In 9 cases alarm was heard. The alarm was mainly because of no flow or excess flow (3 cases each). Other causes for the alarm included slow flow, faulty IV lines showing fluctuations in flow rate and drip chamber not placed properly (1 patient each).

A Bland Altman analysis showing the bias between the readings between the two methods is very small (-0.1963) and there is no significant difference between the methods over the drop rate of 61-74 drops/min .

» Discussion

Fluid management of the pediatric surgical patient is critical. Complex surgical procedures are often associated with rapid changes in fluid requirements necessitating frequent assessment and modifications of fluid therapy.

A study from UK found that errors occurred in almost half the IV drug preparations and administrations, 1% of which were severe and 58% moderate. By counting the number of drops in the administration chamber, it is possible to monitor the infusion rate with high accuracy. However, this places an additional load on an already overburdened nursing staff. An infusion rate monitor ACCUFLOW was developed to provide accurate infusion rate as well as total infused volume. The developed system comprises optical sensor, LCD display and an alarm.

In the present study the rate of flow as displayed by the ACCUFLOW monitor, compared well with the manual reading. In addition, in 9 patients an alarm was heard. The alarm was mainly due to either no flow or high flow. This study was a part of a larger study on 236 patients that also showed similar results (unpublished data). Limitations of the study include a short observation period. The comparison with manual readings has been done for a duration of 1 hour and the accuracy has been tested at an average infusion rate of 61-74 drops/min-hence the applicability to infants and younger children and for longer infusions needs to be determined.

Thus ACCUFLOW would be useful device to adjust and monitor the infusion flow rate, thereby reducing the burden on the nursing staff. Due to the alarm facility it would alert the nursing staff when there is deviation from the preset rate of infusion or when there is no flow. It would also help weed out faulty IV sets. Additionally, it is easy to use, is reusable, portable, has low operational costs and comes with a battery backup. Unlike the infusion pumps it does not require specialized training of the operator and have lower acquisition costs. ACCUFLOW could thus be an attractive option for infusion rate monitoring in developing countries with limited healthcare resources and skewed patient nurse ratios.