HORIZON Nxt®
Contents
1. NTG mcg min 50 mg in 250 ml 100 mg in 250 ml 0 mg in 0ml mcg min Horizon Nxt Modular Infusion System 950520 RevF 6 00 Name Concentration Dosage Units NTG mcg kg min 50 mg in 250 ml 100 mg in 250 ml 0 mg in 0 ml mcg kg min Nitroprusside 200 mg in 500 mg 50 mg in 250 ml 0mgin0ml mcg kg min Norepinephrine 8 mg in 500 ml 8 mg in 250 ml 0 mg in 0 ml mcg min Ondansetron 32 mg in 50 ml 0 mg in 0 ml 0 mg in 0 ml mg kg hr Oxytocin 10 units in 1000 ml 10 units in 500 ml 0 units in 0 ml millU min Phenylephrine 30 mg in 500 ml 50 mg in 500 ml 0 mg in 0 ml mcg min Procainamide 2 g in 500 ml 4 g in 500 ml 0ginOml mg min Propofol mg kg min 200 mg in 20 ml 600 mg in 60 ml 0 mg in 0 ml mg kg min Propofol mcg kg min 200 mg in 20 ml 600 mg in 60 ml 0 mg in 0 ml mcg kg min Propranolol 15 mg in 500 ml 15 mg in 250 ml 0 mg in 0 ml mg hr Ranitidine 50 mg in 100 ml 150 mg in 1000 ml 0 mg in 0 ml mg hr Sufentanil 250 mcg in 5 ml 50 mcg in 1 ml 0 mcg in 0 ml mcg kg hr Horizon Nxt Modular Infusion System 950520 RevF 6 00 Name Concentration Dosage Units Urokinase 750 000 units in 500 ml units kg hr 300 000 units in 200 ml 0 units in O ml Vasopressin 150 units in 250 ml milli U min 200 units in 250 ml 0 units in 0 ml Vercuronium 52. d Lock by rotating the pole clamp lever 1 4 turn toward the rear of the pump Plug the pump s power cord into a hospital grade electrical outlet or the AC Receptacle on the side of another Horizon or Horizon Nxt pump Press the Power key If the Information Screen says PROGRAM Operation Was Interrupted choose an option using the Cursor keys Press the ENTER key PROFILE Operation Was Interrupted choose an option using the Cursor keys Press the ENTER key Open the door of the pump by pulling the Door Lever Prepare the IV fluids as described on the set package Close the downstream roller clamp Position the cassette over the Cassette Alignment Pins with the metal disc toward the pump Thread the tubing through the Air In Line Detector Insert and press the Free Flow Protector Clip into the receptacle Warning Unrestricted fluid flow may occur if the Free Flow Protector 7 8 Clip is not properly installed in the receptacle Close the door of the pump Open all clamps on the pump set Note Do not use a pump with visible damage or with bent damaged or 1 2 3 missing components Press the HoLp key Open the door of the pump Grasp the Free Flow Protector Clip and pull it from the Free Flow Protector receptacle while grasping the tubing as it enters the left side of the pump Gently pull with both hands to remove the cassette from the pump Grasping the Free Flow Protector Clip and removing it f
3. 3 Press ENTER key Cancel Hold is displayed on the LEDs Press the Run key to cancel the pause and begin infusing Press the ENTER key to cancel the extended pause and return to the standard 3 minute hold Press the MENU key to cancel the pause and access the Menu system Micro Rate Limit This option is useful in environments where low rates are critical such as pediatrics or neonatal nurseries The maximum rate limit can be set as low as 5 0 ml hr or as high as 99 9 ml hr Note If the pump is turned on with the Micro Rate Limit activated a Teddy Bear shows on the LCD screen for 4 seconds MICRO OPERATION 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select Alternate Menu 4 Press ENTER key 5 Press Cursor keys to select Micro Rate Limit 6 Press ENTER key Horizon Nxt with MedScan Modular Infusion System 950520 Rev F 5 3 6 00 1 es right Cursor key to select Set Micro Status O flOn n 2 Press down Cursor keys to select Rate Limit 3 Press DATA keys to set a rate limit 4 Press ENTER key Rate Limit 59 9 ml hr Press ENTER when done Note If a rate exists or is entered that is higher than the Rate Limit set an audible signal occurs The user will need to lower the rate or exit this feature 1 Press RUN key to start the MICRO infusion Time Left 7 hr 34 min Total Infused 24 1 ml Occlusion Limit 300 mmHg Monitor Dock
4. 4 Press ENTER key The pump will return to the standard Hold state 6 4 6 00 Chapter 7 SPECIAL MODES PROFILE Mode This mode lets the user deliver fluid in a ramped delivery pattern ramp up plateau deliver and ramp down over a selected period of time If the pump was turned off while in the PROFILE Mode the following screen will appear 1 Press Cursor keys to select the appropriate message 2 Press ENTER key The pump will return to PROFILE Hold state Change PROFILE Parameters Data Entry Horizon Nxt Modular Infusion System 950520 Rev F 1 Press Menu key PROFILE Operation was Interrupted Resume current PROFILE Restart PROFILE Exit PROFILE Mode 2 Press Cursor keys to select Set PROFILE Parameters 3 Press Enter key 1 Press the Cursor keys to select Ramp Up Ramp Down or MAX Rate 2 Press Data keys to change the values 3 Press Cursor keys to select VALIDATE Parameters 4 Presss Enter key Ramp Up 1hr0 min Ramp Down 1 hr 0 min Max Rate 300 ml hr VALIDATE Parmameters Note The minimum ramp time is 10 minutes the maximum ramp time 120 minutes The largest value for maximum rate is 400 ml hr 1 Press MENU key 2 Press CURSOR keys to select PROFILE Mode 3 Press ENTER key 1 Press Data keys to enter the Volume 2 Press CURSOR keys to select time 3 Press DATA keys to enter the Time 4 Press the Cursor keys to select VALIDATE
5. Extender tritio ta said 5 3 Micro Rate Limit an 5 3 Monitor Dockih e e ndo 5 4 Occlusion Warming e ts 5 1 Piesyback Ca llbac a a ios 5 5 PROFM E Mid Oi O ai 5 5 PROGRAM Mod qu o NS 5 5 E CC A a Sect iae Aai ons tad Saat daa A ies a ate 5 5 Schedule NeXt RUM sli dd 5 9 DEIECE MAX Pressure cr id metiera 5 10 Set PROFILE Parameters unida 5 11 Horizon Nxt 6 00 Modular Infusion System 950520 Rev F Set Time and Vol men titi 5 11 Site Tr roo dd nd 5 12 Exit from Men sssusa ee yey sunebaenatedecagatin duadatenshen a a a EE 5 12 Chapter 6 DOSE MODE Paneer tl da 6 1 Dras Menusi a Ramer 6 1 Epid ra CAPO A id 6 2 CONCA in E ries 6 2 Data SOLE io 6 2 Change Sel Par asas 6 3 Titrat Rate susu ld 6 4 E A eiaa 6 4 Exit DOSE Mode sia E OE A 6 4 Chapter 7 SPECIAL MODES quid iia iia tidad 7 1 Profile Mode rss dto siasii 7 1 Change Profile Parameters 5 seco eac aa cla a a E aes 7 1 Data Enty zea a a N ae 7 1 Review Change PROFILE Data tats tespeoeateems aan 7 2 Restart PI Ea cate a o 7 2 mime diate Ramp A O R as 7 2 EXIt PROFILE Mode dad 7 3 Prostam Mod e dd e do 7 4 Data Entry util l 7 4 Review Change PROGRAM 21 5225 s desc0ssaubssactotasedaceacstasanagisagaesdanottonstedouastanen 7 5 Restart PROGRAM sra ia 7 6 Skip PROGRAM Periods ii air 7 6 Exit PROGRAM Modest satis aie ae 7 6 Chapter MAINTENANCE k ar e aee e EAA OS ARTER S E E AET 8 1 Cleaning eea A E eid ieee aadeiGaah 8 1 Alarm TOCE OUILES aeaicctsas ue ceans ie
6. the pump s secondary infusion features should not be used For epidural administration of anesthetic drugs use indwelling catheters specifically indicated for short term 96 hours or less anesthetic epidural drug delivery For epidural administration of analgesic drugs use indwelling catheters specifically indicated for either short term or long term analgesic epidural drug delivery When the Horizon Nxt with MedScan is being used for epidural infusions the source container and administration set should be clearly differentiated from source containers and administration sets used for other routes of infusion Caution To prevent inadvertent infusion of drugs not indicated for epidural administration use only Horizon microbore administration sets without injection sites Following an occlusion alarm a small amount of fluid may be delivered Use of a microbore set assures this is less than 0 1 mL The administration of drugs is restricted to those anesthetic and analgesic drugs labeled for continuous epidural administration Warning Serious injury to the patient may result from epidural administration of drugs other than those specifically labeled for epidural use Caution The higher the pressure limit the less sensitive the pump is to changes in fluid resistance which may be caused by positional IV s or infiltrations High pressure limits can increase the severity of an infiltration without an alarm condition 1 Pre
7. Rate is the parameter calculated unless another parameter is chosen To Choose Another Parameter 1 Press left Cursor key 2 Press up and down Cursor keys to select the parameter to be calculated 3 Press the right Cursor key Note The parameter that was highlighted is now underlined That underlined parameter is the calculated parameter Enter Data 1 Press Data keys to change value e Press CURSOR key to select Cone 400 0m8 500 ful VALIDATE Dose 5 00 mcg kg min 4 Press ENTER key Rate 26 3 ml hr 5 Press RUN key to start the infusion VALIDATE DRUG SETUP Body Weight 70 0 kg Rate and Volume data is transferred to the displays The name of the medication and DOSE are shown on the Information Screen Change SETUP Parameters HorizonNxt Modular Infusion System 950520 Rev F Critical medications require parameters for calculation of doses for example mcg kg min Three categories of parameters are Dosage Concentration Conc and Body Each of these can be independently selected and changed Match the dosage and concentration written by the doctor 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select DOSE Mode 4 Press right Cursor key to select SETUP 5 Press ENTER key 6 3 6 00 Titrate Rate Titrate Dose Exit DOSE Mode HorizonNxt Modular Infusion System 950520 Rev F 1 Press the left or right Cursor keys to DOSAGE CONC BODY mo
8. mcg kg min 50 mcg in 1 ml 2 5 mg in 50 ml 2 5 mg in 50 ml mcg kg min Fentan mcg kg hr 50 mcg in 1 ml 2 5 mg in 50 ml 2 5 mg in 50 ml mcg kg hr Fluorouracil 5 FU 0 mg in 0 ml 0 mg in 0 ml 0 mg in 0 ml mg kg hr Furosemide 100 mg in 50 ml 0 mg in 0 ml 0 mg in 0 ml mg min Heparin units hr Heparin units kg hr 20 000 units in 500 ml 25 000 units in 250 ml O units in O ml 20 000 units in 500 ml 25 000 units in 250 ml 0 units in O ml units hr units kg hr Horizon NxtQ Modular Infusion System 950520 RevF 6 00 Name Concentration Dosage Units Hydromorphone 50 mg in 5 ml 500 mg in 50 ml 0 mg in 0 ml mg hr Insulin Regular 0 units in 0 ml 0 units in O ml 0 units in O ml units hr Isoproterenol 3 mg in 250 ml 6 mg in 250 ml 0mgin0ml mcg min KCL 20 mEq in 50 ml 40 mEq in 100 ml 0 mEq in 0 ml mEq hr Labetalol 200 mg in 200 ml 200 mg in 250 ml 0 mg in 0 ml mg min Lidocaine 2 gm in 500 ml 4 gm in 500 ml 0 gm in 0 ml mg min Magnesium Sulfate 5000 mg in 250 ml 5000 mg in 500 ml 0 mg in 0 ml g hr Methotrexate 0 mg in 0 ml 0 mg in 0 ml 0 mg in 0 ml mg kg min Midazolam 25 mg in 50 ml 50 mg in 50 ml 0 mg in 0 ml mg hr Milrinone 10 mg in 10 ml 20 mg in 100 ml 0 mg in 0 ml mcg kg min Morphine 10 mg in 50 ml 10 mg in 1 ml Omgin0ml mg hr
9. PROFILE 5 Press the ENTER key Volume 1000 0 ml Time 8hr 0min VALIDATE PROFILE 6 00 Profile Ready will appear at top of Information Screen Press Run key to start PROFILE RAMP UP will be displayed on the Information Screen 1 Press ENTER key for a graph RAMP TEXT 2 Press ENTER key for the text UP VOLUME DELIV TIME LEFT 0 2 ml 9H 58M Review Change PROFILE Data Note Volume cannot be changed after an infusion is started 1 Press MENU key 2 Press CURSOR keys to select Review Change PROFILE 3 Press ENTER key 1 Press Cursor keys to select Time 2 Press DATA keys to change the time 3 Press the Cursor keys to select VALIDATE PROFILE 4 Press the ENTER key 5 Press Run to start Immediate Ramp Down Horizon Nxt Modular Infusion System 950520 Rev F 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select Restart PROFILE 4 Press ENTER key 1 Press Cursor keys to select YES 2 Press ENTER key The Restart PROFILE option will cancel the 3 Press Run key present run Is this OK Yes No Cursor lt gt amp Press Enter 1 Press the MENU key 2 Press the Cursor keys to select Immediate Ramp Down 3 Press the ENTER key Immediate Ramp Down shows on the Information Screen Note The Immediate Ramp Down time is 30 minutes or less 7 2 6 00 Upon completion of Immediate Ramp Down the pump ent
10. Press HOLD to Silence Alarm feature must be exited to cancel the present infusion regimen Wait Is shows the amount of time e tart 10 DATA until delivery starts gl eck Wait Is Oh 49m 3 Doses left Total Infused 2 2 ml Note After pressing Enter the pump goes into a waiting period SCHd dLY shows on the LED s No fluid is infusing during this period 1 Press Enter key for the data screen 2 Follow the steps above to change the data if necessary 3 Press ENTER key At the q x Start time the pump will begin the infusion During the infusion SCHd run shows on the LED s The number of doses remaining is shown on the LCD After the infusion is complete the pump will automatically return to the waiting period The pump will continue to infuse and wait for the total number of doses entered q x Delivery DATA Time Left Ohr 29 min Total Infused 2 7 ml Occlusion Limit 300 mmHg 3 Doses left To Exit Horizon Nxt with MedScan Modular Infusion System 5 7 6 00 950520 Rev F Note The pump must be in the Hold state 1 Press MENU key 2 Press CURSOR keys to select Exit g x Schedule 3 Press ENTER key Horizon Nxt with MedScan Modular Infusion System 5 8 6 00 950520 Rev F Schedule Next Run This feature lets the user delay an infusion from Standard DOSE PROFILE or PROGRAM Mode for up to 24 hours Note The rate and volume information must
11. bag more than 8 inches or clamp off the primary tubing Sympathetic flow increases significantly when the piggyback rate is greater than 125 ml hr and clamping the primary tubing is recommended at rates greater than 125 ml hr 4 Press the PIGGYBACK INDICATOR key 5 Enter the Piggyback rate and volume Note The programmed Piggyback volume to be infused must be equal to the amount of fluid in the Piggyback container to prevent incorrect delivery Automatic piggyback is not intended for the infusion of fluids requiring flushing before and after administration because of incompatibility 6 Press the PIGGYBACK Run key When the Piggyback volume is complete the Piggyback Rate and Volume Displays will blank The Primary Rate and Volume Displays will light up The infusion will now be delivered at the primary rate Make sure the primary tubing is not clamped Note If the secondary container is not empty the remaining secondary fluid will be delivered at the primary flow rate This feature causes the pump to alarm and continue the infusion at a KVO rate after the programmed piggyback volume is infused Piggyback Callback must be selected in the User menu During Infusion titration 1 Press the Data keys to change the rate 2 Press the ENTER key or the PRIMARY RUN key to validate data Note If the ENTER key or RUN key is not pressed within 4 seconds of entering a new rate a series of error beeps will occur and the rate change w
12. from menu 2 Press the ENTER key Horizon Nxt with MedScan Modular Infusion System 5 13 6 00 950520 Rev F Chapter 6 DOSE Mode Drug Menus HorizonNxt Modular Infusion System 950520 Rev F DOSE Mode calculates the concentration rate or dose information necessary for use with many critical drug infusions Note Medication names available are listed in Chapter 9 Table 1 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select DOSE Mode 4 Press ENTER key If a drug name was used the last time in DOSE Mode the following screen will appear on the LCD If the medication is correct DOPAMINE 1 Press the ENTER key in the ICU CCU category 2 Go to Data Screen is the current drug ACCEPT CHANGE EXIT MODE Cursor amp Press ENTER or To change to a new medication 1 Press the Cursor key to select Change 2 Press ENTER key or To Exit DOSE Mode 1 Press Cursor key to select Exit Mode 2 Press ENTER key 1 P the C key t lect t DRUG LISTS gt m x D ey to select a category CUCCU Neo amp Pedi TESS ENTER SEY Med Surg Oncology Anesthesia Epidural CLEAR DRUG DOSE An alphabetical list of medications is ICU CCU DRUG LIST shown AMINOPHYLLINE BRETYLIUM 1 a CURSOR keys to select the CISPLATIN medication DEXAMETHASONE 2 Press ENTER key To clear the drug name 6 1 6 00 Epidural Category 1 Press Cursor key to select Cl
13. keys to select Site Trend Now 5 Press ENTER key Note Data is shown from right to left The word Now reinforces the most current data is represented on the right side of the graph The arrow s position whether pointing upward or downward indicates either an increase or a decrease in the downstream fluid resistance To Change Graphical Resolution 1 Press up and down Cursor key to change from MAX MED or MIN resolution Note MAX is the default setting MIN displays more data points compressed along the horizontal axis for a representation of a long term trend MAX displays less data points in the same area for a short term trend Resistance Factor RE Note This feature needs to be activated by the Biomedical Technician The Resistance Factor is a numeric value displayed and updated during an infusion RF appears on either the Hold or Run Screen when activated The numerical value of RF appears after the words Site Trend when the graph is displayed Increasing RF values may alert the clinician to a possible occlusion state due to kinks clogged filters viscous fluids or infiltrations To Exit 1 Press right Cursor key to select Exit 2 Press ENTER key to exit Exit from Menu Horizon Nxt with MedScan Modular Infusion System 5 12 6 00 950520 Rev F This feature returns the pump to the state 1t was in before pressing the Menu key 1 Press the Cursor keys to select Exit
14. microbore administration sets without injection sites are required for epidural administration of drugs Following an occlusion alarm a small amount of fluid may be delivered Use of a microbore set assures this is less than 0 1 mL Serious injury to the patient may result from epidural administration of drugs other than those specifically labeled for epidural use It is not recommended to stack more than five pumps on one I V pole Use only with B Braun Medical Horizon I V Sets Perform testing and or preventive maintenance as defined in the product Service Manual It is necessary to perform all testing and preventive maintenance as defined in the product Service Manual or the reliability and proper functionality of the unit cannot be assured The higher the maximum pressure limit the less sensitive the pump is to changes in fluid resistance which may be caused by positional I V s or infiltrations High pressure limits can increase the severity of an infiltration without causing an alarm condition Unless the pump is plugged into a hospital grade electrical outlet the reliability of the grounding cannot be assured A possible explosion hazard exists if the pump is used in the presence of flammable anesthetics To avoid electrical shock turn off the pump and disconnect it from the 8 5 6 00 Horizon Nxt Modular Infusion System 950520 Rev F electrical outlet before cleaning Do not use the pump in the presence of strong e
15. 01 hr 00 min Doses 4 Dose Rate 200 0 ml hr Dose Vol 100 ml Press ENTER when done Note The time interval can be 1 to 24 hours There must be at least 15 minutes between each run 1 Press down Cursor key to select of Doses 2 Press Data keys to set the total number of doses to be infused Note The total number of doses may not exceed 40 1 Press down Cursor key to select Dose Rate 2 Press the Data keys to set the infusion rate in ml hr 1 Press Cursor keys to select Dose Vol 2 Press the Data keys to set the volume of each dose for example 4 doses each 50 ml Note The Dose Volume of each dose has to be greater than ml but not more than 2000 ml 3 Press the ENTER key To change the time 1 Press up CURSOR key to select Present Time is Present Time is 09 37a 2 Press DATA keys to set the correct Start dose at time 10 35a VALIDATE Note The time is displayed in military time Use 00 00 to represent Horizon Nxt with MedScan Modular Infusion System 950520 Rev F 5 6 6 00 midnight and 12 00 to represent noon Verify that the Time 1s correct 1 Press Cursor to select Start Dose at 2 Press Data keys to set the time the infusion is to begin 3 Press the Cursor keys to select Validate 4 Press ENTER key Note g x Schedule Overlap message appears when doses entered are not at least 15 minutes q x Schedule Overlap apart When this occurs the g x
16. 5 to 1 25 Battery 12 Volt sealed lead acid battery for ambulatory use Run time is dependent on the state of bat tery charge and the rate of fluid delivery Rate Range Standard Primary and Piggyback 0 1 to 999 9 mL hr Micro Primary and Piggyback 0 1 to 99 9 mL hr Volume to be Infused Range 0 1 to 9999 9 mL Occlusion Pressure 75 100 200 300 400 500 and 750 mmHg Standard mode default is 300 mmHg Keep Open Rate 3 mL hr for prescribed delivery rates of 3 to 999 9 mL hr or the continuation of the pre scribed delivery rate for 0 1 to 2 9 mL hr set tings Volume Delivered Accuracy 5 Fluid Types All standard I V fluids Horizon Nxt Modular Infusion System 950520 Rev F 8 8 6 00 Alarms Air In Line Container Empty Door Open Downstream Occlusion Hold Time Exceeded Low Battery Low Flow from Container Close Roller Clamp Sys Err Upstream Occlusion Air in Line Alarm 0 09 cc Hold Time Exceeded Alarm Activated after three minutes on hold without user interaction deactivated if the door of the pump is open Memory Permanent data retention after the pump is turned off unless the battery is depleted or dis connected or unless the Data Retention De faults have been otherwise selected in the Biomed Options Horizon Nxt Modular Infusion System 950520 Rev F 8 9 6 00 Chapter 9 Table 1 Drug List Name Concent
17. 8 2 Alarm Troubleshooting Guilds a 8 3 RA 8 5 Service and Performance Information oooocnncccnonoccnononcnnncnonnncnonononononcnonncnonnnccnnnss 8 7 PEA O e o o e es Lo a de 8 8 Chapter 9 Table FDRUG LAS Pat 9 1 Idex E NO Index 1 Horizon Nxt 6 00 Modular Infusion System 950520 Rev F Chapter 1 INTRODUCTION Warranty Horizon Nxt Modular Infusion System 950520 Rev F B Braun Medical Inc hereby warrants that reasonable care has been used in the manufacture of each Horizon Nxt and that it shall be free from defects in material and workmanship for a period of two years after the date of shipment when properly used and maintained Any Horizon Nxt that 1s found not to meet these standards within this two year period will be repaired after examination by B Braun Medical or at B Braun Medical s option will be replaced without charge If the defect has been caused by misuse unauthorized modification or abnormal conditions or operation repairs will be billed at B Braun Medical s then current charges In this case an estimate will be submitted before work is started if requested The defective device should be returned promptly to B Braun Medical properly packaged postage prepaid Loss or damage in return shipment to B Braun Medical will be at purchaser s risk The foregoing express warranty as conditioned and limited is in lieu of and excludes all other warranties not expressly set forth herein whether expressed o
18. HORIZON Nxt Operation Manual 1999 B Braun Medical Inc This manual may not in whole or in part be copied photocopied reproduced translated or converted to any electronic or machine readable form without prior written consent of B Braun Medical Inc 950520 Rev F Table of Contents Chapter AN TRODUCTION O E o E o 1 1 O ASIS 1 1 Intended Use a aan 1 2 Epidural Administration A a 1 2 BOSA as 1 3 A teers het ie eed acah E ee Gas Bic A ae Soa td lated 1 3 Chapter 2 PRODUCT DESCRIPTION od 2 1 Opera NICHES esc cssc ea cies e tinca 2 1 COB SPARES esta ld tearoom aan e 2 1 TIOS a id 2 2 Important KEYS cier cbsaaiseecaass desevaasaceyecediansias pasha saad anna A qeda setenta datas 2 4 Daisy COMO ito bai ica 2 4 Battery Opera ein 2 4 Chapter 3 PRINCIPLES OF OPERATION ccsccsssssssscsscssccssccessceenssesscessecenneees 3 1 Cassetlo Removal O Rial 3 1 AO Mio Oda 3 2 Por Primary Plastic 3 2 For Piggyback Find pas 3 2 PV VAC Ae aM A Neh gla aia Moe ae catalase ana 3 3 HO CR ACG a cus as ae e ane 3 3 During Infusion titration avia drena 3 3 With Pump on Hold sescca e iie e a oai 3 4 Chapter 4 MENUS ii ia 4 1 Maim Ment ia e Ea T EE EE AE 4 1 AM a de e a O 4 1 Change Alarm Volume ad 4 2 Citar Total usd O E EE R E eee 4 2 Dose Mod a tes ic 4 2 OCASION AA E E A 4 3 Alternate METIA a 4 4 Calcula BSAS 4 4 Set ECD Contras Losa do 4 4 Chapter 5 CUSTOM MENU OPTIONS iii catas 5 1 Check Battery Level comino id 5 2 Hold
19. NU key 2 Press Cursor keys to select Calculate BSA 3 Press ENTER key Note Height can be measured in centimeters cm or inches in Weight can be measured in grams g kilograms kg or pounds lb The height and weight parameters are changed by pressing theCursor to select the parameter and pressing the up or down Cursor key 1 Press Cursor keys to select Ht and Calculate BSA Wt values Ht 100cm Wt 70kg 2 Press the Data keys to enter the information BSA 1 23 m2 3 The BSA value is displayed 4 Press ENTER to exit Press ENTER when done Set LCD Contrast This option allows the user to change the readability of the Information Screen 1 Press MENU key 2 Press Cursor keys to select Set LCD Contrast 3 Press ENTER key 1 Press right and left Cursor keys EXIT to vary the contrast 2 Press ENTER key to validate Adjust cursor gt until this message is clear Then press ENTER key The pump will return to the previous Hold or Run state Horizon Nxt Modular Infusion System 4 4 6 00 950520 Rev F Chapter 5 CUSTOM MENU OPTIONS The following items can be added to either the User or Alternate Menus by the Biomedical Department The Custom Menu items are listed in alphabetical order Check Battery Level graphically displays the state of the charge of the battery Hold Extender lengthens the hold time to a maximum of 120 minutes This option must be turned on by the Biomedic
20. V sets to regulate the flow of primary and secondary fluids when positive pressure is required The infusion system is capable of delivering fluid from a negative head height when the I V fluid container is lower than the pump and provides clinically accepted volumetric accuracy for all standard I V fluids including blood lipids and TPN Positive pressure is frequently a necessity but clinical experience shows that high pressure limits can increase the severity of an infiltration without causing an alarm Because there is a need to control pump pressure settings the Horizon Nxt has user selectable occlusion pressure limit settings which start at 75 mmHg and extend to 500 mmHg At rates of 400 mL hr and higher the pressure setting is automatically increased to 400 mmHg For epidural infusions which require higher pressures the pump has an extended occlusion pressure setting of 750 mmHg Because some infusions require multiple flow rates during the delivery cycle the Horizon Nxt is equipped with two automatic multiple delivery rate modes The Profile Delivery mode incorporates a standard ramped delivery regimen and the Programmable Delivery mode can be set up to sequentially deliver up to nine user selected volumes of fluid each at a user selected rate Both modes are designed for ease of and can be adapted to home care settings The Horizon Nxt also incorporates a Dose Rate mode which automatically calculates the rate when dose informat
21. ack 5 Press ENTER key 1 Press Cursor keys to select On When Piggyback Callback 2 Press ENTER key is ON KVO will alarm as soon as the Piggyback is done Note Piggyback Callback will Set Callback Off return to the Off position when the pump is turned off The Profile Mode is described in Chapter 7 Special Modes PROGRAM Mode q x Schedule Horizon Nxt with MedScan Modular Infusion System 950520 Rev F The Program Mode is described in Chapter 7 Special Modes This option allows the programming of periodic antibiotics chemotherapy or other IV infusions For example antibiotics are written to be infused q 6 every 6 hours It is important to have a maintenance IV infusing This option can only be enabled by Biomedical personnel Note A cassette must be loaded in the pump to program this feature The piggyback option is not available while using this feature The g x option cannot be used while in DOSE PROFILE or PROGRAM Modes 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select q x Schedule 4 Press ENTER key 5 5 6 00 1 Press right Cursor keys to select OK 2 Press ENTER key To Enter Data 1 Press Cursor keys to select g x hrs and min 2 Press the Data keys to set the time interval between infusion For example q 6 hrs 00 min This feature allows for periods of no infusion Ensure IV patency prior to start OK Dose q x
22. al Department Micro Rate Limit limits the infusion rate Useful for Pediatric and Neonatal settings Monitor Docking allows the Horizon Nxt with MedScan to communicate with select monitoring systems to visually display current infusion parameters This option must be turned on by the Biomedical Department Occlusion Warning is designed to alert the clinician of downstream resistance An audible warning three beeps and a visual indication will occur 5 times at 5 second intervals before alarming Occlusion This option must be turned on by the Biomedical Department Piggyback Callback continues the primary infusion at a KVO rate and alarms once the piggyback is complete PROFILE Mode incorporates a ramped delivery regimen based on the patient s specific needs PROGRAM Mode lets the user program a maximum of nine selected volumes of fluid q x Schedule allows the programming of periodic IV infusions Schedule Next Run delays the start of an infusion for up to 24 hours Select MAX Pressure sets the occlusion pressure limit to the maximum value of 750 mmHg Set PROFILE Parameters alters the ramping process Set Time and Volume allows the delivery rate to be calculated based on time for example 1000 ml to be infused over 8 hours Site Trend graphically displays the resistance to downstream fluid flow A Resistance Factor can be enabled by the Biomedical Technician which will display a numerical value b
23. be entered on either the Primary or Piggyback channel and a set must be in the pump before entering this feature 1 Press MENU key 2 Press Cursor keys to select Schedule Next Run 3 Press ENTER key To Change the Time 1 Press CURSOR key to select Schedule Next RUN Time is if necessary Time is 15 15p 2 Press Data keys to set the Delay 2 hr 00 min correct time in military time Sith al her VALIDATE 01 H 00 M DELAY To Change the Delay Note The time is displayed in military time Use 00 00 to represent midnight and 12 00 to represent noon Either Press Cursor keys to select hr or min Press Data keys to set the hours and minutes or Press Cursor keys to select Start at Press Data keys to change the time 1 Press Cursor keys to select Validate 2 Press ENTER key The information is displayed on the Information Screen dLY is shown and the yellow Hold LED will blink Press the HoLD key to cancel Schedule Next Run Note To prevent tampering of the Schedule press the Panel Lock Out Switch on the rear of the pump Horizon Nxt with MedScan Modular Infusion System 5 9 6 00 950520 Rev F Select MAX Pressure The Horizon Nxt with MedScan can be used for epidural administration of anesthetic and analgesic drugs Use this feature when the maximum pressure of 750 mmHg is required for infusion Caution Whenever the pump is being used for epidural infusions
24. e For Example If the occlusion pressure is set to 300 mmHg the pump will infuse at the lowest pressure possible but will alarm if the pressure required to infuse the IV fluid rises above the 300 mmHg value A gravity infusion of DSW with the IV container 3 feet above the IV site is equivalent to approximately 70 mmHg The occlusion warning feature is optional The occlusion warning feature gives an audible warning 3 beeps and a visual indication in the LED display to let the user know an occlusion is occuring downstream from the pump This warning occurs 5 times at 5 second intervals before alarming Occlusion This feature is designed to alert the clinician of downstream resistance before an alarm occurs which stops the infusion Caution The higher the pressure limit the less sensitive the pump is to changes in fluid resistance which may be caused by positional IV s or infiltrations High pressure limits can increase the severity of an infiltration without an alarm condition Note To select a pressure of 750 mmHg refer to Select MAX Pressure 1 Press MENU key 2 Press Cursor keys to select Occlusion Limit 3 Press ENTER key 4 Press Data keys to change the pressure limit 5 Press ENTER key The pump will return to the previous Hold state Horizon Nxt Modular Infusion system 4 3 6 00 950520 Rev F Alternate Menu Items Calculate BSA Use this feature to calculate body surface area BSA 1 Press ME
25. ear Drug 2 Press ENTER 3 Goto Data Screen Note Generic calculation can be used for drugs not appearing on the list 1 Press CURSOR key to select Epidural 2 Press ENTER Pressure will be set to 750 mmHg and Micro Rate will be enabled Use sets labeled for Epidural use only Concentration Screen Data Screen HorizonNxt Modular Infusion System 950520 Rev F A screen with 2 standard concentrations and a wild card line is shown 1 Press CURSOR keys to select a DOPAMINE concentration 2 Press ENTER k 400 mg in 500 ml i ey 400 mg in 250 ml 0 0mgin Oml Press ENTER when done Note No data entry can be done here The concentration can be changed later See Data Screen Body Weight 1 Press Cursor keys to select the Body Weight value if shown 2 Press DATA keys to change the value Body Weight 70 kg Conc 400 0 mg 500 ml Dose 5 0 mcg kg min Rate 26 3 ml hr VALIDATE DRUG SETUP Calculated Parameter Concentration Dose and Rate are interdependent on each other for their 6 2 6 00 numeric values Specifying the amount of two parameters cause the third parameter to be calculated For example Specifying a weight of 70 kg a concentration of 400 mg of Dopamine in 500 ml of fluid at a dose of 5 0 mcg kg min resulted in a calculated rate of 26 3 ml hr Note Either the Concentration Conc Dose or Rate parameter is calculated
26. ers the KVO state To silence the alarm press the HoLD key Exit PROFILE Mode Horizon Nxt Modular Infusion System 950520 Rev F 1 2 The pump will return to the standard Hold state Press HoLD key Press MENU key Press CURSOR keys to select Exit PROFILE Mode Press ENTER key Press CURSOR keys to select YES Press ENTER key The Exit PROFILE mode option will cancel the present run Is this OK Yes No Cursor lt gt amp Press Enter 6 00 PROGRAM Mode This mode lets the user program up to nine different rates and volumes The pump will deliver the fluid sequentially Fluid delivery can be customized for each patient If the pump was turned off while in the PROGRAM Mode this screen will appear 1 Press Cursor keys to select the appropriate message 2 Press ENTER key The pump will return to Program Hold state 1 Press MENU key PROGRAM Operation was Interrupted Resume current PROGRAM Restart PROGRAM Exit PROGRAM Mode 2 Press CURSOR keys to select PROGRAM Mode 3 Press ENTER key Data Entry 1 Press Cursor keys to select Rate or Volume 2 Press DATA keys to change the values 3 Press Cursor keys to select the next period 4 Repeat until all information is entered up to 9 periods Pd Rate Volume 1 0 0 0 0 ZERO 2 0 0 0 0 3 0 0 0 0 VALIDATE TOTAL 0 0 ml Note VALIDATE cannot be selected when 0 0 data is pr
27. esent in the middle of a Program for example NOT ALLOWED Horizon Nxt Modular Infusion System 7 4 950520 Rev F Pd Rate Volume 1 50 0 35 0 2 0 0 0 0 3 30 0 150 0 ZERO VALIDATE TOTAL 0 0 ml 6 00 NOT ALLOWED Pd Rate Volume 1 50 0 35 0 2 35 0 0 0 3 30 0 500 0 ZERO VALIDATE TOTAL 0 0 ml ALLOWED Pd Rate Volume 1 50 0 35 0 2 100 0 500 0 3 0 0 0 0 ZERO VALIDATE TOTAL 0 0 ml 1 Press RUN key to start the infusion 2 Period 1 is infusing as displayed 3 Press ENTER key to display a graph 4 Press ENTER key to return to the text display Each period is represented by a vertical bar which fills as the fluid is infused The height of the bar represents the rate of infusion in that particular period The period presently being infused is displayed in the upper left corner If the vertical bar appears to be missing the rate in that period is much less compared to the other periods Review Change PROGRAM Note A Program cannot be changed after it has been started 1 2 3 1 2 3 Press MENU key Press CURSOR keys to select Review Change PROGRAM Press ENTER key Press CURSOR keys to select rate Press DATA keys to change the rate values Press ENTER key Note Only rate can be changed after an infusion has started 4 5 Restart PROGRAM Horizon Nxt Modular Infusion System 950520 Rev F Press Cursor keys to select Va
28. g in AC System Error SYS Err Turn the pump off and return to Bio medical Professional for service See Help SEEHELP CLOSEROLLERCLAMP then open door Press LOAD and reload tubing Cassette not in place Set Piggyback Rate Set a Piggyback rate Horizon Nxt Modular Infusion System 8 3 6 00 950520 Rev F Set Piggyback Volume Set a Piggyback volume Set Primary Rate Set Primary Volume Set a Primary rate Set a Primary volume Horizon Nxt Modular Infusion System 950520 Rev F 6 00 Cautions Horizon Nxt Modular Infusion System 950520 Rev F Before using the pump in a clinical setting the user should become thoroughly familiar with the proper use of the device as outlined in this Operation Manual The Horizon Nxt Infusion Pump is not intended to substitute for regular patient observation and evaluation Do not attempt to infuse two fluids simultaneously using the Horizon Nxt Infusion Pump Each time the pump is turned on verify that the alarm sounds during the momentary test sequence If the alarm continues to sound or an alarm message is displayed refer to Alarm Procedures Unrestricted fluid flow may occur if the I V set is not properly installed Whenever the pump is being used for epidural infusion the pumps secondary infusion features should not be used To prevent inadvertent infusion of drugs which are not indicated for epidural use only Horizon
29. ill be cancelled The pump will then display the message Rate change aborted and will continue to infuse at the old rate An intermittent alarm will continue to sound to notify the user that a rate change has been attempted and cancelled Pressing any key will silence the alarm With Pump on Hold Horizon Nxt Modular Infusion System 950520 Rev F 3 3 6 00 1 Press the Hor key 2 Press the Data keys to change the rate 3 Press the Run key to start the infusion Horizon Nxt ModularInfusion System 3 4 6 00 950520 Rev F Chapter 4 MENUS Main Menu Alternate Menu Horizon Nxt Modular Infusion system 950520 Rev F The Horizon Nxt can be customized to fit your specific needs The User Menu and Alternate Menu contain options identified by each individual hospital The following options will always appear in one of the 2 menus Change Alarm Volume changes the volume of the audible alarm Clear Total Infused clears the total IV fluid infused shown on the Information Screen Dose Mode calculates the rate or dose information necessary for use with many critical drug infusions Occlusion Limit sets the occlusion pressure limit to 75 100 200 300 400 or 500 mmHg Alternate Menu lists options used less often by the user Exit from Menu returns to the Information Screen Calculate BSA calculates the body surface area BSA Set LCD Contrast changes the readability of the Information Screen Biomed Option
30. imit 4 1 4 3 Occlusion Warning Notification 5 1 5 4 P Panel Lockout Switch 2 3 Piggyback Callback 3 3 5 1 5 5 Piggyback Fluids 3 2 Piggyback Indicator Key 2 2 Power Key 2 2 2 4 Profile Mode 5 1 7 1 Change Profile Parameters 7 1 Data Entry 7 1 Exit PROFILE Mode 7 3 Immediate Ramp Down 7 2 Restart PROFILE 7 2 Review Change PROFILE Data 7 2 Set Profile Parameters 7 1 Program Mode 5 1 7 4 Data Entry 7 4 Exit PROGRAM Mode 7 6 Restart PROGRAM 7 6 Review Change PROGRAM 7 5 Skip PROGRAM Periods 7 6 Horizon Nxt Modular Infusion System Index 2 6 00 950520 Rev F Q q x Schedule 5 1 5 5 S Schedule Next Run 5 1 5 9 Select MAX Pressure 5 1 5 10 Set Time amp Volume 5 1 5 11 Site Trend 5 1 5 12 Standard Mode 2 1 For Primary Fluids 3 2 For Piggyback Fluids 3 2 Sympathetic flow 3 3 T Titration 3 3 6 4 Horizon Nxt Modular Infusion System 950520 Rev F Index 3 6 00
31. in the device As a general recommendation for cleaning and disinfection of this device use a lintfree cloth dampened with a 0 5 Sodium Hypochlorite solution one part bleach with nine parts water The solution is most effective when prepared weekly and allowed to remain on the device for approximately 10 minutes prior to wiping off Please be sure NOT to use abrasive cleaning tools or pressurized spraying devices for these may damage the pressure transducer or cause fluid intrusion Warning To avoid mechanical or electronic damage do not steam autoclave or immerse the pump in any fluids or cleaning solutions Caution To avoid electrical shock turn off the pump and disconnect it from the electrical outlet before cleaning Sterilization of the pump using ethylene oxide EtO gas is not recommended 8 1 6 00 Alarm Procedures Horizon Nxt Modular Infusion System 950520 Rev F An alarm notifies the user that the condition indicated on the Information Display has occurred and that corrective action must be taken to continue the infusion process When an alarm condition occurs the following steps are recommended 1 2 3 4 5 Press the HoLD key Press the MENU key to display on the Information Display the correction messages contained in the Correction column of the Troubleshooting Guide Correct the cause of the alarm Press the Run key to restart the infusion Monitor the process according to hospita
32. ing Monitor Docking allows the Horizon Nxt with MedScan to communicate with select monitoring systems to display current infusion parameters Parameters displayed may vary depending on which monitoring system is being used Refer to Monitor Docking Guide for operations and troubleshooting Set up Clamp the Serial Data Communication IR Infrared Module over the Serial Data Communication fluid resistant window on the back of the Horizon Nxt pump whose information you wish displayed 1 Grasp the Serial Data Communication IR Module with index finger on top and thumb on grooved surface on the bottom 2 Hook the top of the unit onto the pump and with thumb press the grooved surface to clamp the bottom of the unit on the pump Occlusion Warning Occlusion Warning is designed to alert the clinician of downstream resistance An audible warning three beeps and visual a indication will occur 5 times at 5 second intervals before alarming Occlusion This option must be turned on by the Biomedical Department Horizon Nxt with MedScan Modular Infusion System 950520 Rev F 5 4 6 00 Piggyback Callback PROFILE Mode Piggyback Callback if activated continues the primary infusion at a KVO rate and causes the pump to alarm This feature may be accessed during the Run or Hold states 1 Press MENU key 2 Press the Cursor key to select Alternate Menu 3 Press ENTER key 4 Press Cursor keys to select Piggyback Callb
33. ion is entered or the dose when rate information is entered The pump is equipped with distinct audible and visual alarm signals to indicate KVO low battery and actual alarm conditions Epidural Administration The Horizon Nxt can be used for epidural administration of anesthetic and analgesic drugs Caution Whenever the pump is being used for epidural infusions the pump s secondary infusion features should not be used For epidural administration of anesthetic drugs use indwelling catheters specifically indicated for short term 96 hours or less anesthetic epidural drug delivery 1 2 6 00 For epidural administration of analgesic drugs use indwelling catheters specifically indicated for either short term or long term analgesic epidural drug delivery When the Horizon Nxt is being used for epidural infusions the source container and administration set should be clearly differentiated from source containers and administration sets used for other routes of infusion Caution To prevent inadvertent infusion of drugs which are not indicated for epidural use only Horizon microbore administration sets without injection sites that are specified for epidural administration of drugs should be used Following an occlusion alarm a small amount of fluid may be delivered Use of a microbore set assures this is less than 0 1 mL The administration of drugs is restricted to those anesthetic and analgesic drugs labeled for co
34. l policy There are 3 types of alarms 1 2 3 Operation alarms Press the MENU key to see the Help Screen which contains the guidelines in the Correction column of the Alarm Troubleshooting Guide Clear the alarm by pressing the HoLD key System alarm Press the HoLD key and press the Run key to restart the infusion Repair Instrument alarm Press the HoLD key and turn the pump off and then on again Similiar to rebooting a personal computer If the alarm recurs return the pump to a Biomedical Professionial for service For assistance call 800 627 PUMP 8 2 6 00 Alarm Troubleshooting Guide MESSAGE LED MESSAGES CORRECTION Air in Line Air Air in downstream tubing Tubing improperly inserted in Air in Line Detector Battery Very Low Use AC Plug into AC power NOW to contin ue operation Container Empty SOLU Check for air in set IV container empty Check upstream clamp Check cassette installation Door Open door The door must be shut to deliver flu id Downstream Occlusion OCCL Clamp closed or filter blocked Tubing kinked IV positional or infiltrated Catheter or vein too small Check occlusion limit Hold Time Exceeded HOLd Press Hold key three minute time period is restarted KVO flashing LED s Pump is operating in Keep Vein Open state Infusion is complete Set volume to be delivered Restart or turn off the pump Low Battery PLUG IN Battery too low plu
35. lectromagnetic fields The field may permanently damage the pump For further information consult the manufacturer of the equipment in question To avoid mechanical or electronic damage do not steam autoclave or immerse the pump in any fluids or cleaning solutions A possible electrical shock hazard exists 1f the case of the pump is opened or removed Refer all servicing to authorized service personnel Do not use visibly damaged pumps or pumps with bent damaged or missing components Pumps should be tested for proper performance semiannually Federal U S A law restricts this device to sale by or on the order of a physician 8 6 6 00 Service and Performance Information If the pump fails to respond to the operating or troubleshooting procedures listed in this manual and the cause cannot be determined discontinue using the pump and forward it to an authorized B Braun Medical Service Center Should it be necessary to return the pump for repair contact Customer Service at the phone number below for a Returned Goods Authorization RGA number then carefully pack the pump preferably in the original packing and ship it prepaid to the address below B Braun Medical cannot assume any responsibility for loss or damage to returned instruments while they are in transit Service and product performance information operation training service training and service manuals may be obtained from the manufacturer by contacting B B
36. lidate Press ENTER key 7 5 6 00 1 3 4 1 3 Press HoLD key Press the MENU key Press CURSOR keys to select Restart PROGRAM Press ENTER key Press CURSOR keys to select Yes Press ENTER key Press RUN key Skip PROGRAM Periods 1 2 3 4 Press HoLD key Press MENU key The Restart PROGRAM option will cancel the present run Is this OK Yes No Cursor lt gt amp Press ENTER Press CURSOR keys to select Skip PROGRAM Periods Press ENTER key Press the Data keys for VTBD to remove the volume The bar on the graph moves to show the volume skipped Press ENTER key Press RUN key tl Skip 0 0 ml 12 0 left Press ENTER when done Upon completion of the program the pump enters the KVO state Press the HoLD key Exit PROGRAM Mode 1 Press HoLD key 2 Press MENU key 3 Press CURSOR keys to select Exit PROGRAM Mode 4 Press ENTER key Horizon Nxt Modular Infusion System 950520 Rev F 6 00 Chapter 8 MAINTENANCE Cleaning Horizon Nxt Modular Infusion System 950520 Rev F Clean the pump with a soft lint free cloth or swab dampened with soap and water a general nonstaining chemical disinfectant or alcohol 90 concentration or less DO NOT use acetone solutions containing glutaraldehyde ammonium chlorides or abrasive cleansers on the pump If you feel it necessary Betadine or Iodine solutions may be used but they will sta
37. mg in 5 ml mcg kg min 10 mg in 5 ml 0 mg in 0 ml Horizon Nxt Modular Infusion System 9 5 6 00 950520 RevF Caution Federal Law restricts this device to sale by or on the order of a physician B Braun Medical Inc Carrollton TX USA 75006 Horizon Nxt Modular Infusion System 9 6 6 00 950520 RevF INDEX A Air In Line 2 3 Alarm Procedure 8 2 Alarm Volume 4 1 4 2 Alternate Menu 4 1 B Battery Operation 2 4 Blood Infusion 1 3 Body Surface Area BSA 4 1 4 4 C Calculate BSA 4 1 4 4 Cassette Alignment Pins 2 3 Cassette Removal 3 1 Change Alarm Volume 4 1 4 2 Changing the Rate 3 3 Check Battery Level 5 1 5 2 Clear Total Infused 4 1 4 2 D Daisy Chaining 2 4 Data Keys 2 2 2 4 Dose Mode 2 1 4 1 6 1 Body Weight 6 2 Calculated Parameter 6 2 Change Medication 6 1 Change SETUP Parameters 6 3 Clear Medication 6 1 Concentration Screen 6 2 Data Screen 6 2 Drug Menus 6 1 Enter Data 6 3 Epidural 6 2 Exit Dose Mode 6 4 Titrate Dose 6 4 Titrate Rate 6 4 E Enter Key 2 2 2 4 Epidural Administration 1 2 5 9 6 2 F Free Flow Protection Clip 2 3 Horizon Nxt Modular Infusion System 950520 Rev F Index 1 6 00 H Hold Extender 5 1 5 3 I Illustrations Front View 2 2 Rear View 2 3 Inside the Door 2 3 K KVO 2 1 L LCD Contrast 4 1 4 4 M Menu Key 2 2 2 4 Micro Rate Limit 5 1 5 3 Monitor Docking 5 4 O Occlusion l
38. ng ramp up and ramp down time Program Mode offers maximum flexibility in customizing IV fluid administration Up to 9 separate periods of fluid volume can be infused sequentially q x Mode can be used for the periodic infusion of antibiotics chemotherapy or other IV infusions according to a schedule set by the user Assure that there is a maintenance IV infusing in the intervals between pump infusions There are 4 operating states Hold silences an alarm stops an infusion or is a quick escape from the menu Alarm stops an infusion to notify the user of an error KVO 3 mL hr for delivery rates of 3 to 999 9 mL hr or the continuation of the delivery rate for 0 1 to 2 9 mL hr settings Run starts the infusion 2 1 6 00 Illustrations Figure 1 Front View 1 Alarm Indicator 12 Hold Key 2 Run Indicator 13 Menu Key 3 Hold Indicator 14 Cursor Keys 4 Battery Use Indicator 15 Enter Key 5 AC Use Indicator 16 Piggyback Rate Display 6 Power Key 17 Piggyback Volume Display 7 Primary Indicator Key 18 Information Screen 8 Piggyback Indicator Key 19 Primary Rate Display 9 Primary Run Key 20 Primary Volume Display 10 Piggyback Run Key 21 Door Lever 11 Data Keys 000000 Horizon NxtQ Modular Infusion System 950520 Rev F foe T ert mol al ml Y 6 00 Figure 2 Rear View 1 Panel Lock Out Switch 2 Serial Communica
39. ntinuous epidural administration Warning Serious injury to the patient may result from epidural administration of drugs other than those specifically labeled for epidural use Blood Infusion The Horizon Nxt can be used for infusion of blood and blood products For blood infusion a Horizon Pump Blood Set should be used Do not attempt to piggyback blood The normal saline roller clamp on the blood tubing set must be clamped off The high viscosity of blood will cause the saline to infuse before the blood if both clamps are left open q x The Horizon Nxt can be used for the periodic infusion of antibiotics chemotherapy or other IV infusions according to a schedule set by the user Assure that there is a maintenance IV infusing in the intervals between pump infusions Horizon Nxt Modular Infusion System 1 3 6 00 950520 Rev F Chapter 2 PRODUCT DESCRIPTION Operating Modes Operating States Horizon Nxt Modular Infusion System 950520 Rev F The Horizon Nxt has been developed in reponse to the special needs of all caregivers in the medical setting The Horizon Nxt pump has five operating modes Standard Mode for simple IV fluid delivery with piggyback capability Dose Mode used for administration of medication where concentrations and doses are critical The pump will automatically calculate either the dose or rate Profile Mode offers a tapered delivery mode for infusing TPN or other fluids requiri
40. oth on the Run Hold screen and when Site Trend graph is displayed Each of the above options are described more fully in this chapter The options are listed in alphabetical order Horizon Nxt with MedScan Modular Infusion System 5 1 6 00 950520 Rev F Check Battery Level Three states of the battery are possible discharging charging or fully charged Prior to unplugging the pump for transport purposes this feature makes it easy to determine the state of the battery 1 Press MENU key 2 Press CURSOR key to select Alternate Menu 3 Press the Menu key 4 Press CURSOR key to select Check Battery Level 5 Press ENTER key One of the three graphs below will be displayed Discharging Th i l i e pump is unplugged or running dim tal on battery DISCHARGING EXIT Charging The pump is not fully charged pump y Check Battery Level CHARGING Fully Charged Th i r more charged Pp Oo EHATE Check Battery Level FULLY CHARGED EXIT Press the ENTER key to return to the Hold or Run state Horizon Nxt with MedScan Modular Infusion System 5 2 6 00 950520 Rev F Hold Extender The normal Hold Time is 3 minutes Use this option to extend that time to a maximum of 120 minutes 1 Press HOLD key to add time in Dado 3 minute increments or 2 Press Cursor keys to select the Press HOLD to add 3 min hours or minutes and use DATA Cursor to change keys to change the value
41. r implied by operation of law or otherwise including but not limited to any implied warranties of merchantability or fitness since handling storage and cleaning of these devices as well as factors relating to other matters beyond B Braun Medical s control directly affect these devices and the results obtained from their use B Braun Medical shall not be liable for any incidental or consequential loss damage or expense directly or indirectly arising from the use of this device other than replacement of all or part of it B Braun Medical neither assumes nor authorizes any other person to assume for it another or additional liability or responsibility in connection with this device This warranty will not apply to any Horizon Nxt or component thereof which has been 1 repaired by anyone other than an authorized B Braun Medical trained technician or repair facility 2 altered in any way that in B Braun Medical s judgement affects its stability or reliability 3 subjected to misuse negligent handling or accident 4 used in any manner not in accordance with the instructions furnished by B Braun Medical in the Operation and or Service Manual This warranty extends only to the first purchaser or lessee and does not extend to and may not be enforced by any other person 1 1 6 00 Intended Use Horizon NxtQ Modular Infusion System 950520 Rev F The Horizon Nxt is intended for use with B Braun Medical Horizon I
42. ration Dosage Units Alfentanil 3 5 mg in 7 ml 500 mcg in 1 ml 0 mg in 0 ml mcg kg min Aminocaproic Acid 15 g in 500 ml 15 g in 250 ml 0ginOml g hr Aminophy mg hr 500 mg in 500 ml 500 mg in 250 ml 0 mg in 0 ml mg hr Aminophy mg kg hr 500 mg in 500 ml 500 mg in 250 ml 0 mg in 0 ml mg kg hr Amiodarone 150 mg in 100 ml 900 mg in 500 ml 0 mg in 0 ml mg min Amrinone 500 mg in 500 ml 500 mg in 250 ml 0 mg in 0 ml mcg kg min Bretylium 2 g in 500 ml 4 g in 500 ml 0ginOml mg min Cisplatin 0 mg in 1000 ml 0 mg in 500 ml 0 mg in 250 ml mg m hr Cyclophosphamide 0 mg in 0 ml 0 mg in 0 ml 0 gm in 0 ml mg kg min Dexamethasone 0 mg in 0 ml 0 mg in 0 ml 0 mg in 0 ml mg kg hr Diltiazem 125 mg in 125 ml 250 mg in 250 ml 0 mg in 0 ml mg hr Horizon NxtQ Modular Infusion System 950520 RevF 6 00 Name Concentration Dosage Units Dobutamine 500 mg in 500 ml 500 mg in 250 ml 0 mg in 0 ml mcg kg min Dopamine 400 mg in 500 ml 400 mg in 250 ml 0 mg in 0 ml mcg kg min Doxorubicin 0 mg in 0 ml 0 mg in 0 ml 0 mg in 0 ml mg m min Epinephrine 1 1000 3 mg in 250 ml 6 mg in 250 ml 0 mg in 0 ml mcg min Esmolol 5 g in 500 ml 5 g in 250 ml 0 mg in 0 ml mcg kg min Etoposide VP 16 0 mg in 0 ml 0 mg in 0 ml 0 mg in 0 ml mg m hr Fentan
43. raun Medical Inc 1601 Wallace Drive Suite 150 Carrollton Texas 75006 USA Attn Manager of Service Or call 800 627 PUMP Product complaints may be sent to the Manager of Quality Assurance at the above address With each complaint please include 1 The pump s serial number 2 Software Revision 3 A description of the difficulty experienced 4 The pressure limit setting 5 The rate setting 6 The initial volume s to be infused 7 The type of fluid s 8 The amount of time between the start of the infusion and the time the difficulty was noticed 9 The message displayed at the time the difficulty occurred 10 The catalog and lot number of the set s in use 11 Any other information which might aid in the investigation of the complaint Horizon Nxt Modular Infusion System 8 7 6 00 950520 Rev F Specifications Mechanism Volumetric Non Drop Counting Positive Pressure Displacement Reservoir Dimensions Width 12 4 31 5 cm Height 4 8 12 2 cm Depth 12 2 31 5 cm Weight Approximately 11 9 lb 5 4 Kg Power Requirements 90 132 VAC 30 Watts 47 63 Hz excluding accessories domestic 180 264 VAC 30 Watts 47 63 Hz excluding accessories Inter national Grounding Resistance Meets UL Standard 544 Leakage Current Meets or exceeds UL Standard 544 Section 27 2 and ANSI AAMI Safe Current Limits July 9 1985 Plug Hospital Grade 3 pin Pole Size Range 0 7
44. ring The switch can only be used while the pump is infusing Daisy chaining allows up to 5 Horizon Nxt or Horizon pumps to be plugged into each other with only one pump plugged into a wall outlet On the side of each Horizon Nxt pump is an electrical outlet Only another Horizon or Horizon Nxt pump should be plugged into that outlet Caution To daisy chain more than 5 pumps verify that the total leakage current as a system does not exceed 100 uA The Horizon Nxt has been equipped with an internal rechargeable battery which will power the pump automatically if the plug is disconnected during use Battery power is provided as a back up system only and the length of the battery life is affected by the rate of delivery Whenever possible the pump should remain plugged into an electrical outlet The Battery Use indicator will be lit when the pump is operating on its battery The pump must remain plugged into a hospital grade electrical outlet for at least 24 hours to fully recharge the battery from a totally discharged condition 2 4 6 00 Chapter 3 PRINCIPLES OF OPERATION Cassette Removal Horizon NxtQ Modular Infusion System 950520 Rev F Caution Use only with B Braun Medical Horizon I V Sets 1 2 3 4 5 6 To attach the pump to the I V pole a Press down on the pole clamp lever b Position the pump on the pole make sure the pole is up against the slot of the pump c Release the pole clamp
45. rom the pump will automatically stop the flow of fluid in the tubing If gravity infusion is desired close the roller clamp open the Free Flow Protector Clip and adjust the flow with the roller clamp 3 1 6 00 Standard Mode For Primary Fluids 1 Press the PRIMARY INDICATOR key 2 Press the Data keys to enter the rate and volume 3 Press the PRIMARY RUN key to start the infusion 4 Press the PANEL Lock OUT SwITCH to make the key panel tamper proof if desired The time left total infused and occlusion pressure limit are shown on the Information Screen Monitor the infusion according to hospital policy After the infusion is complete the pump will alarm and go into the KVO state For Piggyback Fluids The Piggyback option can only be enabled by Biomedical personnel The piggyback option is not available while operating the pump in the Dose Mode Caution Do not attempt to infuse both fluids simultaneously using this method 1 Prepare IV fluids according to the set package Use primary sets with check valves 2 Connect the piggyback set to the upper injection site the site above the pump on the primary set 3 Lower the primary bag at least 8 inches Note To minimize or prevent fluid flow from the primary container during Horizon NxtQ ModularInfusion System 3 2 6 00 950520 Rev F Piggyback Callback Changing the Rate a piggyback infusion sympathetic flow it may be necessary to lower the primary
46. s allows access to the Biomed Menu Exit from Menu returns to the Information Screen 4 1 6 00 Change Alarm Volume The volume of the alarm can be changed to low medium or high 1 Press MENU key 2 Press CURSOR keys to select Change Alarm Volume 3 Press ENTER key 1 Press Cursor keys to change the intensity of the alarm 2 Press ENTER key Change Alarm Volume Low Medium High Move Cursor amp Press ENTER The pump will return to the previous Hold or Run state Clear Total Infused This feature clears the Total Volume displayed on the Information Screen Note The volume can be cleared while the pump is running 1 Press MENU key 2 Clear Total Infused is already selected 3 Press ENTER key 1 Press ENTER key 2 The total volume displayed on the Information Screen goes to zero The present Total Infused of 125 02 ml will be zeroed Is this OK Cursor Yes No amp Press ENTER The pump will return to the previous Hold or Run state Dose Mode The Dose Mode is fully described in the Dose Mode Chapter Horizon Nxt Modular Infusion System 4 2 950520 Rev F 6 00 Occlusion Limit This feature lets the user change the occlusion pressure limit to 75 100 200 300 400 or 500 mmHg At rates of 400 mL hr and higher the pressure setting is automatically increased to 400 mmHg Occlusion pressure is a threshold valu
47. ss HoLD key 2 Press MENU key 3 Press Cursor keys to select Select MAX Pressure 4 Press ENTER key The occlusion pressure is 750 mmHg To change the occlusion pressure from 750 mmHg turn the pump off and then on again or Horizon Nxt with MedScan Modular Infusion System 5 10 6 00 950520 Rev F See Occlusion Limit to change the value Set PROFILE Parameters Set PROFILE Parameters is described in Chapter 7 Special Modes Set Time and Volume Horizon Nxt with MedScan Modular Infusion System 950520 Rev F Use this feature when an infusion rate is defined by time and volume The pump calculates the delivery rate 1 2 3 4 5 7 Press HoLD key Press MENU key Press CURSOR keys to select Set Time and Volume Press ENTER key Press CURSOR keys to select hr or min Press DATA keys to enter the Set Time and Volume correct hours and minutes Rate 125 00 ml hr Press Cursor keys to select ml Time 8 hr 00 min Press Data keys to enter the Volume 1000 ml volume VALIDATE Press Cursor keys to select VALIDATE Press ENTER key Press the Run key to start the infusion 5 11 6 00 Site Trend Site Trend graphically displays the resistance to downstream fluid flow for three intervals of time MAX MED and MIN 1 Press MENU key 2 Press the Cursor key to select MAX Site Trend Exit Alternate Menu 3 Press ENTER key a nao RS 4 Press CURSOR
48. tion Data Port Q O B Braun Medical Carrollton TX 75006 A SERIAL DATA Caution e e Oi COMMUNICATION the order of e physician langir Possible explosion hazerd If used in the presenca of fionmabie anesthetics Coutlon Electricol shocks hazerd d net open cose Plug into hespital grade electrico LOCK OUT outlets for proper grounding MOVAC Ghz 2000 5 PUNPS edO CEA sbenderd C32 2 Ne 125 Rish Class 2G Patent Nes 4 301 908 4 431 425 2057 0 Figure 3 Inside the Door 1 Cassette Alignment Pins 2 Air In Line Detector 3 Free Flow Protection Clip Horizon Nxt Modular Infusion System 2 3 6 00 950520 Rev F Important Keys An understanding of the function and location of these keys will assist in the use of the pump From Figure 1 e Power key 6 turns the pump on and off e Data keys 11 allow input of data values e Hold key 12 silences an alarm stops an infusion is a quick escape from the menu and extends the Hold state an additional 3 minutes every time it is pushed if Hold Extender is active e Menu Key 13 lets the user see options using a menu screen e Cursor keys 14 move the cursor bar on the Information Screen Enter key 15 validates or accepts the selection made From Figure 2 Daisy Chaining Battery Operation Horizon Nxt Modular Infusion System 950520 Rev F e Panel Lock Out Switch locks the keypanel to prevent tampe
49. ve to the appropriate parameter 2 Press the up or down Cursor keys to change to the correct parameters mcg change lt gt move kg min to units hr Press ENTER when done 3 Press ENTER key mcg kg min mg kg The rate can be titrated while the pump is running Press the Data keys to change the rate The dose is recalculated and shown The ENTER key or RUN key must be pressed within four seconds to validate the change Once made the pump infuses at the new rate Note If the ENTER key or Run key is not pressed within 4 seconds of entering a new rate a series of error beeps will occur and the rate change will be cancelled The pump will then display the message Rate change aborted and will continue to infuse at the old rate An intermittent alarm will continue to sound to notify the user that a rate change has been attempted and cancelled Pressing any key will silence the alarm 1 Press ENTER key 2 Press Cursor keys to select the Dose value 3 Press Data keys to change the values 4 Press Cursor keys to select VALIDATE 5 Press ENTER key Monitor the infusion as indicated by hospital policy The pump will alarm and go into the KVO state when the volume is infused KVO DOSE COMPLETE is shown on the Information Screen 1 Press the HoLD key 2 Press the Data keys to put in a new volume 3 Press RUN key to start infusion 1 Press HoLD key 2 Press MENU key 3 Press Cursor keys to select Exit DOSE Mode
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