Pembuatan Alat Monitoring Infus Berbasis NodeMCU ESP8266

The problem of late replacement of infusion mattresses for patients in a medical institution is still common today. It still helps him closely with the nurses' negligence in monitoring the patient's infusion condition. This condition is very dangerous for the patient's health. Therefore the making of infusion monitoring equipment based on NodeMCU esp8266. This tool works by relying on the results of sensor readings that are inserted into the microcontroller which will be processed by NodeMCU. The sensor used in making this system is the sensor module, the sensor reading sensor is the intended emission sensor - in this case, means the drip drops, the sensor will count the number of drops. From the number of drops, it can be used to count the drip infusion. In this study, it can be concluded that the NodeMCU ESP 8266-based infusion monitoring tool using the IR Obstacle sensor component has been successfully made through the functionality test process.

124. Implementation of IV Push Antibiotics for Outpatients During a National Fluid Shortage Following Hurricane Maria

Background Prior to the introduction of intravenous (IV) drip infusion, most IV drugs were delivered in a single bolus. However, with the advent of new agents, IV drip infusions became the standard for all medication delivery. In September 2017, Hurricane Maria made landfall in Puerto Rico and took a devastating toll. As Puerto Rico is the largest supplier of IV fluid bags, this lead to a worldwide fluid bag shortage. The outpatient antimicrobial therapy program (OPAT) was significantly impacted by the fluid shortage and this required effective stewardship at the Parkland Health and Hospital System in order to serve a largely uninsured and under-insured patient population. Methods Parkland pharmacists evaluated all self-administered antimicrobials for viability of administration as an IV single bolus push (IV-push) instead of a mini-bag infusion (IV-drip infusion). These medications were transitioned to IV-push for patient care. Data was gathered on patient demographics, 30-day readmission rates, mortality, discharge teaching satisfaction, patient satisfaction, and cost evaluation. Results 113 treatment courses were self-administered using the IV-push method and were compared to 102 self-administered courses using the IV drip infusion method, over the same time course. Individuals using IV-push had a statistically significant decrease in hospital length of stay as compared to those using IV-drip infusion. The 30-day readmission rate, emergency department visits, and mortality were similar between groups. Patient satisfaction was greater with IV-push (96% preferring). The shift to IV-push via the S-OPAT program saved 504 liters of normal saline, which along with a reduction in supplies and drug costs, resulted in an additional savings of &43,652 over a 6-month period. Conclusion The abrupt IV fluid shortage following a natural disaster challenged clinicians to think differently about standard practices. This led to implementation of a high value care model that is sustainable without affecting safety, efficacy, or efficiency. Given the cost savings, increased patient satisfaction, and equal clinical outcomes, the IV push model is not only a viable alternative initiated during a crisis; it is preferable in many standard situations. Disclosures All Authors: No reported disclosures

Postoperative Drip-Infusion of Remifentanil Reduces Postoperative Pain—A Retrospective Observative Study

Development of remifentanil-induced hyperalgesia (RIH) postoperatively is an unpleasant experience that requires further treatment. This study assessed the effects of gradual withdrawal combined with drip infusion of remifentanil on postoperative pain and the requirement for rescue analgesics. A total of 559 patients receiving total intravenous anesthesia with propofol and remifentanil were enrolled. All patients either underwent gradual withdrawal of remifentanil (GWR) or gradual withdrawal combined with drip infusion (GWDR) with a dose of 1 mcg·kg−1 for 30 min after extubation. The numeric rating scale (NRS) and the requirement of rescue analgesics were assessed. The requirement for rescue analgesics was significantly lower in the GWDR group than in the GWR group (13.2% vs. 35.7%; p < 0.001). At the post-anesthetic care unit (PACU), patients in the GWDR group had a lower NRS pain score (p < 0.001). In addition, in the postoperative 2nd hour, patients in the GWDR group had a significantly lower NRS than the GWR group (beta, −0.31; p = 0.003). No remifentanil-related adverse effects were observed. We found that gradual withdrawal combined with drip infusion of remifentanil required less rescue analgesics and reduced pain scores. The new way of remifentanil administration may be effective to prevent RIH.