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1. 111 27 19 1 Advanced pump programming na A dy W dE SOW 27 19 2 MENU parameters available during prograMmMing ooocccnnoncccnonocanononcnonnnnnanonnnnncnnos 28 19 3 Clear parameters come back to infusion in ml h oooooooooccccnonocanononononancnononnnoss 28 194 Uts OfINTUSION oeeie T eA GO od ADO 28 19 4 1 Selection of Units of Infusion sa 29 19 5 M dESOFINIUSI MN wa ib 29 19 5 1 Continuous RUSO as 29 PO 22 Anbermithent o AA OO LAWA OWE 29 19 53 Antusion with AA GA al O O W AE 29 19 5 4 Selection of Infusion Mode ds aaa 30 12 06 lt Programimino wh 2 Soda E ETA 30 19 6 1 Continuous Infusion in mg kg h or in other units ooooooccnnoncccnonocanononcnonnnnnnnnns 30 19 6 2 Intermittent Itata AA A WEGO 31 19 6 3 Intermittent Infusion in mg kg h or in other units ococinocccncnoncninnnnninnno 33 19 6 4 Infusion with Profile Types E 33 19 6 5 Infusion with Profile in ml h asi iii 34 19 6 6 Infusion with Profile in mg kg h or in Other UNI S oooooccnnnoccccconoccnonancnnnnnnnnno 35 19 7 Limits of Parameters Values Model S2 only ooooooccnonoconinonccnnoonnccnnancononnncnonnos 35 19 8 Options Additional Infusion ParameterS oooooconcnonococononononnnononononnnnnnnnnnnnnonccnnoss 36 19 8 1 TADA lao 36 19 8 2 BO S A A AO E 36 19 8 3 Induction DOS 36 19 8 4 BEBO oO OE no A Od AAC 37 19 8 5 A A aiea a 37 19 8 6 SMN AI 37 19 8 7 DU AGUA AA Aca 37 20 DRUG LIBRAR Y cis
2. and confirm e Press and confirm e On display Password Cancelled The password and the serial number should be written on the last page of User s manual IZA Date Format e Using select Date Format e Press NO after every pressing the new format will appear e Selected format confirm 22 4 3 Contrast Change of display contrast e Select Contrast e Press to select proper contrast e Press to confirm e Press ESC to close the window 2242 Default Values Default values typical standard values that appear after the change of infusion mode see p 19 3 page 28 e Bolus 500 ml h Bolus rate e Bolus time 15 sec Time of bolus dose delivery e Induction time 60 sec Time of induction dose delivery Entering parameters e Using select the parameter e Enter value and confirm e Press ESC to finish 10 001 03 3 45 60 22 4 5 Limits There are e Max Rate 2000 ml h Limits max infusion rate e Max Bolus 2000 ml h Limits max bolus rate e Prime the line 1000 ml h Rate for priming e Using select the parameter e Enter value and confirm e Press ESC to finish 22 4 6 Alarm Options Alarm parameters description e Volume level Level of alarm loudness e Melody 1 9 Type of sound e Pre alarm time 5 min Time to the SYRINGE EMPTY and INFUSION END 1 30 min e Occlusion pre YES NO Warning of pressure increase switch on off see p 18 alarm page 25 e Line disconnected YES NO Warning of pre
3. Internal functions can have additional options check by pressing MENT again Buttons used to select parameters or functions Review of the infusion parameters Button used to confirm value or information displayed Button used to reset or reject information displayed Numeric keys for entering parameters and names Button used to stop or exit selected window or entered data Starts stops infusion Infusion indicator yellow flashing Acoustic alarm reset button Longer pressing starts alarm tests Alarm red flashing Purge bolus button Bolus indicator blue flashing during bolus infusion Turn on turn off button To turn off press for 3 sec Power status indicator Green mains or 12V Yellow flashing battery 5 2 Display IO 001 03 3 1 Mode of infusion 7 Battery charge status 2 Infusion rate 8 Power status 3 Drug name 9 Chosen syringe type and size 4 Infusion rate in ml h 10 Infusion rate units 5 Infusion cycle number 11 Infusion pressure and chosen 6 Infusion status flashing during infusion occlusion level indicator 9 60 6 UNPACKING Despite careful packaging the risk of transport damage cannot be entirely eliminated Upon delivery please check that nothing is missing and the device is not damaged In case of any problems please contact an authorized Medima representative or the manufacturer Complete set includes e Syringe pump model according to the order specif
4. SYRINGE INFUSION PUMP USER S MANUAL MODEL S1 MODEL S2 1011 Please read these instructions carefully prior to using the device to ensure correct operation and to avoid patient injury In case of any doubts please contact an authorized MEDIMA representative or manufacturer directly WI 06 02V0 0 CONTENS 10 1 10 2 10 3 10 4 11 12 13 14 15 16 16 1 16 2 16 3 16 4 16 5 16 6 16 7 17 17 1 17 2 17 3 17 4 17 5 17 6 17 7 2 60 PATIENT S SAFETY WARNINGS AND PRECAUTIONS 222112211122112 5 DIFFERENCES BETWEEN MODELS zadatki rias 6 MAINTENANCE 0000 RIN 6 MANUFACTURER S RESPONSIBILITY coooocnocccccocononnnconnncnnnnnonnncconnncononcnnn cnn nncnnnss 7 PUMP CONSTRUCTION asistida a aea a i n 7 Keyboard a dei O NA RAS ARA 9 DSP anitat ad i 9 UNPACKING ada R Z O OAZA 10 PUMP INSTALLAT O N ori asa dO Nada Ra ONE sin 10 Attaching the Pump to the IV Pole or Vertical Column ee eu sesuusu222 10 Mounting the pump into the docking station recommended 10 EDITING PARAMETERS cunas 12 Entering the Value of Numeric Parameters i e rate volume 12 Bntenne daw ORA W RANO AA OLO E 12 Permanent Resetting of PATAS A bO A WAGA 12 Change the Type OESTE oi liso 12 SWITCHING THE PUMPON a ido 13 INFUSION PROGRAMMING ml h ooooooccnoccnononononnnonnncnonnnononocnnn nono nonnon conc nnnnnn noo
5. a progressive bar will appear The dose will be cleared after 1ts disappearance 17 4 Pressure KVO In any time during the infusion process modifications of pressure level and KVO rate are possible Press during infusion or during pause in infusion Select Pressure KVO and confirm After selecting this function the following parameters are available Occlusion pressure levels 1 6 press to change the level KVO 0 5 0 ml h Keep Vein Open the rate of the delivery of medicine to keep vein open when the infusion is stopped The resistance depends on the following factors e rate of infusion density of fluid inside diameter and the length of the extension line diameter of the needle usage of additional elements like antibacterial filters that increase resistance with increase of time of infusion e quality of used syringes The resistance is difficult to estimate and different at each case At the lowest pressure levels the alarm may occur despite the lack of occlusion In this case e change an antibacterial filter e change a pressure level for higher see above e Change a syringe for a new one A syringe itself could cause a problem It is forbidden to prime the syringe again even with the same drug 10 001 033 23 60 Because of the higher resistance of high flow rates the pump automatically changes preset pressure level as follows e Above 500 ml h lowest level 2 e Above 1000 ml h lowest level 3 e Abo
6. disabled e Bolus YES NO bolus enabled disabled e Induction dose YES NO induction dose enabled disabled e Report YES NO available for intermittent and infusion with profile only e Cycle Alarm YES NO available for intermittent and infusion with profile only e Start time YES NO start time enabled disabled e Drugactivity YES NO drug activity enabled disabled e Using select a parameter and press to activate it or to deactivate it e Press ESC to revert to the parameters modified according to the chosen parameters options 19 8 1 Total Dose If this option is enabled disabled Total dose parameter will appear disappear on the display It is recommended to disable it if not required For the infusion in ml h Volume and Time will disappear and Total Dose for infusion in other units It should be remembered that if the above mentioned parameters are disabled or their volume not entered INFUSION END alarm will not occur Only SYRINGE EMPTY alarm will occur 19 8 2 Bolus If this option is enabled disabled Bolus parameter will appear disappear on the display It is recommended to disable it if not required It is very important because the delivery of bolus dose could be dangerous for a patient It is worth adding that the delivery of bolus dose can be also secured by a password see p 22 4 8 Security page 46 19 8 3 Induction Dose If this option is enabled disabled Induction dose paramete
7. during priming the line pressure alarm is active 1 30 min programmable Flow rate accuracy Total accuracy of infusion including a syringe is 2 according to Flow rate accuracy depends on the quality of syringe EN60601 2 24 Mechanical accuracy of pumps is 0 5 54 60 WI 06 02V0 0 10 001 03 3 Maximal volume 0 5 ml for flow rate 2000 ml h infused during 0 2 ml for flow rate below 500 ml h malfunction 0 1 ml for flow rate below 100 ml h Battery Ni MH 2000 mAh Battery life 20 hours 5 ml h Recharging time 5 hours 100 Foreseen for about 400 recharges 2 years Memory retention The memory of the unit will be retained for min 5 years when not powered T 0 5 A 250 V Casing Material ABS Protection class IP22 according to EN60529 Dimensions 355 x 115 x 166 W x H x D excluding pole clamp Below 2 5 kg without power suppl cord Event log capacity Minimal 2000 records of operation activities with date and time of event Power supply AC 100 240 V AC 15 10 50 60 Hz max 15VA DC 12 16 V DC max 1 A C Type CF protection against defibrillation class I Temperature 5 C 40 C humidity maximum 90 Transport conditions Temperature 20 C 50 C humidity maximum 95 EN 60601 1 EN 60601 1 2 EN 60601 2 24 EN 1789 standards MDD93 42 EEC IIB e RS232C rate of transmission 38 kb e Infrared for communication with docking station Drug Library e Up to 120 drug
8. 10 001 03 3 19 60 BOLUS dose is included in the programmed dose of infusion It means that a patient will receive only such a dose of medicine that has been programmed regardless from the quantity of delivered bolus doses The total dose delivered to the patient can be read in information about infusion after pressing see p 16 4 Review of Information about Infusion page 20 16 4 Review of Information about Infusion e Press e Review information using e Coming back to the infusion window after pressing ESC or automatically after 10 seconds During the infusion process the following information about infusion is available e nfused volume dose it can be cleared press and hold until a progressive bar disappears Time to the end of syringe Time to the end of infusion if programmed volume or time of infusion Time of infusion Battery charge status KVO rate 16 5 Suspension and Restart of Infusion To stop the infusion for longer period of time e Press to stop the infusion e Leave the syringe in the pump e Switch the pump off To restart the infusion e Switch the pump on again On display Continue press e Press START STOP to start the infusion all previous data and volume dose counter will be retained To remind about suspended infusion use the Timer function see p 22 7 Timer page 49 that starts alarm after expiry of the programmed time 16 6 Empty Syringe Just before a syri
9. 22 4 2 Date format page 45 e Short pressing will cancel last number and long pressing will cancel whole date e Press ESC to close the window 22 4 Pump Configuration Configuration Menu contains parameters which allow adapting the device to special user s needs To modify configuration e Press and hold e Select Configuration and confirm If the configuration of device was locked by password and pump would ask for password enter password and confirm YES If the password was forgotten read information in p 32 page 55 very carefully The following parameters will appear e Password Locks access to pump configuration and other options e Date Format dd mm yyyy mm dd yyyy yyyy mm dd e Contrast Display contrast setting e Default Values Typical parameters set after change of infusion mode e Limits Maximal limits for parameters e Alarm Options Alarm parameters e Night mode options Night Mode parameters e Security Security parameters e Enter Ward Name Possibility of entering hospital ward name for identification 44 60 WI 06 02V0 0 IO 001 03 3 D Password The user can enter the password to lock pump configuration and other options see p 22 4 8 Security page 46 e Using select Password and confirm e Enter password and confirm e Enter password again and confirm e Incase of lose of password read carefully information in p 32 page 55 To cancel the password e Using select Password
10. 22 94 Clearing DS LID ti ion 51 23 CLEANING AND DISINFECTION zaa aras 51 24 INTERNAL BATTERY OPERATION o oooocccccnnonncnonncanancnnnnannanononnannnnenoonnnnnncccoonnnns 52 25 LONGER INTERRUPTION IN PUMP OPERATION ccconcoconcncnnnnnnnnononinnanononnnnnnos 52 26 NURSE CALL CONNECTION a Om 52 277 CONNECTION LEAD 12 Vta 53 29 INTERFACE RS232C RS 53 29 ACCESSORIE S iii ia 53 Ur REPLACE OFAC FUSE maen DNI OO act 54 Sko TECHNICA D DARA a Gl alei 54 32 CONVERSI N FAG TORS auc GRA GA WNE ACC 55 332 LISTOESYRINGE S da 56 34 GRAPHS OF INFUSION ACCURACY sssssessesseerrsrssssesrrerrrsesssseerrerersessssssreee 57 34 1 Start up curves and trumpet CUFVES zac ik EO EE A ia 57 34 2 Occlusion Reaction Time and Residual Bolus coconnnncoonononananococonananananononoss 58 35 DOCKING STATION eee dia OE O PA dE 59 36 INFORMATION ABOUT MANUFACTURER ooocconcccnncnononannnnnncnnnnanonconannananononnnns 61 3 DOCUMENTS TORA Gadka wia RCA R W A SE 61 4 60 WI 06 02V0 0 I0 001 03 3 1 PATIENT S SAFETY WARNINGS AND PRECAUTIONS Syringe infusion pumps are designed for the precise intravenous infusion feeding nutrition etc Decision concerning usage of the device can be made by the qualified healthcare professionals only Only syringes of volume name and type chosen in infusion parameters can be used Use of another syringe than specified in the pump even of the same volume may cause significant infusion errors and patient i
11. 37 20 1 Recording Drug Procedures Drug Libraries CreatiON ooooooocnnonccononocccnononcnnnnnnnos 38 20 2 Dosing Procedures Recalde 38 20 3 Review Ol Dr g Paraiso iaa 39 20 4 Del te PE ad O RAA AA AA 39 20 5 Change of Drug Name cese 39 20 6 Creation of Concise Drug LI ia 40 207 Pump to Pump Drug Library Transfer aa d A CA 40 20 8 Drug Library Creation with the Use of DRUG EDITOR Software 40 21 CREATION OF USER S OWN LIST OF SYRINGES eeuaaoe aaa aaa aaecaaaccaa 41 22 FUNCTIONS AVAILABLE WHEN THE PUMP IS SWITCHED OFF 42 2 AE IDO ad 42 222 31210 A D E AEG RAO EROS EASED E RE SER T 44 222 EMO OAc ee NO EE eet ete tet tue tate Rete Eh at els 44 224 UP UMP ConfisuraiON d tetas aaah ere ee oa cae EK R ALA 44 10 001 03 3 WI 06 02V0 0 3 60 Dads RASS A OE LARW A O 45 e A AAN A A A 45 LU E o do A 45 MAA A A A WO A 45 O O CORNER JEGO GN 46 2240 AMOO PO EOG ZOP OWA CEO SS 46 224 1 Night Mod PON OE AK hania 46 O died OOOO RE O OOO JAZ OWA OZONE 46 22 4 9 Enter Ward NAMES GERE aid ad ARA ia 47 22382 A a R R AO A O OO EA PT 47 22 0 A A ada 48 D2 Ole gt DS aT LOT E n A RZA A 48 220 2 RUM di TO 48 2203 AUS ds OKO AR EKO A 49 223 E AAA A bag een e 49 2203 E O O 49 SS A A O EA 50 229 1 A A l estan 50 22 9 2 Pump to Pump Drug Library Transfer 51 22 9 3 Pump to Pump Configuration Transfer oooooconnnonocnnoncccnonononnnnnnnnnnnononnnnnnncnnnnnnnns 51
12. Anti Bolus System As can be observed the Anti Bolus System significantly reduces volume of fluid accumulated in the patient line This volume is subtracted from the total volume received by the patient These measurements were taken using BD PLASTIPAK 50 ml and standard extension set of 2 m 58 60 WI 06 02V0 0 10 001 03 3 35 DOCKING STATION The docking stations are recommended to save valuable space around the bedside DS2 for 2 pumps DS4 for 4 pumps DS6 for 6 pumps DS8 for 8 pumps DS4E DS6E DS8E version with Ethernet They enable quick installation of pumps at the patient s bed and creation of sets required by actual therapy Power supply and communications ports are connected automatically after mounting a pump into the docking station In option there are communication modules that enable to connect a pump to the hospital information system We offer software that enables observation of infusion in the real time at any PC connected to LAN in the hospital ward It also gives a possibility to transfer a drug library and configuration to all pumps mounted into docking stations 10 001 03 3 59 60 60 60 WI 06 02V0 0 10 001 03 3 sma 36 INFORMATION ABOUT MANUFACTURER MANUFACTURER REPRESENTATIVE MEDIMA Sp z 0 0 tel 48223132266 02 486 Warszawa fax 48223132269 Al Jerozolimskie 200 POLAND Serial Number Hospital Ward Name 37 DOCUMENT HISTORY on Issue EE 2 EG GG e
13. Infusion parameters Loading unloading a syringe Start stop of infusion Start pause and end of induction and bolus doses Each change of parameters during infusion All alarms including the moment of their muting by an operator Exceeding the value limits of infusion parameters model S2 Detailed information on review about infusion history is in p 22 1 page 42 24 60 WI 06 02V0 0 IO 001 03 3 17 6 Time date This function allows changing time and date of the internal clock Enter new data and confirm YES Press ESC to close the window 17 7 Ward Name Entered Ward Name will display after choosing this function see p 22 4 9 Enter Ward Name page 47 e Press during infusion or during a pause in infusion e Using select Ward Name and confirm YES 17 8 Information This function allows reading information about the pump e Press MENU during infusion or during a pause in infusion e Using select Information and confirm YES The following will appear e Druglibrary Information about drug library name version creation date and modification date entered using DRUG EDITOR see p 20 8 page 40 e Pump Information about the pump see p 22 6 on page 48 e Statistics Statistical information about pump and battery working time see p 22 6 page 48 17 8 1 Information about Drug Library Version This information appears only if a drug library has been downloaded to the pump using
14. MEDIMA DRUG EDITOR see p 20 8 page 40 The information is very important as it enables to check weather the drug library in the pump is the proper one the latest version and weather it was modified in the pump All the incompatibilities in the drugs protocols may cause significant infusion errors and danger to a patient s life 18 ALARMS Alarms are indicated by e Audible sound with a descriptive message on the display e Blinking of the display flashing and a red lamp next to i To silence the alarm press 5H or M 10 001 03 3 25 60 e Doesn t stop the infusion Doesn t stop the infusion Minimum 30 minutes of operation left After muting the sound the red lamp still flashes and the sound activates periodicall INFUSION STOPPED KVO also BATTERY EMPTY After muting the sound or after 3 minutes pump will switch off Restart of operation possible on AC power INFUSION STOPPED KVO also When the alarm is cancelled the pump moves the arm back OCCLUSION to reduce a residual bolus after occlusion release ANTI BOLUS SYSTEM The pump reduces infused volume counter Change the occlusion pressure level if needed see p 17 4 Pressure KVO page 23 Doesn t stop the infusion HIGH PRESSURE Pre alarm at 75 of programmed pressure level enables personnel intervention before the infusion is stopped Alarm needs activation see p 22 4 6 Alarm Options page 46 INFUSION STOPED KVO also Rapid pressure drop i
15. case the infusion will be continued until a syringe is empty and alarm END OF INFUSION will not occur Number of cycles shows number of infusion pause e Enter clear or omit induction dose parameters if enabled see p 19 8 Options Additional Infusion Parameters page 36 e Enter clear or omit BOLUS parameters Bolus dose possible to be disabled see p 19 8 Options Additional Infusion Parameters page 36 e The procedure of drug dosing can be entered into the pump s memory creating this way an own drug library see p 20 page 37 e Using Y select Confirm and press a parameters window will be closed e To come back to the parameters window and to review or modify the infusion parameters press and hold MENU until a window with parameters appears II nd way Select INFUSION MODE intermittent infusion see p 19 5 4 page 30 UNITS ml h see p 19 4 1 page 29 Parameters programming e Check whether the type and size of syringe on display is as required If not choose the required one Enter volume of single cycle and confirm Enter time of infusion hours amp min of single cycle and confirm Enter time of pause hours amp min and confirm Enter number of cycles and confirmY ES you can omit this parameter In this case the infusion will be continued and alarm END OF INFUSION will not appear Enter clear or omit induction dose parameters 1f displayed e Enter clear or omit BOLUS
16. charge status of the new battery is unknown Battery controller is scaled to use with MEDIMA battery type Use of other than original battery can cause improper pump operation This can cause danger to a patient s life 50 60 WI 06 02V0 0 10 001 03 3 22 9 2 Pump to Pump Drug Library Transfer To transfer a drug library pump to pump e Connect both pumps to the mains MEDIMA logo appears on display e Connect the pumps by special connection cord using RS232 sockets e Inthe pump with demo drug library e Press and hold MENU e to select Service and confirm e Enter password 159 0 and confirm select function Send drugs and confirm YES both pumps will display information about sent received programs e Check whether sent drugs library is correct The previous drug library is cleared by the next one downloaded to the pump 22 9 3 Pump to Pump Configuration Transfer To transfer configuration pump to pump act the same way as with drug library see p 20 page 37 but select Send configuration instead of Send drugs 22 9 4 Clearing Drug Library In case of the suspicion of unauthorized drug library modification it is recommended to clear it and to retransfer it from another pump or from MEDIMA DRUG EDITOR software 23 CLEANING AND DISINFECTION Unload the syringe and switch the pump off e Disconnect the pump from the AC power supply e Wipe the surface over with the cloth dampened with wa
17. proper values The following should be carried regularly e Control of power supply cable in case of insulation damages the power supply cable should be changed e Inspections according to service manual carried by qualified personnel e Cleaning and disinfection of outer pump surface see p 23 page 51 22 9 Service These features are for the personnel of technical department only and are secured by password e Press and hold MENU to select Service and confirm Enter password 159 0 and confirm YES select right function and confirm YES The following features are available e New battery Function of battery recharge with reset of battery controller It is recommended after batter replacement e Time to next Allows technical staff to plan next technical inspection One technical inspection can select period of time amount of infusions given volume and amount of battery recharges e Send drugs Allows sending drug library to other pump Requires a special cable see p 29 page 53 e Send configuration Allows sending configuration to the other pump for easy configuration of all the pumps at the ward in the same way Requires a special cable see p 29 page 53 e Delete drugs Allows clearing drug library for example when unauthorized modification is suspected 22 9 1 New Battery This function enables to charge a battery and to reset battery controller It is always necessary after battery replacement as the
18. will be continued with the new parameters 17 2 New infusion New infusion function is available when the infusion is finished or stopped by pressing START STOP After selecting that function The infused volume counter will be reset and new infusion parameters programming option will be available Induction dose starts the infusion if it was previously programmed Start of new infusion according to new parameters or previous parameters e Press to stop the infusion Press MENU Using select New infusion and confirm YES Select enter and confirm new parameters Load a syringe prime the extension line connect the extension line to a patient and press START STOP or Press to stop the infusion Turn off the pump Turn on the pump CONTINUE Select enter and confirm new parameters Load a syringe prime the extension line connect the line to a patient and press 22 60 WI 06 02V0 0 IO 001 03 3 17 3 Clear Dose In any time during infusion the reset of volume dose of medicine is possible Infusion will be continued and induction dose will not be infused again Press MENU during infusion or during pause in infusion Select Clear dose Press and hold a progressive bar will appear and the dose will be cleared after 1ts disappearance The pump will return to the infusion window or Press Information about the amount of delivered medicine will appear Press and hold
19. 13 Infusion Rate Only way I ita diiniita 13 Rate and Volume of Infusion way II oooooonncnnnonoccnonononconoconononcnnnnnnonononccnnnno conos 14 Rate and Time of Infusion way IHD ooooocccnnoccccnonaccnonacnnonononononononoonnnnonnnncnnnnnnnnno 15 Volume and Time of Infusion Way IV nasada di oi A dE 15 LOADING SYRINGE A make i ah Z OC AA 16 PRIMING THE LINE START OF INFUSION e ueeeeeaao aaa ae ea aaa eaa aa caaaaccanaca 17 UNTOADING A SYRINGE sti lan aa AA 17 AUTO INFUSION Life and Health of Patient under Threat 11 11 18 FUNCTIONS AVAILABLE BEFORE THE START OF INFUSION 18 INFUSION a si ca tia 18 Induction DOSE UE 18 Quick Change of Infusion Rate without stopping the infusion 19 O a eta 19 Review of Information about InfUSION oooonocccnnoncccnonacanonannnononnnnnnnnnnononnnoncnnnnnnnns 20 Suspension and Restart Of InTUSTON ina nietas 20 IN A R A OE AAA O OAZA 20 IGOR Infusion WAG o ZLA o a 21 INFUSTON MENU rat SNS NARA ao 21 DAT AUC A Rf WNE ONO i A 22 NEWINIUSION AS A oma Graven at 22 Clear DOS bis 23 PESTO KV O kd an dd ad da dba ddd 23 A ON 24 AYE cs A ok a A 25 Ward Names altas 25 WI 06 02V0 0 IO 001 03 3 17 8 o A AEE E O NODE 25 17 8 1 Information about Drug Library Version cocoocccnnonccnnoooncnnonononnnnononnnccnnnnncoconnncnnnnos 23 R ACARMS dani aa DAE 25 19 ADDITIONAL POSSIBILITIES OF INFUSION programming
20. 24 standards start up curves inform about the errors at the beginning of infusion depending on flow rate trumpet curves inform about the accuracy of fluid delivery over various time period Start up curves represent continuous flow versus operating time from the start of the infusion The in onset delivery is caused by different factors To reduce it always fill up the line after the syringe replacement for low flow rate use the syringe of a small capacity use possibly diluted drugs and higher rates Trumpet curves named for their characteristic shape display discrete data averaged over particular time period or observation windows Over long observation windows short term fluctuations have little effect on accuracy This graphs show how large of uniformity errors can be expected depending on half life of the drug and flow rate For drugs of shorter half life or for application were flow uniformity is a concern possibly diluted drugs and flow rates of 1 0 ml h or above and small syringe size are recommended Differences in factors such as size and plunger force in compatible syringes produced by the others manufacturers can cause variations in accuracy and trumpet curves as compared to those represented Additional curves for compatible syringes are available upon request Start up and trumpet curves may not be indicative of operation under negative pressure 10 001 03 3 57 60 Tests taken using BD PLASTIPAK
21. 50 ml syringe 20 Qilmifh Q r 1 00 10 Epl j ECO re 0 24 0 0 10 a 30 60 30 120 min 0 10 20 30 40 min Start up Curve Trumpet Curve Nominal infusion rate r 1 0 ml h Average terror 0 24 Testing time 120 min Observation window 2 5 11 19 31 min Sampling time 30 s eo Gilmi h Q r 5 01 10 Epl 6 0 A IP AA AA A 2 0 5 0 0 s wa __ 10 E E 0 30 60 90 120 min a 10 20 30 40 min Start up Curve Trumpet Curve Nominal infusion rate r 5 0 ml h Average terror 0 25 Testing time 120 min Observation window 2 5 11 19 31 min Sampling time 30 s 34 2 Occlusion Reaction Time and Residual Bolus Pump reaction time for occlusion depends on many factors e Set pressure level the lower the level the sooner pump will signal occlusion in patient line e Flow rate the higher the rate the sooner the occlusion alarm will occur e Elasticity of extension line the thicker the walls of the extension line the sooner the occlusion alarm will occur e Length of extension line the longer line will increase reaction time for occlusion When occlusion occurs the extension line will expand due to the pressure and more fluid will be accumulated within The higher the pressure level set in the pump the thinner the walls of the extension line and the longer the extension line will become more fluid will be accumulated occurs at 1 ml h occurs at 5 ml h Anti Bolus System
22. EDITOR Software Dosing procedures can be entered from the pump keyboard but it is easier to use MEDIMA DRUG EDITOR software and create a drug library in PC MEDIMA DRUG EDITOR software enables to create from simple to very sophisticated drugs protocols It is a very easy and useful tool which allows keeping records of the all versions of drug libraries and safe transfer to all pumps at the hospital ward All data are secured and modification of library is blocked If a drug library is downloaded to the pump from MEDIMA DRUG EDITOR software then in the function Information see p 22 6 1 page 48 will appear a library name version creation and modification This information enables to check weather in all pumps in the hospital ward there is the latest drug library Information about library name will also appear at the drug list headline see p 20 2 page 38 MEDIMA DRUG EDITOR software is not a standard delivery enclosure Contact an authorized MEDIMA representative or the manufacturer directly to obtain an information More details at our website www medima com pl 40 60 WI 06 02V0 0 10 001 03 3 MEDIMA Sp z 0 0 i ADRENALINUM Das eel G Transfer 2 Trash Print m Save Help b b b a a Created 8 29 2006 10 18 AM a 8 29 2006 8 29 2006 x Infusion parameters Concentration E mg ml v aaa ight ko 19 kg min Y im i L ml h Cl DEMO LIB i New drug Open X Delete GyPrint 2 Trash Library n
23. In addition in can programme an induction dose previously enabled see p 19 8 Options Additional Infusion Parameters page 36 programmed as the BOLUS function For this infusion the alarm INFUSION END would not occur because volume and time of infusion were not programmed Infusion would last until the syringe is empty or infusion is stopped 10 2 Rate and Volume of Infusion way ID e Ensure the type and size of syringe on display is accurate If not choose the correct one e Enter infusion rate and confirm you can choose following units ml h ml min ml 24h e Enter volume of infusion and confirm YES the pump will calculate and show time of infusion e Enter clear or omit BOLUS parameters e Using yvjselect Confirm and press a window with parameters will be closed e You can revert to the infusion parameters window see way I In addition you can programme an induction dose previously enabled see p 19 8 Options Additional Infusion Parameters page 36 programmed as the BOLUS function After infusing the programmed volume of medicine the pump will stop the infusion and the alarm INFUSION END will appear 14 60 WI 06 02V0 0 IO 001 03 3 10 3 Rate and Time of Infusion way III e Ensure the type and size of syringe on display is correct If not choose the appreciate one e Enter infusion rate and confirm you can choose following units ml h ml min ml 24h e Enter time
24. Infusion with Profile The choice of one of the mentioned modes of infusion will cause the appearance of proper parameters for this mode of infusion on the display 19 5 1 Continuous Infusion l pz e e Programmed volume over time the pump automatically calculates the flow rate e Programmed time or volume E e Programmed bolus and induction dose 19 5 2 Intermittent Infusion JUL Programmed volume over time the pump automatically calculates the flow rate Programmed time of infusion and time of pause Programmed number of infusion pause cycles Programmed bolus and induction dose EN E Possible unloading of syringe during pause f a a 19 5 3 Infusion with Profile Ll e Up to 24 cycles each with flow rate and time or volume and time Ea e Programmed flow rate with possibility of ramp on ramp off e Programmed bolus and induction dose 10 001 033 29 60 19 5 4 Selection of Infusion Mode window with infusion parameters e Press MENU Using select INFUSION MODE and confirm Using select required infusion mode and confirm If you want to reject the changes press If you want to come back to continuous infusion choose the proper mode of infusion or use the function Clear Parameters 19 6 Programming Examples 19 6 1 Continuous Infusion in mg kg h or in other units J L Select INFUSION MODE continuous infusion see p 19 5 4 page 30 UNITS for e g mg kg h see p 19 4 1 page 29 Paramet
25. M A Pate 720 nh MU Ari UL UFA QURATION 3 UD Doaduwiiwa geneous w e Dzrmand riezitow 320 cenad Sap ing MIKI a bone F3irametsra 1A1J88 mpi imli 4 Tas O aas Ince bssaws m 02 40 14 Cin bolus dese chances 136 Cin bolus cose changes 14 21 08 Cin bolus cese changes Ce Can DENI DAA A UST A Maw A wn A AO incur dose Elrzen Lense SS vince cole CE Ua derrand amm lt Panas 1 Complete infurinn Current infusion mament Te 104 850 HAN 1 LED 87 840 57 1 u Tezeseds ra Dorada ne 30 Med dered ne Ta demence w a7 Orka bks w ir celbchs ro 7 nuaca 3 Surs 2 Draxn 16 13 26 Daan 07 00 10 wudlns 1022005 0 40 39 PM 10 001 03 3 43 60 22 2 Battery To obtain the information about the battery charge status and time of full recharge e Press and hold MENU e Using select Battery and confirm YES an information window will be displayed e Press ESC to finish 22 3 Time Date The proper time and date setting 1s necessary for proper information in the Event log e Press and hold MENT e Using select Time date and confirm WES e Using select Time and enter hours minutes and seconds e Short pressing will cancel last number and long pressing will cancel whole number e Press when entered time is the same as real time e Press to close the window or set date e Using select Date enter date and confirm see p
26. S Ta ees e CE A 1011 N 4 10 001 03 3 61 60
27. activate it or lock it e Press ESC to exit security options In case of switching off all security options entered password will secure configuration parameters only Removal of the password results in unlocking pump configuration and switching off the Security function 22 4 9 Enter Ward Name For the easy identification of the owner of the pump there is a possibility to enter the ID number 16 signs or name including maximal four lines 20 signs each To process e Using select Enter Ward Name and confirm Enter or omit ID number Enter the name in selected line using numerical keys like SMS and Press YES to confirm entered name for selected line Press ESC to finish 22 5 Ward Name This function enables to read entered Ward Name 10 001 033 47 60 22 6 Information This function allows reading information about the pump stored in the memory e Press and hold MENU e Using select Information and confirm YES The following will appear e Drug library Information about drug library name version creation date and modification date entered using DRUG EDITOR e Pump Pump data e Statistics Information about pump and battery working time e Using select desired function and confirm YES 22 6 1 Drug library This information will appear only when the drug library was created and sent using MEDIMA DRUG EDITOR see p 20 8 page 40 The information is very important as it enables to c
28. ame DEMO LIB Version 3 0 Disable editing of limits in pumps Disable editing of drugs in pumps Drug name ADRENALINUM Continuous 8 29 2006 O AMIODARONE i ATRACURIUM DOBUTAMINE DOLARGAN O DOPAMINE EBRANTIL FENTANYL FUROSEMID a ee Llojo ujaja ajwjh 21 CREATION OF USER S OWN LIST OF SYRINGES Parameters of many syringe types are calibrated in the pump Not all of them are used in each hospital To shorten the list Start programming of infusion parameters Using A Y select displayed syringe type Press NO list of syringes will appear Press Using select Create own list and confirm YES Using and NO select desired syringes to create own list Press ESC to finish To revert to the full list of syringes after pressing select All syringes 10 001 03 3 41 60 22 FUNCTIONS AVAILABLE WHEN THE PUMP IS SWITCHED OFF There are options available when the pump is switched off but connected to the power supply e Switch off the pump and connect a power supply cord MEDIMA logo will be displayed e Press and hold MENU a list of available options will be displayed e Event log Review of information about the previous infusions e Battery Information about battery charge status and time left to full battery recharge e Time Date Settings of time and date e Configura
29. ame of drug library appears on the display e Using select a desired drug and confirm YES instead of the numerical keys can be used to chose the first letter from drug name Recalled parameters should be checked and modified if needed The name of drug will be displayed during infusion 38 60 WI 06 02V0 0 10 001 03 3 20 3 Review of Drug Parameters When we are not sure about the chosen parameters they could be reviewed e Press MENU when a parameters window is displayed Using select Drugs and confirm Using select desired program and confirm YES instead of the numerical keys can be used to choose the first letter from drug name Press Using select Parameters and confirm Using scroll the list of parameters not all are visible on the display Press ESC to finish review 20 4 Delete Drug e Press MENU when a parameters window is displayed Using select Drugs and confirm Using select desired program and confirm YES instead of the numerical keys can be used to chose the first letter from drug name e Press Using select Delete drug and confirm e Press ESC to exit 20 5 Change of Drug Name e Press when a parameters window is displayed e Using select Drugs and confirm e Using select desired program and confirm YES instead of the numerical keys can be used to chose the first letter from drug name e Press MENU e Using select Change name and confirm e Ent
30. case of any doubts concerning correct pump operation the device should be removed from service and properly marked or secured as to prevent accidental use until the problem is resolved by an authorized MEDIMA representative or the manufacturer Before dispatching the pump to the maintenance workshop it should be cleaned and disinfected Original packaging is recommended to prevent possible damages during transport 6 60 WI 06 02V0 0 10 001 03 3 4 MANUFACTURER S RESPONSIBILITY The manufacturer is responsible for the safety reliability and correct operation of the pump on the condition that Installation operation and modification are performed in accordance with the user s manual and manufacturer s instructions Inspections and repairs are made be authorized personnel trained by MEDIMA Technical inspections of devices are carried out every two years 5 PUMP CONSTRUCTION e FA 4 4 Y M a Sas se y Ce 4 w RZ mee ON e 1 Pump stem end 10 12V connector socket 2 Plunger grippers 11 RS232C socket 3 Syringe flange clamp 12 Alarm connector 4 Syringe clamp 13 Pole clamp 5 Extension set hook 14 Clamp knob 6 Keyboard 15 Battery cover 7 Display 16 Release button for the docking 8 Caring handle station 9 Mains socket 10 001 03 3 WI 06 02V0 0 7 60 5 1 Keyboard BOLUS O K b A f B A g Additional functions button Exit from MENU by ESC
31. cted e Dueto configuration replacement of battery should be done only by the trained technical personnel e To achieve optimum operation ensure that the battery is fully recharged after full discharge periodically 25 LONGER INTERRUPTION IN PUMP OPERATION In case of expected interruptions in pump operation for longer period of time it is recommended e to clean an disinfect the device e to fully charge the battery e to recharge the battery regularly every 3 months or leave the pump connected to the electrical outlet 26 NURSE CALL CONNECTION Nurse call alarm connection provides the communication remote backup to the internal audible alarm Use of original connection lead is recommended The connection is not needed when the pump is mounted in the docking station Check the connection pressing 55 on the keyboard until test alarm occurs 1 2 COMM 3 4 NO Output normally open with COMM and closed during alarm C 5 6 N Output normally closed with COMM and open during alarm Use of original connection is recommended 52 60 WI 06 02V0 0 IO 001 03 3 27 CONNECTION LEAD 12V Use of DC12 V connection allows operating the pumps in ambulances Proper connection is signalized same as AC power connection 1 12V 2 EI V 3 NC Use of original connection is recommended 28 INTERFACE RS232C Pumps are equipped with interface RS232C which enables e Transmission of contains of event log to the outside PC which a
32. e which can cause an automatic plunger motion and uncontrolled infusion Its rate depends on e Height above patient s heart on which a syringe is held when the pump is mounted e Syringe diameter for small volume syringes the force of plunger movement caused by negative pressure is smaller probability of auto infusion is smaller The biggest danger is for 50 60ml syringes mostly used in the infusion For the typical syringe of the mentioned volume rise of syringe for the height of 70 cm above patient s heart causes plunger suction force about 0 5 kg and sudden auto infusion with the rate much higher than 1000ml b In order to minimize threat of auto infusion exchanging a syringe must be made extremely carefully after isolation of an extension line from a patient Isolation may include closing a tap in the patient line 15 FUNCTIONS AVAILABLE BEFORE THE START OF INFUSION After the confirmation of infusion parameters before the start of infusion and during the infusion the following functions are available after pressing for details see p 17 INFUSION MENU page 21 16 INFUSION Button STA P starts stops the infusion 16 1 Induction Dose Induction dose is a single dose delivered with high flow rate at the beginning of infusion Delivery of induction dose in this mode begins automatically after start of infusion if this parameter has been programmed A button stops restarts delivery of the dose If you don t want
33. e available after pressing MENU e Parameters Allows reviewing and modifying some of infusion parameters e New infusion Resetting the volume of medicine counter and allows to change all the infusion parameters Induction dose if it is programmed will start the infusion e Clear dose Enables to reset the counter of the delivered medicine during infusion or before the next one e Pressure KVO Enables change of the level of occlusion pressure and KVO e Event log Enables reviewing full history about previous infusions e Time date Enables changing time and date e Ward name Allows reviewing entered ward name e Information Information about the pump and the drug library downloaded from the MEDIMA DRUG EDITOR software name version creation date and modification date and about the total time of the pump s work 10 001 03 3 21 60 17 1 Parameters During infusion all programmed parameters can be reviewed and the following can be modified during the infusion course e Flow rate e Volume of infusion total dose e Bolus parameters To modify parameters during infusion or during pause in infusion e Press and hold MENT until a window with parameters appears or e Press e select Parameters and confirm Review and modification like in programming parameters Pressing ESC will revert to infusion window It will happen automatically after 10 sec Entered changes do not reset volume dose counter and the infusion
34. e cycle the last cycle will last until the syringe is empty or infusion Ma stopped alarm INFUSION END will not occur 3 Not entered the flow rate of the first last or both cycles the flow rate of infusion will rise at the beginning and P gt N drop at the end TPN 4 Not entered the flow rate of medium cycle the flow rate of this cycle will change from the level of previous T cycle the level of the next one 5 Entered zero for flow rate for chosen cycle pause in infusion during this cycle will occur KVO will also not be active All the above mentioned cases could be mixed and connected together to create desired infusion profile 10 001 03 3 33 60 19 6 5 Infusion with Profile in ml h TUL Infusion with profile it is infusion with max 24 cycles Flow rate or volume and time can be programmed Actually delivered infusion cycle number is displayed I st way Select INFUSION MODE infusion with profile see p 19 5 4 page 30 UNITS ml h see p 19 4 1 page 29 Parameters programming e Check whether the type and size of syringe displayed is as required If not choose the required one e Enter number of profile cycles and confirm Enter flow rate of following cycle and confirm you can select units ml h ml min ml 24h Enter time of infusion hours amp min of following cycle and confirm Enter clear or omit induction dose parameters if displayed Enter clear or omit BOLUS pa
35. e syringe axle Press lt lt lt the pump will move the arm and grippers will lock the syringe plunger Ensure that the grippers 4 are fully locked and the syringe plunger is secured otherwise danger of auto infusion will occur see p 14 page 18 Unloading a syringe is possible only when the pump is switched on or switched off but connected to the mains 16 60 WI 06 02V0 0 IO 001 03 3 12 PRIMING THE LINE START OF INFUSION The pump enables to fulfil an extension line with medicine In order to do this e Press and hold lt lt lt a progressive bar will be displayed and after its disappearance the pump will start to prime the line until the button is released maximal volume is limited to 5 ml Ensure that there is no air in the extension line or in the syringe e Secure the extension set using the extension set hook 1 on the left side of casing to protect against accidental dislodging of syringe from the clamp e Connect the extension line to a patient Please note that the pump does not signal accidental removal of the needle from the vain Check the connection as much as possible or practical e Check the alarm operation press and hold XX audible signal will sound all controlled lamps on the keyboard will flash display will show ALARM e Press to start the infusion yellow lamp by START STOP button will flash flashing arrow in the upper right corner of display will indicate that the pump
36. ed volume of medicine and revert to standard infusion Press to stop the infusion of bolus and revert to standard infusion To start delivery of Bolus dose Press lt The window with the information about programmed bolus dose will appear If the value is proper press again Delivery of bolus dose will start If there is necessity of change the value enter new value and confirm YES Press lt lt lt to start delivery of bolus in changed value When bolus dose was not programmed or was cancelled press and hold ee and bolus will be delivered until the button is pressed All parameters of bolus dose time amp rate can be modified during the infusion Press and hold WENT until a window with parameters appears or Press MENU Select Parameters and confirm YES a window with parameters will appear Select Bolus and press a window with Bolus parameters will open Enter new parameters and confirm Coming back to the infusion window after pressing ESC If none of Bolus function parameters 1s programmed the function will not be available Delivery of bolus dose gives a signal through blinking of the blue lamp near the button lt lt lt and information about the delivered volume and dose will appear on the display If during delivery of bolus dose the programmed volume dose of the total infusion is exceeded the pump will stop the infusion and END OF INFUSION will appear on the display
37. er infusing the programmed volume of medicine the pump will stop the infusion and the alarm INFUSION END will occur 10 001 033 15 60 11 LOADINGA SYRINGE After proper entering infusion parameters the pump waits for a syringe to be loaded displaying INSERT SYRINGE Never load a syringe to the pump if the extension set is connected to a patient Uncontrolled infusion or back flow may occur and cause danger to the patient s life For safety reason isolate the patient by closing the tap in the extension line Check if there is air in the syringe and if yes remove it e Ensure that the used syringe type and size are the same as on the display e Pull the syringe clamp 2 on display SYRINGE UNLOCKED e Set the plunger in the position x not Correct X Incorrect S N i A f position position s e Insert the syringe ensuring that the finger flanges are located between the casing and syringe flange clamp 3 and the syringe is properly located e Let go off the syringe clamp 2 CHECK SYRINGE on display means the syringe is improperly inserted or the type or size of syringe is incorrect Change the syringe or make a change in programming parameters To make a change in programming parameters press and hold MEND until a parameters window appears Ensure that the syringe plunger is correctly located If yes on display PRESS lt lt lt Check if the syringe plunger lies horizontally in th
38. er the new drug name See p 20 1 Recording Drug Procedures Drug Libraries Creation page 38 e Press ESC to exit 10 001 03 3 39 60 20 6 Creation of Concise Drug Library A drug library can contain up to 120 dosing procedures according to the requirements of a few wards or the specificity of application To speed up choice of a drug from the list an operator can create an own concise drug library according to the requirements of a specified application Press MENU when a parameters window is displayed Using select Drugs and confirm Again press MENU Using select Create list and confirm YES Using select required drugs Press ESC to exit In your library you will find only selected drugs To revert to the full list of drugs act as above using a function All drugs instead of Create list 20 7 Pump to Pump Drug Library Transfer In case of big quantity of pumps at one hospital ward is very important all of them have the same dosing procedures Manual entering of many drugs procedures takes time and can cause errors In such a case entering all procedures to one pump and transferring to all others is recommended A function Send drugs see p 22 9 page 50 enables to transfer of data by interface RS232 A special connection cord is needed see p 29 page 53 Transfer of data between different models S S1 S2 S PCA is not allowed 20 8 Drug Library Creation with the Use of DRUG
39. ers programming e Check whether the type and size of syringe on display is as required If not choose the required one e Drug concentration I st way Use to select Conc parameter press shortly a window for concentration counting will open enter volume of dilution and confirm enter drug dose and confirm change of units possible In order to do so press and hold until units field flashes using or select required units and confirm e Drug concentration Il nd way Use to select Conc Parameter if required units not displayed press and hold until units field flashes using or create required units and confirm enter drug concentration and confirm e Enter patient weight and confirm e Enter flow rate and confirm you can change the units press and hold until units field flashes using or create required units and confirm e Enter total dose and confirm YES entering this parameter is not obligatory In this case alarm INFUSION END will not occur only EMPTY SYRINGE The dose units possible to change This parameter can be disabled if not used see p 19 8 Options Additional Infusion Parameters page 36 30 60 WI 06 02V0 0 10 001 03 3 e Enter clear or omit BOLUS parameters Entering press a window for bolus will open enter bolus dose and confirm change of units possible enter time of bolus in seconds and confirm rate will be counted automatically Time can be omitted and rate e
40. erter USB RS232 Docking station DS4 E Docking station DS6 E JOU EL Dn 10 001 03 3 53 60 30 REPLACE OF AC FUSE If the pump is connected to the AC power supply and the display shows NO MAINS the fuse can be broken To replace it e Disconnect the AC power cord from the electric outlet e Open the drawer with the fuse replace for identical one and close the drawer e Connect the power cable and check if the green lamp on the keyboard next to 6 will come on If not check the power supply cord and the outlet socket 31 TECHNICAL DATA Flow rate 0 1 2000 ml h for 50 ml syringe 0 1 1200 ml h for 30 ml syringe 0 1 1000 ml h for 20 ml syringe 0 1 600 ml h for 10 ml syringe 0 1 400 ml h for 5 ml syringe programmable by 0 1 ml h Volume of infusion 0 1 10000 ml in 0 1ml increments up to 999 9 and above in 1 ml increments Time of infusion 1 min 200 hours in I min increments Bolus Volume from 0 1 ml up to syringe capacity in 0 1 ml increments Rate Minimal 2 x flow rate maximal 2000 ml h in 1 ml h increments Induction dose 0 5 0 ml h programmable by 0 1 ml h Occlusion pressure 1 0 2 kgf cm2 bar 50 levels 2 0 4 kgf cm2 40 3 0 6 kgf cm2 30 4 0 8 kgf cm2 29 o 5 6 1 0 kgf cm2 25 7 0 1 2 kgf cm2 29 A Priming the extension line 500 1500 ml h programmable default value 1000 ml h or less Rate depending on the used syringe Volume max 5 ml
41. etition of the same activities Just choose it from the drug library list and modify dosage parameters if necessary It is the quickest and the safest way of pump programming To create a drug library MEDIMA DRUG EDITOR software is recommended see p 20 8 page 40 CYCLE END 10 001 03 3 27 60 19 2 MENU parameters available during programming During programming infusion parameters but before the infusion is started the following functions are available after pressing MENU that enable modification of the current infusion e Clear parameters Allows clearing all entered parameters and reverting to basic infusion in ml h e Drugs Drug library dosing procedures saved in the pump s memory see p 20 2 page 38 e Save drug Allows recording a new dosing procedure in the drug library see p 20 1 page 38 e Units Allows selecting flow rate units see p 19 4 page 28 Infusion mode Allows selecting infusion mode see p 19 5 page 29 Options Additional infusion parameters see p 19 8 page 36 19 3 Clear parameters come back to infusion in ml h After choosing this function all programmed infusion parameters will be cancelled and return to the basic continuous infusion in ml h will be available This function is in particular useful when after the infusion composed of many parameters or taken from the drug library it is necessary to start a basic infusion in ml h 19 4 Units of Infusion Flow rate can be p
42. heck weather the drug library in the pump is the proper one the latest version and weather 1t was modified in the pump All the incompatibilities in the drugs protocols may cause significant infusion errors and danger to a patient s life The following information will appear e Drug library name given in DRUG EDITOR software e Library version given in DRUG EDITOR software e Creation date im DRUG EDITOR software e Upload date from DRUG EDITOR software e Modify date im DRUG EDITOR software or in the pump e Drug changes locked preset in DRUG EDITOR software Use to review the information 22 6 2 Pump Here is information regarding pump identification e Serial number e Prod date e Pump type e Software Software version e g V6 3 1 e WD Watch dog version Use to review the information 48 60 WI 06 02V0 0 10 001 03 3 22 6 3 Statistics You can find the following information here Pump e Inf counter Total number of infusion done by the device e Infused vol Total volume infused by the device e Working time Total working time Battery e Working time Total working time on battery e Instal date Battery installation date e Charge counter Total number of recharges see p 24 Internal Battery Operation page 52 Use to review the information 22 7 Timer Allows switching on the alarm after programmed time the pump remains switched off e Press and hold MENU e Using select Timer and co
43. hours amp minutes and confirm YES the pump will calculate and show volume of infusion Enter the hour number Enter minutes after pressing or Y ES To enter minutes without hours press J Press to finish e Enter clear or omit BOLUS parameters e Using select Confirm and press the window with parameters will be closed e You can revert to the infusion parameters window see way I In addition you can programme the induction dose previously enabled see p 19 8 Options Additional Infusion Parameters page 36 programmed as the BOLUS function After infusing the calculated volume of medicine the pump will stop the infusion and the alarm INFUSION END will appear 10 4 Volume and Time of Infusion way IV e Ensure the type and size of syringe on display is accurate If not choose the correct one e Clear rate of infusion enter or press and confirm YES e Enter volume of infusion and confirm YES e Enter time hours amp minutes and confirm YES the pump will calculate and show rate of infusion in ml h e Enter clear or omit BOLUS parameters e Using Y select Confirm and press the window with parameters will be closed e You can revert to the infusion parameters window see way I In addition you can programme an induction dose previously enabled see p 19 8 Options Additional Infusion Parameters page 36 programmed as the BOLUS function Aft
44. ication e AC power supplying cable e User s manual Prior the first use of the device plug the pump power cord into the electrical outlet to fully charge the battery Ensure that after connecting the mains the green led on the keyboard lights and the Medima logo appears on the display If the pumps were kept or transported in low temperature below 0 C it is recommended to leave them for a few hours at room temperature prior to connecting to the power supply In case of condensation on exterior of the device it should be left out for 4 to 8 hours until the casing surface is dry 7 PUMP INSTALLATION 7 1 Attaching the Pump to the IV Pole or Vertical Column 1 Unscrew the clamp knob 14 see the picture page 7 to fit it to the diameter of the IV pole 2 Put the IV pole inside the pole clamp 3 Screw on the clamp knob and ensure that the pump is securely fastened to the IV pole 4 Plug in the power cord Never attach the pump on the unstable IV stand Is it not recommended to use more than two pumps with one IV stand Do not mount the pump in a vertical position with the syringe pointing upwards as this could lead to an infusion of air which may be in the syringe 7 2 Mounting the pump into the docking station recommended 1 Hold the pump horizontally and push it into a free space in the docking station Ensure that the pump clicks and is fastened securely If the pump is not fixed properly display shows Imp
45. infusion with induction dose cancel induction dose parameters or block it in Options Additional Infusion Parameters see p 19 8 page 36 For safety reason before starting infusion the pump will require confirmation of delivery of induction dose that allows its omitting in justifiable cases Induction dose is not included in the programmed dose of infusion It means that a patient will receive the sum of the programmed dose of the infusion and the induction dose The total dose delivered to the patient can be read in information about infusion after pressing see p 16 4 Review of Information about Infusion page 20 18 60 WI 06 02V0 0 10 001 03 3 16 2 Quick Change of Infusion Rate without stopping the infusion e Enter new infusion rate with numerical keys you can start entering by pressing e Confirm YES leaving entered new value without confirmation will not change the rate 16 3 Bolus Bolus shock dose is a volume dose delivered with high flow rate to increase quickly the concentration of medicine in blood serum It can be delivered several times during infusion Depending on programmed bolus parameters it can be infused as follows 1 When volume dose of bolus is not programmed bolus will be infused until lt lt lt is pressed After infusing 1ml of medicine the infusion will be stopped for 2 seconds and short sound will occur 2 When volume dose of bolus are programmed pump will infuse the programm
46. is in operation Never prime the line when a patient is connected to the line Filling the line is possible only before the start of infusion or when empty syringe is replaced Volume infused during priming the line is not added to the volume of infusion 13 UNLOADING A SYRINGE e Press to stop the infusion by safety valve e Isolate the extension line from the patient e Pull the syringe clamp down and wait until the plunger grippers will release the syringe about 2 sec In case of any problems with the plunger grippers lock the syringe clamp move the syringe plunger and pull the syringe clamp again e Unload the syringe when the arm is moving e Unloading a syringe is possible only when pump is switched on or switched off but connected to the mains Never load and unload the syringe with the extension line connected to the patient Uncontrolled dangerous infusion or back flow may occur Use a safety valve in the patient s line for protection Every new connection of the extension set to the patient should be done after ensuring that there is no air in the line and in the syringe 10 001 033 17 60 14 AUTO INFUSION Life and Health of Patient under Threat Auto infusion during drug delivery is one of the largest threats for patients life and health It appears when a syringe is above the patient s body and it is caused by gravitation Liquid in the infusion line beneath a syringe makes negative pressur
47. l S2 can be stored in the pump s memory under the created drug name Collection of all stored dosing procedures creates a Drug Library Creating drug library is recommended as it e Significantly increases safety of infusion entering limits of infusion parameters reduces the risk of medicine s overdose e Checked and entered into the pump s memory dosing procedure doesn t require parameters entering before infusion but only their review or modification it s enough only to select a required drug from the list and infusion parameters will be automatically fulfilled This shortens infusion programming and reduces the probability of errors Besides it is possible to disable a possibility of change of chosen parameters for example drug concentration see p 19 7 page 35 10 001 03 3 37 60 e Increases safety of the pump operation a drug name is always displayed during infusion It is important in particular when many pumps are the patient bedside MEDIMA DRUG EDITOR software is recommended to create drug libraries see p 20 8 page 40 20 1 Recording Drug Procedures Drug Libraries Creation e Select enter and check all infusion parameters infusion type units options Not all parameters must be entered but check 1f the units of not entered parameters are correct It is recommended to save parameters same for the most of infusions for the drug like concentration bolus All other parameters may be omitted or ty
48. llows review printing and archiving of data about the previous infusions To do this MEDIMA HISTORY FILE software is necessary which is not a standard delivery enclosure e Downloading a drug library to the pump s memory from MEDIMA DRUG EDIOR which is not a standard delivery enclosure Pump to pump drug library transfer see p 22 9 page 50 Pump to pump configuration transfer or from to PC Upgrade of the pump s software Visualization of the current infusion status RS232 cable with battery is required To visualize and archive information about infusion course it is recommended to use docking stations that enables to connect to hospital ward information system practically unlimited quantity of pumps via LAN Ethernet see p 35 Docking station page 59 Devices to transfer or receive digital data can be connected to pumps only by trained personnel They must meet requirements of EN60950 specification and the whole system should comply to EN60601 1 1 specification Connection of the pump which is at medical stand in a direct contact with a patient to PC is only possible by means of a special cable RS232 with isolation Contact an authorized MEDIMA representative or the manufacturer directly to obtain an information 29 ACCESSORIES Power supply cord 12 V Cable lead RS232 without isolation Cable lead RS232 with isolation Cable lead for pumps connection for drug library and configuration transfer Conv
49. ly Press once again MENU Choose Search and press YES enter the date the pump will find and display the list of all infusions executed during that day For easy review and to keep records about the previous infusions event log could be transferred to the PC MEDIMA HISTORY FILE software enables presentation of all data infused volume and dose time of infusion number of boluses etc in a graphic or chart form MEDIMA HISTORY FILE software is not a standard delivery enclosure Contact an authorized MEDIMA representative or the manufacturer directly to obtain an information More details at our website www medima com pl Data stored in event log cannot be reset If the event log fills up the oldest information will be removed Event log capacity 1s about 2000 records It is difficult to estimate how many full infusions can be stored in the memory as it depends on quantity of events during infusion alarms parameters etc MINIPHINE VIERA 171241279 AM BCA intuston Devicedete Padertdete Fit _Fzmsgwias Catiocs MORPHINE UL DCA rze Monday Oclube CZ 2005 intaram re 76 ses 40 Tr rans Johny DZ eg Lars Walker E Meno gt se Stan paramotor Tamarit A mpd IA ZA Poi bows Lose 1m Tirs CE WAU UU LEW HU Ut PATO GU IU 17 p es e neliwil Mar Swena dza AE OB AZ al bedd ma Clinica bolus 2m Dese lis 10 mz Duration 1n Indurinn dase Dose 2 m R Da 5 R Tire 10 af 10 mnt mal 1
50. nfirm YES The following parameters will appear time left time left to the switch the alarm on time on time when the alarm will be switched on Enter one of the parameters the second will be calculated 22 8 Pump Tests This function enables starting basic pump tests e Press and hold MENU e Using select Tests and confirm FES e Using select a proper function and confirm YES For correct and safe operation the following tests should be carried regularly e Keyboard test checks proper keyboard operation e Display test checks damages of display e Alarm test available also after pressing 5 during infusion e Clamp test checks operation of syringe diameter measuring system Compare result on display with the measurement taken with the slide calliper The error cannot exceed 0 8 mm e Batt controller test checks operation of battery controller system e Battery test indicates status of battery discharge e Battery test event log enables to read results of four previous battery tests 10 001 03 3 49 60 Battery test takes even up to 15 hours as it is controlled discharge of battery If the pump should be ready for patient transfer the battery test is not recommended The result of battery test below 80 requires battery replacement as it means that rapid decrease of battery capacity is expected and the pump could not work unless connected to the mains The indicator of battery charge status will not show
51. nge is empty the pump will stop infusion and alarm will occur the volume remaining in the syringe can be although it s not recommended infused by restarting the infusion process press START STOP The syringe can be unloaded after turning the alarm off see p 13 page 17 exchanged for a full one and the infusion can be 20 60 WI 06 02V0 0 10 001 03 3 restarted without necessity of programming parameters Please observe all safety precautions when changing the syringe Volume dose counter will add volumes of all consecutive syringes A counter can be reset when needed see p 17 Infusion Menu page 21 Depending on the size of the syringe used for infusion the amount of medicine left in the syringe is as follows e 0 5 ml for syringes 50 and 30 ml e 0 25 ml for syringes 20 and 10 ml e 0 1ml for syringes 5ml Due to different types and volumes of syringes the volume remaining in the syringe can be different 16 7 End of Infusion After infusing programmed volume of medicine pump will stop the infusion and alarm will sound displaying INFUSION END If you want to repeat the infusion with the same parameters e Change empty syringe for full one see p 13 Unloading a Syringe page 17 e Prime the extension line see p 12 Priming the Line Start of Infusion page 17 e Start the infusion pressing START STOP 17 INFUSION MENU During the infusion or during the brake in infusion the following functions ar
52. njury A list of recommended syringes is entered into the pump and is available during infusion programming These are three piece syringes with a rubber plunger and a Luer Lock end In case of any doubts concerning the used syringes infusion errors or pump operation immediately contact an authorized MEDIMA representative or the manufacturer directly The pumps should be properly marked and secured to prevent accidental use until the problem is resolved Connecting the extension set to the patient should be done after the syringe is loaded into the pump and the extension line is filled with fluid Otherwise uncontrolled infusion or back flow could occur and endanger the patient The extension set and the pump should be carefully checked for the presence of air as the pump does not have its own system of air detection in the extension line The replacement of syringe should be done after the extension set is isolated from the patient Every new connection to the patient should be done after checking for the presence of air in the line and the fixation of the syringe Uncontrolled flow of medicine may result if the syringe is removed from the pump before the extension set is properly isolated from the patient The pump should be mounted not higher than 70 cm above the patient heart as it may worsen the uniformity of infusion The most accurate pressure monitoring in the extension set is achieved when the pump is positioned close to the patient s hea
53. ntered only Bolus dose can be omitted see p 19 8 Options Additional Infusion Parameters page 36 e Enter clear or omit induction dose parameters if displayed see p 19 8 Options Additional Infusion Parameters page 36 The way of entering the same like for bolus e Dosing procedure can be stored in the pump memory for own drug library creation see p 20 page 37 e Using Y select Confirm and press YES a window with parameters will be closed e To come back to the parameters window and to review or modify the infusion parameters Press and hold MENT until a parameters window appears or Press MENT Using select Parameters and confirm Using review or modify parameters Press ESC to finish 19 6 2 Intermittent Infusion in ml h TUL A I st way Select INFUSION MODE intermittent infusion see p 19 5 4 page 30 UNITS ml h see p 19 4 1 page 29 Parameters programming e Check whether the type and size of syringe on display is as required If not choose the required one e Enter flow rate and confirm you can select units ml h ml min ml 24h press and hold until units field flashes using or select required units and confirm e Enter time of infusion hours amp min of single cycle and confirm YES e Enter time of pause hours amp min and confirm 10 001 03 3 31 60 e Enter number of cycles and confirm YES entering this parameter is not obligatory In this
54. parameters if displayed e The procedure of drug dosing can be entered into the pump s memory creating this way an own drug library see p 20 page 37 e Using fyjselect Confirm and press a parameters window will be closed e To come back to the parameters window and to review or modify the infusion parameters Press and hold MENU until a window with parameters appears It is recommended to use Report function for the infusion with the bigger quantity of cycles The information about the infusion time and drug volume will be displayed 1f the number of cycles is entered e Press MENT when a parameters window is displayed e Using select Options and confirm e Using select Report and confirm or press to switch off e Press ESC to end 32 60 WI 06 02V0 0 10 001 03 3 19 6 3 Intermittent Infusion in mg kg h or in other units TUL Select INFUSION MODE intermittent infusion see p 19 5 4 page 30 UNITS for e g mg kg h see p 19 4 1 page 29 Editing parameters and other remarks like in infusion in ml h Additionally will appear e Drug concentration e Patient weight See p 19 6 1 Continuous Infusion in mg kg h or in other units page 30 19 6 4 Infusion with Profile Types The following profile types can be programmed 1 All parameters of profile cycles entered after the infusion of programmed volume alarm INFUSION END will occur 2 Not entered the time of the last profil
55. pection by a qualified service engineer In case of any doubts please contact an authorized MEDIMA representative or the manufacturer directly The damaged device should be properly marked or secured as to prevent accidental use For power supply use grounded outlets only 2 DIFFERENCES BETWEEN MODELS Medima Model S A base very simple model operates in ml h ml min ml 24h ml h and in continuous infusion mode only Gives the possibility to enter and display up to 120 drug names Medima Model S1 This model allows infusion in ml h and in many other mass units like ng ug mg uU mU U kU umol mmol mol kg min h 24h and operates in many advanced modes continuous infusion infusion with profile and intermittent infusion Additionally allows recording drug library up 120 drugs but without limits on parameters Medima Model S2 Offers capabilities of model S1 and additionally enables to enter upper and lower soft and hard limits for all infusion parameters see p 19 7 page 35 Medima Model S PCA The pump is designed to improve management of acute post operative pain Syringe cover with lock and patient s bolus button is provided Additionally the pump offers capabilities of model S2 3 MAINTENANCE For correct and safe operation the manufacturer recommends to carry out a technical inspection every two years All maintenance work and repair should be done only by the personnel trained by the manufacturer In
56. pical values saved In Model S2 all limits for all or most important parameters could be saved see p 19 7 page 35 It is also recommended to disable a bolus function induction dose and other parameters in Options 1f they are not used see p 19 8 page 36 e Press when a parameters window is displayed e Using select Save drug and confirm e Enter a drug name using numeric keys like SMS in mobiles next pressing changes entered letter for e g to enter C you have to press 2 three times entering next sign available after 1 sec or after pressing next button short pressing cancels last sign and long pressing cancels whole name to enter space press ff press to finish entering the name press to cancel entering the name and revert to infusion parameters window If the entered drug name with the same infusion name and type already exists the warning will appear The review of parameters of both programmes and cancelling one of them is recommended Saving the same dosing procedures under the same name is possible only when the type of infusion is different continuous infusion intermittent infusion infusion with profile Type of syringe and patient weight are not stored in the memory 20 2 Dosing Procedures Recalling e Press MENT when a parameters window is displayed e Using select Drugs and confirm If the drug library was created with the use of DRUG EDITOR software see p 20 8 page 40 the n
57. r will appear disappear on the display It is recommended to disable it if not required 36 60 WI 06 02V0 0 10 001 03 3 19 8 4 Report This function enables displaying information about the total volume dose and time of infusion at the end of parameters programming Available only for e Intermittent Infusion when the number of cycles entered e Infusion with Profile when the time of last cycle entered 19 8 5 Cycle Alarm This option switches on off the alarm after each infusion cycle for intermittent infusion or infusion with profile 19 8 6 Start Time This function enables automatic start of infusion at programmed time After selecting this option an additional parameter time of infusion start will appear in the programming window This parameter can be omitted the infusion will start without the delay ROS 7 Drug Activity This function enables monitoring the time of drug degradation increase of activity After selecting this option time left to the DRUG NOT ACTIVE alarm will appear in the programming window This parameter can be omitted the alarm will not occur The time of drug activity is counted from the moment of syringe loading and not when infusion starts Each syringe unloading resets the counter Switching off the pump doesn t stop counting when a syringe is still loaded 20 DRUG LIBRARY Programmed earlier values of infusion parameters and options additional parameters and limits Mode
58. rameters if displayed The procedure of drug dosing can be entered into the pump s memory creating this way an own drug library see p 20 page 37 Using Y select Confirm and press a parameters window will be closed e To come back to parameters window and to review or modify the infusion parameters press and hold MENU until a window with parameters appears Il nd way Select INFUSION MODE infusion with profile see p 19 5 4 page 30 UNITS ml h see p 19 4 1 page 29 Parameters programming e Check whether the type and size of syringe displayed is as required If not choose the required one Enter number of profile cycles and confirm Enter volume of following cycle and confirm Enter time of infusion hours amp min of following cycle and confirm Enter clear or omit induction dose parameters if displayed Enter clear or omit BOLUS parameters if displayed The procedure of drug dosing can be entered into the pump s memory creating this way an own drug library see p 20 page 37 Using fy select Confirm and press a parameters window will be closed e To come back to the parameters window and to review or modify the infusion parameters press and hold MENT until a window with parameters appears 34 60 WI 06 02V0 0 10 001 03 3 19 6 6 Infusion with Profile in mg kg h or in other units Select INFUSION MODE infusion with profile see p 19 5 4 page 30 UNITS mg kg h
59. rm water and detergent solution e After cleaning wipe the device with the dry cloth and wait until the surface is fully dried e Do not immerse the pump in any fluids as this may damage the pump and may cause electrical shock Only the external parts of the pump should be cleaned Do not steam autoclave or ethylene oxides sterilise Disinfectants which could cause surface discoloration or degrade ABS are forbidden 10 001 03 3 51 60 24 INTERNAL BATTERY OPERATION e Internal rechargeable battery allows continued operation when the AC power is unavailable for example during patient transfer or AC failure e The battery recharges automatically after connection the pump to the AC power supply Infusion doesn t impact on battery charging speed e When operating on batteries a yellow lamp next to flashes and an icon on the display appears The icon also shows battery charge status and its precise value can be read in Information after pressing Winro see p 16 4 page 20 e Battery capacity will decrease in time Battery tests should be carried every 2 3 months after one year of 1ts use and in case of capacity drop up to 80 the battery should be replaced e Battery status can also be evaluated from information about the number of recharges in the pump s statistics see p 22 6 2 page 48 The battery effective life time equals to 400 recharges After exceeding this number quick battery capacity degradation could be expe
60. rogrammed in the following mass units in all above mentioned modes of infusion e mlh ml min ml 24h e U h U min U 24h ml kg h ml kg min ml kg 24h U kg h U kg min U kg 24h e ng h ng min ng 24h e kU h kU min kU 24h ng kg h ng kg min ng kg 24h kU kg h kU kg min kU kg 24h e ugh ug min ug 24h e nmol h nmol min nmol 24h ug kg h ug kg min ug kg 24h nmol kg h nmol kg min nmol kg 24h e mg h mg min mg 24h e molh umol min umol 24h mg kg h mg kg min mg kg 24h umol kg h umol kg min umol kg 24h e uU h U min uU 24h e mmol h mmol min mmol 24h uU kg h uU kg min uU kg 24h mmol kg h mmol kg min mmol kg 24h e mU h mU min mU 24h e molh mol min mol 24h mol kg h mU kg h mU kg min mU kg 24h mol kg min mol kg 24h Selection of flow rate units will cause the proper choice of unit for all other parameters of infusion for conversion factors see p 32 page 55 28 60 WI 06 02V0 0 10 001 03 3 19 4 1 Selection of Units of Infusion window with infusion parameters Press MENU Using select UNITS and confirm Using select required unit and confirm If desired units are not on the list select OTHER UNITS and press Using create desired unit If you want to reject the changes press Come back to infusion in ml h choose units or use the function Clear Parameters 19 5 Modes of Infusion Three modes of infusion are available e Continuous Infusion the most popular e Intermittent Infusion e
61. roper fixing In such case push the pump firmly into the docking station 2 To release the pump from the docking station press release button 16 at the right side of casing and pull the pump forward see drawing page 7 10 60 WI 06 02V0 0 10 001 03 3 10 001 033 11 60 3 Check if the green mains indicator on the pump s keyboard is on if not check the docking station s power supply or the pump s fixation Both the pumps and docking station should be plugged into a grounded electrical outlet only 8 EDITING PARAMETERS Use to select the parameter Start modification of the parameter by clearing the previous value pressing or entering it with numeric keys Each new value should be confirmed pressing YES If the entered value exceeds the allowed limits a window with the upper and lower limits will appear The window with the warning will close after pressing ESC or after 5 seconds Not all parameters have to be entered 8 1 Entering the Value of Numeric Parameters i e rate volume e Press or enter value with numeric keys confirm YES Pressing clears last number e Pressing and holding allows you to change the unit of the parameter Use or press to select the proper units and confirm YES 8 2 Entering Time Press or enter value for hours Enter minutes after pressing or To start entering minutes omitting hours press J Press to finish Pressing clears last number and long holding the button clea
62. rs all entered value 8 3 Permanent Resetting of Parameters If you want to clear the value of a parameter leave it without entering a value and press and then press 8 4 Change the Type of Syringe e Using select the type of syringe press NO a list of syringes will appear Using select desired syringe type and confirm YES During the syringe type selection MENU with additional functions is available user s own list of syringes can be simply created see p 21 page 41 12 60 WI 06 02V0 0 IO 001 03 3 9 SWITCHING THE PUMP ON e Ensure that the pump is not damaged In case of problems contact technical staff immediately Press 6 The pump will start AUTOTEST Two audible signals will sound Check screen for completeness of all pixels on the display Check if all control indicators on the keyboard are working After finishing the tests CONTINUE may appear on the display will clear all information about the course of the previous infusion dose or volume and time of infusion and allow continuing setting the parameters of new infusion allows to continue previous infusion dose volume and time of the previous infusion will not be cleared 10 INFUSION PROGRAMMING ml h After every change or entry of parameters check whether they are correct and the units are proper After switching the pump on the device goes to AUTOTEST and displays the parameters of the last infusion You can e Confirm each parame
63. rt level The pump should be operated within a safe distance from the patient so his accidental movements cannot stop the infusion The patient must be informed by the medical personnel that touching the pump keyboard by any unauthorised persons may cause a risk to his health or life If several pieces of infusion equipment are connected together it is possible there may be mutual influence Please note that simultaneous administration of various medications in the same line may cause unwanted medical effects and affect patient safety or the efficiency of the treatment Information about possible interference between different medications should be obtained directly from their manufactures The pumps should be protected against infusion fluids spills Do not place containers with fluid directly above the pump Any spills should be cleaned immediately An explosion hazard exists if the instrument is used in the presence of flammable anaesthetics Locate the unit away from any hazardous sources 10 001 03 3 WI 06 02V0 0 5 60 EMC EN 60601 1 2 However measures should be taken to place the pumps a sufficient distance from equipment emitting a strong electromagnetic field 1 e x ray instruments electro surgical equipment defibrillators and cellular telephones If the pump is affected by this external interference it may stop the infusion and the alarm will sound If the pump is struck or dropped it should be removed from service for ins
64. rt of pause for intermittent infusion KVO PAUSE active Alarm occurs when option Cycle Alarm is chosen see p 19 8 5 page 37 e Information about end of pause for intermittent infusion Alarm PAUSE END E when option Cycle Alarm is chosen see p 19 8 5 page e Infusion starts automatically if the syringe is loaded e Information about end of cycle for infusion with profile alarm occurs when option Cycle Alarm is chosen see p 19 8 5 page 37 e Infusion starts automatically for the next cycle 2 2 min e Occurs every two minutes when the switched on device is left wisi without the infusion 5 EE DRUG NOT e Doesn t stop the infusion l z e Warning about the degradation of drug s activity ACTIVE e After muting the alarm the red lamp is flashing until the syringe is unloaded MALFUNCTION e INFUSION STOPPED KVO also XXX 19 ADDITIONAL POSSIBILITIES OF INFUSION programming 19 1 Advanced pump programming Apart from the simple basic infusion the pump also gives possibilities of programming other more complicated infusions described below see p 19 5 Modes of Infusion page 29 Choose a proper mode and units of infusion and next enter necessary parameters not all parameters have to be entered A dosing procedure created in this way can be entered into a drug library pump memory named as a drug name see p 20 Drug Library page 37 Next infusion of that medicine will not require the rep
65. s dosing procedures drug names and all infusion parameters In addition for Model S2 parameters limits e Drug library can be transferred from pump to pump or from to PC using RS232C 32 CONVERSION FACTORS 1 0 g 1000 m g 1 0 m g 1000 u g 1 0 u g g 1000 n g 1 0 u g min 60 0 u g h 1 0 u g h 24 0 u g 24h 100 1g ml 1 10 mg ml 1 0mg kg h X 50 kg 1 0 mg ml 50 ml h 1 0mg kg min X 60 X 50 kg 1 0 mg ml 3000 ml h 1 0 ug kg min X 60 X 50 kg 1 0 mg ml 3 0 ml h Password 13 46 79 camma OP ACE EAS ALE SO Xe mg ml mg ml X 1000 mg ml X 1000 The example counts are shown for mass units They are correct also for other units for example U mol 10 001 03 3 55 60 33 LIST OF SYRINGES Below you will find the list of syringes appropriate for use in syringe pumps S S1 S2 and S PCA All the syringes are three part have a rubber plunger B Braun Omnifix B Braun Perfusor BD Plastipak 56 60 WI 06 02V0 0 10 001 03 3 RZ GRAPHS OF INFUSION ACCURACY 34 1 Start up curves and trumpet curves In syringe infusion pumps the action of the pumping mechanism and variations in individual syringes cause short term fluctuations in rate accuracy Knowledge of system accuracy may be important when choosing parameters of infusion depending on the drugs being administered it solution and half life in patient body Below tests were performed in accordance with EN 60601 2
66. see p 19 4 1 page 29 Programming and remarks like for profile in ml h additionally will appear e Drug concentration see p 19 6 1 Continuous Infusion in mg kg h page 30 e Patient weight In the same way parameters of infusion in other units can be programmed 19 7 Limits of Parameters Values Model S2 only Model S2 enables to enter limits for each infusion parameter to warn the operator and makes infusion safer The entering of the two different types of limits is possible e Soft limit Only warn about the crossing of recommended values of parameter min amp max but doesn t block the entering the value During programming the information about the recommended values of parameter will appear e Hard limit Block the entering of parameter values exceeding the limit During min amp max programming the information about the admissible values of parameter will appear Entering the limits makes infusion much safer and it is recommended when an own drug library is created see p 20 page 37 Not all drugs have to have the limits entered Those which have them entered differ from the others by letter L before the drug name The sign L appears only when at least the limits for flow rate were entered Missing of limits for that parameter will not activate the sign L even when the limits for other parameters were entered If during infusion one of the entered limits for any of the infusion parameters is e
67. ssure drop switch on off see p 18 page 25 Entering the value e Using select the parameter e Enter value and confirm e Press ESC to finish 22 4 7 Night Mode Options Night Mode allows tuning of alarm loudness and backlight brightness e Switch on YES NO Switch on Switch off of night mode e Volume level Level of alarm loudness e Melody 1 9 Type of sound e Start 22 00 Time of start of night mode e Finish 07 00 Time of finish of night mode 22 4 8 Security This function allows configuration of security options the list with the following parameters will appear 46 60 WI 06 02V0 0 10 001 03 3 e Switch on YES NO Activation or locking of all the security options e Drug library YES NO Locking of recording modification reset and change of name of programs stored in pump memory Does not lock recalling and start of infusion based on program e Parameters YES NO Locking of parameters modification change e Date time YES NO Locking of date and time modification change e Infusion start YES NO Locking of start of infusion stop is not locked e Bolus start YES NO Locking of bolus dose delivery e Off YES NO Locking switching the pump off Enter password before using the functions secured by password If the password was forgotten read information in p 32 page 55 very carefully Setting security options e Pressing activate Security function e Using select desired security option and pressing YES
68. t can occur when line is disconnected LINE during delivery fluids at high rates for e g bolus induction DISCONNECTED dose Alarm needs activation see p 22 4 6 Alarm Options page 46 Alarm will be activated only when the occlusion pressure is set above the 2 nd level INFUSION STOPED KVO active until the syringe unloaded o Improper syringe fixation during the infusion It can be caused for example by too tight pulling of the extension line Doesn t stop the infusion 5 MIN TO Occurs when volume dose or infusion time is programmed INFUSION END Time can be programmed from 1 to 30 minutes see p 22 4 6 Alarm Options page 46 INFUSION STOPPED KVO active up to syringe INFUSION END unloading Occurs when volume dose or infusion time is programmed i 7 1 5 MIN TO Doesn t stop the infusion Warning that the syringe will be empty soon Time can be SYRINGE a EMPTY programmed from 1 to 30 minutes see p 22 4 6 Alarm Options page 46 26 60 WI 06 02V0 0 IO 001 03 3 e INFUSION STOPPED KVO active until the syringe unloaded e Occurs just before a syringe is totally empty 0 5 ml for syringes SYRINGE EMPTY 50 and 30 ml 0 25 ml for syringes 20 and 10 ml 0 1 ml for syringes 5 ml e Possibility to delivery left drug quantity after switching the infusion on Due to different types and volumes of syringes the volume remaining in the syringe can be different than mentioned above e Information about sta
69. ter pressing e Modify parameter entering new value and confirm pressing e Clear all displayed parameters and return basic infusion parameters in ml h e Press e Using select Clear parameters and confirm e Basic infusion parameters in ml h will appear 10 1 Infusion Rate Only way I e Ensure the type and size of syringe on display is accurate If not Use to find the name and the size of syringe Press list of syringes will appear Use to select the appropriate syringe and confirm e Enter infusion rate and confirm you can choose the following units ml h ml min ml 24h Press and hold until the units field starts flashing Pressing or select the proper units and confirm them e Clear infusion volume press and confirm 10 001 033 13 60 e Enter clear or omit BOLUS parameters when displayed can be switched on off see p 19 8 Options Additional Infusion Parameters page 36 Press NO a window with bolus parameters will open Enter or clear bolus dose pressing and confirm pressing Enter time of bolus dose in seconds and confirm rate will be counted You can omit the time and enter the rate only e Using Y select Confirm and press a window with parameters will be closed e You can revert to the infusion parameters window Press and hold MENU until parameters appear or Press Using select Parameters and confirm Using review or change parameters Press ESC to finish
70. tion Set of configuration parameters e Ward name Display of programmed ward name pump s identity e Information Information about the pump and drug library name version creation date and modification date entered using DRUG EDITOR software Timer Switch on of alarm after programmed time Tests Check of proper pump s operation e Service Features for hospital service department 22 1 Event Log The pump records in the memory full history of infusion each alarm and all parameters with date and time Stored information is available during the infusion and when the pump is switched off The information about the current and previous infusions could be reviewed The following information is stored Infusion parameters Loading unloading a syringe Start stop of infusion Start pause end of the delivery of induction and bolus doses Each change of parameters during infusion All alarms including also these with moment of their muting by operators Overridden limits values for infusion parameters Model S2 e Press and hold MENU e Select Event log and confirm e Using select required infusion and confirm a list of events for selected infusion will be displayed e Parameters of selected infusion could be reviewed Press once again MEND Select Drug parameters and press parameters of selected infusion will be displayed 42 60 WI 06 02V0 0 IO 001 03 3 e The required infusion can be found easi
71. ve 1500 ml h lowest level 4 This regards induction dose bolus normal infusion mode and priming the line The pump is equipped with ANTY BOLUS SYSTEM which enables the automatic reduction of residual bolus after occlusion release The excess of medicine accumulated in the extension line is removed by withdrawal of the syringe plunger The system also corrects the counter of delivered volume dose of medicine This function is activated automatically after muting OCCLUSION alarm KVO This parameter determines the rate of the delivery of medicine to keep vein open in the following cases e Stop of infusion by pressing START STOP End of infusion e Empting a syringe there is always a residual amount of medicine in a syringe e Pause in intermittent infusion The KVO function is shown on the display by a blinking lettering and is active until a syringe is unloaded The KVO function can be programmed in the limits 0 5 0 ml h When the value 0 is entered or KVO values are cleared the function will be disabled When infusion rate is lower than KVO the infusion will not be stopped in the above mentioned cases 17 5 Event Log The pump records in the memory full history of infusion each alarm and all parameters with date and time Stored information is available during the infusion and when the pump is switched off The information about the current and previous infusions could be reviewed The following information is stored
72. xceeded the sign L will not flash Not all four limits have to be entered enter the needed ones only Entering the limits a parameters window on the display e Using select Rate Press and hold MENU until a window with limits for this parameter appears Review enter change or delete limit values Units can be changed Press ESC to close the window Using select next parameter for example Bolus dose and repeat the procedure of limits entering When the parameter s value exceeds programmed limits an alert window will appear e Save the drug in the drug library see p 20 1 page 38 e Setting the same value for hard limits as minimum and maximum will limit the choice to this value only 10 001 03 3 35 60 19 8 Options Additional Infusion Parameters The additional parameters will appear after selection of below options There is no need to select and programme these parameters for each infusion they remain in the memory and they are used in following infusions They will be also saved in the pump s memory in each dosing protocol in the drug library each dosing procedure can have different options if enabled disabled before entering MEDIMA DRUG EDITOR software offers the same possibilities Option selection window with the infusion parameters e Press MENU e Using select Options and confirm YES A window with list of parameters will open e Total dose YES NO total dose enabled

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