CPNB pumps

[Oggg]

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Anyone have experience with the Ambu or GoBlock/BBraun pumps? My hospital thinks On Q is too expensive.

 

[BLADEMDA]

Anyone have experience with the Ambu or GoBlock/BBraun pumps? My hospital thinks On Q is too expensive.

Get a sample. Try it. On Q is too expensive

 

[Oggg]

Yeah a few months ago BBraun only had a 4cc/h pump, but now they have a selectable flow 2-10cc/h, no demand bolus. At my place, they are a few dollars cheaper than Ambu.

 

[climbingak]

Ambu pumps are pretty good. The patients like On-Q the best where I am so we have stuck with them. But we get reimbursed for them by billing them like an implant. Most private insurance have paid. Medicare/caid won't but they will pay a facility fee that makes up for a lot of it. Talking to my administrator, all in all its a wash for the facility. Its a sum zero, and patients and surgeons love it so we have stuck with them.

I wouldnt mind switching to Ambu. They quoted me about half as much as On Q (200 vs 400). But On Q has also sent me to various trainings and such that have been helpful. Ambu did not offer that, but I didnt ask.

 

[Oggg]

Ambu and BBraun have recognized that On Q is big into training ppl, so they are starting to offer similar educational activities.

 

[lord_jeebus]

When I was a resident we were using the Ambu pumps for a while. We stopped because a lot of them would leak from the bolus device, maybe 10-20%.

 

[Oggg]

Anyone fill their own pumps in a freestanding surgery center?

 

[climbingak]

Best not to unless you want to take the liability for its sterility. Ive been told it should be filled under a hood. Ive also heard filling it on the back table of the OR sterilely is acceptable.

I started out filling my own, its tedious. Found out the cost difference between me filling them and getting them prefilled from Pharmedia was about $10. I order them prefilled now.

 

[Oggg]

Yeah it sounds tedious. I filled some in residency when it wasn't regulated.

I think there's a loophole where the anesthesiologist can fill the pump at his/her cart for immediate use, similar to all our over drugs.

I definitely want to get prefilled, but I'm actually planning to self fill one or two free sample pumps and do some pilot cases at our surgery center.

 

[climbingak]

I have also filled some myself, but honestly you are taking on liability in the rare instance they get infected. On-Q clearly states they should be filled in a sterile environment. They may even state it should be under a hood. Everytime I end up doing it (if we run out of prefilled) I think "ahhh infections are rare" then after I worry for 3 days straight.

The only drawback to prefilled is that they expire. You have to set your par level right. You don't want to lose one of those prefilled ones to expiration at almost $500 with pump and med.

 

[Oggg]

BBraun doesn't have a demand bolus option yet, just a selectable flow rate of 2-10cc/hr. I will let my patients turn up the rate themselves as needed.

 

[Oggg]

Ok, so Ambu and B Braun have come out with selectable flow CPNB pumps that are cheaper than I Flow's On Q pump. They are trying to displace On Q based on price. Then I hear this rumor that B Braun's GoBlock is FDA approved only for percutaneous use (not perineural). Then I hear that iFlow is making this up about Braun and it's all a lie. Anyone know the truth?

 

[periopdoc]

FUD


Doesn't Braun license the pump and technology from Symbios?

Symbios GoBlock

B. Braun GoBlock

GOBlock-SF is a trademark and GOBlock and Symbios are registered trademarks of Symbios Medical Products, LLC

Either way, both companies discuss the use of this pump for peripheral nerve block which would be illegal if the device was not FDA approved for that application.

-pod

 

[Oggg]

I asked them. Braun says they are approved, iflow/on q says they're not. I Flow sent me a FDA letter saying On Q is approved for perineural, percutaneous, epidural use. Braun's FDA approval says percutaneous use. Basically it was probably written by a non medical person, and the difference between the two documents implies that percutaneous means local wound infiltration. But to a medical person, we know that percutaneous could describe Paraneural, wound, epidural, even intravenous.

 

[Outrigger]

With Obamacare, get used to having the cheapest possible equipment: Chinese endotracheal tubes, epidural catheter kits, nerve block kits, LMA's, et al. Hospitals are being encouraged to bundle payments so if you can't charge separately for that LMA supreme, your hospital won't let you stock it.