Infusion pump upstream occlusion detection with air entrainment assistance

Abstract

The infusion device determines, using a pressure sensor, a pressure decay inside the infusion line associated with the infusion device injecting a fluid into the patient, where the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm. Additionally, the infusion device detects, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm. The infusion device then triggers an occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold.

Description

[Background technology]

[0001] A common concern associated with infusion pumps is blockage of the pump's fluid lines. A "downstream" blockage typically occurs due to an obstruction between the pump and the patient. A blockage between the intravenous (IV) medication bag and the pump is referred to as an "upstream blockage." An upstream blockage typically results from an obstruction upstream of the pump, preventing the IV medication from being delivered. An upstream blockage can also result, for example, from a clinician forgetting to unclasp the line between the bag and the pump before starting an infusion. In some cases, an upstream blockage can slow the flow of fluid to the patient. Depending on how long an upstream blockage is left unattended, air can begin to enter the fluid line as the pump pulls on the blockage. Thus, patient care can be compromised by increasing the risk of nutritional deficiencies, medication deficiencies, and air embolism.

[0002] Therefore, many infusion pumps currently include a pressure sensor to facilitate the detection of an occlusion. When the sensor detects a significant drop in pressure in the fluid line, it may imply that the pressure drop is due to an upstream occlusion, and therefore the infusion pump triggers an upstream occlusion alarm. While this method of upstream occlusion detection is effective for infusion pumps operating at maximum flow rates, the method may not be effective for some infusion pumps operating at slower flow rates. When an occlusion occurs at a slower flow rate, the pressure in the fluid line decreases at a correspondingly slower rate. Thus, the time between the occurrence of an upstream occlusion and the detection of the upstream occlusion may be several minutes, or possibly hours. Thus, a faster scheme for detecting upstream occlusion is desirable, especially for infusion pumps operating at lower flow rates. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] U.S. Patent No. 10,226,571 Summary of the Invention

[0004] In accordance with various aspects of the subject technology, a method includes determining, using a pressure sensor, a pressure decay inside an infusion line associated with an infusion of fluid to a patient by an infusion device, where the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detecting, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; and triggering an occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold.

[0005] In accordance with various aspects of the subject technology, a system includes one or more shut-off valves having a lower shut-off valve configured to cause compression of a fluid tubing mounted on an infusion pump when activated, the compression fluidly isolating a downstream portion of the fluid tubing from an upstream portion of the fluid tubing when the lower shut-off valve is operating under normal operating conditions; a lower pressure sensor downstream of the lower shut-off valve; an air entrapment sensor; a pressure sensor; an occlusion alarm; and a processor configured to determine, using the pressure sensor, a pressure decay inside an infusion line associated with infusion of fluid to a patient by an infusion device, where the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detect, using the air entrapment sensor, an amount of air inside the infusion line that does not meet the default air entrapment threshold for triggering an air entrapment alarm; and trigger an occlusion alarm based on the determined pressure decay and the amount of air detected before the pressure decay meets the default pressure threshold.

[0006] In accordance with various aspects of the subject technology, a non-transitory computer-readable medium includes instructions that, when executed by one or more processors, cause the one or more processors to determine, using a pressure sensor, a pressure decay inside an infusion line associated with an infusion of fluid to a patient by an infusion device, where the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detect, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; and trigger an occlusion alarm based on the determined pressure decay and the amount of air detected before the pressure decay meets the default pressure threshold.

[0007] It is understood that other configurations of the subject technology will become readily apparent to those skilled in the art from the following detailed description, in which various configurations of the subject technology are shown and described by way of illustration. When implemented, the subject technology is capable of other and different configurations, and its several details are capable of modification in various other respects, all without departing from the scope of the subject technology. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.

[0008] For a better understanding of the various implementations described, reference should be made to the following detailed description taken in conjunction with the following drawings, in which like reference numerals refer to corresponding parts throughout the figures and description, and in which: [Brief description of the drawings]

[0009] [Figure 1] 1 depicts an example infusion device shown in its intended environment, in accordance with various aspects of the subject technology. [Diagram 2] A diagram depicting an example infusion device with a front door open in a perspective view showing upstream and downstream portions of a fluid infusion line operatively engaged with the example infusion device, in accordance with various aspects of the subject technology. [Figure 3A]1 is an example graph with example curves illustrating pressure in an infusion line under normal and closed conditions, as well as thresholds for detecting pressure, in accordance with various aspects of the subject technology. [Figure 3B] 1 is an example graph with example curves illustrating the amount of air present in an infusion line under normal and closed conditions, as well as thresholds for detecting the amount of air, in accordance with various aspects of the subject technology; [Figure 4] 1 depicts a first example process for triggering an occlusion alarm, in accordance with various aspects of the subject technology. [Diagram 5] 11 depicts a second example process for triggering an occlusion alarm, in accordance with various aspects of the subject technology. [Figure 6] 1 is a conceptual diagram illustrating an example electronic system for detecting an upstream occlusion, in accordance with various aspects of the subject technology. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] Reference will now be made to implementations, examples of which are illustrated in the accompanying drawings. In the following description, numerous specific details are set forth in order to provide an understanding of the various implementations described. Nevertheless, it will be apparent to one of ordinary skill in the art that the various implementations described may be practiced without these specific details. In other instances, well-known methods, procedures, components, circuits, and networks have not been described in detail so as not to unnecessarily obscure aspects of the implementations.

[0011] It has been found that upstream occlusions at very low flow rates (e.g., below 1 mL / hr) can result in a very long time-to-alarm ("TTA"), in some cases resulting in an air inclusion alarm being triggered before an occlusion is detected. In traditional pumps, alarms can occur based on pressure or air bubbles, with pressure-based alarms often being associated with occlusion (e.g., an occlusion alarm can be triggered based on pressure). The subject technology provides an occlusion alarm under conditions where neither a pressure-based nor an air-based alarm is triggered. Thus, the subject technology can alert the clinician to an occlusion in the system much earlier than traditional mechanisms.

[0012] FIG. 1 depicts an example infusion device 10 (e.g., an infusion pump) shown in use in its intended environment in accordance with various aspects of the subject technology. In particular, the infusion device 10 is shown mounted to an intravenous (IV) pole 12 carrying a fluid source 14 containing IV fluid. The fluid source 14 is connected in fluid communication with an upstream portion 16 of a fluid infusion line 21. The fluid infusion line 21 is a conventional IV infusion type tubing typically used in hospital or medical environments and is made from any type of flexible tubing, such as silicone, suitable for use in infusing therapeutic fluids into a patient. The flexible portion 18 of the fluid infusion line 21 is mounted in operative engagement with a peristaltic pump mechanism 19 for advancing fluid through a downstream portion 20 of the fluid infusion line 21, for example, in the patient's arm 22.

[0013] It will be understood by those skilled in the art that the upstream portion 16, the flexible portion 18, and the downstream portion 20 of the fluid infusion line 21 may be portions of the same continuous flexible tubing, with this portion being defined by its location relative to the peristaltic pumping mechanism 19. For convenience, the continuous length of flexible tubing is designated by the numeral 21. A roller clamp 23 (e.g., configured to perform mechanical compression of the line to block flow) may be placed on the downstream portion 20 of the fluid infusion line 21 between the infusion device 10 and the patient's arm 22. In this context, the term "upstream" refers to the portion of the flexible tubing that extends between the fluid source 14 and the peristaltic pumping mechanism 19, and the term "downstream" refers to the portion of the flexible tubing that extends from the peristaltic pumping mechanism 19 to the patient's arm 22.

[0014] 2, the infusion device 10 is shown with a front door 50 open in a perspective view showing an upstream portion 16 and a downstream portion 20 of a fluid infusion line 21 in operative engagement with the infusion device 10. The infusion device 10 is operatively engaged with a peristaltic pumping mechanism 19 that connects the upstream portion 16 to the downstream portion 20 of the fluid infusion line 21 to form a continuous fluid infusion line 21 extending from the respective fluid source 14 of FIG. 1 to the patient's arm 22 of FIG. 1, with the fluid passing through the fluid infusion line 21 acting directly on a flexible portion 18 of the fluid infusion line 21, which is acted upon by a pump to move the fluid downstream to the patient's arm 22. Specifically, the peristaltic pumping mechanism 19 acts as a flow control device for the infusion device 10 to move fluid through the fluid infusion line 21. The upstream portion 16, downstream portion 20, and / or flexible portion 18 of the fluid infusion line 21 may be coupled to a pump cassette or cartridge configured to be coupled to the infusion device 10, such as the type described in U.S. Pat. No. 10,226,571, issued March 12, 2019, currently owned by the applicant, and incorporated by reference herein.

[0015] The type of peristaltic pump mechanism 19 may vary, for example, it may be a multi-finger pump mechanism. For example, the pump mechanism may be of the "four-finger" type, including an upstream closure finger 72, a primary pump finger 74, a downstream closure finger 76, and a secondary pump finger 78. "Four-finger" pump mechanisms, and mechanisms used in other linear peristaltic pumps, operate by sequentially compressing a segment of fluid tubing with the upstream closure finger 72, the primary pump finger 74, the downstream closure finger 76, and the secondary pump finger 78. Pressure is applied at sequential locations on the fluid infusion line 21, beginning at the upstream end of the peristaltic pump mechanism 19 and working toward the downstream end. At least one finger is always compressing hard enough to occlude the fluid infusion line 21. As a practical matter, one finger cannot be withdrawn from occluding the tube until the next finger in turn has already occluded the tube, and thus there is never a direct fluid path from the fluid source to the patient. The operation of peristaltic pumps, including four-finger pumps, is well known to those skilled in the art and further operational details will not be provided here.

[0016] In this particular implementation, Figure 2 depicts a downstream pressure sensor 82 in the infusion device 10 at a downstream location relative to the peristaltic pump mechanism 19. The downstream pressure sensor 82 is mounted to the infusion device 10 and located adjacent to the pump mechanism 19. The downstream pressure sensor is also located downstream from the flow control device, i.e., at a location between the pump mechanism 19 and the patient's arm 22 of Figure 1, so that connection of the correct fluid source with the correct pump can be verified before any fluid is pumped to the patient.

[0017] Still referring to FIG. 2, an upstream pressure sensor 80 is also depicted. The upstream pressure sensor is associated with the peristaltic pump mechanism 19 and is further provided as an integral part of the infusion device 10 in this example. The upstream pressure sensor may be placed adjacent to and upstream from the peristaltic pump mechanism 19, for example, at a location between the fluid source 14 of FIG. 1 and the peristaltic pump mechanism 19, so that connection of the correct fluid source with the correct pump can be verified before any fluid is pumped to the patient. For purposes of this disclosure, the term "pressure sensor" may also be used to describe or include a force sensor. The pressure sensor described herein may be replaced by a force sensor for all implementations described herein. The force sensor looks at the compressive force on the tube and the pressure sensor looks at the pressure of the tube as it is compressed inside the pump. Both mechanisms are envisioned and the term "pressure sensor" as used herein (and the value read from the pressure sensor) should be interpreted as either.

[0018] According to various implementations, the infusion device 10 can include one or more sensors for detecting air in the fluid infusion line 21. In the depicted example, a sensor 84 is configured within the infusion device 10 and located below the flexible portion 18 of the fluid infusion line 21 and adjacent to the peristaltic pump mechanism 19. Although depicted as part of the infusion device 10 and downstream of the peristaltic pump mechanism 19, the sensor 84 may be located upstream of the peristaltic pump mechanism 19 or may be separate and independent from the infusion device 10.

[0019] In some implementations, the sensor 84 can include a light or ultrasonic sensor. Thus, electromagnetic energy (e.g., light) or acoustic energy (e.g., ultrasonic pulses) is passed through the fluid infusion line 21 (e.g., from a transducer at the door 50) and the sensor 84 monitors the variations in the received energy. Because air generally transmits light and / or acoustic energy differently than the intravenous fluid solution due to different transmission characteristics such as absorption and / or refraction, monitoring the variations in the ability of the light or sound to pass through the solution can provide a generally accurate determination that air is present in the fluid line.

[0020] An analog-to-digital converter may receive output signals from the sensor 84 and convert these signals to a digital format at a particular sample rate controlled by a processor. The output signal indicates the amount of air in the line at a particular time. In some implementations, a dating device, such as a volume accumulator, provides a dating value for the output digital signal, the dating value being a function of the volume introduced through the fluid line. (A clock may also provide a dating value based on the time the output digital signal was generated or received, depending on the particular system). The processor may receive the digital signal and process the digital signal to determine an air concentration value representing air that has passed through the fluid delivery system. The air concentration value may represent the number of bubbles in the fluid infusion line 21, the volume of air in the fluid infusion line 21, or some combination of both. One or more alarms (e.g., integrated within the infusion device 10 or a remote device) may be provided to indicate an insufficient air concentration value in the fluid infusion line 21. In some implementations, the concentration may be evaluated as an accumulation over a period of time, or an accumulation of the total amount of air detected by the device.

[0021] FIG. 3A depicts a graph with example curves representing pressure in a fluid infusion line (e.g., fluid infusion line 21 of FIG. 1) under normal and occlusion conditions, in accordance with various aspects of the subject technology, including thresholds for detecting pressure. As previously described, a processor (e.g., in infusion device 10 of FIGS. 1 and 2) can detect pressure in the fluid infusion line using a sensor (e.g., upstream pressure sensor 80 of FIG. 2). The X-axis of the depicted graph represents time, and the Y-axis represents pressure. Curve 321 represents pressure in the fluid infusion line in the absence of an upstream occlusion. As depicted, in the absence of an occlusion, the pressure remains stable. Meanwhile, curve 322 represents pressure during an upstream occlusion. As depicted, during an upstream occlusion, the pressure decreases over time.

[0022] The default pressure threshold 323 represents a default pressure threshold for triggering an upstream occlusion alarm based on pressure. For example, the default pressure threshold 323 may be pre-programmed into the infusion device 10 when an infusion is initiated. When there is an occlusion upstream, the peristaltic pump mechanism 19 of the infusion device will create a suction force on the infusion line causing the line to collapse and / or pinch. When the tube collapses, the pressure sensor (e.g., upstream pressure sensor 80 in FIG. 2) will measure the pressure drop and trigger an alarm when the pressure drop falls below the default pressure threshold 323. Generally, an upstream occlusion will be indicated by a rapid drop in pressure. Nevertheless, at lower flow rates (e.g., below 1 mL / hr), when the pump is pumping little fluid, the pressure drop will be much more gradual and the time to alarm period 325 will be greater. It has been found that in some instances, detection may not occur for up to two hours. Therefore, under such conditions, it would be desirable to have the pump trigger an alarm faster.

[0023] Thus, the modified pressure threshold 324 represents an alternative pressure threshold that may be used in place of the default pressure threshold 323 under certain conditions. Under some conditions, the modified pressure threshold 324 may be dynamically set based on detection of other conditions that may contribute to an occlusion. For example, as will be further described, the modified pressure threshold 324 may be set and / or adjusted based on air detected in the fluid infusion line (e.g., fluid infusion line 21 of FIG. 1). As another example, upon detecting a pressure decay in the fluid infusion line, the algorithm of the subject technology begins to determine, using a sensor (e.g., sensor 84 of FIG. 2), whether air is also being introduced into the line. Upon detecting a predetermined amount of air or a diffusion amount of air (see, e.g., threshold 314 of FIG. 3B), the algorithm may switch to using threshold 324 to trigger an alarm.

[0024] The time period 325 represents the amount of time between the occurrence of an example upstream occlusion and the triggering of a pressure alarm under default conditions (e.g., using threshold 323). According to some implementations, the TTA (time to alarm) will be dynamically shortened based on certain conditions when threshold 324 is used, as shown in the depicted graph.

[0025] FIG. 3B depicts a graph with example curves representing the amount of air present in a fluid infusion line (e.g., fluid infusion line 21 of FIG. 1) under normal and occluded conditions, in accordance with various aspects of the subject technology, including thresholds for detecting the amount of air. Silicone tubing is permeable to air under vacuum or near-vacuum conditions. When an upstream occlusion occurs and the pump is pumping against the collapsed tubing, a vacuum may be created in the tubing, causing air to diffuse through the silicone walls and into the tubing and / or fluid, thereby forming air bubbles in the tubing and / or fluid. As previously described, a processor (e.g., in the infusion device 10 of FIGS. 1 and 2) may detect the amount of air in the infusion line using a sensor (e.g., sensor 84 of FIG. 2).

[0026] The X-axis of the depicted graph represents time and the Y-axis represents the amount of air in the fluid infusion line. Curve 311 represents the amount of air detected in the infusion line under normal conditions (e.g., in the absence of an upstream occlusion). As depicted, the amount of air detected varies minimally in the absence of an occlusion. Meanwhile, curve 312 represents an example variation in the amount of air in the infusion line during an upstream occlusion. In the depicted example, an upstream occlusion occurs and the amount of air increases over time, represented by the increasing slope depicted in curve 312.

[0027] The default air infusion threshold 313 represents a threshold for triggering an air infusion alarm under normal conditions. For example, the default air infusion threshold 313 may be pre-programmed into the infusion device 10 by the time an infusion is initiated. When the amount of air reaches the default air infusion threshold 313, an alarm is triggered to notify the clinician that air is present in the fluid infusion line 21. Although the infusion device 10 may include both an occlusion alarm and an air infusion alarm, in some implementations, the air infusion alarm may be interpreted as an occlusion alarm.

[0028] The secondary air entrainment threshold 314, on the other hand, represents a secondary threshold that may be used in place of the default air entrainment threshold 313 under certain conditions. For example, similar to the pressure example in FIG. 3A, the secondary threshold 314 may be used when the pressure sensed by a pressure sensor (e.g., upstream pressure sensor 80 in FIG. 2) detects a predetermined pressure decay over time and / or reaches a certain pressure (e.g., the modified pressure threshold in FIG. 3A). Although the secondary air entrainment threshold 314 is depicted in FIG. 3A as being less than threshold 313, in some implementations the secondary threshold 314 is equal to or greater than threshold 313.

[0029] The time period 315 represents the amount of time between the occurrence of an example upstream occlusion and the triggering of an air inclusion alarm under default conditions (e.g., using threshold 313). According to some implementations, this TTA (time to alarm) will be dynamically shortened based on certain conditions when threshold 314 is used, as shown in the depicted graph.

[0030] FIG. 4 depicts a first example process 410 for triggering an occlusion alarm in accordance with aspects of the subject technology. One or more blocks of the process 410 may be performed, for example, by one or more computing devices, including, for example, the infusion device 10. In some implementations, one or more of the blocks may be performed based on one or more machine learning algorithms. In some implementations, one of the blocks may be performed separately from the other blocks and by one or more different processors or devices. Additionally, for purposes of explanation, the blocks of the example process 410 are described as occurring sequentially or linearly. Yet, multiple blocks of the example process 410 may occur in parallel. Additionally, the blocks of the example process 410 need not be performed in the order shown, and one or more of the blocks of the example process 410 need not be performed.

[0031] An algorithm executed by a processor associated with the infusion device 10 (see, e.g., FIG. 6) continuously monitors pressure values ​​using a pressure sensor (e.g., the upstream pressure sensor 80 or the downstream pressure sensor 82 of FIG. 2) to determine whether the current pressure in the liquid infusion line 21 meets a default predetermined (high or low) pressure limit (e.g., the default pressure threshold of FIG. 3A) for triggering an occlusion alarm. In process 410, the algorithm determines a pressure decay inside the fluid infusion line 21 associated with the infusion device 10 injecting fluid into the patient, and the pressure decay does not meet (411) the default pressure threshold for triggering an occlusion alarm. In some implementations, the determined pressure decay can include a pressure value measured by a pressure sensor (e.g., the upstream pressure sensor 80 of FIG. 2), and the default pressure threshold can be a minimum pressure value for triggering an occlusion alarm. With brief reference to FIG. 3A, the currently detected pressure may be less than the modified pressure threshold 324, but in this instance, the default pressure threshold 323 has not been reached. Thus, an occlusion alarm may not be triggered based on the pressure reading alone. In some implementations, the determined pressure decay may be a slope value of the pressure decay over time. In such implementations, the default pressure value may include a fixed pressure value or may be a maximum slope value of the pressure decay over time. In some implementations, the pressure decay is a rate of change and the thresholds described herein may be a rate of change of pressure over a period of time.

[0032] In the depicted example, the algorithm detects 412 an amount of air inside the infusion line using the air sensor 84 that does not meet a default air inclusion threshold for triggering an air inclusion alarm. For example, the processor of the infusion device 10 can continuously monitor the sensor value provided by the air inclusion sensor 84 for a predetermined threshold amount of air. With brief reference to FIG. 3B, the amount of air may be greater than the secondary air inclusion threshold 314, but in this example, the default air inclusion threshold 313 has not been reached. In some implementations, the amount of air is measured as the volume of air in the line. In some implementations, the amount of air is measured as the number of air bubbles in the line.

[0033] While both the aforementioned pressure and air conditions are indicative of a potential occlusion in the infusion line, either condition alone may be insufficient to trigger an alarm. The algorithm of the subject technology observes the pressure decay in addition to increasing the air in the infusion line, and before the pressure decays enough to meet the default pressure threshold, the algorithm triggers an occlusion alarm based on the determined amount of air and the determined pressure decay (413). In this regard, the algorithm utilizes a threshold below the threshold normally utilized to trigger any particular alarm.

[0034] The thresholds and measurements (e.g., from pressure or air sensors) described herein may be for fixed values ​​at a single point in time, or may be averages or mean values ​​over a predetermined period of time. In some implementations, these thresholds and measurements may be respective values ​​that indicate a gradient or rate of change of the corresponding parameter (air or pressure). In one example, the algorithm may utilize a modified pressure threshold 324, which may be a predetermined percentage (e.g., 80%, 70%, 60%, 50%, etc.) of a default pressure threshold 323 (e.g., a default threshold programmed into the infusion device 10). In some implementations, the threshold of one parameter is adjusted proportionally based on the value of the other parameter relative to the threshold of the other parameter. For example, as the amount of air detected approaches the default air inclusion threshold, the modified pressure threshold may change (e.g., become larger) toward a value that is more easily triggered.

[0035] Similarly, the algorithm may utilize the described secondary air ingress threshold 314, which may be a predetermined percentage of the default air ingress threshold 313 (e.g., a default threshold programmed into the infusion device 10). In some implementations, the thresholds 314 and 324 (and / or thresholds 313, 323) may include a predetermined slope value (or, in some implementations, a rate of change). For example, if the thresholds 313 and 323 are not met and a slope greater than the predetermined slope for one of the parameters is detected for more than a predetermined amount of time before the threshold is met, an alarm may be triggered. In some implementations, the thresholds 314, 324 (and / or thresholds 313, 323) may include a predetermined rate of change. By reducing the alarm limits for each factor (e.g., pressure and air), the time to occlusion alarm may be faster than by meeting one or both default alarms.

[0036] FIG. 5 depicts a second example process 510 for triggering an occlusion alarm according to aspects of the subject technology. According to various implementations, the process 510 may operate similarly to the process 410 and / or replace or extend the process 410. One or more blocks of the process 510 may be performed, for example, by one or more computing devices, including, for example, the infusion device 10. In some implementations, one or more of the blocks may be performed based on one or more machine learning algorithms. In some implementations, another of the blocks may be performed separately from the other blocks and by one or more different processors or devices. Additionally, for purposes of explanation, the blocks of the example process 510 are described as occurring sequentially or linearly. Nevertheless, multiple blocks of the example process 510 may occur in parallel. Additionally, the blocks of the example process 510 need not be performed in the order shown, and one or more of the blocks of the example process 510 need not be performed.

[0037] In the illustrative process 510, the algorithm determines a pressure decay inside the infusion line associated with the infusion device injecting fluid into the patient using a pressure value obtained from the pressure sensor 84, and the pressure decay meets a modified pressure threshold that is different from the default pressure threshold for triggering an occlusion alarm (511). With reference to FIG. 3A and FIG. 5, if the pressure decay detected by the pressure sensors 80, 82 meets the threshold 323 (e.g., the pressure value resulting from the pressure decay), an occlusion alarm may be triggered. If the detected pressure decay does not meet the thresholds 323 and 324, the process returns to monitoring air and pressure (using the pressure sensors 80, 82 and the air sensor 84). (START). If the detected pressure meets the threshold 324 but not the threshold 323, the algorithm determines the condition of the air in the infusion line to determine whether an occlusion alarm should be triggered. The algorithm triggers an occlusion alarm in response to both the threshold 324 and the threshold 314 being met.

[0038] The algorithm detects an amount of air inside the infusion line using the air sensor 84 that does not meet the default air inclusion threshold for triggering an air inclusion alarm (512). With reference to FIG. 3B and FIG. 5, if the amount of air detected by the air sensor 84 meets the threshold 313, an air inclusion alarm may be triggered. If the amount of air detected does not meet the thresholds 313 and 314, the process returns to monitoring air and pressure (using the pressure sensors 80, 82 and the air sensor 84). (START). In some implementations, if the amount of air detected meets the threshold 314 but not the threshold 313, the algorithm triggers an occlusion alarm upon determining that there is pressure decay and meets certain measures, such as meeting the threshold 324. The algorithm triggers an occlusion alarm in response to both the threshold 324 and the threshold 314 being met (515, 520).

[0039] Although the present disclosure generally relates to occlusion alarms based on detected pressure and air, in some implementations, an air intrusion alarm may be triggered earlier based on the aforementioned parameters and thresholds. For example, if the detected amount of air does not meet the thresholds 313 and 314, the process returns to monitoring air and pressure (using pressure sensors 80, 82 and air sensor 84). (START). If the detected amount of air still meets the threshold 314 but not the threshold 313, the algorithm may trigger an air intrusion alarm upon determining that a pressure decay exists and meets certain criteria, such as meeting the threshold 324 (515, 520). In some implementations, the infusion device 10 may be configured to trigger both an air intrusion alarm (based on air) and an occlusion alarm (based on pressure). The algorithm may be configured to switch from issuing an air intrusion alarm to an upstream occlusion alarm based on the detected amount of air meeting the threshold 314 but not meeting the threshold 313 and the pressure decay meeting the threshold 324.

[0040] According to some implementations, the secondary air intrusion threshold is dynamically adjusted based on the determined pressure in the infusion line before the occlusion alarm is triggered. For example, in some implementations, the secondary air intrusion threshold is adjusted when the determined pressure is below a predetermined amount. As another example, in some implementations, the secondary air intrusion threshold may be scaled up or down based on the determined pressure.

[0041] In some implementations, the secondary air intrusion threshold is adjusted based on the flow rate of the fluid inside the infusion line before the occlusion alarm is triggered. For example, the secondary air intrusion threshold may be adjusted (e.g., to trigger the occlusion alarm faster) when the flow rate of the fluid inside the infusion line is less than 1 milliliter per hour. As another example, the secondary air intrusion threshold may be adjusted (e.g., to trigger the occlusion alarm faster) when the flow rate of the fluid inside the infusion line is less than 0.1 milliliter per hour. In some implementations, the secondary air intrusion threshold is dynamically set based on multiplication of the threshold by a factor determined based on the flow rate of the fluid inside the fluid infusion line 21. For example, in some implementations, when the flow rate is 1 milliliter per hour, the factor is 1 / 2. Thus, when the flow rate is 1 milliliter per hour or less, the secondary air intrusion threshold is set to 1 / 2 of the default air intrusion threshold (e.g., the default air intrusion threshold multiplied by a factor of 1 / 2). As another example, in some implementations, when the flow rate is 0.1 milliliters per hour, the factor is 1 / 4. At a flow rate of 0.1 milliliters per hour, the secondary air inclusion threshold would therefore be set to 1 / 4 of the default air inclusion threshold.

[0042] In some implementations, the modified pressure threshold is dynamically set based on the determined air volume before the occlusion alarm is triggered. For example, the modified pressure threshold may be adjusted when the determined air volume is equal to or greater than a predetermined amount. As another example, the modified pressure threshold may be scaled up or down based on the determined air volume.

[0043] In some implementations, before the occlusion alarm is triggered, the modified pressure threshold is dynamically set based on the flow rate of the fluid inside the infusion line. For example, the modified pressure threshold may be dynamically set when the flow rate of the fluid inside the infusion line is less than 1 milliliter per hour. As another example, the modified pressure threshold may be dynamically set when the flow rate of the fluid inside the infusion line is less than 1 milliliter per hour. In some implementations, the modified pressure threshold is dynamically set based on multiplication of the threshold by a factor determined based on the flow rate of the fluid inside the fluid infusion line 21. For example, in some implementations, when the flow rate is 1 milliliter per hour, the factor is 2. Thus, the modified pressure threshold is set to twice the default pressure threshold (e.g., the default air inclusion threshold multiplied by a factor of 2) when the flow rate is equal to or less than 1 milliliter per hour. As another example, in some implementations, when the flow rate is 0.1 milliliter per hour, the factor is 4. At a flow rate of 0.1 milliliters per hour, the modified pressure threshold should therefore be set to four times the default pressure threshold. As another example, the modified pressure threshold may be scaled up or down based on the determined air volume.

[0044] According to various implementations, the disclosed algorithms may be configured to disable the infusion device 10 or otherwise terminate ongoing infusion or administration of fluid to the patient in response to the conditions described herein for triggering an occlusion alarm or, in some implementations, an air inclusion alarm. In this regard, the steps of triggering alarms 413 and 520 of the respective processes 410 and 510 may be replaced or supplemented by disabling the pump or terminating the infusion. In some implementations, disabling the pump and / or terminating the infusion may further include acknowledging the corresponding alarm and / or locking a user interface associated with the pump such that a clinician cannot reactivate the pump or infusion without providing authority based on elevated access rights (e.g., supervisory access rights).

[0045] Many of the example processes 410, 510 and related features and applications described above may also be implemented as software processes specified as a set of instructions recorded on a computer-readable storage medium (also referred to as a computer-readable medium) and may be executed automatically (e.g., without user intervention). When these instructions are executed by one or more processing units (e.g., one or more processors, processor cores, or other processing units), they cause the processing units to perform the actions indicated in the instructions. Examples of computer-readable media include, but are not limited to, CD-ROMs, flash drives, RAM chips, hard drives, EPROMs, etc. Computer-readable media does not include carrier waves and electronic signals, whether passing wirelessly or over a wired connection.

[0046] The term "software" is intended to include, where appropriate, firmware resident in read-only memory or applications stored in magnetic storage that can be read into memory for processing by a processor. Also, in some implementations, multiple software aspects of the subject disclosure can be implemented as subportions of a larger program while remaining entirely distinct software aspects of the subject disclosure. In some implementations, multiple software aspects can also be implemented as separate programs. Finally, any combination of separate programs that together embody the software aspects described herein is within the scope of the subject disclosure. In some implementations, the software program, when installed to operate on one or more electronic systems, defines one or more specific machine implementations that execute and perform the operations of the software program.

[0047] A computer program (also known as a program, software, software application, script, or code) can be written in any form of programming language, including compiled or interpreted languages, declarative or procedural languages, and can be deployed in any form, including as a stand-alone program or as a module, component, subroutine, object, or other unit suitable for use in a computing environment. A computer program may, but need not, correspond to a file in a file system. A program can be stored in part of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to that program, or in multiple coordinated files (e.g., a file containing one or more modules, subprograms, or code portions). A computer program can be deployed to be executed on one computer or on multiple computers located at one site or distributed across multiple sites and interconnected by a communication network.

[0048] 6 is a conceptual diagram illustrating an example electronic system 600 for detecting an upstream occlusion, in accordance with aspects of the subject technology. The electronic system 600 may be implemented by a computing device for execution of software associated with one or more portions or steps of processes 410 and / or 510, or the components and methods provided by Figures 1-5. In this regard, the electronic system 600 may include the infusion device 10 and / or a computing device within or connected to the infusion device 10.

[0049] The electronic system 600 can include various types of computer readable media and interfaces for various other types of computer readable media. In the depicted example, the electronic system 600 includes a bus 608, a processing unit 612, a system memory 604, a read only memory (ROM) 610, a permanent storage device 602, an input device interface 614, an output device interface 606, and one or more network interfaces 616. In some implementations, the electronic system 600 may include or be integrated with other computing devices or circuitry for operation of the various components and methods described above.

[0050] Bus 608 collectively represents all system, peripheral, and chipset buses that communicatively connect the numerous internal devices of electronic system 600. For example, bus 408 communicatively connects processing unit 612 with ROM 610, system memory 604, and permanent storage device 602.

[0051] From these various memory units, the processing unit 612 retrieves instructions to execute and data to process in order to perform the processes of the subject disclosure. The processing unit can be a single processor or a multi-core processor in different implementations.

[0052] The ROM 610 stores static data and instructions required by the processing unit 612 and other modules of the electronic system. The permanent storage device 602, on the other hand, is a read-and-write memory device. This device is a non-volatile memory unit that stores instructions and data even when the electronic system 600 is off. Some implementations of the subject disclosure use a mass storage device (such as a magnetic or optical disk and its corresponding disk drive) as the permanent storage device 602.

[0053] Other implementations use a removable storage device (such as a floppy disk, flash drive, and its disk drive counterpart) as the permanent storage device 602. Like the permanent storage device 602, the system memory 604 is a read-and-write memory device. Yet, unlike the storage device 602, the system memory 604 is a volatile read-and-write memory, such as a random access memory. The system memory 604 stores some of the instructions and data that the processor needs during execution. In some implementations, the processes of the subject disclosure are stored in the system memory 604, the permanent storage device 602, and / or the ROM 610. From these various memory units, the processing unit 612 retrieves instructions to execute and data to process in order to execute the processes of some implementations.

[0054] The bus 608 also connects to input and output device interfaces 614 and 606. The input device interface 614 allows a user to communicate information and select commands to the electronic system. Input devices used with the input device interface 614 include, for example, alphanumeric keyboards and pointing devices (also called "cursor control devices"). The output device interface 606 allows, for example, the display of images generated by the electronic system 600. Output devices used with the output device interface 606 include, for example, printers and display devices, such as cathode ray tubes (CRT) or liquid crystal displays (LCD). Some implementations include devices, such as touch screens, that function as both input and output devices.

[0055] 6, the bus 608 also couples the electronic system 600 to a network (not shown) through a network interface 616. The network interface 616 may include, for example, a wireless access point (e.g., Bluetooth or Wi-Fi) or radio circuitry for connecting to a wireless access point. The network interface 616 may also include hardware (e.g., Ethernet hardware) for connecting a computer to a network of networks, such as a local area network ("LAN"), a wide area network ("WAN"), a wireless LAN, or an intranet, or to a portion of a network of computers, such as the Internet. Any or all of the components of the electronic system 600 may be used in conjunction with the subject disclosure.

[0056] These functions described above can be implemented in computer software, firmware, or hardware. The techniques can be implemented using one or more computer program products. The programmable processor and computer can be included in or packaged as a mobile device. The processes and logic flows can be implemented by one or more programmable processors and by one or more programmable logic circuit devices. General purpose and special purpose computing and storage devices can be interconnected through a communication network.

[0057] Some implementations include electronic components, such as a microprocessor, storage, and memory, that store computer program instructions on a machine-readable or computer-readable medium (also referred to as a computer-readable storage medium, machine-readable media, or machine-readable storage medium). Some examples of such computer-readable media include RAM, ROM, read-only compact disks (CD-ROMs), writeable compact disks (CD-Rs), rewritable compact disks (CD-RWs), read-only digital versatile disks (e.g., DVD-ROMs, dual-layer DVD-ROMs), various recordable / rewritable DVDs (e.g., DVD-RAMs, DVD-RWs, DVD+RWs, etc.), flash memory (e.g., SD cards, mini SD cards, micro SD cards, etc.), magnetic and / or solid state hard drives, read-only and writeable Blu-ray disks, extra-high density optical disks, any other optical or magnetic medium, and floppy disks. The computer-readable medium can store a computer program executable by at least one processing unit and including a set of instructions for performing various operations. Examples of computer programs or computer code include machine code, such as produced by a compiler, and files containing higher level code that are executed by a computer, electronic component, or microprocessor using an interpreter.

[0058] Although the above discussion primarily refers to microprocessors or multi-core processors executing software, some implementations are performed by one or more integrated circuits, such as application specific integrated circuits (ASICs) or field programmable gate arrays (FPGAs). In some implementations, such integrated circuits execute instructions stored on the circuitry itself.

[0059] As used herein and in any claims of this application, the terms "computer," "server," "processor," and "memory" all refer to electronic or other technological devices. These terms exclude people or groups of people. For purposes of this specification, the terms display or displaying mean displaying on an electronic device. As used herein and in any claims of this application, the terms "computer-readable medium" and "computer-readable media" are entirely restricted to tangible physical objects that store information in a form readable by a computer. These terms exclude any wireless signals, wired download signals, and any other ephemeral signals.

[0060] To perform interaction with a user, implementations of the subject matter described herein can be performed on a computer having a display device, e.g., a CRT (cathode ray tube) or LCD (liquid crystal display) monitor, for displaying information to the user, and a keyboard and pointing device, e.g., a mouse or trackball, through which the user can perform input to the computer. Other types of devices can be used to perform interaction with the user as well, e.g., feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback, and input from the user can be received in any form, including acoustic, speech, or tactile input. In addition, the computer can interact with the user by sending documents to and receiving documents from a device used by the user, e.g., by sending web pages to a web browser on the user's client device in response to requests received from the web browser.

[0061] Implementations of the subject matter described herein can be implemented in a computing system that includes back-end components, e.g., as a data server, or includes middleware components, e.g., an application server, or includes front-end components, e.g., a client computer having a graphical user interface or a web browser through which a user can interact with an implementation of the subject matter described herein, or includes any combination of one or more such back-end, middleware, or front-end components. The components of the system can be interconnected by any form or medium of digital data communication, e.g., a communications network. Examples of communications networks include local area networks ("LANs") and wide area networks ("WANs"), inter-networks (e.g., the Internet), and peer-to-peer networks (e.g., ad-hoc peer-to-peer networks).

[0062] A computing system can include clients and servers. Clients and servers are generally remote from each other and can interact through a communications network. The relationship of clients and servers arises by virtue of computer programs running on the respective computers and having a client-server relationship to each other. In some implementations, a server transmits data (e.g., HTML pages) to a client device (e.g., to display the data to a user interacting with the client device and to receive user input from the user). Data generated at the client device (e.g., the result of a user interaction) can be received at the server from the client device.

[0063] Those skilled in the art should recognize that the various illustrative blocks, modules, elements, components, methods, and algorithms described herein may be implemented as electronic hardware, computer software, or a combination of both. To illustrate this interchangeability of hardware and software, the various illustrative blocks, modules, elements, components, methods, and algorithms have been described above generally in terms of their functionality. Whether such functionality is implemented as hardware or software depends on the particular application and design constraints imposed on the overall system. The described functionality may be implemented in varying manners for each particular application. The various components and blocks may all be arranged relative to one another (e.g., arranged in a different order or partitioned in a different manner) without departing from the scope of the subject technology.

[0064] It is understood that the specific order or hierarchy of steps in the disclosed processes is an illustration of a sample approach. Based on design preferences, it is understood that the specific order or hierarchy of steps in the processes may be rearranged. Some of the steps may be performed simultaneously. The accompanying method claims present elements of the various steps in a sample order, and are not intended to be limited to the specific order or hierarchy presented.

[0065] (Clause as an illustration of the subject technology) Various examples of aspects of the present disclosure are described as numbered clauses (1, 2, 3, etc.) for convenience. These are provided as examples and do not limit the subject technology. Figure and reference number identification is provided below for example and illustration only, and the clauses are not limited by these identifications.

[0066] Clause 1) A method comprising: determining, using a pressure sensor, a pressure decay inside an infusion line associated with the injection of fluid into a patient by an infusion device, wherein the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detecting, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; and triggering an occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold.

[0067] Clause 2) The method of clause 1, wherein the detected amount of air comprises one of the volume of air in the line or the number of air bubbles in the line.

[0068] Clause 3) The method of clause 1, wherein the pressure decay is determined when it occurs upstream from the infusion device, and the occlusion alarm comprises an upstream occlusion alarm.

[0069] Clause 4) The method of clause 1, wherein triggering the occlusion alarm includes setting a modified pressure threshold for triggering an injection alarm based on the detected amount of air satisfying a secondary air inclusion threshold that is different from a default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold, and triggering the occlusion alarm based on the modified pressure threshold.

[0070] Clause 5) The method of clause 4, wherein the modified pressure threshold is lower than the default pressure threshold and the amount of air satisfying the secondary air entrainment threshold comprises the detected amount of air being greater than the secondary air entrainment threshold but lower than the default air entrainment threshold.

[0071] Clause 6) The method of clause 4, wherein the pressure decay has a current pressure value and the default pressure threshold is a minimum pressure value for triggering an occlusion alarm.

[0072] Clause 7) The method of clause 4, wherein the secondary air entrainment threshold comprises a rate of change of the detected air volume over a period of time or the modified pressure threshold comprises a rate of change of the pressure decay over a period of time.

[0073] Clause 8) The method of clause 4, further comprising adjusting a secondary air entrainment threshold based on the determined pressure decay or adjusting a modified pressure threshold based on the detected amount of air before triggering an obstruction alarm.

[0074] Clause 9) The method of clause 4, further comprising adjusting at least one of the corrective pressure threshold and the secondary air inclusion threshold based on a flow rate of fluid inside the infusion line before triggering an occlusion alarm.

[0075] Clause 10) The method of clause 4, wherein the modified pressure threshold is set to a predetermined percentage of the default pressure threshold or the secondary air entrainment threshold is set to a predetermined percentage of the default air entrainment threshold.

[0076] Clause 11) An infusion pump having one or more shut-off valves, the one or more shut-off valves having a lower shut-off valve configured to cause compression of a fluid tubing mounted on the infusion pump when activated, the compression fluidly isolating a downstream portion of the fluid tubing from an upstream portion of the fluid tubing when the lower shut-off valve is operating under normal operating conditions; an air entrapment sensor; a pressure sensor; an occlusion alarm; and a processor configured to determine, using the pressure sensor, a pressure decay inside an infusion line associated with the infusion of fluid to a patient by the infusion device, where the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detect, using the air entrapment sensor, an amount of air inside the infusion line that does not meet the default air entrapment threshold for triggering an air entrapment alarm; and trigger an occlusion alarm based on the determined pressure decay and the amount of air detected before the pressure decay meets the default pressure threshold.

[0077] Clause 12) The infusion pump of clause 11, wherein triggering the occlusion alarm includes setting a modified pressure threshold for triggering an injection alarm based on the detected amount of air satisfying a secondary air inclusion threshold that is different from a default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold, and triggering the occlusion alarm based on the modified pressure threshold.

[0078] Clause 13) An infusion pump as described in Clause 12, wherein the processor is further configured to adjust a secondary air inclusion threshold based on the determined pressure and to adjust a corrective pressure threshold based on the amount of air detected before triggering an occlusion alarm.

[0079] Clause 14) An infusion pump as described in Clause 12, wherein the processor is further configured to adjust at least one of the corrective pressure threshold and the secondary air inclusion threshold based on the flow rate of fluid inside the infusion line before triggering an occlusion alarm.

[0080] Clause 15) The infusion pump of clause 12, wherein the modified pressure threshold is set to a predetermined percentage of the default pressure threshold or the secondary air entrapment threshold is set to a predetermined percentage of the default air entrapment threshold.

[0081] Clause 16) A non-transitory computer-readable medium having instructions that, when executed by one or more processors, cause the one or more processors to: determine using a pressure sensor a pressure decay inside an infusion line associated with an infusion of fluid to a patient by an infusion device, wherein the pressure decay does not meet a default pressure threshold for triggering an occlusion alarm; detect using an air sensor an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; and trigger an occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold.

[0082] Clause 17) The non-transitory computer-readable medium of clause 16, wherein triggering the occlusion alarm includes setting a modified pressure threshold for triggering an injection alarm based on the detected amount of air satisfying a secondary air inclusion threshold that is different from a default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold, and triggering the occlusion alarm based on the modified pressure threshold.

[0083] Clause 18) The non-transitory computer-readable medium of clause 17, further comprising instructions that, when executed, cause one or more processors to adjust a secondary air entrainment threshold based on the determined pressure decay and adjust a revised pressure threshold based on the detected amount of air before triggering an occlusion alarm.

[0084] Clause 19) A non-transitory computer-readable medium as described in clause 17, further having instructions that, when executed, cause one or more processors to adjust at least one of the corrective pressure threshold and the secondary air inclusion threshold based on a flow rate of fluid inside the infusion line before triggering an occlusion alarm.

[0085] Clause 20) The non-transitory computer-readable medium of clause 17, wherein the corrective pressure is set to a predetermined percentage of the default pressure threshold or the secondary air entrainment threshold is set to a predetermined percentage of the default air entrainment threshold.

[0086] (Further consideration) It is understood that the specific order or hierarchy of steps in the disclosed processes is an illustration of a sample approach. Based on design preferences, it is understood that the specific order or hierarchy of steps in the processes may be rearranged. Some of the steps may be performed simultaneously. The accompanying method claims present elements of the various steps in a sample order, and are not intended to be limited to the specific order or hierarchy presented.

[0087] The foregoing description is provided to enable any person skilled in the art to practice the various aspects described herein. The foregoing description provides various examples of the subject technology, and the subject technology is not limited to these examples. Various modifications to these aspects will be readily apparent to those skilled in the art, and the general principles defined herein may be applied to other aspects. Thus, the claims are not intended to be limited to the aspects set forth herein, but are to be accorded full scope consistent with the language of the claims, and references to elements in the singular are not intended to mean "one and only one" unless specifically so stated, but rather, are intended to mean "one or more". The term "some" refers to one or more, unless specifically stated otherwise. Masculine pronouns (e.g., his) include feminine and neuter genders (e.g., her and its), and vice versa. Headings and subheadings, if any, are used for convenience only and do not limit the invention described herein.

[0088] The predicate words "configured to," "operable to," and "programmed to" do not imply any particular tangible or intangible modification of the subject matter, but rather are intended to be used interchangeably. For example, a processor configured to monitor and control an operation or component can also mean that the processor is programmed to monitor and control the operation, or that the processor is operable to monitor and control the operation. In the same manner, a processor configured to execute code can be interpreted as the processor being programmed to execute code, or that the processor is operable to execute code.

[0089] The term "automatic" as used herein can include implementation by a computer or machine without user intervention, for example, by instructions in response to asserted actions by a computer or machine or other initiating mechanism. The word "exemplary" is used herein to mean "serving as an example or illustration." Any aspect or design described herein as "exemplary" should not necessarily be construed as preferred or advantageous over other aspects or designs.

[0090] A phrase such as "aspect" does not imply that such aspect is essential to the subject technology or that such aspect applies to all configurations of the subject technology. Disclosure regarding an aspect may apply to all configurations, or to one or more configurations. An aspect may provide one or more examples. A phrase such as an aspect may refer to one or more aspects, and vice versa. A phrase such as "implementation" does not imply that such implementation is essential to the subject technology or that such implementation applies to all configurations of the subject technology. Disclosure regarding an implementation may apply to all implementations, or to one or more implementations. An implementation may provide one or more examples. A phrase such as an "implementation" may refer to one or more implementations, and vice versa. A phrase such as "configuration" does not imply that such configuration is essential to the subject technology or that such configuration applies to all configurations of the subject technology. Disclosure regarding a configuration may apply to all configurations, or to one or more configurations. A configuration may provide one or more instances. A phrase such as "a configuration" may refer to one or more configurations, and vice versa.

[0091] As used herein, a "user interface" (also referred to as an interactive user interface, graphical user interface, or UI) may refer to a network-based interface that includes data fields and / or other control elements for receiving input signals or providing electronic information and / or for providing information to a user in response to any received input signals. The control elements may include dials, buttons, icons, selectable areas, or other perceptible markers presented via the UI that, when interacted with (e.g., clicked, touched, selected, etc.), initiate an exchange of data for the device that presented the UI. The UI may be implemented in whole or in part using technologies such as HyperText Markup Language (HTML), Flash™, JAVA™™, NET™, C, C++, Web Services, or Rich Site Summary (RSS). In some implementations, the UI may be included in a standalone client (e.g., thick client, fat client) configured to communicate (e.g., send or receive data) according to one or more of the described aspects. The communication may be to or from the medical device or a server in communication with the medical device.

[0092] As used herein, the term "determine" or "determining" encompasses a wide variety of actions. For example, "determining" can include calculating, computing, processing, deriving, generating, obtaining, searching (e.g., searching a table, database, or another data structure), ascertaining, and the like, via a hardware element without user intervention. Also, "determining" can include receiving (e.g., receiving information), accessing (e.g., accessing data in a memory), and the like, via a hardware element without user intervention. "Determining" can include resolving, selecting, choosing, establishing, and the like, via a hardware element without user intervention.

[0093] As used herein, the terms "providing" or "providing" encompass a wide variety of actions. For example, "providing" can include storing a value at a location on a storage device for subsequent retrieval, transmitting a value directly to a recipient via at least one wired or wireless communication medium, transmitting or storing a reference to a value, and the like. "Providing" can also include encoding, decoding, encrypting, decrypting, validating, verifying, and the like via a hardware element.

[0094] As used herein, the term "message" encompasses a wide variety of formats for communicating (e.g., transmitting or receiving) information. A message may include a machine-readable collection of information, such as an XML document, a fixed-field message, a comma-delimited message, JSON, a custom protocol, or the like. A message may, in some implementations, include a signal utilized to transmit one or more representations of information. Although recited in the singular, it will be understood that a message may be composed, transmitted, stored, received, etc., in multiple parts.

[0095] As used herein, the terms "selectively" or "selective" can encompass a wide variety of actions. For example, a "selective" process can include determining an option from a plurality of options. A "selective" process can include one or more of dynamically determined inputs, pre-configured inputs, or user initiated inputs to make a decision. In some implementations, an n-input switch may be included to provide a selective function, where n is the number of inputs used to make a selection.

[0096] As used herein, the terms "meet" or "correspond" or "corresponding" encompass a structural, functional, quantitative, and / or qualitative correlation or relationship between two or more objects, data sets, information, and / or the like, and preferably, a correspondence or relationship may be used to link one or more of two or more objects, data sets, information, and / or the like such that they appear the same or equivalent. Correspondence may be evaluated using one or more of thresholds, value ranges, fuzzy logic, pattern matching, machine learning evaluation models, or combinations thereof.

[0097] In some implementations, the generated or detected data can be transferred to a "remote" device or location, where "remote" means a location or device other than the location or device where the program is executed. For example, a remote location can be another location in the same city (e.g., an office, a laboratory, etc.), another location in a different city, another location in a different state, another location in a different country, etc. Thus, when one item is referred to as being "remote" from another item, what is intended is that the two items can be in the same room but separated, or at least in different rooms or different buildings, and can be at least 1 mile, 10 miles, or at least 100 miles apart. "Communicating" information refers to transmitting data representing this information as electrical signals over an appropriate communication channel (e.g., a private or public network). "Transmitting" an item refers to any means of moving the item from one location to the next, whether or not the item is physically transported (if this is possible), and includes, at least in the case of data, physically transporting the medium carrying the data or communicating the data. Examples of communication media include radio or infrared transmission channels, as well as network connections to another computer or networked device, and the Internet, or e-mail transmissions, and information stored on websites, and the like.

Claims

1. determining, using a pressure sensor, a pressure decay inside an infusion line associated with an infusion of fluid into a patient by an infusion device, the pressure decay not meeting a default pressure threshold for triggering an occlusion alarm; detecting, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; triggering the occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold. The method includes:

2. The method of claim 1 , wherein the detected amount of air comprises one of a volume of air in the line or a number of air bubbles in the line.

3. The method of claim 1 , wherein the pressure decay is determined to occur upstream from the infusion device, and the occlusion alarm comprises an upstream occlusion alarm.

4. Triggering the occlusion alarm comprises: setting a modified pressure threshold for triggering the injection alert based on the detected amount of air satisfying a secondary air inclusion threshold that is different from the default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold; triggering the occlusion alarm based on the revised pressure threshold. The method of claim 1 , comprising:

5. 5. The method of claim 4, wherein the modified pressure threshold is lower than the default pressure threshold, and the amount of air satisfying the secondary air entrainment threshold has the detected amount of air greater than the secondary air entrainment threshold but lower than the default air entrainment threshold.

6. The method of claim 4 , wherein the pressure decay has a current pressure value and the default pressure threshold is a minimum pressure value for triggering the occlusion alarm.

7. the secondary air inclusion threshold comprises a rate of change of the detected amount of air over a predetermined period of time; or the modified pressure threshold comprises a rate of change of the pressure decay over the predetermined period of time; The method according to claim 4.

8. prior to triggering said occlusion alarm; modifying the secondary air entrainment threshold based on the determined pressure decay; or Modifying the revised pressure threshold based on the detected air amount. The method of claim 4 further comprising:

9. prior to triggering said occlusion alarm; Modifying at least one of the modified pressure threshold and the secondary air entrainment threshold based on a flow rate of the fluid inside the infusion line. The method of claim 4 further comprising:

10. The method of claim 4 , wherein the modified pressure threshold is set to a predetermined percentage of the default pressure threshold or the secondary air entrainment threshold is set to a predetermined percentage of the default air entrainment threshold.

11. 1. An infusion pump comprising: one or more shut-off valves, the shut-off valve having a lower shut-off valve configured, when activated, to cause compression of fluid tubing mounted on the infusion pump, the compression fluidly isolating a downstream portion of the fluid tubing from an upstream portion of the fluid tubing when the lower shut-off valve is operating under normal operating conditions; An air inclusion sensor; A pressure sensor; 1. A processor comprising: determining, using a pressure sensor, a pressure decay inside an infusion line associated with an infusion of fluid into a patient by an infusion device, the pressure decay not meeting a default pressure threshold for triggering an occlusion alarm; detecting an amount of air inside the infusion line using the air inclusion sensor that does not meet a default air inclusion threshold for triggering an air inclusion alarm; triggering the occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold. a processor configured to: An infusion pump comprising:

12. Triggering the occlusion alarm comprises: setting a modified pressure threshold for triggering the injection alert based on the detected amount of air satisfying a secondary air inclusion threshold that is different from the default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold; triggering the occlusion alarm based on the revised pressure threshold.

12. The infusion pump of claim 11, comprising:

13. The processor, prior to triggering the occlusion alarm, modifying the secondary air entrainment threshold based on the determined pressure; modifying the revised pressure threshold based on the detected air amount; The infusion pump of claim 12 , further configured to:

14. The processor, prior to triggering the occlusion alarm, Modifying at least one of the modified pressure threshold and the secondary air entrainment threshold based on a flow rate of the fluid inside the infusion line. The infusion pump of claim 12 , further configured to:

15. 13. The infusion pump of claim 12, wherein the modified pressure threshold is set to a predetermined percentage of the default pressure threshold, or the secondary air intrusion threshold is set to a predetermined percentage of the default air intrusion threshold.

16. A non-transitory computer-readable medium that, when executed by one or more processors, determining, using a pressure sensor, a pressure decay inside an infusion line associated with an infusion of fluid into a patient by an infusion device, the pressure decay not meeting a default pressure threshold for triggering an occlusion alarm; detecting, using an air sensor, an amount of air inside the infusion line that does not meet a default air inclusion threshold for triggering an air inclusion alarm; triggering the occlusion alarm based on the determined pressure decay and the detected amount of air before the pressure decay meets the default pressure threshold.

23. A non-transitory computer-readable medium having instructions for causing the one or more processors to:

17. Triggering the occlusion alarm comprises: setting a modified pressure threshold for triggering the injection alert based on the detected amount of air satisfying a secondary air inclusion threshold that is different from the default air inclusion threshold, the modified pressure threshold being different from the default pressure threshold; triggering the occlusion alarm based on the revised pressure threshold.

20. The non-transitory computer readable medium of claim 16, comprising:

18. The non-transitory computer-readable medium, when executed, prior to triggering said occlusion alarm; modifying the secondary air entrainment threshold based on the determined pressure decay; modifying the revised pressure threshold based on the detected air amount; 20. The non-transitory computer-readable medium of claim 17, further comprising instructions for causing the one or more processors to:

19. The non-transitory computer-readable medium, when executed, prior to triggering said occlusion alarm; Modifying at least one of the modified pressure threshold and the secondary air entrainment threshold based on a flow rate of the fluid inside the infusion line.

20. The non-transitory computer-readable medium of claim 17, further comprising instructions for causing the one or more processors to:

20. 20. The non-transitory computer readable medium of claim 17, wherein the modified pressure is set to a predetermined percentage of the default pressure threshold or the secondary air entrainment threshold is set to a predetermined percentage of the default air entrainment threshold.

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