Evaluation of the advantages to be derived from automating injectable hospital preparations of paediatric synges and analgesia bags

Introduction
Hospital preparation of pediatric syringes (antibiotics and analgesics) and analgesia bags (ropivacaine and suphentanil) is time-consuming and calls on the operator to accomplish repetitive movements. Automating preparation, that reduces the risk of human error factors, would allow the time needed to be reduced and improve work ergonomics.

Equipment and Methods
Preparation of 100 syringes of 5 ml of cefotaxime 50 mg/ml and a preparation of 10 1 litre analgesia bags was selected. Each preparation was performed using the pump (AP) and without the BAXA Repeater® volumetric (SP) pump by 2 different technicians to reduce variability between individuals. An assessment of the preparation time and arduousness (on a scale of 1 to 10) of the AP and SP batches was made. The operating procedures were adapted for use of the pump. Finally, cost budget analysis was conducted.

Results
For the cefotaxime syringes, the total preparation time was greater with the pump: 107.5 min (AP) versus 79.5 min (SP). The mean filling time per syringe was identical (0.1 min), but the mean time between filling of syringes was around 0.25 min (AP) versus 0.16 min (SP). The rating in terms of drudgery was similar: 6.5 (AP) versus 6 (SP). For analgesia bags, the time for removal of 210 ml of NaCl 0.9% per bag was 2.08 min (SP) versus 0.86 min AP; the level of drudgery was rated 8 (SP) versus 1 (AP). An overall timesaving was observed for batches of more than 10 bags to be prepared. Using the pump required additional stages: decontamination, draining and calibrating the pump.

Discussion-Conclusion
The time measured with use of the pump is slightly overestimated as the handler was not used to operating it. Acquisition of a pump is only justified for a number greater than 10 bags of analgesic to be prepared (time-saving and ergonomics) but is not warranted for large series of small volume paediatric syringes.