyback infusion have been configured, the caregiver may review the parameters and initiate the piggyback infusion. depicts a flowchart of example method steps for configuring ack infusion options including selecting or ying an action to perform at the end of the piggyback infusion. depicts a flowchart of example method steps for configuring a concurrent on. Like a piggyback infusion, the ver may select or specify the substance to be delivered to the patient, the dose, the VTBI, and various concurrent infusion options.

As also noted above, a caregiver may configure various ed infusion types at an infusion device (e.g., TPN, intermittent, multi-step, inter-channel sequencing, and "infinite" flow). As also noted above, a caregiver may select an advanced infusion type via "Mode" button on the user interface to add a step to a continuous infusion.

Alternatively, the infusion device may present a user interface with "quick mode" selection s. depicts an example user interface of an on device at which a caregiver may select to configure an advanced infusion type. The user interface includes buttons for configuring infusions at two infusion devices each having two lines. As seen in , the primary line (Line A) of the first infusion device is currently performing an infusion at the patient. The user may select to program another infusion at the secondary line (Line B) of the first infusion device such as a concurrent or piggyback on as discussed above. The caregiver may also select to configure an infusion at the primary line (Line C) or the secondary line (Line D) of the second infusion device. As also seen in , the caregiver may select one of the buttons to program a continuous infusion at the lines of the second on device or an advanced infusion type. depicts a flowchart of example method steps for selecting an advanced infusion type to configure at an infusion device. Upon selection of an advanced infusion type button, the infusion device may display a list of the ed infusion types available for selection. As noted above, advanced infusion types may include TPN, intermittent, multi-step, inter-channel sequencing, and "infinite" flow. The user may then select the desired advanced on type and configure the parameters for the advanced infusion type selected. depicts a flowchart of example method steps for uring a TPN infusion at an on device. As seen in , the caregiver may select a desired TPN protocol at the infusion device. Similar to the duplicate safety check for the substances delivered the patient, the infusion device may perform a duplicate safety check for the protocol selected. In particular, the infusion device may compare the selected TPN protocol to other TPN protocols that have been ured for the patient at the current infusion device or at other infusion devices associated with the patient.

The safety checks may also include duplicate and compatibility safety checks for the substances delivered to the patient during the respective TPN protocols. In addition, if not already specified via the selected TPN ol, the caregiver may select or y a VTBI, total infusion duration, taper up time, taper down time, delivery source volume, and KVO rate for the selected TPN protocol. These parameters may be pre-populated based on the TPN protocol specified. The caregiver may also modify the pre-populated parameters at the infusion device. Once the selected protocol has been configured, the caregiver may confirm the selected parameters and initiate the TPN infusion. depicts a flowchart of example method steps for selecting a TPN protocol at an infusion device. As seen in , the on device ys the TPN protocols available for selection, and the caregiver may select one of the TPN protocols displayed.

The infusion device may then determine whether the selected ol has already been configured at the current infusion device or another infusion device associated with the patient. If so, the infusion device may y a notification to the caregiver indicating that the ed TPN ol is (or may be) a duplicate TPN protocol currently being delivered or scheduled for delivery to the patient. The caregiver may acknowledge the notification indicating the ially ate TPN protocol. The infusion device may also determine whether the selected TPN ol is compatible with substances currently being delivered or scheduled to be delivered to the t. The infusion device may notify or warn the ver when it determines that the TPN protocol is (or may be) incompatible with the substances considered. The caregiver may likewise ledge the notification or warning and respond accordingly. The ver may, for example, select to override the potential incompatibility and ue with the ed TPN protocol. depicts a flowchart of example method steps for configuring a multistep infusion at an infusion device. As seen in , the caregiver may select the substance to be delivered to the patient as well as the total number of infusion steps to perform. For each infusion step, the caregiver may specify the dose and VTBI for the on step. Once the caregiver has configured the parameters for all of the infusion steps for the multi-step infusion, the caregiver may confirm and initiate the multi-step infusion.

FIGS. 48-55 depict example user interfaces and arts of e method steps for configuring an inter-channel sequencing infusion. depicts a art of example method steps for configuring an inter-channel sequencing infusion. As seen in , caregiver may configure an channel sequencing infusion by selecting a pre-defined protocol from a library of protocols or manually configure each on step of the inter-channel sequencing infusion. As also seen in , the infusion device may request confirmation from the caregiver of each step in the inter-channel sequencing infusion. During confirmation of each infusion step, the infusion device may also prompt the caregiver to set up the delivery source for the infusion step being confirmed. s a flowchart of example method steps for selecting a predefined inter-channel sequencing protocol. As seen in , the ver may select an inter-channel sequencing protocol to deliver to the patient. The caregiver may also gang multiple infusion devices together to deliver the inter-channel sequencing infusion. The caregiver may assign one or more of the infusion steps of the selected protocol to individual infusion devices ganged together. Once the infusion steps for the inter- channel sequencing protocol have been configured and assigned to respective infusion devices, the caregiver may confirm and initiate the inter-channel sequencing infusion. depicts an e user interface for selecting an channel sequencing protocol at an infusion device. As seen in , the on device may display a list of inter-channel sequencing protocols ble for selection. The caregiver may select one of the protocols from the list, and the user interface may subsequently display an interface for selecting the ganged together infusion devices to perform the selected protocol and an interface for confirming the parameters configured for the selected protocol.

Like the other advanced infusion types, the on device may perform safety checks based on the selected inter-channel sequencing protocol. depicts a flowchart of example method steps for performing safety checks based on a selected inter-channel cing protocol. Like the safety checks discussed above, the safety checks may include a duplicate safety check and a compatibility safety check to check whether any ate or incompatible substances are being delivered or are scheduled to be delivered to the patient during the inter-channel sequencing infusion. The infusion device may similarly notify or warn the caregiver if the infusion device identifies any duplicate or incompatible substances. The caregiver may also likewise acknowledge and override the cation or warning.

As noted above, inter-channel sequencing infusion may involve multiple infusion devices. An infusion device may allow a caregiver to identify and gang together additional infusion devices to be utilized during an inter-channel sequencing infusion.

The process of ganging infusion devices together will be discussed in further detail below. , however, depicts an example user interface of an infusion device for listing and selecting infusion devices to be used in an inter-channel sequencing infusion.

As seen in , the user ace displays a list of infusion devices in signal ication with the current infusion device that may be ganged together for the inter-channel sequencing infusion. The list of infusion devices may include a unique identifier for the available on devices and the total number of lines available at each of the on devices. The caregiver may select one or more of the available infusion devices from the list to include in the inter-channel sequencing infusion currently being configured at the infusion device. As also seen in , the user interface includes a button to poll infusion devices (e.g., wirelessly) that are nearby the current infusion . Polling nearby infusion devices will be sed in further detail below.

Upon selection of one of the available infusion devices, a notification may be transmitted to the ed on device that the caregiver has ed it to be ganged to the current infusion device. Upon receipt of the notification, the selected infusion device may display a confirmation request. depicts an example user interface of an infusion device displaying a confirmation request to gang the infusion device to another infusion device. As seen in , the confirmation request includes the respective identifiers for the infusion devices and buttons allowing the caregiver to confirm or deny the request. The user interface in also depicts how the list of available infusion devices is updated upon the confirmation or denial of a request to gang a selected infusion device to the current infusion device.

For an inter-channel sequencing infusion, one of the infusion devices may be designated the master infusion device and the other on devices may be designated the slave infusion devices. The on device at which the caregiver configures the inter-channel sequencing infusion and adds additional infusion devices to the interchannel sequencing infusion may be designated as the master on device for the infusion. The additional infusion devices added to the inter-channel sequencing infusion may be ated as the slave infusion devices. The notification sent to a ed infusion device from the master infusion device may be sent via a medication ment system the infusion devices are connected to. Additionally or alternatively, the notification sent to a selected infusion device from the master infusion device may be sent via a direct wired or wireless communication between the master infusion device and the slave infusion device. Similarly, the response to the confirmation request (e.g., confirmed or denied) may be sent back to the master on device from the selected infusion device via a medication management system or via a direct wired or wireless communication between the infusion devices.

The master infusion device may also be ured to confirm that the number of infusion devices needed to carry out the inter-channel sequencing infusion have been ganged together. As one example, the total number of infusion lines may be required to match the total number of unique substances selected to be delivered to the patient, and the master on device may be configured to confirm that enough on devices have been ganged er to provide the total number of infusion lines needed. If the caregiver attempts to proceed to the review screen without having ed the number of infusion devices needed to carry-out the inter-channel sequencing infusion, the infusion device may display a notification that additional infusion devices are needed. In some example implementations, a "review" button may be inactive until the caregiver has selected enough infusion devices.

Once the caregiver has selected enough infusion devices for the inter-channel sequencing infusion, the infusion device may prompt the caregiver to tively assign an infusion line to each step in the infusion. depicts a user interface of an on device for assigning infusion lines to steps of an inter-channel cing infusion. As seen in , the user interface displays the details of the currently selected step of the inter-channel sequencing on including, e.g., the substance to be delivered, the dose, and the VTBI. The user interface also displays a list of the infusion devices that have been ganged together for the inter-channel sequencing infusion. The caregiver may select one of the infusion devices, and the user interface may display the lines of the selected infusion device that are available to be assigned to the t step. The caregiver may proceed through the steps of the inter-channel sequencing infusion and select a line to be assigned to each respective step. The user interface may deactivate (e.g., gray out) or hide selections for lines of infusion devices that have already been assigned to an infusion step. The user ace may also deactivate or hide ions of on devices that have no lines remaining to be assigned to an infusion step. In some entations, the infusion device may allow the ver to associate an infusion device and line when an infusion device is selected for the inter-channel sequencing infusion.

As noted above, the caregiver may specify the parameters for each step in an inter-channel sequencing infusion as the infusion steps are added to the ce. depicts a flowchart of example method steps for configuring the steps of an interchannel sequencing infusion. As seen in , the caregiver may select or specify, for each step, a dose, VTBI, and delay offset. Once the step is fully specified, the ver may proceed to the next step in order to specify the parameters for that step. The delay offset may be an optional parameter. Once all steps are configured, the caregiver may review the steps of the channel sequencing infusion and initiate the infusion at the infusion device. During the review and confirmation process, the infusion device may remind the caregiver to ensure the delivery sources have been setup and connected to the infusion devices.

During the inter-channel sequencing infusion, the infusion devices may provide a visual tion to indicate their status as either the master infusion device or one of the slave infusion devices. FIGS. 56A-B depict respective user aces that include a visual indicator to identify the infusion device as a master or slave infusion device. As seen in A, the user ace of the infusion device es a dark-colored background (e.g., dark blue) to identify the infusion device as the master infusion device.

As seen in 8, the user ace of the infusion device es a light-colored background (e.g., light green) to identify the infusion device as a slave infusion device.

Additional and alternative types of visual indicators may be selectively employed to visually distinguish master and slave infusion devices. depicts an example of a le inter-channel sequencing infusion that may be implemented utilizing the infusion s described herein. As seen in , three infusion devices are connected to a patient: a first dual LVP infusion device connected to three delivery sources (A, B, and, C); a second e infusion device connected to one delivery source (D); and a third single LVP infusion device connected to two delivery sources (E and F). As also seen in , the dual LVP infusion device has been ated the master infusion device while the syringe infusion device and the single LVP infusion device have been designated slave infusion devices. The master infusion device in is in signal communication with the slave ication devices via wireless communications. An example inter-channel sequencing infusion performed by the infusion devices in may be, for e: flush from delivery source A; infuse from delivery source B; flush from delivery source A; infuse from delivery sources C and D together; flush from delivery source A; deliver from delivery source E; flush from delivery source A; deliver from delivery source F; and flush from delivery source A. In some example implementations, the each of the delivery sources may be connected to a manifold (e.g., an omni-flow manifold), and the ld may be connected to an infusion device to infuse the patient from all of the delivery sources via a single channel.

As noted above, a caregiver may also manually configure an inter-channel sequencing infusion rather than select from a list of predefined protocols. depicts a flowchart of example method steps for configuring the steps of an interchannel sequencing infusion manually. As seen in , the caregiver may select one or more infusion devices to utilize for the channel sequencing infusion. The caregiver may select the infusion devices to use as described above. Having selected the on s, the caregiver may specify the total number of steps to be performed for the inter-channel sequencing infusion. The caregiver may configure an infusion step to include one or more deliveries to the t. For each step, and for each delivery in a step, the caregiver may assign an infusion device and line to the current step and the current delivery of that step. The caregiver may also select or specify, for the current delivery of the current step, the substance to be delivered to the patient, the dose, and the VTBI. The caregiver may also specify a delay offset. The caregiver may repeat these actions for each delivery of the current step. Once all deliveries of the current step have been configured, the caregiver may proceed to the next step in the infusion sequence and likewise configure each delivery for the next on step selected. The caregiver may also view at the infusion device all steps of the inter-channel sequencing infusion, review the steps, and initiate the infusion.

FIGS. 59-60 depict example user aces of an infusion device for configuring the steps of an inter-channel cing infusion. depicts a user interface for configuring the first ry of the second step of an inter-channel sequencing infusion.

As seen in , the user interface displays the selected infusion and line, the substance to be red to the patient and its concentration, the dose and units, the weight/BSA, the delivery rate, the VTBI, and the total delivery on. The user interface in also includes a button to specify whether or not the current ry should be red concurrent with the other deliveries of the current step. The user interface in additionally includes buttons to configure options for the current delivery of the current step (e.g., a delay ), view all the steps of the infusion, confirm the parameters set for the current delivery of the current step, and advanced to the next delivery or step of the infusion. As described above, the multi-step view may allow that caregiver to select steps and deliveries, rearrange steps and deliveries, or delete steps and deliveries. The user interface in includes similar information for the second delivery of the sixth step in the on sequence. As seen in , the user interface includes the unique identifier of the on device that has been assigned to the current step.

Interconnected Infusion Devices As noted above, the infusion devices described herein may include communication modules that allow infusion devices to interconnect with one another for inter-channel and device sequencing for infusion procedures. The communication modules may thus facilitate -to-device communications as well as communications between infusion devices via a medication management system.

Communications between infusion devices may be wired or ss, via an MMS, or via an interconnecting device such as, e.g., a backplane, rack, or dock. Communication between infusion devices may also enable infusions between different types of infusion devices (e.g., LVP, syringe, and PCA infusion device types) as well as inter-channel sequencing ms in which multiple deliveries are d within one step. Moreover communications between infusion devices may advantageously permit the use of pre- programmed inter-channel sequencing protocols for infusions to a patient. , depicts an example of an implementation of an infusion device 6500 is shown. The infusion device 6500, in this example, includes a wireless network interface 6502 and a wired network interface 6504.The infusion device 6500 may be in signal communication with an interconnecting device 6506 via a communication port 6508 of the wired network interface 6504. The infusion device 6500 may also be in signal communication with one or more infusion devices 6510 via an antenna 6512 of a transceiver 6514 of the ss k interface 6502. Through the interconnecting device 6506, the infusion device 6500 may be in signal communication with another on device 6516 as well as a tion management system 6518. The on device 6500 may also be in signal communication with the MMS 6518 via the wireless network interface 6502.

The interconnecting device 6506 may be, e.g., a wired backplane, dock, or rack that mounts or otherwise ts multiple infusion devices. The multiple infusion devices mounted at the interconnecting device may be housed in a common housing.

The interconnecting device 6506 may be configured such that one of the infusion s mounted at the interconnecting may be considered to be a lead infusion device.

As an e, in an interconnecting device in which infusion devices are mounted from top-to-bottom, the lead infusion device may be the t infusion device. As another example, in an interconnecting device in which infusion devices are mounted from leftto-right , the lead on device may be the left-most infusion device. Additional examples will be appreciated with the benefit of this sure. The subsequent infusion devices may be subordinate to the lead infusion device based on their position at the interconnecting device in the sequence of infusion devices. For e, the next leading infusion device may be the infusion device just below the top-most on device or just to the right of the leftmost infusion device and so forth.

The wireless network interface 6502 may be configured to exchange wireless communications with other infusion devices or an MMS using one or more wireless communication protocols. Example of suitable wireless communications protocols include radio-frequency identification (RFID) protocols, one or more of the IEEE 802.11 protocols (e.g., a, 802.11b, 802.11g, 802.11n), Bluetooth protocols, and other wireless communication protocols suitable for interconnecting infusion devices. depicts an example of a set of interconnected infusion devices 6600. As seen in , a first set of infusion devices 6602 are d at a first interconnecting device 6604, and a second set of infusion devices 6606 are mounted at a second interconnecting device 6608. As also seen in , one of the infusion devices 6610 at the interconnecting device 6604 has been designated the master infusion device. The other infusion devices 6612 at the interconnecting device 6604 have been designated slave infusion device. In addition, the master on device 6610 is in wireless signal communication with the onnecting device 6608. When wireless communication with infusion s of an onnecting device, the infusion devices mounted at that interconnecting device may be ered as a singular unit. In , each of the infusion devices 6614 at the interconnecting device 6608 have been designated slave infusion devices. The master infusion device 6610 is also in direct wireless signal communication with an infusion device 6616 that has been designated a slave infusion device as well as an infusion device 6618 via an MMS 6620. The infusion device 6618 interconnected to the master infusion device 6610 via the MMS 6620 has also been designated a slave infusion devices.

As described in further detail below, interconnected infusion devices may designate a master infusion device when an MMS is and is not present. Designating a master infusion device via an MMS will be discussed in further detail below. If an MMS is not present, however, interconnected infusion devices may designate a master infusion device based on whether the infusion devices are in signal ication wirelessly or via an interconnecting . If interconnected via an interconnecting device, the infusion devices may designate the lead infusion device as the master infusion device (e.g., the top-most or left-most infusion device). If communication with the master infusion device is lost, then the infusion devices may designate a new master infusion device which may be the next infusion device subordinate to the master infusion device in the sequence of on devices (e.g., the next top-most or next left-most infusion device). If the infusion devices are onnected wirelessly, then the infusion devices may ate the ng device having the t infusion duration as the master infusion . If communication with the master infusion device is lost, then the on devices may designate the infusion device having the next longest on duration as the new master on device. Designating the master infusion device when an MMS is not present will also be discussed in further detail below. depicts interconnected infusion devices tively associated with patients. As seen in , a set of ganged together on devices 6702 are associated with a first patient (Patient A). The ganged infusion devices 6704 and 6706 of the set of infusion devices 6702 are in wireless signal communication with each other.

One of the infusion devices 6704 has been designated the master infusion device, and two of the infusion devices 6706 have been designated as slave infusion devices.

Another infusion device 6708 is associated with another patient (Patient B). As seen in , the master infusion device 6704 may be in the ty of the other infusion device 6708 and thus in signal communication with the other infusion device. As explained in further detail below, however, the other infusion device 6708 may not be available to be ganged with the set of ganged infusion devices 6702 since it is associated with a different t (i.e., Patient B vs. Patient A). depicts a flowchart of example method steps for ganging together infusion devices via a medication management system. An infusion device connects to an MMS (block 6802). In response to connecting to the infusion device, the MMS s a list of infusion devices (block 6804). The list of infusion s maintained at the MMS may identify the patient each infusion device is respectively associated with (e.g., using a unique identifier respectively associated with each patient). The MMS may also query an infusion device to determine which patient the infusion device is associated with. A caregiver initiates the g procedure at one of the infusion devices connected to the MMS (block 6806). The infusion device at which the ganging process is initiated may be designated as the master infusion device.

The master infusion device then s the MMS for a list of infusion devices available to be ganged to the master infusion device (block 6808). In response to the query, the MMS responds to the master infusion device with the list of available infusion devices (block 6810). The MMS may generate the list of available infusion devices based on the patient the master infusion device is associated with. The list of available on s may, for example, only include infusion devices currently associated with the patient or, additionally or alternatively, infusion devices that have not yet been assigned to a patient and thus available to be associated with the patient the master infusion device is associated with. The master infusion device displays the list of available infusion devices (block 6812), e.g., at a display screen for review by the caregiver. The master infusion device receives from the caregiver a selection of one of the available infusion s to gang to the master infusion device (block 6814). The master infusion device then transmits the selection to the MMS (block 6816), and the MMS in turn transmits a notification of the selection to the selected infusion device (block 6818).

In response to receipt of the notification, the selected infusion device displays (e.g., at a display screen) a confirmation request for the caregiver to confirm the selected infusion device should be ganged to the master on device as a slave on device (block 6820). If the caregiver does not confirm that the selected on device should be ganged to the master infusion device (block 6822:N), then the selected infusion device is not ganged to the master on device (block 6924). If, however, the caregiver does confirm that the selected infusion device should be ganged to the master infusion device (block 6822:Y), then the selected infusion device is ganged to the master infusion device (block 6826). The caregiver may gang multiple on devices to the master on devices. Accordingly, if the caregiver wishes to gang additional infusion devices to the master infusion device (block 6828:Y), the caregiver may repeat the steps above to gang additional infusion devices to the master infusion device. If the caregiver does not wish to gang additional infusion devices to the master infusion device (block 6828:N), or once the caregiver has ganged the desired number of infusion devices to the master infusion device, the caregiver may e the infusion sequence configuration information to the master infusion device (block 6830). Once the caregiver has configured and confirmed the inter-device infusion sequence, the ver may initiate the infusion sequence and the master infusion device controls the infusion sequence across the ganged infusion devices (block 6832). depicts a flowchart of example method steps for ganging together infusion devices via direct communications. A caregiver initiates the ganging procedure at an infusion device ured to exchange direct communications (e.g., wired or wireless) with other on devices. (block 6902). The infusion device at which the ganging process is initiated may likewise be designated as the master infusion device.

The master infusion device polls nearby infusion devices with a query message that may include a unique identifier (ID) for the patient associated with the master infusion device (block 6904). The patient ID may indicate the patient an infusion device is associated with, and in infusion device may store the patient ID. Nearby infusion devices may include infusion devices mounted at the same onnecting device as the master infusion device as well as infusion devices within a broadcast range of the master infusion device. Accordingly the master infusion device may poll nearby infusion devices with a query message transmitted via a wired or wireless communication.

A polled infusion device may e the query message from the master infusion device and compare the t ID included in the query message with its stored patient ID (block 6906). If the patient IDs do not match (block 6908:N), then the polled infusion device may transmit a response to the master infusion device indicating that the patient IDs do not match (block 6910) and that the polled infusion device is thus unavailable to be ganged to the master infusion device. If, r, the t IDs do match (block 6908:Y), then the polled infusion device may assess whether it is ble to be ganged to the master infusion device. If the polled infusion device is not ble to be ganged to the master infusion device (block 6912:N), then the polled infusion device may respond to the master infusion device that it is currently lable. Alternatively the polled infusion device may simply not d to the master infusion device if it is currently unavailable. If, however, the polled infusion device is ble (block 6912:Y), then the polled infusion device may respond to the master on device indicating that it is available to be ganged to the master infusion device (block 6916). The polled infusion device may also respond to the master infusion device indicating that is available to be ganged to the master infusion device if the polled infusion device is not currently associated with a patient.

Multiple infusion devices may respond to the master infusion device indicating they are ble to be ganged to the master infusion device. Once the master infusion device has received response from the polled infusion devices, the master infusion device generates and displays a list of infusion devices that are available to be ganged together (block 6918). The master infusion device then receives from the caregiver a selection of one of the infusion devices to gang to the master infusion device (block 6920). The master infusion device then transmits a notification of the selection to the selected infusion device (block 6922).

In response to receipt of the notification, the selected infusion device ys (e.g., at a display screen) a confirmation request for the caregiver to confirm the selected infusion device should be ganged to the master infusion device as a slave infusion device (block 6924). If the caregiver does not m that the selected infusion device should be ganged to the master infusion device (block 6926:N), then the selected infusion device is not ganged to the master infusion device (block 6928). If, r, the caregiver does confirm that the selected infusion device should be ganged to the master infusion device (block 6926:Y), then the selected infusion device is ganged to the master on device (block 6930). The ver may gang multiple infusion devices to the master infusion devices. Accordingly, if the ver wishes to gang additional infusion s to the master infusion device (block 6932:Y), the caregiver may repeat the steps above to gang additional infusion devices to the master infusion . If the caregiver does not wish to gang additional infusion devices to the master infusion device (block 6932:N), or once the caregiver has ganged the desired number of infusion devices to the master infusion device, the caregiver may provide the infusion sequence configuration information to the master infusion device (block 6934). Once the caregiver has configured and confirmed the inter-device infusion sequence, the caregiver may initiate the infusion sequence and the master infusion device controls the on sequence across the ganged infusion devices (block 6936). depicts a flowchart of example method steps for designating a master infusion device for on devices ganged together via an interconnecting device. A set of infusion devices may be onnected via an interconnecting device (block 7002).

The lead on device at the interconnecting device may be identified (block 7004), e.g., the top-most or left-most infusion device mounted at the interconnecting device.

The lead infusion device may be set as the master infusion device (block 7006) and one or more of the other infusion devices mounted at the interconnecting device may be designated as slave on devices to gang those infusion devices with the master infusion device (block 7008). The master infusion device may initiate an infusion sequence involving the ganged infusion devices (block 7010) and control the ganged on devices during the infusion ce (block 7012).

While the slave infusion devices remain in signal communication with the master infusion device (block 7014:Y), the master infusion device may continue to l the ganged infusion devices during the infusion sequence (block 7012). If, however, the slave infusion devices lose the connection to the master infusion device and are no longer in signal communication with the master infusion device (block 7014:N), then the next tial infusion device at the interconnecting device (e.g., the next top-most) may be identified (block 7016) and designated as the new master infusion device (block 7018). The new master infusion device may take over controlling the ganged infusion devices during the infusion sequence (block 7012). depicts a flowchart of example method steps for designating a master infusion device for on devices ganged together via wireless communications. A set of infusion devices in wireless signal communication with each other may be ganged together (block 7102), and a caregiver may configure a multi-step infusion sequence for the ganged infusion s (block 7104). The caregiver may assign various steps of the multi-step on sequence to various infusion devices that have been ganged together (block 7106). The duration of each step may be calculate (block 7108), and the infusion device having the longest infusion duration may be designated as the master infusion device (block 7110). The other infusion devices may be designated as slave infusion devices for the master infusion device (block 7112).

During the infusion sequence, the master infusion device may control the slave infusion devices (block 7114). While the slave infusion s remain in signal communication with the master infusion device (block 7116:Y), the master infusion device may continue to control the ganged infusion devices during the multi-step infusion sequence. If, however, the slave infusion devices lose the connection to the master infusion device and are no longer in signal communication with the master on device (block 7116:N), then the infusion device having the next longest infusion duration is identified (block 7118) and designated as the new master infusion device (block 7120). The new master infusion device may take over controlling the ganged on devices during the infusion ce (block 7114).

It will be appreciated with the benefit of this disclosure that various combinations of the steps described above may be employed where the ganged together infusion devices include infusion s that are in signal communication both wirelessly and via an onnecting device. As an example, the ganged er infusion devices include infusion devices mounted at an interconnecting device as well as infusion devices that exchange communications wirelessly. In this example, the infusion devices at the interconnecting device may take precedence over the infusion devices ganged together wirelessly such that the lead infusion device at the interconnecting device may be designated the master infusion device. If the connection to the master infusion device is lost, the new master infusion device may be designated from the next sequential infusion device at the interconnecting device until connection with all infusion devices at the interconnecting device has been lost at which point, the new master infusion device may be the wirelessly icating infusion device having the longest duration. If the set of ganged together infusion devices includes le interconnecting devices and connection to all on s at one of the interconnecting devices has been lost, then the lead infusion device at the next sequential interconnecting device may be designated as the new master infusion device and so forth. s another flowchart of example method steps for ganging together infusion devices that are onnected via a medication management system.

Interconnecting infusion devices wirelessly, via an interconnecting device, or via a medication management system provides various advantages when performing infusions at a patient. Some e advantages include limiting the total infusion rate across each infusion device associated with a patient, tracking accumulated air across the infusion devices associated with a t, choosing a ting site for an on device and checking drug compatibility across the same connection site, and checking for duplicate drug selections across each infusion device associated with a patient. With respect to limiting the infusion rate, inter-device communication allows a caregiver or care facility (e.g., a hospital) to limit the total infusion rate across each on device associated with the t to an infusion rate ined by the caregiver or care facility. The total infusion rate may be limited across each channel on a hannel infusion device or across each respective channel of multiple infusion devices.

Potentially unsafe infusion rates may thus be identified and tracked. With respect to tracking accumulated air, the inter-device communication allows a caregiver or care facility to track the air that has been accumulated across all infusion device types associated with a patient, e.g., LVP, syringe, and PCA infusion device types. The onnected infusion s may provide an alarm when the accumulated air reaches an air accumulation threshold which may be set by the caregiver or care facility.

A caregiver may also select a connection site for the infusion devices and initiate a drug compatibility check. As described above, a caregiver may be ed of any potential drug atibilities at a common connection site which the caregiver may override if needed. A caregiver may likewise initiate a duplicate drug selection check across infusion devices associated with a patient and e notification of any duplicate drugs selected to be infused at the t and again override if needed.

The drug duplication and compatibility checks may happen in the background as the caregiver continues programming the infusion sequence thus ting delays in therapy in the case where there is no duplicate. When connected via an MMS, the duplicate drug check may be accomplished in various ways, e.g., 1) if the drug is being programmed for an inter-channel sequence then the infusion device checks the selected drug against the other selected drugs for all other steps in the therapy; 2) the infusion device sends a status message with the selected medication to the MMS which checks if the selected drug is programmed on other channels for the patient, and the MMS will respond with the results of the duplication check; 3) the infusion device sends the selected drug to the other infusers connected via an interconnecting device and the other infusion devices will respond with the results of the duplication check; 4) the infusion device polls nearby infusers ssly to check if they are associated to the same patient and, if so, the infusion device sends the selected drug to the other on devices associated with the patient. The other infusion devices may then respond with the results of the duplication check.

Similar techniques may be ed to check for drug compatibility. An on device may likewise check for potential drug incompatibility in various ways, e.g., 1) the infusion device may send its currently programmed clinical care area (CCA) to the other infusion devices. If the other infusion devices are in the same CCA, the infusion device may send the mmed drug to the other infusion devices which may issue a response indicating that no compatibility issues exist or d with the incompatible drug name; 2) the infusion device sends its currently programmed CCA to the other infusion devices, and if the other infusion devices are not in the same CCA, the infusion device sends a list of incompatible drugs for the programmed drug to the other infusion devices which issue a response indicating no compatibility issues exist or d with the atible drug name; 3) the infusion device requests the drugs with which the other infusion devices are programmed and the first infusion device checks for compatibility against its drug library.

With respect to ng accumulated air across each infusion device associated with a t, if an MMS is present, the MMS may be configured to receive periodic status messages that include accumulated air values from infusion devices during an ongoing infusion. The MMS may aggregate the accumulated air values from the infusion devices associated with the patient and send the aggregated value to each infusion device in a response to the periodic status message or as a separate message. If one of the infusion devices associated with the patient detects accumulated air that exceeds the threshold for accumulated air, that infusion device will e a notification or alarm.

The infusion device may continue infusing based on ality of the substance being infused or other drug library rules. The other associated infusion s may continue infusing until they also detect accumulated air, at which point they will also provide a notification or alarm. The caregiver may then attend to the alarming infusion devices, which may include dismissing the alarm message, resetting the accumulated air value, or removing air from the infusion device. Once the ver resets the accumulated air value, the MMS may be notified via the status message and may disseminate the reset value to the associated infusion devices. If the MMS connection is lost, then the infusion devices may continue operating on the most recently received aggregate accumulated air value, adding to the value as it tracks air, if any. Each infusion device may provide a notification or alarm individually if it exceeds the accumulated air threshold. When the MMS connection is reestablished, the infusion devices may send their current accumulated air values to the MMS which may sum the accumulated air across all infusion devices from the previous aggregate value and disseminate that value to the associated infusion devices. The infusion devices may also be configured to connect locally to the other ated infusion s to continue tracking the aggregate accumulated air. This may occur whether the MMS was ally present or not. If connected via an onnecting device, the topmost infusion device may designated as the master infusion device as described above and may be responsible for computing the aggregate accumulated air value. If the infusion devices utilize point-to-point wireless communication, the infusion device having the longest infusion duration remaining may be designated the master infusion device and likewise be responsible for computing the accumulated air value. If the infusion devices were communicating locally and a connection to an MMS is established, the master infusion device may send its aggregated value to the MMS and the infusion s which lost tion to the master infusion device, if any, may also send their accumulated air values. The MMS may then inate the new aggregate accumulated air value.

Limiting the total infusion rate across each infusion device associated with a t may function in a fashion similar to that of ng the accumulated air. The total infusion rate may be set by the caregiver, the care ty, or the CCA. If an MMS is present, the MMS may track the total infusion rate. If, however, an MMS is not present, then the infusion devices may communicate with one another to designate a master infusion device, and the master infusion device may track the total infusion rate. s a flowchart of example method steps for configuring an infusion at an infusion device. A first infusion of a first type may be initiated at an infusion device (block 7302). While the first infusion is infusing, the infusion device may receive, at an input device, input ting a selection of a second infusion of a second type (block 7304). The infusion device may display, at an output device, a configurable parameter of the second infusion (block 7306). The infusion device may then receive, at the input device, input indicating a value for the configurable parameter (block 7308). The infusion device may then initiate the second infusion. depicts a flowchart of example method steps for configuring a sequence of infusion steps at an infusion device. An infusion device may initiate a first infusion step of an infusion (block 7402). While the first infusion step is being performed, the infusion device may e, at an input device, input corresponding to a second on step (block 7404). The second infusion step may be configured based on the input received (block 7406), and the infusion device may initiate the second infusion step (block 7408). depicts a flowchart of example method steps for interconnecting multiple infusion devices and controlling the interconnected infusion devices from a master on device during an infusion. An infusion device may receive, via an input device, input corresponding to an infusion sing a plurality of infusion steps (block 7502).

The infusion device may establish a connection with at least one other infusion device via a communication interface to yield a plurality of interconnected infusion devices (block 7504). One of the interconnected on devices may be ated as a master infusion device (block 7506). During the on, the interconnected infusion s may be controlled from the infusion device designated as the master infusion device (block 7508).

While the disclosure has been described with respect to specific examples including presently illustrative modes of carrying out the disclosure, a person having ordinary skill in the art, after review of the entirety disclosed herein, will iate that there are numerous variations and permutations of the above-described systems and techniques that fall within the spirit and scope of the disclosure.

Claims (16)

WHAT IS CLAIMED IS:

1. An infusion device configured to infuse a fluid to a patient, the infusion device comprising: a first pump; an input device; an output device; one or more processors; and memory storing ctions that, when executed by one or more of the processors, cause the infusion device to: initiate a first infusion of a first type, receive, at the input device while the first infusion is infusing, input indicating a selection of a second on of a second type, display, at the output device, a urable parameter of the second infusion, receive, at the input device, input indicating a value for the configurable parameter, determine whether the second infusion of the second type is duplicated in r step in a current program, request, from a medication management system, a ination that the second infusion of the second type is ated on another line of a second pump that is also connected to the patient, determine whether the second infusion of the second type is duplicated in any ganged infusion pumps, and initiate the second infusion based on the determination that there is no duplication in the r step, the determination from the medication management system, and the determination from any of the ganged infusion pumps.

2. The infusion device of claim 1, wherein: the second infusion comprises a plurality of infusion steps.

3. The infusion device of claim 2, wherein: the configurable parameter comprises a total number of infusion steps to perform.

4. The infusion device of claim 3, n: the second infusion is an intermittent infusion.

5. The infusion device of claim 2, wherein: the second infusion is a multi-step infusion; and the configurable parameter ses, for one of the infusion steps, at least one of a dose, an infusion rate, a volume-to-be-infused, and an infusion duration.

6. The on device of claim 2, wherein: a first infusion step of the plurality of infusion steps infuses via a first channel connected to a first delivery source; and a second infusion step of the plurality of infusion steps infuses via a second channel connected to a second delivery source.

7. The infusion device of claim 6, wherein: the first infusion step and the second infusion step are performed concurrently.

8. The infusion device of claim 6, n: the instructions, when executed by one or more of the processors, further cause the infusion device to pause the first on step, initiate the second infusion step, and resume the first infusion step upon completion of the second infusion step.

9. The infusion device of claim 6, wherein: each of the first channel and the second channel are connected to the first pump of the infusion device.

10. The on device of claim 6, further comprising: a communication interface in signal communication with r infusion device; wherein the first channel is connected to the first pump of the infusion device; and wherein the second channel is connected to a pump of the other infusion device.

11. The infusion device of claim 1, r comprising: a dual-channel te connected to the first pump; a first channel connected to the cassette and to a first delivery ; a second channel connected to the cassette and a second ry source.

12. The infusion device of claim 11, wherein: the instructions, when executed by one or more of the processors, further cause the infusion device to switch between the first channel and the second channel during the second infusion such that an infusion flow is not interrupted during the second infusion.

13. The infusion device of claim 12, wherein: the instructions, when executed by one or more of the processors, further cause the infusion device to switch from the first channel to the second channel responsive to ining that the first delivery source is depleted, and switch from the second channel to the first channel responsive to determining that the second delivery source is depleted.

14. The on device of claim 13, wherein: the instructions, when executed by one or more of the processors, further cause the infusion device to provide a notification responsive to determining that either the first delivery source or the second delivery source is depleted.

15. The infusion device of claim 11, wherein: the instructions, when executed by one or more of the processors, further cause the on device to present a display at the output device wherein the display comprises an indication of which of the first channel or the second channel is tly infusing during the second infusion.

16. The infusion device of claim 2, wherein: the configurable parameter comprises a predetermined infusion ol to perform. i DELIVERY ATiGN iNPUT DEVICE (PDA) :NPUT /GUTPUTE DEVECE I WO 41012