A ‘smart’ pump is the commonplace term given to a programmable computerised drug infusion device that contains a drug library, also known as a dose error-reduction system. Smart pumps enable the delivery of i.v. fluids and medications within the bounds of preset parameters, such as drug concentration and dose. They can also be programmed to deliver a bolus dose over a preset time interval, and can calculate weight-based dosing schemes automatically. Most important is the decision support capabilities of a dose error-reduction system, which are composed of institution-specific ranges for each drug. The user is alerted when the programmed dose (or concentration or duration of infusion) differs from the preset minimal or maximal limits. Depending on the drug and institutional preference, these alerts are divided into ‘soft limits’, that are manually overridable, and ‘hard limits’, that cannot be overridden. Drug libraries can also be divided into different clinical care areas. For example, anaesthesia care providers can have different soft and hard limits than other types of clinicians. Smart pumps are thus able to provide real-time feedback to reduce medication infusion errors, and improve patient safety.

Litman RS, O’Neill S, Beard JW. What can we learn from smart-pump infusion data analysis? [published online ahead of print, 2020 Aug 12]. Br J Anaesth. 2020;S0007-0912(20)30550-X. doi:10.1016/j.bja.2020.07.002