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Graseby 500 & 3000 Infusion Pump User Manual

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1. Tarer uF 1h Bm Fress when set Ter down 8h 45m Press when set Maximum 174 mLzh To continue Cannot infuse To review RUM to infuse Resets Tarer Tafer A mL this infusion Options When the infusion time is correct press the key Enter the hours and minutes for the taper up period enter zero hours and minutes if you do not want to taper up When the correct Taper up time period is entered press the key Enter the hours and minutes for the taper down period enter zero hours and minutes if you do not want to taper down When the correct Taper down time period is entered press the key The pump calculates the maximum rate that is required to complete the Rate Taper infusion within the specified time period If the maximum rate is correct for the patient press the key If you need to change the maximum rate press the key twice to take you back to step 2 and adjust the program a longer total time may be required If was pressed and this display appears then you need to review the program you have set You will have to adjust to the volume time and or maximum rate value Press the key This takes you back to step 2 to review the program values If ready to start the Rate Taper infusion press the Run key or press the key to review your settings If you pressed the key t
2. YAm Sec infusion The Volume to be Infused display shows the volume remaining for the Secondary infusion The Secondary volumes are kept separate from the Primary totals To view the combined infusion volume press Total Volume Bolus totals If you have carried out a Bolus infusion you can view the volumes as follows 1 Press the Secondary Bolus key 2 Press 3 to choose the Bolus volume 3 The Message Display shows the infused volume for the Bolus infusion as shown in this example 3 2 mL Bolus infusion The Bolus volumes affect the Primary infusion volumes The volume that was infused as a Bolus is added to the Primary infusion volume infused figure and deducted from the Primary infusion Volume to be Infused figure Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Re running infusions at the same rate When an infusion is complete you may want to repeat it with the same Rate and VTBI values The Rate is still displayed but you need to bring back the previous VTBI You can either bring back the VTBI and start the infusion immediately or bring back the VTBI to check it before you start the infusion To bring back the VTBI and start the infusion immediately 1 Press the Volume to be Infused key TWO TIMES The VTBI is not displayed at this point 2 Press the Run key When you press Run the VTBI value for the previous infusio
3. 9 dreug bag For new mode Press the key repeatedly to display g MG and mcg When the display is correct enter the drug amount value from the keypad Volumetric Infusion Pump Instruction Manual 3 21 Options Graseby Medical Ltd When entering the amount the precision depends on the units you are using See the Specification at the end of the manual for the increments for each range When the dosing rate mode selected requires units input only units bag appears in the Message Display Once you have entered the drug amount you are next asked to enter the volume of the bag This is used with the drug amount to calculate the drug concentration Programming the volume When you enter the volume display you see a display similar to the following 2548 mL in bad Press when set For the range of volumes that can be entered see the section on Primary and Secondary infusion in the Specifications at the end of this manual Enter the number of millilitres in the fluid container This must be the volume when the bag is full It is used to calculate the concentration When the setup is complete When the programming steps for the Dose Rate Calculation infusion are completed the display shows that the infusion is ready to run or be reviewed RUM to infuse Reviews Dosing You will need to review if an invalid rate is calculated and the Message Display s
4. Using the pump on battery The pump contains an internal rechargeable battery However in everyday use the pump should be connected by its cord to a suitable AC mains supply if one is available The battery is then kept fully charged and will continue to be charged whilst the pump is infusing The pump automatically uses the battery e if you switch on whilst the power cord is unplugged or e if the AC power fails whilst the pump is operating Switching on using the baitery When you switch on the pump if it is being powered by internal battery e you need to hold down the On Off key to turn the pump on If the pump is operating on the AC mains supply it switches on instantaneously when you touch the On Off key e there is a short pause whilst the pump carries out the Battery Test and displays the Battery Gauge screen to indicate the current battery capacity LOW battery FULL Note The battery is always tested when the pump is switched on even though the Battery Gauge is not displayed during Dose Rate Calculation DRC Recovery or Rate Taper infusion start up Testing the battery At any time when operating on battery you can check the battery capacity by carrying out the Battery Test described in Chapter 3 Options Operating using the battery During operation of the pump on battery e the yellow Battery indicator is lit e the Message Display light turns off if the pu
5. Verify that the rate and volume to be infused settings are correctly displayed Open the roller clamp on the Secondary administration set Press the Run key to start the Secondary infusion The Message Display shows the volume infused When the infusion is complete see Ending a Secondary infusion on page 2 32 Volumetric Infusion Pump Instruction Manual 2 29 Operating the pump Graseby Medical Ltd Secondary infusion Bolus enabled This section shows the different screens and the additional step for a Secondary infusion with the Bolus feature enabled on the Technician Menu Max SE Rate 750 Press when set Secondary Bolus Press 1 oor 3 Se mL Secs infusion a C a 2 one lo T3 Jm Seg infusion 2 Secondary Bolus Press the Hold key if the pump is running IfSecondary Min and Max Rates and Max Secondary VTBI are enabled on the pump ensure that they are appropriate for the infusion by pressing the Options key To find out more see page 2 15 Press the Secondary Bolus key With the Bolus feature is enabled the Message Display tells you to press 1 for Secondary or 3 for Bolus To enter the Secondary rate press 1 The Message Display shows the volume of the previous Secondary or Bolus infusion The yellow Secondary indicator is lit Press the Rate key and enter the Secondary infusion rate in mL h Press
6. or 220 240 V AC 80 mA 50 60 Hz Battery type Rechargeable sealed lead acid 12 Volt 1 3 Ah Battery operating time 6 hours at 100 mL h 99 9 mL h on Micro 505 with approximately 1 2 hour warning of discharged battery Battery recharge time Approximately 10 hours depending on the operating conditions The batteries will be charging during an infusion Leakage current 100 to 120 V less than 20 microamps ungrounded or 220 to 240 V less than 50 microamps ungrounded This is measured between the ground stud and the earth protective prong of the AC mains connector Over current protection Voltage AC line fuse Thermal fuse Battery fuse 100 to 120 V 200 mA 130 1 0 amp 220 to 240 V 2 x 80 mA 130 1 0 amp Note All fuses are time delay fuses Volumetric Infusion Pump S 3 Specification Graseby Medical Ltd Primary and Secondary Infusions Rate range Model 500 Range Increment 0 1 to 99 9 mL h 0 1 mL h 1 to 999 mL h 1 mL h Micro 505 Range Increment 0 1 to 99 9 mL h 0 1 mL h Volume to be infused Model 500 Range Increment 0 1 to 999 9 mL 0 1 mL 1 to 9999 mL 1mL Micro 505 Range Increment 0 1 to 999 9 mL 0 1 mL Rate Taper Infusions Rate range Model 500 Range Increment 0 1 to 99 9 mL h 0 1 mL h 1 to 400 mL h 1mL h Micro 505 Range Increment 0 1 to 99 9 mL h 0 1 mL h Volume to be infused Model 500 Range Increment 0 1 to 999 9 mL 0 1 mL 1 to 4400 mL 1mL Micro 505 Range
7. Capacity A new fully charged battery will operate the pump for approximately 6 hours at 100 mL h 99 9 mL h on Micro 505 The battery may discharge more quickly if the battery has aged and is in a poor condition even though it was recently charged Pump in storage You should connect the pump to the AC mains supply to charge the battery every three months even when the pump is not in service This helps to maintain the life of the battery Volumetric Infusion Pump Instruction Manual Operating the pump Graseby Medical Ltd Sounds on the Volumetric The Volumetric pump makes a click sound as you press each key It also sounds an audio alarm to alert you toa condition that requires attention on the pump either an insistent three tone or non insistent two tone alarm The click and non insistent alarm do not sound if the pump is switched on in Quiet Pump mode See next page As a further safety feature the Volumetric emits a high pitched system alarm to indicate a problem requiring the attention of a Graseby Medical qualified technician Audio alarm When the Volumetric pump requires attention it uses an audio alarm to indicate that there is a problem Whilst sounding the alarm it also displays a message to explain the problem A full list of all the alarm messages their possible causes and how to solve the problem is explained in Chapter 4 Troubleshooting This section explains the different
8. Graseby Medical Ltd Troubleshooting Insistent alarms continued Message display Possible causes Action Ho flow Insufficient flow from 1 If the fluid container is above FUME the container to the empty replace it pump 2 Raise the height of the fluid container so that the bottom of the drip chamber is 15 30 cm 6 to 12 inches above the top of the pump 3 Open the upper clamp if closed remove any rest riction to the upper tubing 4 Replace the admin set if there is damage to the spike or other admin set problem Dec lusion Pressure below pump Open the lower roller clamp below FUME exceeds the Occlusion remove any restriction to the Alarm Setting lower tubing Change the Occlusion Alarm Setting if not appropriate for infusion Verify patient catheter is patent Pump is on hold for Press the Silence or Hold key On Hold 2 minutes with the to silence the alarm door closed Press the Run key to start the or 6 minutes with the infusion or turn the pump off door open if not in use Secondary Secondary Bolus Press the Silence or Hold key Complete infusion ended and to silence the alarm Secondary Stop has Press the Primary key been enabled on the Press Run to start the Primary Technician Menu infusion Note In Medium or High occlusion alarm settings when downline pressure exceeds the alarm threshold the motor pauses the Run key remains lit and th
9. If this happens you should 1 Silence the alarm 2 Check the Rate or VTBI display to see which has changed to find out which limit has been exceeded start running 3 Check the prescription 4 Check the Min and Max Rate and Max VTBI settings by pressing the Options key until each is displayed 5 Make corrections as necessary 6 Press Run to start the infusion 2 20 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Infusion information displays Message Display The Message Display starts at zero and counts up in mL to show the volume infused so far for example 1 4 mL this infusion Rate display and Pumping indicator The Rate display shows the infusion rate The Pumping indicator is a horizontal line located at left of the Rate display The indicator moves to show that the solution is being infused The speed of the Pumping indicator is approximately proportional to the infusion rate Volume to be Infused display The Volume to be Infused display initially shows the programmed volume During the infusion it counts down to show the volume remaining for this infusion Volume to be Infused Original volume to be infused To find out the original programmed Volume to be Infused add the amount in the Volume to be Infused display to the amount in the Message Display Running Rate Change Rate titration Whilst the pump is r
10. If you press the Options key when an infusion is running you will also see the current label but will not be able to change it Drug Library This is a complete alphabetical list of the drug labels retained in the pump s memory Due to the number of characters that the pump can display some of the drug names have been shortened or abbreviated The drug label provides a visual reminder of the name of the drug but it does not control any pump features It is your responsibility to ensure that the correct drug name is selected Acetylcysteine Doxorubicin Propofol Alfentanil Droperidol Prostaglandin Aminophylline Epidural Remifentanil Carboplatin Fentanyl Bupiv Ritodrine Cisplatin Fluorouracil Ropivacaine Cyclophosphamide Hartmanns Saline Dextrose Heparin Syntocinon Dextrose Saline Morphine TPN Dobutamine Nitroglycerine Dopamine Nitroprusside Doxapram Oxytocin 3 34 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Crug Label Herariri Options Checking the current drug label Switch the pump off and then on or Press when the pump is on hold or infusing Herariri to change drug to clear label 4 t for new drug Synta ocinon 4 t to confirm Syntocinon to change drug Crud Label SyAbLoOc AON o1 Selecting a new drug label 1 Press Hold if the pump is infusing 2 Press the Options key until you se
11. foe i Y Graseby Instruction Manuals This publication has been compiled and approved by Graseby Medical Ltd for use with their respective products It is supplied in this format to permit users to access the text and illustrations for their own use e g training and educational purposes Users of the equipment must ensure that they have read and understood the contents of the complete manual including the warnings and cautions and have been trained in the correct use of the product Graseby Medical Ltd cannot be held responsible for the accuracy and any resulting incident arising from information that has been extracted from this manual and compiled into the users documentation These manuals are subject to revision and it is the users responsibility to ensure that the correct version of manual text illustration is used in conjunction with the equipment ACCEPT REJECT Model 500 and Micro505 Volumetric Ny nfusion gt Instruction anual Published by Graseby Medical Limited All possible care has been taken in the preparation of this publication but Graseby Medical Limited accepts no liability for any inaccuracies that may be found Graseby Medical reserves the right to make changes without notice both to this publication and to the product which it describes Copyright 2002 Graseby Medical Limited No part of this publication may be reproduced transmitted transcribed or stored in a retri
12. 16 3 28 preset limits exceeded 2 20 Trumpet curves S 10 Tubing set see Administration set U Unit of measure 3 21 Unlock keypad 2 22 V Voltage S 3 Volume checking infused totals 2 33 set the VTBI 2 19 VTBI key 2 3 Volume Over Time 3 17 Volumetric standards S 9 VTBI dose rate calculation 3 22 secondary 2 28 setting limit 3 29 Ww Warnings messages no alarm 4 7 Weight Kg or Ibs 3 21 of pump S 1 patient s 3 19 programming in D R calc 3 21 Volumetric Infusion Pump Instruction Manual Index 5 Index Graseby Medical Ltd TE Index 6 Volumetric Infusion Pump Instruction Manual For further information please contact your local distributor or Graseby Medical direct on 44 0 1923 246434 GRASEBY CE Graseby Medical Ltd Colonial Way Watford Herts UK WD24 4LG Telephone 44 0 1923 246434 Facsimile 44 0 1923 231595 http www graseby co uk PartNo 0166 0027 B February 2002 smiths 2002 Graseby Medical Ltd Smiths Medical A part of Smiths Group plc
13. Once the solution is ready and the cassette is loaded into place in the pump check that the Primary indicator is lit If not press the Primary key Max Rate Fire Press when set Options D aml Beh Bem Fress to clear Total Volume MEDIUM Occlusion Occlusion Alarm Setting Setting E pun m n Volume Li LI ea 1 4 mL this infusion WARNING The Occlusion alarm level must be checked before starting an infusion to ensure that it is appropriate for the infusion Failure to do so may result in an unacceptably slow time to Occlusion alarm resulting in patient injury or death Operating the pump 1 If Min and Max Rates and Max VTBI are enabled on the pump ensure they are appropriate for the infusion by pressing the Options key To find out more see page 2 15 2 Ifthe infusion is for a new patient or if you need to clear the totals for this patient press Total Volume then press 3 Press the Occlusion Alarm Setting key to display the current setting and continue pressing if necessary to set an appropriate level 4 Press the Rate key then use the keypad to enter the infusion rate in mL h 5 Press the Volume to be Infused key then use the keypad to enter the volume in mL Ensure that the Rate and Volume to be infused are correct for this Primary infusion then open the roller clamp Inspect the fluid path for kinks a closed clamp or any other upstream o
14. To program a Rate Taper by Total Time oo eee eeeeeeeeneeeeenneeeeeaeeeenneeereeeees 3 10 To program a Rate Taper by Maximum Rate eee eeeeeeeseeeeeeneeeeeeeeeeeneees 3 12 Using the End Early feature nieko enar TEES 3 14 Resuming restarting or reprogramming the Rate Taper seecccereeeenee 3 15 Programming or reprogramming the Rate Taper with Limits set 0 3 16 7 Volume Over Time VOT cceceeseeeeeeeeeenseneaeeeeeensnesaeeeeeensneeseseeeeness 3 17 To uSe VoIUME Over TIME eeeeeeceeeeeeeeeeeseeteaeeeeeceaeeeaaeeeaeetaaeeeaeessaeeeaeeteaetaes 3 18 8 Dose Rate Calculation sccccessceceeeeeeeesneeeeeeneeseeeeeeeesseaeeenseeesenseeaeess 3 19 Dose Rate Calculation Recovery ecceeceeteeereeenreeeeeeeeeeeeeeeeeeeeeesneeeeeeeeee 3 19 To enter or exit Dose Rate Calculation ccceecceeeceeeeeeeneeeeeeeeeeeneeseneeeneetenes 3 20 Dose Rate Calculation Steps 0 eeecceeeeeceseeeeseeeneeseeeeeaeeseaeeeseeeeaeesseeseaeeeaeete 3 20 Dose Rate Calculation programming example ccceceeeeseeeeeteeteteeeneeeee 3 23 Changing the dosing rate without stopping the infusion ee eects 3 25 Changing the infusion rate without stopping the infusion s 3 26 Dose or rate Change Alaris cceseeeeeseeeeeseeneeeseneeseeneeeseesenseenenseeeeeeeenneneaes 3 27 Programming or reprogramming Dose Rate Calculation with Limits set 3 28 Setting Rate and VTBI limit
15. carries out a series of tests to ensure that all components are functioning correctly If any electrical or mechanical problems are detected or if any potential problems are detected then a message is displayed and the alarm sounds See Chapter 4 Troubleshooting for more details on handling alarms Message Display at Switch on The messages displayed when you switch on the pump depend on which features have been enabled on the pump and whether or not it is connected to the AC mains supply If all the pump options have been enabled the pump displays messages to provide you with the following information about itself e Pump Identifier e Drug Label e Primary Min Rate and Max Rate e Primary Max VTBI e Battery gauge displayed only if the pump is disconnected from the AC mains supply e Service due date After switching on When the pump has completed its self tests it is ready for you to program load a cassette see page 2 18 or start an infusion You see a screen something like this A A mL this infusion Volumetric Infusion Pump Instruction Manual Operating the pump Switching off For safety reasons the front door must be properly closed and any infusion must be on Hold before you switch off the pump Graseby Medical Ltd e Ifthe pump is running an infusion press the Hold key e ifthe front door of the pump is open close it with the latch e then press the On Off key
16. connector rails and slide the second pump up or down until it is connected to the centre pump When the connection is secure you hear a distinct click 4 Before releasing the handle of the second pump double check that the connection is secure by moving the pump up and down and exerting pressure on the top of the pump To attach a third pump to the other side of the first pump repeat steps 2 3 and 4 Note If the connection is loose or the pumps seem to wobble disconnect then carefully reconnect them making sure both edges of the modular connectors engage Do not use pumps where the connection is loose but return them to a suitably qualified technician for repair Graseby Medical Ltd Moving an IV pole with pumps connected If you need to move the IV pole once the pumps are attached always ensure that you grasp the IV pole with one hand and steady the pumps with the other hand if necessary Disconnecting modular connected pumps You must always disconnect modular connected pumps one by one before removing the centre mounted pump from the IV pole Disconnect the left and right hand pumps from the centre mounted pump as follows 1 Grasp handle of pump to be removed Lift the pump slightly 3 Press the disconnect button and slide the pump up or down to disconnect from the centre pump 4 Place the pump in a location where it will not be damaged WARNING Do not push or pull on the pumps or th
17. types of alarm sounds made by the pump You may hear three types of alarm from the Volumetric e insistent e non insistent e continuous backup alarm Insistent alarm This type of alarm indicates that fluid delivery has stopped or cannot be started It alerts you to a condition that must be corrected before the infusion can be started or continued for example if an occlusion is detected The insistent audio alarm consists of three tones two high pitched and one low pitched repeated at two second intervals To silence an insistent alarm press the Silence or Hold key The alarm will recur unless you correct the problem as described in Chapter 4 Troubleshooting This chapter describes each alarm its cause and action to take Non insistent alarm This type of alarm alerts you toa condition that needs attention but has not caused the infusion to stop For example you hear a non insistent alarm if the pump is running on batteries and the batteries are low or if the infusion has switched to a KVO rate The non insistent audio alarm consists of two tones one high pitched and one low pitched repeated at two second intervals To silence this type of alarm e press the Silence or Run key to silence the alarm without stopping fluid delivery e press the Hold key to silence the alarm and stop fluid delivery Note In Quiet Pump mode there is no audio alert for certain non insistent alarms See the next pa
18. 00 m The highest number of minutes that you can enter is 59 Times of 60 minutes or higher must be entered as hours or hours and minutes Volumetric Infusion Pump Instruction Manual 3 17 Options Graseby Medical Ltd To use Volume Over Time i 1 With the pump on hold press the Volume over Time Options key then press numeric key Press to set 7 or press the Options key until the Volume Over Time option appears Press the key to set the program 3 infi 250 mL in AGRaAM 2 Enter the volume to be a When mL set When the correct volume is displayed press the key If an incorrect value has been entered press the Volume to be Infused key and re enter the volume 3 Enter the total infusion time in 230 mL i A 26h38m hours and minutes If you make an When time set error while entering a time value press any numeric key until the first hour digit is flashing then enter the correct time value To start entering values again from step 2 press the Volume to be Infused key When the correct time is displayed press the key 4 Press the Run key to start the pene use infusion or press the key to review the settings A A mL 5 When you press Run the Message this infusion Display shows the Standard Message When the infusion is completed the pump sounds an alarm and continues to infuse at the KVO rate until you press Hold Cannot inf
19. Increment 0 1 to 999 9 mL 0 1 mL Time range Model 500 amp Micro 505 Range Increment 0 to 59 minutes 1 minute 0 to 48 hours 1 hour S 4 Volumetric Infusion Pump Graseby Medical Ltd Volume Over Time Infusions Specification Rate range Model 500 Range Increment 0 1 to 99 9 mL h 0 1 mL h 1 to 999 mL h 1 mL h Micro 505 Range Increment 0 1 to 99 9 mL h 0 1 mL h Volume to be infused range Model 500 Range Increment 0 1 to 99 9 mL 0 1 mL 1 to 9999 mL 1mL Micro 505 Range Increment 0 1 to 99 9 mL 0 1 mL 1 to 999 mL 1mL Time range Model 500 amp Micro 505 Range Increment 0 to 59 minutes 1 minute 0 to 48 hours 1 hour Dose Rate Calculation Infusions Dose range Range Increment 0 01 to 99 99 0 01 0 1 to 999 9 0 1 1 to 9999 1 Body weight range Units Range Increment Kilograms kg 0 10 to 99 99 kg 0 01 kg 0 1 to 453 kg 0 1kg Pounds lbs 0 22 to 99 99 Ibs 0 01 lbs 0 2 to 999 lbs 0 1 Ib Volumetric Infusion Pump Specification Drug amount modes range Graseby Medical Ltd Mode Range Increment MG drug bag 0 01 to 99 99 0 01 0 1 to 999 9 0 1 1 to 99999 1 Gm drug bag 0 01 to 99 99 0 01 0 1 to 99 9 0 1 1 to 999 1 mcg drug bag 0 01 to 9 99 0 01 0 1 to 99 9 0 1 1 to 9999 1 units bag 0 01 to 99 99 0 01 0 1 to 999 9 0 1 1 to 99999 1 Rate range Model 500 Range Increment 0 1 to 99 9 mL h 0 1 mL h 1 to 999 mL h 1 mL h Micro 505 Range Increment 0 1 to 99 9 mL h 0 1 mL h Volume to be infused ran
20. Secondary infusion are silent The alarm is silent in the following circumstances e when the pump automatically switches from Secondary to Primary when the Secondary infusion is complete e when you program the Secondary infusion but press the Primary key then the Run key without running the Secondary infusion e when you press Run to start the Secondary infusion with the Volume to be Infused set to zero Alarms and computer control If a pump is being run under computer control you can silence it from the computer However you must resolve the problem causing the alarm on the pump WARNING If a backup alarm sounds the pump should be immediately removed from the patient and sent to be repaired by a Graseby Medical qualified technician Failure to do so may cause patient injury or death Volumetric Infusion Pump Instruction Manual 244 Operating the pump Types of infusion Hospital protocols dictate how the Primary Secondary and or Bolus features are used and the pump should be configured to conform with these protocols This section summarises the typical use of these features of the pump Graseby Medical Ltd Using the pump you may carry out e a Primary infusion e a Primary and a Secondary infusion e a Primary and a Bolus infusion Primary For a Primary infusion you set up the pump to deliver solution from a single container This diagram shows an example of how a pump looks wh
21. accordance with local protocol you must periodically inspect the patient s infusion site for signs of infiltration Failure to do so may result in an unacceptably slow time to Occlusion resulting in patient injury or death 2 24 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Ending the Primary infusion The pump warns you that the infusion is complete when the Primary Volume to be Infused reaches zero At this moment the pump sounds a two tone alarm You can decide to e silence the alarm and stop the infusion press the Hold key e silence the alarm and continue to infuse at the KVO Rate press the Silence key see details below KVO If you press Silence to stop the alarm the pump continues to infuse at the KVO Keep Vein Open rate The KVO rate is shown on the Rate display infusion Depending on how the pump is configured the KVO rate may be e the default KVO rate of 3 0 mL h e the programmed infusion rate if that was less than 3 0 mL h e the KVO rate specified for this pump see Specifying a different KVO Rate below The Message Display shows KVO as well as the combined Primary and KVO volume infused for example KUO Sel mL this infusion The pump continues to infuse at the KVO rate After six minutes the two tone alarm sounds again as a reminder that the KVO infusion is still running You can decide to e silen
22. alarm e displays the message Secondary Complete Ending a Bolus infusion At the end of a Bolus infusion the pump sounds a non insistent alarm twice It then reverts to the Primary infusion running at the previously programmed Primary rate The Secondary Stop feature does not have any effect on a Bolus infusion 2 32 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Checking infusion Before during or after an infusion you can check the fluid volumes that have been infused and the volumes remaining to be infused Operating the pump totals The pump can display the following totals e Total volume infused e Primary totals e Secondary totals e Bolus totals Total Volume infused To view the combined total volume of all fluid infused by the pump since the total was last cleared for example to check the fluid balance for a patient e press the Total Volume key If the pump is running an infusion the total volume is displayed on the Message Display as follows 18 5mL B h 7m total infusions The total volume includes the volumes from any of the following types of infusion e Primary e Secondary e Bolus e KVO e Rate Taper e Dose Rate Calculation The Message Display also shows the total hours and minutes that the pump has been in use since the display was last cleared higher than 99 hours reads 100 hrs Clearing the Total Vol
23. be used for epidural administration This feature is described fully in Chapter 3 Options e do not use IV administration sets which contain injection sites differentiate the pump and IV set being used for epidural delivery from those being used for other routes of administration A yellow Epidural Label Set for the Volumetric Infusion Pump part number TPF 00306 is available from Graseby Medical The labels should be stuck on the front top and sides of the pump to help staff to identify a pump that is dedicated to epidural application WARNING The use of administration sets incorporating injection sites could lead to an improper or inappropriate infusion resulting in serious patient injury or death WARNING Failure to clearly identify the pump and administration sets could lead to an improper or inappropriate infusion resulting in serious patient injury or death Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Introduction Pump features The main features of the 500 and 505 pumps are listed below Easy to use features The pumps have been designed to be easy to use e they are easy to set up and operate yet with all the advanced features typically associated with the more complicated infusion systems e they have a straightforward keypad and an easy to read message display e the unique air in line removal system allows clearing of bubbles in the line by simply opening and
24. closing the door air is prevented from going beyond the cassette this increases patient safety minimises the risk of infection and saves operator time e they can be used at the bedside or as transportable equipment using the internal battery which also switches in automatically if the pump is being used on mains power and this is interrupted Use of administration sets The pumps can only be used with Graseby Medical administration sets These administration sets have the following features e all Graseby Medical administration sets incorporate a safety clip to prevent accidental free flow when the administration set is removed from the pump e when used with Graseby Medical blood administration sets the pumps deliver blood and blood products without significant haemolysis of red blood cells Infusion mode features e accurate 2 fluid delivery e the pumps can be configured to stop at the end of a Secondary infusion or automatically switch to infuse at the programmed Primary rate e a Bolus infusion may be programmed so that the volume infused is deducted from the primary infusion volume to be infused e KVO rate may be specified for an infusion or remain at the default rate for a particular pump e the pumps offer a quick rate change feature for complete titration capability e automatic delivery of a secondary medication if a secondary infusion has been set up Safety features The pumps hav
25. if you leave the pump untouched for one minute If you touch a key the Message Display reminds you that the keypad has been locked Keyrad locked automatically Unlocking the keypad To unlock the keypad once it is locked press the grey Keypad lock button on the rear of the pump e for a manually locked keypad press the button once e for an automatically locked keypad press the button twice To silence alarm with keypad locked If the pump is sounding an alarm whilst the keypad is locked you must e first unlock the keypad with the button on the rear of the pump e then press the Silence key 2 22 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump oO SSS SSE Display the Drug Label The pump may be configured in the To display the Drug label on the Technician Menu to display the Drug Message Display for two seconds Tae e press the key If the Drug List is enabled you can For more information on Drug Labels display the Drug Label that was last see Chapter 3 Options selected using the Options key Stop the infusion To stop the infusion at any time e press the Hold key If an occlusion is detected If an occlusion is detected the Run If an occlusion alarm occurs light remains lit but the Pumping indicator stops The pump does not give an occlusion alarm immediately but only alarms if the occlusion pressure continues to exceed the
26. in compromised function of the product patient injury or user injury Height of solution container above the pump If necessary adjust the height of the pole so that the bottom of the solution container is between 15 cm and 30 cm between 6 inches and 12 inches above the top of the pump On Model 500 30 cm 12 inches may be required for rates over 500 mL h On both Model 500 and Micro 505 30 cm 12 inches may be required when using thick solutions and or 60 drops mL sets Note A thick solution in this case may be certain cytotoxic agents lipid based fluids and other viscous solutions for example Total Parenteral Nutrition 2 16 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Prime the administration set Example You must always follow the Instructions for Use that accompany the administration set to be primed This section shows an example to explain the basic priming steps to be carried out on an administration set without a bi directional check valve filter injection site or c clamp GM0166 0007 GB A With the solution container hanging on the IV pole and the administration set spike inserted into the container prime the administration set as follows WARNING Remove any air to prevent air embolism The presence of air within the infusion can result in complications resulting in patient injury or death WARNING Use only Graseby Med
27. in patient injury or death WARNING The Occlusion detection system measures downline pressure in the admini stration set but does not detect infiltration In accordance with local protocol you must periodically inspect the patient s infusion site for signs of infiltration Failure to do so may result in an unacceptably slow time to Occlusion resulting in patient injury or death WARNING If an Occlusion alarm occurs immediately clamp the line to the patient Then inspect the fluid pathway to determine what has caused the obstruction An unintentional bolus of medication can result in patient injury or death Volumetric Infusion Pumps Warnings and Cautions SSS l 18 19 20 21 22 23 WARNING Do not run parallel infusion lines below the pump Delivering a Secondary infusion means running a second line above the pump Failure to do so may result in an inaccurate delivery of medication resulting in patient injury or death WARNING Check the Secondary set carefully since an occlusion above the pump on the Secondary line could cause the Primary fluid to be delivered instead of the Secondary infusion Administering the wrong medication may cause serious patient injury or death WARNING The Secondary volume to be infused must match the amount of fluid in the secondary container Primary flow resumes when the secondary container is empty If the volumes do not correspond the wrong infusion may be delive
28. indicated for epidural use Epidural administration of other drugs could result in serious patient injury or death WARNING The use of administration sets incorporating injection sites could lead to an improper or inappropriate infusion resulting in serious patient injury or death WARNING Failure to clearly identify the pump and administration sets could lead to an improper or inappropriate infusion resulting in serious patient injury or death WARNING Remove any air to prevent air embolism The presence of air within the infusion can result in complications resulting in patient injury or death WARNING To avoid over infusion do not prime the infusion line when the admini stration set is connected to the patient Over infusion can result in patient injury or death WARNING The Occlusion alarm level must be checked before starting an infusion to ensure that it is appropriate for the infusion Failure to do so may result in an unacceptably slow time to Occlusion alarm resulting in patient injury or death WARNING Prior to starting an infusion inspect the fluid path for kinks a closed clamp or other obstructions Failure to do so may result in the infusion not being delivered correctly resulting in patient injury or death WARNING If using a blood pressure cuff above the patient s venipuncture site take extra care in setting the Occlusion alarm pressures Failure to do so may result in unnecessary Occlusion alarms resulting
29. infused values for each pump When you set up an infusion the pump rejects a Rate or VTBI value that is not within the Minimum Maximum rate limits or is greater than the maximum VTBI For example you should set a maximum rate on a pump that is intended for use in an Epidural application or set a maximum VTBI on a pump to be used in a neonatal environment Setting rate limits is also called Rate Capping Rate Taper Volume Over Time and Dose Rate Calculation are also affected by limit settings The following Options are used to limit the infusion rates and volumes to be infused on the pump For Primary infusions e Min Rate Max Rate Max VTBI For Secondary or Bolus infusions e Min S B Rate Max S B Rate Max S B VTBI To define the ranges the items must be enabled on the Technician Menu and then set using the Options key See page 3 32 for more details on how limits affect programming an infusion The instructions on the following pages explain how to set values for the Primary Minimum and Maximum Rate and Maximum VTBI Once you have understood how to change these values you will find that you can set the Secondary Bolus minimum and maximum rates in the same way Minimum and Maximum Infusion Rates If the Primary Min Rate and Max Rate are enabled in the Technician Menu their current settings are displayed when you switch on the pump If the defaults have not been changed on a Model 50
30. infusion 2 25 option 3 33 specify rate 2 25 L Label show drug 3 34 Leakage current S 3 Library of drug labels 3 34 Light backlight on off 3 4 message display 3 4 Limits effect on infusion 2 15 effect on rate taper 3 9 in dose rate calcs 3 19 programming rate taper 3 16 setting rate and VTBI 3 29 Loading dose 2 26 Lock keypad 2 22 Low battery alarms 2 9 occlusion alarm setting 2 24 M Mass units 3 20 Maximum infusion rate for rate taper 3 12 KVO 2 25 range available on pump S 4 setting limit 3 29 Maximum VTBI 3 31 Medium occlusion alarm setting 2 24 Message Display at switch on 2 7 option for backlight 3 4 rate andVTBI 2 21 Volume to be Infused 2 34 Messages warning 4 3 Micro 505 1 1 Minimum infusion rate onpump S 4 setting 3 29 Model500 1 1 Modular connection system 2 5 Multiple pumps ona pole 2 5 No flow above pump 4 5 Non insistent alarms 2 10 4 6 Nurse Call Feature 1 5 O Occlusion below pump message 2 24 4 5 detection 2 23 Occlusion Alarm 2 23 4 5 approx values of settings 2 24 S 7 change the setting 2 24 setting 2 18 Options 3 1 Battery Test 3 5 Dose Rate Calculation 3 19 Drug Label 3 34 effect on infusions 2 15 fast access to 3 2 KVO Rate 3 33 Max min rate and VTBI 3 29 Message Display Light 3 4 Quick Rate Change 3 7 Rate Limit 3 29 Rate Taper 3 8 Standard Message
31. new options e new features that the menu and options provide To find out the software version of a particular pump check the instructions label on the right side of the pump If there are more than eight options listed then the software version is 0 71 or later For full details on how to use the pump see the Volumetric Instruction Manual For information on configuring the pump see the Technical User Manual and for more detailed technical information obtain a copy of the Volumetric Service Manual New Menu A Technician Menu has been introduced to simplify the configuration of each pump Some of the items on the Technician Menu affect how the pump behaves others control the options that appear to the pump user when they press the Options button to show the Options menu The configurable items on the new Technician Menu are shown on page 12 of the Technical User Manual If the Technician Menu settings are left at their factory defaults the pump behaves as the previous version of the pump New Options The new options and some of the previous options can be enabled on the Technician Menu This means that they can appear when appropriate but can be disabled if not required On the instruction label on the pump Options numbered 1 to 8 are the ones that appeared in previous versions of the pump software The additional new options shown on the label are e Primary infusion Minimum e Primary infusi
32. occlusion threshold for 10 seconds This helps to avoid nuisance occlusions If an occlusion alarm occurs immediately clamp the line to the patient Then inspect the fluid pathway to determine what has caused the obstruction However the pump monitors any temporary occlusions and if such occlusions persist then the occlusion alarm is generated If an occlusion is detected when the occlusion alarm is set to Low the pump alarms immediately Volumetric Infusion Pump Instruction Manual 2 23 Operating the pump Graseby Medical Ltd Change the Occlusion alarm setting You can check the current occlusion alarm setting when an infusion is running if you press the Occlusion Alarm Setting key You can change the setting if you first put the infusion on Hold see steps in opposite column When you switch the pump on the Occlusion Alarm setting is always the same and is defined by the Technician Menu configuration setting You should set the alarm to be appropriate for the infusion before pressing Run The occlusion alarm setting determines the amount of back pressure allowed before the pump alarms There are three possible settings Low Medium or High When an occlusion alarm occurs the pumping mechanism backs off to reduce down line pressure and bolus potential bolus potential is approximately 0 3 mL regardless of the rate and the administration set used Whilst the pump is infusing particularly at hig
33. off the limits are left with safe value settings Volumetric Infusion Pump Instruction Manual Ato Operating the pump Setting up a Primary To set up and run a Primary infusion the main steps are e attach the pump to the IV pole described on page 2 5 e set the Options for the infusion if appropriate particularly Rate or VTBI Limits if they are enabled as described on page 2 15 Graseby Medical Ltd Infusion e prepare the solution e prime the administration set e load the administration set into the pump e program the infusion e start the infusion Prepare the solution Using an aseptic technique prepare the solution container and prime the administration set following the instructions provided with the set As a guide 1 Remove the solution container from its packaging and remove the cap from the fluid outlet 2 Remove the administration set from its packaging and close the roller clamp 3 Remove the cap from the spike on the administration set and insert the spike into the fluid outlet on the solution container 4 Hang the container with the administration set on the IV pole and ensure that the container is the correct height above the pump WARNING Correct entry of data is essential in order to ensure that the intended infusion is performed Before confirming any displayed data when setting up an infusion you should ensure that it is correct Failure to do so may result
34. over the selected flow rate Larger inaccuracies are detected by the pump and cause the pump to stop infusing and to alarm Air bubbles are detected by electronic opto encoder detection device with self checking sensors located on cassette housing Accuracy 2 of displayed rate and volume to be infused The quoted accuracy is 2 for a long term infusion Below rates of 1 mL h this accuracy may not be achieved for a short term infusion During the total infusion time the accuracy averages out see trumpet curves in this chapter Accuracy measurement equipment 50 mL glass measurement burette graduated in 0 1 mL increments and traceable to National Institute of Standards and Technology or appropriate international standards bureau Test solution Sterile water or normal saline at room temperature 70 F 5 21 C 8 Graseby standard primary 20 drops mL non checkvalve administration set 8C820 Testing conditions Model 500 Micro 505 Fluid level in the solution container 46 cm 18 inches above top of the pump rate set at 999 mL h and volume to be infused of 49 mL Fluid level in the solution container 46 cm 18 inches above top of the pump rate set at 99 9 mL h and volume to be infused of 25 0 mL Volumetric Infusion Pump Graseby Medical Ltd Specification TT SSS SSS SSS ESS Power AC power supply Internally configured for either 100 120 V AC 200 mA 50 60 Hz
35. provided to aid in testing troubleshooting and service e the last 200 events are recorded and available on these menus e downloading of the pump history is possible using the RS232 port with a special optional kit Part no 0150 0673 Together with the ability to configure the pump using the Technician Menu these features offers greater management flexibility Instructions for using these functions appear in the Technical User Guide and the Volumetric Service Manual Optional features Some pumps are optionally fitted with a Nurse Call Feature which allows a pump to be connected to a hospital nurse call system and signal alarms occurring in the pump Note This feature is not available in all countries Volumetric Infusion Pump Instruction Manual 1 5 Introduction Graseby Medical Ltd TE 1 6 Volumetric Infusion Pump Instruction Manual ing the gump hapter 2 Graseby Medical Ltd Operating the pump eer wrr wr E R Introduction This chapter introduces the Volumetric pump It explains all the terminology that you should understand and the techniques that you use to operate the pump Who should read this chapter This chapter is aimed at all users who have been trained in how to use the Volumetric pump It is not designed to be used as a self teach manual but should be used to reinforce the best practice techniques demonstrated during training sessi
36. the Volume to be Infused key to clear the display and enter the Secondary volume in mL This should normally match the volume in the Secondary container Verify that the rate and volume to be infused settings are correctly displayed Open the roller clamp on the Secondary administration set Press the Run key to start the Secondary infusion The Message Display shows the volume infused When the infusion is complete see Ending a Secondary infusion on page 2 32 2 30 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump TT SE SEE Running a Bolus infusion This section shows how to administer a Bolus with the Bolus feature enabled on the pump on the Technician Menu 1 Press the Hold key if the pump is running 2 If Secondary Min and Max Rates and Max Secondary VTBI are Max S E Rate 750 enabled on the pump ensure that they are appropriate for the infusion Press when set by pressing the Options key To find out more see page 2 15 3 Press the Secondary Bolus key Secondary Bolus Secondary When the Bolus feature is enabled Press 1 or 3 Sale the Message Display tells you to press 1 for Secondary or 3 for Bolus 9 2 mL 4 To enter the Bolus rate press 3 Bolus infusion 3 The Message Display shows the volume of the previous Secondary or Bolus infusion The yellow Secondary indicator is lit Press the Rat
37. the backlight remains on constantly until you turn the option or the pump off You may need to monitor the battery capacity if you keep the light on as the light uses the battery power Turning the light on and off To turn the light on Press the Options key then press numeric key 3 or repeatedly press the Options key until the Message Display shows the following To keer light on Press Press the key to keep the light on The light will remain on until the pump is turned off or until it is returned to normal operation CAUTION The backlight has a limited life and may if used constantly cause the light to dim Eventually the message display may then need to be replaced To preserve the life of the message display you should only turn on the Message Display Light as described here if it is specifically required Misuse of this feature could lead to both battery and LCD depletion To turn the light off Press the Options key then press key 3 or press the Options key until the Message Display shows the following To turn light off Press Press the key to turn the backlight display off Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options 4 Battery Test The battery is automatically tested as part of the power on sequence if the pump is disconnected from the AC mains supply when it is switched on The Battery Gauge is displayed to i
38. the occlusion alarm is generated this helps to avoid nuisance occlusions Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Introduction Special infusion features The pumps have a number of special infusion options e a Volume over time option allows the user to set the volume to be infused and total time for the infusion the pump automatically calculating the infusion rate e a Dose rate calculation option which allows automatic calculation of the infusion rate by entering infusion dose patient weight kg or lbs drug amount in fluid container in MG Gm or mcg units and volume of fluid in the container in mL e a Rate Tapering option allows automatic tapering of the infusion rate either up or down for administration of IV nutrition Multiple use features When multiple infusion lines are required two or three pumps can be fitted together e modular side rails and hooks mean that one two or three pumps may be connected to a single IV pole this provides space saving e the modular connection system has a safety feature which ensures that the first pump must be correctly attached to an IV pole before the second and third pumps can be connected Servicing features The pumps have been designed with a number of features for Biomedical engineers e a Service Due Indicator allows a service date to be set which is displayed on power up with an alarm e special menus are
39. units 1 Press Options to display this screen _ med min For new mode 2 Press until the screen shows the dosing rate mode you want to use for the infusion Dosing rate modes available The following dosing rate modes are available e mceg kg min micrograms kilogram minute e mceg min micrograms minute e MG min milligrams minute e MG hour milligrams hour e units hr units hour e MG kg hr milligrams kilogram hour e mcg kg hr micrograms kilogram hour e MG kg min milligrams kilogram minute units kg hr units kilogram hour 3 20 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Enter new value for the dosing rate When you have the mode you want to use on the screen enter the value for the dosing rate from the keypad The screen changes to show that you are entering a value and not selecting the mode as if you had just entered Dose Rate Calculation Press when you have done so When you enter values the precision with which you can enter them depends on the range e 0 01 to 99 99 in increments of 0 01 e 0 1 to 999 9 in increments of 0 1 e 1 to 9999 in increments of 1 If you have chosen one of the following modes using patient weight mcg kg min MG kg hr mcg kg hr MG kg min or units kg hr you are next asked to enter it as described in Programming the patient weight below For dosing rate modes without th
40. your program is correct press Run As well as the Message Display which shows the volume infused and the dosing rate the programmed Volume to be Infused appears in the Volume display and the calculated infusion rate appears in the Rate display 3 24 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Changing the dosing rate without stopping the infusion The pump allows you to change the dosing rate thus altering the infusion rate without stopping the infusion Infused fel mL AA megzkgzmin Infused fe mL BA mog ko min Infused fe4 mL 193 megrkgrmin To change the dosing rate without stopping the infusion press the key The current dosing rate displayed in the Message Display starts flashing and the infusion Rate display goes blank However the pump continues to infuse at the original rate Enter the new dosing rate value using the keypad Within 10 seconds of entering the new dose press the Run key If a warning appears in the Message Display and the pump alarms refer to Dose or rate change alarms on page 3 27 The pump calculates the new dosing rate and new infusion rate The new dosing rate is now displayed in the Message Display and the new infusion rate in the rate display The pump is now infusing at the new rate If a warning appears in the Message Display and alarms refer to Dose or Rate change
41. 0 the screen looks like this Max Rate Min Rate The Secondary Bolus Maximum and Minimum rates are not displayed when you switch on the pump even if they are enabled and set 999 4 Entering rates Rates must be entered as whole numbers they cannot include a decimal point If the Min Rate is set to zero there is no lower limit The Max Rate may be set to 999 on a Model 500 or 99 on a Micro 505 Unless the display includes S B the rate being changed is always the Primary Volumetric Infusion Pump Instruction Manual 3 29 Options Graseby Medical Ltd To set the minimum and maximum infusion rate If the Options are enabled you can change either or both values This section explains how to change both values Min Rate J Fress when set Min Rate 1 Press when set Max Rate To Fress when set Max Rate 306 Fress when set Max Rate SHH Press the Options key repeatedly until you see the Minimum Rate display The current minimum infusion rate flashes showing that you can change this value Enter a new rate using the numeric keypad then press the key to confirm If it is correct to leave the rate unchanged just press If the pump finds that the rate is invalid the number continues to flash so you should repeat this step With the value for Min Rate static press the Options key to display the fla
42. 3 3 Time Remaining 3 3 using 3 2 Volume Over Time 3 17 VTBI limit 3 29 Volumetric Infusion Pump Instruction Manual Index 3 Index Graseby Medical Ltd P Patient weight in dose rate calculation 3 19 Kg or Ibs 3 21 Pole clamp 2 5 saver 2 5 Power supply 2 7 S 3 Preset limits alarm message 4 3 effect on infusions 2 15 error message on Run 2 20 setting 3 29 Pressure see Occlusion Alarm Primary Infusion 5 or 6 step setup 2 19 ending 2 25 overview 2 12 setting up 2 16 totals 2 34 Prime administration set 2 17 secondary admin set 2 27 Problems handling 4 2 Programming alarms 4 3 keys 2 3 KVO rate 3 33 mass units 3 20 patient s weight 3 21 primary infusion 2 19 rate taper infusion 3 9 secondary infusion 2 29 volume over time infusion 3 18 Pump features 1 3 indicators and displays 2 2 programming keys 2 3 service alarm 4 3 sounds 2 10 switching on 2 7 Pumping indicator 2 21 2 23 Q Quick Rate Change option 3 7 Quiet Pump Mode 2 7 2 11 R Rate change in D R calc 3 25 change while running 2 21 quick rate change option 3 7 setting min max limits 3 29 titration 2 21 Rate change not completed 4 6 Rate Taper 3 8 end early feature 3 14 preset limits set 3 16 program by max rate 3 12 program by total time 3 10 restart or reprogram 3 15 Re run infusion 2 35 Rear of the pump 2 4 symbols appearing on S 8 Rechar
43. Chapter cec cccsesceceseeeeeseeeneseeceeseneesesceeneneeeeeseneeeesees 4 1 Handling problems with the PUMP s cccesseeeseeeeesseeeeeeeeeesesseeeeesseneeees 4 2 PUMP Messages ccnsnctiecnc cess cccecece censccte ced censsctecne cen sscccueeeedeesstteneddeesscuenceredens 4 3 Pump Will not Switch On menais na niin eae ee 4 3 Programming Messages With alarms eeceeseeeeeeeeeeneeeeeneeeeeneetenneeeenaeeeee 4 3 Warning Messages With alarms 0 ce eeceeeeeeeeeeeeeeeeneeeteneeeeenaeeeeeaeeereeeeeeneeeeeas 4 3 Warning Messages with no alarms 00 cc eeseeeeeseeeeeeeeeeeneeeeeeeeeeeeeeeeeneeeeseneeeeees 4 7 Instrument Gareca aeaea aaaea cca nen reaa eaaa aa aa eE aa diaaa dadaan Naani 4 8 Specifications Standards Specifications iea cane che E E a E S 1 Standards necssosacurcnseoiei eNA 9 TUM et CUIVES ceeeeee eee ennnee eee e ens nneee sees ens neeeeeeeengneeeeeeeseaaneeeeeeeeeeeneeseeneees S 10 Appendix Nurse Call Feature ccccccssseeeeeseeeeeseeeeesneeeeeeeeeeesseeeeaseaeeeessaesenseeeeeasenaeeees A 1 Index iv Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Contents New features of version 0 71 software The information in this section is intended for technicians and clinicians already familiar with earlier versions of the Graseby 500 505 volumetric pump It summarises the changes to the pump that appear with version 0 71 of the pump software e new menu e
44. Dose Rate Calculation Recovery is an additional feature which can only be enabled in the Technician Menu It enables you to set up a Dose Rate Calculation program for later use To use Dose Rate Calculation Recovery 1 Program the Dose Rate Calculation infusion see page 3 20 2 Press Run then Hold 3 Switch off the pump When it is next switched on the pump displays RUH to infuse Reviews Dosing WARNING Correct entry of data is essential in order to ensure that the intended infusion is performed Before confirming any displayed data when setting up an infusion you should ensure that it is correct Failure to do so may result in compromised function of the product patient injury or user injury You can e press Run to restart the previous Dose Rate Calculation infusion or e press to review the dose rate prescription or enter new values for an infusion or e press Options then to leave Dose Rate Calculation and return to the Standard Message display Note When you switch on the pump with DRC Recovery enabled no information screens are displayed in the self test However if there is a problem such as low battery a warning message is displayed with an alarm sounding WARNING Dose rate calculation requires care in entering data Refer to specific product drug labelling for information on appropriate administration techniques and dosages Entering incorrect data may result in patient i
45. For more details see page 3 16 Rounding in rate steps If a rate step calculates to less than 1 mL h it always appears in the display as 10ths At 1 mL h and higher the pump may calculate a rate step and deliver in 10ths however the display will show a rate which is rounded to the nearest whole number Entering hours and minutes When programming by total time for a total time of less than 10 hours enter 0 before the hours digit for example 09h 00min The highest allowed number of minutes is 59 For 60 minutes or higher enter the time as hours or hours and minutes To enter Rate Taper To program an infusion using the Rate Taper option the pump must be on hold Rate Tarer Press to set 1 Press the Options key then press numeric key 6 or press the Options key until you see this screen 2 Press the key then follow the steps given to program by total time on page 3 10 or maximum rate on page 3 12 To exit Rate Taper To end a Rate Taper infusion you must use the Option key to exit the Rate Taper and return to the standard operation Exit Rate Tarer Press to exit A A mL this infusion 1 Press the Hold key and then press the Options key repeatedly until you see this screen 2 Press the key to return to the Standard Message Display Volumetric Infusion Pump Instruction Manual Options Graseby Medical Ltd To program a
46. Graseby Medical Ltd Appendix 00000 a arr y Nurse Call Feature Some pumps are fitted with a Nurse the Nurse Call Connector see Call feature which makes these pumps illustration below on the pump s rear compatible with most existing hospital panel call oe nurse call systems Once connected any activation of the A Graseby Medical pump equipped pump s various audio alarms also with the nurse call feature may be activates the hospital nurse call connected to the hospital s system by system inserting a 0 25 inch system plug into Note This feature is not available in all countries Nurse Call Connector MAX Located on 24V 15W Rear Panel of Pump GM0166_0017 GB A Symbol Definitions Attention Nurse Call consult accompanying documents Volumetric Infusion Pump Instruction Manual A 1 Appendix Graseby Medical Ltd peere I A 2 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Index Index Symbols 5 Step Setup 2 19 A Accessing options 3 2 Accessories S 7 Accuracy of pump spec S 2 Administration set loading cassette 2 18 loading problem alarm 4 4 priming 2 17 Air detect system S 2 Airin cassette 4 4 Alarms audio backup 2 11 dose rate change 3 27 insistent 4 4 low battery 2 9 messages 4 3 non insistent 4 6 occlusion below pump 2 24 overview 2 10 programming messages 4 3 warn
47. KVO rate when the pump goes into KVO it will continue pumping at the programmed lower rate KVO rates cannot be changed when an infusion is running but if you press the Options key the current setting is displayed Setting a KVO rate KUO Rate aH Press when set KUO Rate 4 4 Press when set 1 Press the Options key until you see the KVO rate display The current value flashes showing that you can enter a new value 2 Enter the new KVO Rate using the numeric keypad then press to confirm If the rate is correct press Options to move on to the next Option In the unusual situation that the rate you enter is not accepted then the Max Primary Rate limits are set below the value you wish to enter The Min Primary Rate does not affect the KVO entry Volumetric Infusion Pump Instruction Manual 3 33 Options Graseby Medical Ltd Drug Label The Drug List feature if enabled in the Technician Menu allows you to use the Options key to select a drug label from a predefined list that is stored in the pump When the Drug List is enabled the selected drug label is displayed for two seconds when you switch on the pump for example Crug Label Herarin If no drug label has been selected the screen is shown like this Drug Label The selected Drug Label is displayed for two seconds if you press when the pump is on hold or infusing
48. Medical Ltd Handling problems with the pump Most problems in using the pump are signalled by alarms whose accompanying messages are described in the rest of this manual You should also use your experience in using the pump to take action if the pump behaves as if it is faulty Follow the warnings and cautions on this page to take appropriate action to send the pump to a suitably qualified technician for checking Pump will not switch on If the pump does not switch on when the On Off key is pressed when connected to an AC power supply Check that the keypad lockout feature is not active see Safety keypad lockout page 2 22 CAUTION Refer all service repair and calibrations only to qualified technical personnel Unauthorised modifications to the pump must not be carried out WARNING You should ensure that the performance offered by the pump is fit for the intended purpose Failure to do so may result in compromised function of the product patient injury or user injury WARNING Do not use a faulty pump If the pump detects a fault when it is first turned on or if it develops a fault during operation then a continuous system alarm sounds The pump must be referred to a suitably qualified technician or returned to Graseby Medical in order to have the fault rectified WARNING Before using the pump it should be inspected for physical damage The pump should not be used if damage is evident and should be retur
49. Rate Taper by Total Time If you need to select the exact total time for the Rate Taper delivery you should choose the Total Time Rate Taper method Rate Tarer Press to set Volume 156060 mL Fress when set 1 For total time 2 For max rate Total B39h 3am Press when set In this example for Total Time we have chosen the following values to program a volume of 1500 mL to be infused over a time period of 9 hours and 30 minutes taper up for 1 hour taper down for 45 minutes Press the Options key and numeric key 6 or press the Options key repeatedly until the Message Display shows the Rate Taper option then press the key to begin Enter the volume to be infused If an error is made while entering the new volume press the Volume to be Infused key and re enter the correct setting or alternatively press the Volume to be Infused key twice to return to previous setting When the correct volume is displayed press the key Press numeric key 1 to select total time Enter the hours and minutes required to complete the infusion Enter the leading zero as shown in this example for numbers less than 10 If you make an error while entering the time press any number key repeatedly until the first number in the hour value is flashing then enter the correct time 3 10 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd
50. ade if the volume or time requirements vary from one infusion to another This option cannot be used while the Quick Rate Change Volume Over Time setup or Dose Rate Calculation is in use If the pump is switched off whilst in Rate taper mode and not connected to the AC mains supply when it is switched on again the automatic battery test is carried out but the Battery Gauge is not displayed If the battery is low the alarm sounds and a warning message is displayed Neither the primary or secondary indicator lights are lit when in Rate Taper The diagram below shows a typical Rate Taper infusion and the four programming variables that must be set Total Time 2 or lt Maximum Rate gt 10 steps up pump calculates rates 3 Taper up time zero may be entered if taper up not needed GM0166_0011 GB A on 1 Volume 10 steps down 4 Taper down time zero may be entered if taper down not needed KVO Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Rate and volume limits The highest allowable infusion rate in Rate Taper is 400 mL h 99 9 mL h on Micro 505 The highest allowable volume to be infused in Rate Taper is 4400 mL 999 9 mL on Micro 505 Any limits set with options such as Rate or VTBI limits will apply You will be able to program Rate Taper as normally but you will be prevented from running the infusion
51. akes precedence over the Primary infusion For details on what happens if the Volume to be Infused is less than the contents of the Secondary container see page 2 27 Secondary Rate and VTBI limits may be set if enabled in the Technician menu See page 2 15 for more details Bolus feature enabled If the Bolus feature has been enabled in the Technician Menu you can use the Secondary Bolus key to e run a Secondary infusion where the volume infused is not deducted from the Primary Volume to be Infused or alternatively e runa Bolus infusion where the volume infused is deducted from the Primary Volume to be Infused Setting up a Secondary infusion To set up a Secondary infusion you need a means of combining a Primary and Secondary infusion This may be the combined Primary Secondary 8C 6200 IV Administration set from Graseby Medical product code 591 096 GM0166 0009 GB A Alternatively use an administration set with an injection site or Y site as shown here plus a Secondary Administration set not shown The basic steps for setting up a Secondary infusion are described in the following sections e lower the Primary solution container e prime the Secondary administration set e connect the Secondary to the Primary administration set e program the Secondary infusion with or without the Bolus feature enabled e start the infusion 2 26 Volumetric Infusion Pump Instructi
52. al Weight 5 kg 11 pounds Dimensions including pole clamp Height 28 cm 11 inches Width 21 5 cm 8 6 inches Depth 23 5 cm 9 45 inches Temperature Operating 18 to 40 C 64 to 104 F Storage 25 to 55 C 13 to 131 F Relative humidity Operating 30 to 75 non condensing Storage 30 to 75 non condensing Pressure range Operating 50 kPa to 106 kPa Storage 19 kPa to 106 kPa Immunity levels Immunity levels are the full levels specified in EN60601 1 2 radiated immunity is 3 V m and ESD immunity is 3 kV contact and 8 kV air Free flow protection The pump mechanism operates the safety clip on the administration set Head height Model 500 Micro 505 From bottom of drip chamber to top of pump 15 cm 6 ins minimum for flow rates lt 500 mL h 30 cm 12 ins minimum for flow rates gt 500 mL h 30 cm 12 ins when using 60 drops mL sets 30 cm 12 ins when using thick solutions 15 cm 6 ins minimum 30 cm 12 ins when using 60 drops mL sets 30 cm 12 ins when using thick solutions certain cytotoxic agents lipid based fluids and other viscous solutions for example Total Parenteral Nutrition Self test Dual microprocessors independently test each other Volumetric Infusion Pump Specification Graseby Medical Ltd Maximum over infusion Air detect system Under a single fault condition the maximum over infusion which may occur is 12 5
53. alarms on page 3 27 If the calculated rate is rounded up the pump will back calculate and display the actual dosing rate being infused Volumetric Infusion Pump Instruction Manual 3 25 Options Graseby Medical Ltd Changing the infusion rate without stopping the infusion The pump allows the infusion rate to be changed thus altering the dosing rate without stopping the infusion Infused Yel mL negd k 9 1 Fi Infused fed mL esl mog ko min Tochange the infusion rate without stopping an infusion press the Rate key The current dosing rate displayed in the Message Display and the infusion Rate display goes blank However the pump continues to infuse at the original rate Enter the new infusion rate using the keypad Within 10 seconds of entering the new rate press the Run key If a warning appears in the Message Display and the pump alarms refer to Dose or rate change alarms on page 3 27 The pump calculates the new dosing rate The new dosing rate is now displayed in the Message Display and the new infusion rate in the rate display The pump is now infusing at the new rate If a warning appears in the Message Display and alarms refer to the next page Dose or rate change alarms 3 26 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Dose or rate change alarms Dose or rate change not completed within 10
54. anual Options Graseby Medical Ltd 44444444444444 A fully charged battery in good condition will power the pump for LOW batters FULL approximately 6 hours at 100 mL h This indicates a fully charged 99 9 mL h on Micro 505 battery 4 When the test is complete you can press Run to restart the infusion If the battery capacity is low you must connect the pump to the AC mains supply to recharge the battery For further information on batteries see Chapter 2 Operating the pump or Specifications 3 6 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options 5 Quick Rate Change The Quick Rate Change option if enabled allows you to change the infusion rate with single presses of the keypad while the pump is running The option applies while the pump is running or when on hold but changes cannot be made when the pump is in Rate Taper Volume Over Time or Dose Rate Calculation The Quick Rate Change is automatically discontinued when the pump is turned off The next time the pump is turned on it will display the Standard Message display Any rate limits which are set will apply The pump will alarm if you try to set a rate outside the limits Performing Quick Rate Changes t Rate Change Press to begin Press 1 to Press 3 to t t 2o8 mL this infusion Exit t Rate Press to exit 1 Press the Options ke
55. bstructions 6 Press the Run key to start the infusion WARNING Prior to starting an infusion inspect the fluid path for kinks a closed clamp or other obstructions Failure to do so may result in the infusion not being delivered correctly resulting in patient injury or death Volumetric Infusion Pump Instruction Manual 2 19 Operating the pump During the infusion This section explains the main activities you may want to carry out once you have started the infusion When the infusion is running you can e see the progress of the infusion from the information shown on the different displays on the pump e change the infusion rate e lock the keypad to provide security on the pump Graseby Medical Ltd e display the drug label if this feature is enabled e stop the infusion If you press Hold to stop the infusion you can e change the occlusion alarm setting see page 2 24 e set up and start a Secondary infusion see page 2 26 If the infusion will not This will only occur if you have one or more of the following features enabled on the Technician menu e Min and Max Rate e Max VTBI If you have entered a rate which is outside the set limits or a VTBI which is greater than the maximum when you press Run you see the message Preset Limits Exceeded and an alarm sounds The Rate or VTBI display also changes to the one used before you programmed the infusion
56. ce the alarm and stop the infusion press the Hold key e silence the alarm and continue to infuse at the KVO Rate press the Silence key Specifying a different KVO rate If the KVO Rate Entry option has been enabled in the Technician Menu you can use the Options key to specify a KVO rate before you start the infusion When you set the KVO rate you can go to a maximum of 10 mL h on a 500 pump or 3mL h on a 505 pump or the Max Primary Rate if one is also enabled and set below these limits If the programmed infusion rate is less than the set KVO rate when the pump goes into KVO it will continue pumping at the programmed lower rate For full details on how to set the KVO rate see Chapter 3 Options Volumetric Infusion Pump Instruction Manual 2 29 Operating the pump Graseby Medical Ltd About Secondary infusions The pump has the facility for you to set up and run a Secondary infusion for example to e administer a dose of antibiotics to a patient who is already receiving a Primary infusion e administer a loading dose of a drug of a different concentration of the same drug as in the Primary container You use the Secondary Bolus key to program a Secondary infusion The Secondary volume infused is kept as a separate total It is not deducted from the Primary Volume to be Infused Once you have started an infusion from the Secondary set the solution from the Secondary container t
57. d technician or returned to Graseby Medical Volumetric Infusion Pump Instruction Manual 4 3 Troubleshooting Graseby Medical Ltd Insistent alarms pump stops infusing Message display Possible causes Action Air in cassette Air detected in the To remove air cassette 1 Close the lower roller clamp 2 Open the door latch 3 Wait briefly for the cassette to fill 4 Slowly close the door latch 5 Repeat if necessary or Cassette loaded Make sure cassette is backwards properly loaded flat side out pillow side in Battery too low Battery is depleted AC power cord must be Plug in cord plugged in to continue infusion Close clamp Tubing safety clip To load the safety clip Load Safety Clir is not correctly loaded 1 Close lower roller clamp 2 Open the door 3 Place safety clip in the slot 4 Close the door 5 Open the lower roller clamp Door oren Door was opened Always press the Hold key while the pump and close the roller clamp was running before opening the door To restart the infusion 1 Press Silence 2 Close the door 3 Press Run Loading problem Problem detected 1 Open the door Check tubing set above the pump as 2 Check clamps and tubing the door was being for any restrictions closed 3 Reload cassette if necessary 4 Close the door 4 4 Volumetric Infusion Pump Instruction Manual
58. e the Drug Label display It shows the name ofthe drug that is currently stored in the pump Press to change the drug 4 To select the drug label press e the 1 key to scroll down through the list or e the 3 key to scroll up through the list When the required drug label is displayed press the key to confirm the name This display shows that the selected drug is now stored in the pump as the Drug Label Press the Options key to take you to the next option When you see the Standard Message Display press to show the Drug Label for two seconds Volumetric Infusion Pump Instruction Manual 3 35 Options Graseby Medical Ltd Clearing the drug label 1 Press Hold if the pump is infusing Suntocinon 2 Press the Options key until you see to change dryg the Drug Label display to clear label 3 Press to display this screen t for new drug ee 4 Press to clear the label and to change drug display this screen 5 Press the Options key repeatedly to return to the Standard Message Display 3 36 Volumetric Infusion Pump Instruction Manual roubl esho doting Chapter 4 Graseby Medical Ltd Troubleshooting Introduction This chapter covers all the error messages and alarms displayed by the Volumetric that notify you of any operating problem If you cannot solve the problem after reading this chapter the pump should be inspected and
59. e patient weight you are next asked to enter it as described in Programming the drug amount opposite Programming the patient weight The Patient s body weight follows the dosing rate entry for the following dosing rate modes e mcg kg min e MG kg hr e mcg kg hr e MG kg min e units kg hr You need to enter the patient weight when you see a display similar to the following Pt wt fo kg Press when set Press the Options key to change the weight measurement from kg to lbs or lbs to kg The pump recalculates any value entered into the new weight units If you press the Options key a second time by mistake you are taken back to the beginning of programming Just press to get back to entering and confirming the patient weight Enter the patient weight from the keypad When entering the weight the precision depends on the units you are using See the Specification at the end of the manual for the increments for each weight unit Press to set the weight and move on to the drug amount Programming the drug amount The drug amount entry follows the dosing rate entry or the patient weight if a dosing rate involving weight is selected When you are asked to enter the drug amount display you will see a display similar to the following 464 MG drug bad Press when set If you need to change from MG drug bag in this example press the Options key to enter the change screen
60. e IV pole may tip over or the pumps fall to the floor Do not try to remove modular connected pumps from the IV pole whilst they are joined together Either of these could cause the administration set to separate from the fluid container thus spilling the medication or the pumps themselves could be damaged Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Switching the pump on and off Before switching the pump on visually check for any cracks on the case or damage to any part of the pump or its connectors Plug the AC mains cord into an AC mains supply if possible If necessary the pump can be run on its internal batteries see Using the pump on batteries later in this chapter Switching on To switch on the pump you can do either of the following e press the On Off key e open the front door by lifting the latch Note If the pump is switched off and connnected to AC power and the saftey keypad lockout feature is active the pump cannot be switched on via the keypad see Safety keypad lockout page 2 22 Switch on in Quiet Pump mode If you want to use the pump without any key clicks and also suppress the non insistent alarms you can switch on in quiet pump mode 1 Press the Silence key and keep it pressed down 2 Press the On Off key Note Quiet Pump operation is cancelled when you turn off the pump Self test When you switch it on the pump
61. e Pumping indicator stops If within 10 seconds the pressure drops back below the threshold pumping resumes and the alarm does not sound if pressure remains high the alarm sounds If repeated pressure spikes occur causing the pump to enter this filtering mode for a total of 30 seconds measured over the last 4 minutes that the pump was infusing the alarm sounds Occlusions detected in the Low occlusion alarm setting cause an immediate alarm Volumetric Infusion Pump Instruction Manual 4 5 Troubleshooting Graseby Medical Ltd Non insistent alarms pump continues to infuse Message display Dose setur not completed Possible causes Dose rate calculation program setup started with the pump running dosing parameters not completed Action Press the Silence or Run to silence the alarm if necessary re enter the Dose rate calculation program setup Dose change not completed Running dosing rate Press the Silence or Run key change was attempted to silence the alarm Re enter but not properly completed the running dose change see Chapter 3 Options Dose change not accerted The entered dose or calculated rate is incorrect Press the Silence or Run key to silence the alarm Re enter the parameters KUO MERKEL this infusion The infusion is complete and the pump has switched Press the Silence or Run key to silence the alarm and continu
62. e been designed with a high emphasis on safety e there is an optional automatic keypad lock which prevents inadvertent operation and increases patient safety e the keypad can also be locked manually at any time e apump may be configured so that its Infusion Rate and Volume to be Infused are limited to a suitable range this prevents values being entered accidentally which are inappropriate for infusions in particular environments such as epidural infusions e the pumps have indicators that are lit to show if they are running on battery or mains Volumetric Infusion Pump Instruction Manual Introduction Graseby Medical Ltd e when using the battery a test is performed on power up and the level is shown on the display manual testing is also available e the pumps have an RS232 interface allowing connection to a computer for external monitoring Display features Apart from the standard display pumps can be configured to show extra information either as a standard message display or by pressing a key to toggle the display Standard displays are e the volume infused in the current infusion e the infusion rate e the Volume to be Infused in the remainder of the infusion Additionally e the rate and volume to be infused displays are automatically adjusted to make them easy to read in any light e the time remaining in the present infusion may be viewed e the total volume of fluid deli
63. e key and enter the Bolus rate in mL h a co co eS oO 6 Press the Volume to be Infused key E z youn to clear the display and enter the pe Infused Bolus volume in mL 7 Verify that the rate and volume to be infused settings are correctly displayed for the Bolus 8 Press the Run key to start the Aas mL Bolus infusion The Message Eolus infusion Display shows the Bolus volume infused so far The volume infused is deducted from the Primary Volume to be Infused When the infusion is complete see Ending a Secondary or Bolus infusion on the next page Volumetric Infusion Pump Instruction Manual 2 31 Operating the pump Graseby Medical Ltd SS SS ae Ending a Secondary infusion The pump is configured to work in one Restarting Primary infusion of two ways when the Secondary infusion is complete depending on the Secondary Stop setting in the Technician Menu With Secondary Stop disabled on the Technician Menu the pump If Secondary Stop is enabled on the pump you restart the Primary infusion as follows 1 Press the Silence key 2 Press the Primary key er 3 Press Run e sounds a non insistent alarm twice and then reverts to the Primary infusion running at the previously programmed Primary rate Alternatively if Secondary Stop is enabled on the Technician Menu the pump e stops the at the end of the Secondary infusion is put on Hold and sounds an insistent
64. e the KVO delivery The to KVO rate pump re alarms every 6 mins or press the Hold key to silence the alarm and stop infusing Battery nearly Plug in the AC power cord if Lou partera depleted 1 2 hour or possible less remains or Press the Silence or Run key to silence the alarm for 6 minutes and continue running the infusion Rate change not completed Infusion rate change was attempted while running but not completed Press the Silence or Run key to silence the alarm Re enter the running rate change see Chapter 2 Operating the pump Secondary Secondary infusion Press Hold then Secondary key was set was programmed but Re enter the VTBI and Rate the Primary was run Press the Run key 4 6 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Troubleshooting Warning Messages with no alarms Message display Keyrad locked Possible causes Keypad Lock unlock button on rear of the Action Press the Keypad Lock unlock button on the rear of the pump pump has been to unlock the keypad pressed Keypad locked Keypad Auto lock Press the Keypad Lock unlock automatically button has been enabled button on the rear of the pump twice to unlock the keypad Note The keypad will automatically lock 1 minute after the last key is pressed ft oo ML Quick rate change See Chapter 3 Option
65. ed Press the key when the correct time is displayed FUH to end early 4 FAN Se start tapering To continue If the early feature is not required then press the key to continue the Rate Taper program as originally programmed If the pump is on hold press the Run key to continue the infusion 5 When the rate has tapered down hee wei an mL over the set length of time the pump alarms then continues to infuse at the KVO rate 3 14 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Resuming restarting or reprogramming the Rate Taper If the pump is turned off when Rate Taper is selected the current Rate Taper program is stored in memory You can use this feature of the pump to set up a program ready for later use When the pump is turned on again the Message Display depends on whether or not the Rate Taper has been run Rate Taper programmed but not run When the pump is turned on again if the Rate Taper was programmed but not run the Message Display shows RUM to infuse Resets Tarer Either e press Run to start the infusion using the pre programmed settings or e press to review or reprogram the settings Rate Taper run but not completed When the pump is turned on again if the Rate Taper was programmed and Run but not completed the Message Display shows Tarer 23 mL this infusion e Press the Run key
66. ededs cones scigesatehs atentaudeteeavGsenvadesuntacuelagetgesiueeeceassons 2 33 Primary Otal Session a Rees 2 34 Secondary totalSreieonn nnna Aid nein eee 2 34 Bolus Totals aese a a a erae ER 2 34 Re running infusions at the same rate aeseacessneernesnarrernrrnrnrrannrrnnnnnnennnnnnna 2 35 ii Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Contents Chapter 3 Options INTFOGDUCUION enn 3 1 Options available oo oreinaren aaar enia ekaia aa ka eaaa a aE 3 1 Using OptionS enasna eee eee 3 2 1 Standard MeSsSage inci lt 0scccsccteceeccseesecteccesssecceeestnereseucecsennecteecteeteessueasssccenss 3 3 2 Time RROMALINIING oon scce insects ccrensenceeiccee ceseceeevecececcsctivectusecesbuccesssuccreredcerenseet 3 3 3 Message Display Light cccsseccesseeeseeeeeeeseeeeeesneeeeseeeeesseeeeeeeseeseeeeees 3 4 Turning tthe light on and Offise 3 4 4 Battery Test icsi a aaa AE SA 3 5 Using the Battery Test Option ccscceceseseeeseeeeeeseeeeseeceeeseeeeseeeneeseeaeeeneenessaeees 3 5 5 QUICK Rate Change s sede iae aanne aaae anaana aaa Haaa aaa aaaea 3 7 Performing Quick Rate Changs seosisniisereirii enoi nara 3 7 6 Rate Taper ssieciciscsccecctcicesttcesseccenedsdveceentevestuededenebbvecdeceaesuscersystenedentceseennce 3 8 Toventer Rate Taper sssccsesececcseee cass lcntesesaeheciudeatieetanteeeveeceepsctesbaiiesauevessuuneeeveoenae 3 9 To exit Rate Tapers innorari a E aA EEA RA 3 9
67. en Battery indicator yellow Door latch lit when pump is lit when pump is pull the latch up and connected to AC switched on but not out to switch pump mains supply connected to AC on and open door for mains supply loading Flashes when battery Swing door closed is low and push the latch GM0166_0001 GB A in to secure the door 2 2 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Ge I Programming keys Display Confirm Options View Total Options or reset Total Volume menu volume infused View change Primary Occlusion Alarm infusion Setting for current key Total Occlusio infusion Volume satin 7 Program Primary Paraan Secondary or Bolus Secondary rate Bolus Secondary Volume infusion key Bolus Infused Program Primary Secondary or Bolus volume to be infused Keys also used as up and down arrow keys used only in Start infusion Options Stop infusion Numeric keypad used Decimal point to enter key numbers Switch on Alarm GMO0166_0002 GB A or off silence key Volumetric Infusion Pump Instruction Manual 2 3 Operating the pump Graseby Medical Rear of the pump Alarm Outlet for alarm Alarm volume control Keypad lock unlock button used to protect the keypad from tampering during an infusion Modular connection used when attaching more than one pump 000 0000 3 ini to an IV pole aC J Rails i Hoo
68. en set up for a Primary infusion using a Standard administration set 8C 820 The pump s Volume to be Infused Display shows the remaining Volume to be Infused and on its Message Display the pump shows the total infused so far For full details on how to set up a Primary infusion see Setting up a Primary Infusion page 2 16 GM0166_0005 G8 A 2 12 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump oer ewwowTwTgTere erETr rt reereeeoeocet __ SST SSS SSS 58S S562 SSS Primary and Secondary For a Primary and a Secondary infusion two containers are used Secondary e one to deliver the Primary infusion for example a hydration solution e a second to deliver an additional infusion for example an antibiotic Primary dose this is sometimes called a piggyback infusion The pump keeps separate totals for the Primary and Secondary infusions the total infused in the Secondary infusion is not deducted from the Primary Volume to be Infused The pump can be configured to work in one of two ways at the end of the Secondary infusion see Ending a Secondary infusion over the page For full details on how to set up a Secondary infusion e first follow the steps in Setting up a Primary Infusion page 2 19 e then see About Secondary Infusions page 2 26 Secondary inf
69. eval system or translated into any human or computer language in any form or by any means without the prior permission of Graseby Medical Limited GRASEBY MEDICAL LIMITED Colonial Way Watford Hertfordshire United Kingdom WD24 4LG Telephone 44 0 1923 246434 Facsimile 44 0 1923 231595 http www graseby co uk Registered in England Company number 995550 Trademarks and acknowledgements Graseby and Smiths are registered trademarks of the Smiths Group ple All other trademarks are acknowledged as the property of their respective owners Graseby Medical Ltd Warnings Warnings tell you about dangerous conditions that could lead to death or serious injury to the user or patient that can occur if you do not obey all of the instructions in this manual 1 WARNING You should ensure that the performance offered by the pump is fit for the intended purpose Failure to do so may result in compromised function of the product patient injury or user injury 2 WARNING Do not use a faulty pump If the pump detects a fault when it is first turned on or if it develops a fault during operation thena continuous system alarm sounds The pump must be referred to a suitably qualified technician or returned to Graseby Medical in order to have the fault rectified 3 WARNING Before using the pump it should be inspected for physical damage The pump should not be used if damage is evident and should be returned to service per
70. evious setting will flash even if no value previously been entered You can either enter a new value or accept the existing value by pressing the key or by pressing the Options key again to move onto the next option To enter a new value use the numeric keypad when the value is flashing and then press the key If you make a mistake do not press the Options key wait a few seconds and the value will flash again You can enter a value whenever the value is flashing It will flash again even though you have pressed the key If you press the Options key without first pressing any changes you make are discarded Using Options while infusing If you press the Options key while running a standard infusion then the options where you enter values such as rate limits display the current values but will not allow you to change them Backlight and Quick Rate change options can be activated Options for programming other special types of infusions Dose Rate calculation Rate Taper and Volume over Time will tell you to place the pump on Hold To leave Options When you have entered a value or set an option use the Options key to move to the next Option or start programming the pump by pressing an active key for example Rate Occlusion Alarm Setting or Volume to be Infused Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options 1 Standard Message The Standard Message refers to the pum
71. f the Options without correct training Options available The first options are 1 Standard Message 2 Time Remaining 3 Message Display Light Backlight 4 Battery Test The Backlight and all options after Battery Test only appear in the Option menu if they have been enabled in the Technician Menu 5 Quick Rate Change 6 Rate Taper 7 Volume Over Time 8 Dose Rate Calculation The pump can be programmed with Minimum and Maximum infusion rates and Maximum VTBI to limit the Primary and Secondary Bolus Rate and Volume to be Infused values These are provided by the following options WARNING Before confirming any displayed data the user should ensure that it is correct Failure to do so may result in compromised function of the product patient injury or user injury e Min Rate e Max Rate e Max VTBI e Min S B Rate e Max S B Rate e Max S B VTBI The final two options appear if they have been enabled in the Technician Menu e KVO Rate e Drug List You can go directly to options with numbers against them using the Fast access method described on the next page WARNING Correct entry of data is essential in order to ensure that the intended infusion is performed Before confirming any displayed data when setting up an infusion you should ensure that it is correct Failure to do so may result in compromised function of the product patient injury or user injury Volumetric Infusion Pump Inst
72. for their recovery either by recycling or energy recovery Important Existing national or local regulations concerning waste disposal must take precedence over the above advice Patents USA 5401256 GB 2247765 5103214 France 2715073 5429485 5017192 Volumetric Infusion Pump S 9 Specification Graseby Medical Ltd Trumpet curves The curves were developed while testing the Model 500 using a Graseby Medical Standard Adult Set 8C 820 administration set The curves for the Micro 505 are identical since both pumps have the same pumping mechanism The trumpet curve represents the worst case rate error in any given observation window over the whole infusion period These trumpet curves were prepared according to the requirements of IEC 601 2 24 Trumpet curve for Volumetric pump 1ml hr 0 93 0 93 Flow error Oo 154 GM0166_0014 GB A 20 25 30 35 Observation window minutes S 10 Volumetric Infusion Pump Graseby Medical Ltd Specification Trumpet curve for Volumetric pump 25 ml hr 15 10 Observation window minutes 0 50 5 0 50 35 Flow error 15 GM0166_0015 GB A Trumpet curve for Volumetric pump 100 mil hr 15 10 Observation window minutes Flow error 10 15 GM0166_0016 GB A Volumetric Infusion Pump S 11 Specification Graseby Medical Ltd SSS I S 12 Volumetric Infusion Pump
73. g the infusion See Chapter 3 Options for full details Infusing with Rate and VTBI limits enabled If the features for setting limits are enabled on the Technician Menu the limit values can be set or examined using the Options key They can be set independently for Primary and Secondary infusions and may not all be enabled If Primary Rate or VTBI limits are enabled you can also see the settings displayed after the pump is switched on When limits are enabled you cannot run an infusion with a Rate or Volume to be infused set outside the limits Also you cannot change the rate while running to go outside the limits If you try to do this or if you program a value outside the limits and then press the Run key you see the message Preset Limits Exceeded Wherever possible check or set the limits before you program the infusion especially if you might have to give a Secondary infusion or a Bolus The easiest way to check Primary infusion settings is to look at the message display when you switch the pump on To check Secondary infusion settings you must use the Options key Setting limits is described in Setting Rate and VTBI limits on page 3 29 in Chapter 3 Options Limits are enabled and set for a safety purpose for example where the pump is used for Epidural administration If you are likely to be in a situation where you have to give an infusion in an emergency ensure that when a pump is switched
74. ge Model 500 Range Increment 0 1 to 999 9 mL 0 1 mL 1 to 9999 mL 1mL Micro 505 Range Increment 0 1 to 999 9 mL 0 1 mL Volumetric Infusion Pump Graseby Medical Ltd Specification naaa SSS Occlusion sensing Alarm levels approximate values Pressure units Low Medium High mmHg 103 mmHg 259 mmHg 517 mmHg psi 2 psi 5 psi 10 psi kPa 13 5 kPa 34 5 kPa 68 9 kPa Time to occlusion Maximum measured 25 delay times for activation of the Occlusion below pump alarm Rate Low setting High setting maximum time maximum time to alarm to alarm 1 mL h 11 min 5 sec 1 hour 10 min 25 mL h 15 sec 2 min 35 sec KVO rate Default KVO rate 3 0 mL h or at the programmed rate if set at less than these values Configurable KVO rates Model 500 0 1 to 10 0 mL h Micro 505 0 1 to 3 0 mL h Accessories For a complete list of Administration Sets please contact Graseby Medical or your local distributor Volumetric Infusion Pump S 7 Specification Graseby Medical Ltd Symbols used on the pump Front panel symbols SS Battery is charging mains power applied R ines Audio alarm silence button Side panel symbols ij Use pump only in upright DA position Rear panel symbols xx f S Attention consult i accompanying documents gH Data input output 7 CF Application cardiac floating Audio alarm volume cont
75. ge for more details 2 10 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Continuous backup alarm In addition to the insistent and non insistent operational alarms the Volumetric pump has a fail safe backup alarm system This has a distinctive high pitched tone e should the audio alarm system fail then the pump sounds the backup alarm with a 1 5 second pause between alarm tones Operating the pump e should an electromechanical system failure occur the pump sounds the backup alarm continuously If you hear the backup alarm sounding you should immediately remove the pump from the patient and have it repaired by a Graseby Medical qualified technician Quiet Pump mode In some circumstances it may be desirable to operate the Volumetric without the associated sounds For safety reasons you cannot turn off the insistent or continuous alarms but if necessary you can operate the pump without the key press click sound and certain non insistent alarms This is called a Quiet Pump infusion Torun a Quiet Pump infusion 1 Ensure that the pump is turned off 2 Press Silence and keep it held down 3 Turn on the pump with On Off The keypad click and non insistent alarm sound is now off The pump remains in Quiet Pump mode until you switch off and then on again Silent alarms in Quiet Pump mode When running the pump in Quiet Pump mode certain alarms associated with a
76. ging the battery 2 9 Recovery dose rate calculation 3 19 Restore infusion rate 2 35 Rollerclamp 2 17 Running rate change 2 21 S Safety clip 2 18 S 1 clip alarm message 4 4 dose rate change alarms 3 27 4 6 rate and VTBI limits 3 29 Safety keypad lockout 2 22 Secondary infusion alarm 4 6 bolus enabled 2 30 ending 2 14 2 32 programming 2 29 secondary stop 2 28 setting up 2 26 totals 2 34 VTBI 2 28 Index 4 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Index OT I a ae Security on pump 2 22 Self test 2 7 S 1 Service due date display 2 7 pump service warning 4 3 servicing features 1 5 Silence key 2 7 2 11 2 22 Solution prepare for infusion 2 16 thick S 1 Sounds 2 10 Standard Message display option 3 3 Standards S 9 Start up label showing options 3 1 on battery 2 8 switching on 2 7 Stop infusion 2 23 Storage of pump S 1 Switching off 2 8 Switching on 2 7 using the battery 2 8 System check alarm 4 3 T Taper rate 3 8 Technician Menu 3 1 Test battery 3 5 conditions S 2 Thick solutions warning S 1 Time rate taper program 3 10 to occlusion S 7 volume over time program 3 17 Time Remaining display option 3 3 Titration rate 2 21 Total infusion volume Bolus 2 34 Primary 2 34 Secondary 2 34 Total Volume checking 2 33 clearing 2 33 TPN 3 8 Troubleshooting 4 2 preset limits and rate taper 3
77. has been added This means that when messages are not actioned within the timeout period for example setting a value the pump reverts to the previous display e safety keypad lockout this feature is only activated when operating the pump on AC power It allows the user to lockout the keypad after setting the pump up for use so that it can be ready for infusion at a later time Configurable safety features that can be controlled on the Technician Menu are e automatic keypad lock after one minute to prevent malicious tampering and increase patient safety e preset rate and VTBI limits so that Infusion Rate and Volume to be Infused are limited to a suitable range this prevents values being programmed accidentally which are inappropriate for infusions in particular environments such as epidural infusions or paediatric applications Display features e configured parameters are shown on the Message Display when the pump is switched on Configurable display features that can be controlled on the Technician Menu are e the backlight may be activated when the keypad is touched or kept on permanently e one of 30 preset drug labels may be selected and viewed as required during an infusion e the display of micrograms when programming an infusion using dose rate calculation can be shown as ug or mcg e the time display may include the suffix GMT or the suffix can be suppressed if it is not a
78. her infusion rates or with thick solutions see Note opposite or with small diameter cannulas you may see the following alarm message Occlusion below FUME WARNING If using a blood pressure cuff above the patient s venipuncture site take extra care in setting the Occlusion alarm pressures Failure to do so may result in unnecessary Occlusion alarms resulting in patient injury or death If there is no obvious reason for the alarm the message may occur because you have not selected an appropriate Occlusion Alarm Setting for the infusion If this is the case you may want to change the Occlusion Alarm Setting To change the Occlusion Alarm Setting during an infusion whether or not an alarm has occurred 1 Press Hold to silence the alarm if necessary and stop the infusion 2 Press the Occlusion Alarm Setting key once to display the current setting 3 Press the Occlusion Alarm Setting key repeatedly to display the available settings 4 When the correct setting is displayed press Run Note A thick solution may be certain cytotoxic agents lipid based fluids and other viscous solutions for example Total Parenteral Nutrition Approximate Occlusion alarm settings Low 2 psi 103 mmHg 13 5 kPa Medium 5 psi 259 mmHg 34 5 kPa High 10 psi 517 mmHg 68 9 kPa WARNING The Occlusion detection system measures downline back pressure in the administration set but does not detect infiltration In
79. hows Cannot infuse Reviews Dosing As well as the Message Display which shows the volume infused and the dosing rate the programmed volume to be infused appears in the Volume display and the calculated infusion rate appears in the Rate display HEM Volume to be Infused Calculated infusion rates may be rounded up as follows e below 100 mL h rounded to the nearest 0 1 mL h e above 100 mL h rounded to the nearest 1 mL h The pump also back calculates and displays the actual dosing rate being delivered if rounding has occurred Changing the volume to be infused If you do not want the whole bag to be infused you can change the volume to be infused if the pump is on Hold and the Message Display shows RUM to infuse Reviews Dosing or when the infusion has been started and then stopped Infused Jd mL 16 68 mcarkgzmin To alter the volume e press the Volume to be Infused key e enter the new volume to be infused e press Run Note Changing the Volume to be infused does not affect the programmed dosing rate or the calculated infusion rate 3 22 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options If you do not enter any values when programming but accept each previous value by pressing at every option the VTBI may not be correct for the infusion Set it to an appropriate value before running the infus
80. ical administration sets with this product Failure to do so may result in compromised system accuracy leading to complications resulting in patient injury or death 1 Squeeze the drip chamber and fill until it is at least one third full The drip chamber may fill completely during loading and or an infusion This will not adversely affect the fluid delivery or the operation of the pump 2 Hold the cassette inverted so that the roller clamp is above the cassette as shown here 3 Slowly open the roller clamp to allow the solution to flow through and prime the cassette and the line You can control the flow by moving the roller clamp as necessary 4 When the entire set is primed close the roller clamp WARNING To avoid over infusion do not prime the infusion line when the administration set is connected to the patient Over infusion can result in patient injury or death Volumetric Infusion Pump Instruction Manual 2 17 Operating the pump Graseby Medical Ltd SS SSS SSS ae Load the cassette into the pump With the administration set primed and the solution container hanging on the IV pole you can load the cassette into the pump as follows 1 Open the door of the pump by raising the latch 2 With the flat side of the cassette towards you and the roller clamp below the cassette match the four holes in the corners of the cassette with the four metal pins inside the pump 3 Press the cassette
81. ing infused from the Secondary container WARNING The Secondary volume to be infused must match the amount of fluid in the Secondary container Primary flow resumes when the Secondary container is empty If the volumes do not correspond the wrong infusion may be delivered which could cause serious patient injury or death 2 28 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Program the Secondary infusion This section describes how to program the Secondary infusion on a pump where the Bolus feature is disabled on the Technician Menu Max SB Rate 750 Press when set Secondary Bolus 1 4 mL this infusion igu a Volume to be Infused 2 9 mL this infusion D Press the Hold key if the pump is running If Secondary Min and Max Rates and Max Secondary VTBI are enabled on the pump ensure that they are appropriate for the infusion by pressing the Options key To find out more see page 2 15 Press the Secondary Bolus key The yellow Secondary indicator is lit The Message Display shows the volume from the previous Secondary infusion The Rate Display shows the last rate used for a Secondary infusion Press the Rate key and enter the rate for the Secondary infusion in mL h Press the Volume to be Infused key and enter the Secondary volume in mL This should normally match the volume in the Secondary container
82. ing messages 4 3 Audio alarm 2 10 Automatic keypad locking 2 22 Back pressure 2 24 Backlight 3 4 Backup audio alarm 2 11 Bag height above pump 2 16 2 27 Bag height above pump S 1 Battery battery test option 3 5 recharging 2 9 specification of S 3 too low 4 4 using the pump on 2 8 Bolus ending 2 32 feature enabled 2 26 setting up and running 2 31 totals 2 34 Button see also Keys unlock keypad 2 22 C Cassette loading into pump 2 18 CE Marking S 9 Change rate dosing rate change 3 25 quick rate change option 3 7 running rate change 2 21 warning messages 4 6 Clamp attach pump to IV pole 2 5 roller clamp on admin set 2 17 warning 4 4 Clip safety 2 18 S 1 Connecting pump to IV pole 2 5 secondary admin set 2 28 Continuous backup alarm 2 11 D Design standard S 10 Diagram front of pump 2 2 loading cassette 2 18 modular connection system 2 5 primary infusion 2 12 rate taper infusion 3 8 rear of pump 2 4 secondary infusion 2 13 Dimensions of pump S 1 Disconnect modular connected pumps 2 6 Volumetric Infusion Pump Instruction Manual Index 1 Index Graseby Medical Ltd Display H infusion information 2 21 light 3 4 Height on pump 2 2 bag above pump 2 16 2 27 S 1 Disposal of pump S 9 no flow warning 4 5 Door High open alarm 4 4 occlusion alarm setting 2 24 Dose Rate Calculation 3 19 History on pump 1 5 examp
83. ing rate on page 3 20 4 Enter the dosing rate value then press the key Volumetric Infusion Pump Instruction Manual 3 23 Options Pt wt fa kg Press when set 466 MG drug bad Press when set HG drug bag For new mode 506 MG drug bag Press when set 248 mL in bag Press when set RUM to infuse Reviews Dosing Infused B B mL THA megrkgrmin Graseby Medical Ltd 5 In this example because the dosing rate mode chosen is meg kg min the patient weight screen is displayed as described in Programming the patient weight on page 3 21 The weight is displayed in either kgs or lbs Changing the weight measurement is described in Programming the patient weight on page 3 21 Either accept the patient weight that is currently shown by pressing or enter the new weight of 73 then press the key 6 The next message asks for the drug amount in the bag If you need to change the entry type see Programming the drug amount on page 3 21 Enter the correct drug amount in the bag and press the key 7 Next enter the fluid volume of the bag and press the key 8 Before you start the infusion it is good practice to review your settings Press the key to review the program and make any necessary changes Note You may also need to review if the pump finds that the values you have entered are incompatible 9 When
84. into place and run your finger down the cassette to ensure that it is flat and correctly fitted 4 Slide the safety clip up to the base f of the cassette and push it fully The safety clip on the administration inward into its slot Betts marked with PONS w nate 5 Close the door pushing the latch the correct direction for insertion into place GM0166 0008 GB A The pump is marked with a diagram showing the position of the safety clip slot Setting the Occlusion Alarm When you switch the pump on the Occlusion Alarm setting is always the same and is defined by the Technician Menu configuration setting See the Specification section at the end of this manual for details on the pressure values for High Medium and Low settings Before an infusion always check and if necessary change the setting to suit the infusion by pressing the Occlusion Alarm Setting key Continue pressing WARNING The Occlusion alarm level the key until you see the setting you must be checked before starting an A infusion to ensure that it is appropriate want Never use a Low setting with for the infusion Failure to do so may high infusion rates result in an unacceptably slow time to For full details see Change the Occlusion alarm resulting in patient Occlusion Alarm setting on page 2 24 injury or death 2 18 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Primary infusion setup
85. ion Changing it will not affect the calculated rate Programming the pump using a fixed infusion rate Once you have completed the programming steps for the Dose Rate Calculation infusion you can change the infusion rate instead of accepting the calculated infusion rate When the Message Display shows RUM to infuse Reviews Dosing e press the Rate key and enter the desired rate then e press the Run key The pump will then back calculate the dosing rate based on the new infusion rate that you have entered Dose Rate Calculation programming example In this example we have chosen the following values to program e dosing rate 5 mcg kg min e patient weight 73 kg e drug amount in fluid container 400 mg e volume of fluid in container 250 mL Dose Rate Calc Press to set 2 megd k9 mMin Press wher set ee mog ko min For new mode 2 Megd ko mMin Press when set This example includes patient weight Step 5 is not necessary if you program without it 1 To enter Dose Rate Calculation press Options then numeric key 8 or press Options until you see this screen Press the key to enter the dosing rate display 2 You can either accept the dosing rate or enter a new dosing rate 3 If you need to change the dosing rate mode press the Options key Press the key until the required mode is displayed as described in Programming the dos
86. is chapter ccceesceeeeeseeeeeeeeseeeeeeeseeeeeneeseaeeeeeseaeeeeeeeentens 2 1 What this chapter COVefSimiiaicssns asse aa rE 2 1 Front of the DUNN ic scec eee ceccc cscs ieeceetccenscncasvaceceecennessnteceeseteaddecnsassennedeeseneneee 2 2 Indicators and CIS PIAS irs cas ssieee cose seek eoin nesai aaya EENE anA A E RE SEa 2 2 Programming KEYS sssri ients n a edes aaia yaaa 2 3 Rear Of the PUMP essnee 2 4 Connecting the pumps to an IV pole ccessccceseeeeeeseseeeeneeeeesneeeeeneneeeeeeeees 2 5 SWITCHING ON se detsdt Alea tilts died ie eee 2 7 Switching the PUMP ON and Off cscceeeeeteeesneeeeeeeeeeesneeeeeneeeeseeseeeseaneeeeeeea 2 7 SWITCHING OFF E E EE AE ee AHS add LLL Liha candcse hice ek cadet eee das 2 8 Using the pump on battery s sisccs kale i ee ee 2 8 Sounds ON the Volumetric c cceeceessseeeeeeeeeeeeeeeeeessaeeenseeeesneaeeeesseeeeeeeeeees 2 10 Audio alan spcco vases meatereateneantedetuaases sdscease sates nanereacec r E 2 10 Quiet PUMP Modestas anae cake died lah j uct E EASA dian 2 11 Alarms and computer Control ccccseeceseeeseeeeeesenceneeeceeseeeeeeneneeseeeeeereceeees 2 11 Types Of INTUSION use cccccc cdc cessce ce pseccec cette ceseneceddseseetenctecepcteeetveastestentereseseeerse 2 12 PIMANY ciscceies E aids sive edoas adit tienda Wiel adi eel ie adda Lede 2 12 Primary and Secondary ets nacelle ieee dala nenild ae 2 13 Primary and BONUS zirien a aieia ea r aa aE 2 14 Ending a Sec
87. k Disconnect button Pole clamp AC mains cord secured by retainer Equipotential earth point GM0166_0003 GB A Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump Connecting the pumps to an IV pole In use Graseby Medical recommend that the pump should be connected to a suitably balanced IV pole using the pole clamp as illustrated in the diagram on the opposite page The diameter of the pole must be between 1 2 cm and 3 8 cm 0 5 and 1 5 inches To provide maximum stability when using the modular connection system ideally the IV pole should have 6 wheels and a low centre of gravity The base diameter should be 56 cm 22 inches Attaching a single pump to an IV pole To attach the pump to a suitably balanced IV pole 1 Loosen the screw on the pole clamp 2 Hold the pump by the handle and slip the arms of the pole clamp onto the pole 3 Tighten the screw on the pole clamp to firmly attach the pump to the pole Attaching more than one pump to an IV pole When multiple infusion lines are required you can connect up to three pumps to a single pole using the hooks and rails that make up the modular connection system As all pumps have connectors on both sides you can use any one as the centre left or right pump This diagram shows how three pumps may be connected together using the Volumetric s modular connection system IV Pole Cen
88. l details on how to administer a bolus infusion see Running a Bolus Infusion on page 2 31 Ending a Secondary infusion The Secondary Stop feature in the Technician Menu controls how the pump works when the Secondary infusion is complete e With Secondary Stop disabled the pump automatically reverts to the Primary infusion at the previously programmed rate so that there is a continuous flow When the Primary infusion starts a non insistent alarm sounds e With Secondary Stop enabled the pump stops and sounds an alarm until you manually silence it and start the Primary infusion 2 14 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Operating the pump The effect of Options settings on infusions Some of the Options settings can affect the way you program the infusion what you can do during the infusion or the way the pump behaves For example if the pump has the appropriate Options enabled on the Technician menu you may choose to e turn on the Message Display backlight e set the KVO rate e select a Drug Label e program a Dose Rate Calculation Volume Over Time or Rate Taper infusion However the settings which may most affect the way you program an infusion are Rate and VTBI limits Such limits restrict the values you can use during an infusion and their use is described below If you need to make any changes to these Options settings you must do so before programmin
89. lculated rate dose Volumetric Infusion Pump Instruction Manual 3 27 Options Graseby Medical Ltd Programming or reprogramming Dose Rate Calculation with Limits set If any Limits are set for the Primary Rate or Max VTBI then these will apply when you program the Dose Rate Calculation or if you modify a program Setting limits is described on page 3 29 Before you enter Dose Rate Calculation It is worthwhile checking what values are set for Min and Max Primary Rate limits and for Max VTBI before you enter Dose Rate Calculation If they are inappropriate for the prescription you can adjust them and not have the infusion halt as described below If you program outside the limits The pump tests whether the entered or calculated values are within the limits when you press Run If the pump detects that the calculated rate is outside the limits or the VTBI is too high then the alarm sounds and the Message Display shows Preset Limits Exceeded Note This happens when the cal culated rate is valid but is outside the VTBI or infusion rate limits set on the pump It is not the same as the cannot infuse message displayed if the calculation is invalid To silence alarm and leave DRC If you see the Preset Limits message when you are programming or reprogramming a Dose Rate Calculation infusion Press the Silence key to silence the alarm The pump automatically leaves Dose Rate Calc
90. le 3 23 Hold recovery 3 19 alarm 4 5 warning messages 4 6 key 2 20 Dosing rate 3 20 l Download history 1 5 Drug amount 3 21 Indicators Drug Label Battery operation 2 8 display 2 23 Mains operation 2 2 example 3 34 Primary infusion 2 2 option 3 34 Pumping 2 21 selecting 3 35 Secondary Bolus infusion 2 2 E Infusion bolus 2 31 Electrical safety standard S 9 change rate while running 2 21 Ending effect of options on 2 15 bolus infusion 2 32 KVO 2 25 3 33 primary infusion 2 25 limits 3 29 rate taper infusion 3 9 options available 3 1 secondary infusion 2 32 overview of types 2 12 Epidural administration 1 2 primary 2 19 ranges of rates times volumes S 4 F restore previous rate 2 35 secondary 2 26 Fast Access to Options 3 2 stop 2 23 Faulty pump 4 3 Fluid Ingress protection S 9 Free flow protection S 1 Front of the pump 2 2 volume infused 2 33 Volume Over Time 3 18 Insistent alarm 2 10 4 4 Instrument care 4 8 symbols appearing on S 8 IPX1 S 10 Fuses S 3 IV pole 2 5 G K Giving set Keypad lock sats 2 18 manual or automatic 2 22 p 9 warning message 4 7 Graph trumpet curve S 10 Index 2 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Index or _eor MM ee_aQS_L iCi Keys hold 2 20 programming 2 3 unlock keypad 2 22 Kg orlbs 3 21 KVO alarm message 4 6 default rate S 7
91. led instructions in the Volumetric Infusion Pumps Service Manual Do not use unapproved cleaning agents CAUTION When turning the pump on if screens similar to those illustrated are not displayed do not use the pump and send the pump to authorised service personnel CAUTION Only carry the pump by the handle Failure to do so may result in damage to the pump or the pump may be dropped which could cause internal damage to the pump CAUTION The backlight has a limited life and may if used constantly cause the light to dim Eventually the message display may then need to be replaced To preserve the life of the message display you should only turn on the Message Display Light as described here if it is specifically required Misuse of this feature could lead to both battery and LCD depletion Volumetric Infusion Pumps Graseby Medical Ltd Contents Contents New features of version 0 71 software cccscccssssccseesesseseceeseseseeseeneenseeaeees v Chapter 1 Introduction Introduction to the 500 505 PUMPS ccccssseeeeeeeeeeseeeeeeeeeeesseeeeeeeeeseeeenenees 1 1 Model 500 Volumetric PUI cceseceeesecceeeeeeeeesceeeenceeenseeeesesenesseeeenesennensennes 1 1 Micro 505 Volumetric PUMP scsi sdseiieiiniv cee een eis cle 1 1 EPiCUralll ACMIMISTATION 5 cece cz cae bles satan sulfa E EE Eia 1 2 PUMP Teat ESen r AET A EA 1 3 Chapter 2 Operating the pump INTFOGDUCUION ecaa a 2 1 Who should read th
92. limits which you cannot do when you are in Rate Taper Troubleshooting Preset Limits error in Rate Taper program To find out why the Rate Taper program exceeds the limits check the following 1 Check the prescription volume against the Maximum VTBI limit and adjust the limit if it is incompatible with the prescription 2 Ifthe prescription requires that you enter a Maximum Rate check this against the Max Rate limit setting 3 Ifthe VTBI or Rate limits are acceptable note all limits that are set by using the Options key Re enter Rate Taper and check if you have made a mistake in programming the prescription 4 Step through the program look at the calculated values and compare them to the limits 3 16 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options 7 Volume Over Time VOT This option if enabled in the Technician Menu allows you to set up an infusion using the volume to be infused and the total time with the pump automatically calculating the infusion rate It can be used with either Primary Secondary or Bolus infusions Note If rate limits are enabled and set you may be restricted in the values you enter Always use the Options key to check any limits before you enter the mode See page 3 30 for more details Rounding up calculated rates If the calculated rate is 99 9 mL h or less the rate will be rounded to the nearest 0 1 of a mL h On the Model 500
93. matic keypad locking feature is enabled To lock the keypad during an infusion press the grey Keypad lock button on the rear of the pump The Message Display confirms that the keypad is locked Keypad locked If you touch any of the keys on the keypad once it is locked the pump re displays the message Safety keypad lockout The saftey keypad lockout is only active when operating the pump on AC power It allows the user to lockout the keypad so that after setting up the pump for use it is ready for infusion at a later time To set the saftey keypad lockout switch the pump off and connect to an AC power supply Then press the keypad lock button once If you now attempt to switch the pump on the keypad is locked out and the pump inactive The pump can only be switched on by e pressing the keypad lock once and then switching the pump on using the On Off key e or by opening the door Graseby Medical Ltd If the AC power supply is removed during the lockout the feature is abandoned pressing the On Off key switches the pump on If the AC power is removed and reconnected without any user interface with the pump the lockout remains active When the pump is used on battery power this feature is inactive Automatic keypad locking Before starting the infusion you can enable the Autolock Keypad feature in the Technician Menu With Autolock Keypad enabled the keypad locks automatically
94. mp is left on Hold unless you have set the Backlight on option described in Chapter 3 Options Low battery When you switch on the pump and during operation the pump warns you when the battery capacity is low If you see the yellow Battery indicator flashing whilst the pump is infusing you should plug the power cord into the AC mains supply as soon as possible Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Low battery alarms When approximately one hour of operation remains the pump sounds an alarm and displays this message Low battery Plug in cord If you see this message plug the power cord into the AC mains supply as soon as possible If you decide that you must continue to use the pump on battery another alarm sounds approximately half an hour before it is fully discharged This message is displayed Battery too low Plug in cord It is essential that the pump is plugged into the AC mains supply at this point WARNING Correct management of battery charging as described in this documentation is essential to ensure that the pump can operate on battery for the time specified Failure to do so may result in compromised function of the product or patient injury Operating the pump Recharging the battery To charge the battery plug the power cord into the AC mains supply It takes approximately 10 hours to recharge a completely depleted battery
95. mum infusion volume Max UTBI tat 1 Press the Options key repeatedly mi until you see the Max VTBI display Press when set The current maximum VTBI flashes showing that you can change this value Max UTBI 608 2 Enter anew VTBI using the Fress when set numeric keypad then press the key to confirm If it is correct to leave the VTBI unchanged just press If the pump finds that the rate is invalid the number continues to flash so you should repeat this step 3 Press the Options key to take you to the next option Volumetric Infusion Pump Instruction Manual 3 31 Options Graseby Medical Ltd Programming and running infusions with limits If limits are set and you try to run an infusion the pump will prevent you from running with a rate or VTBI value entered outside the limits This includes special infusion modes such as Volume over Time Rate Taper and Dose Rate calculation In the latter two infusion modes the pump behaves in a slightly different way For Rate Taper instructions on programming with limits set are described on page 3 16 For Dose Rate Calculation instructions on programming with limits set are described on page 3 28 If you change rates while running or put the pump on hold and change the volume the limits are checked when you press Run The pump continues to infuse at the previous rate when an error is detected during a rate change while run
96. n is displayed and the infusion starts immediately Alternatively to bring back the VTBI to check it before you start the infusion 1 Press the Volume to be Infused key TWO TIMES 2 Press the Hold key When you press Hold the VTBI value for the previous infusion is displayed but the infusion does not start 3 To start the infusion press the Run key Note You can also bring back the previous VTBI if you press the Volume to be Infused key TWO TIMES and then wait for 10 seconds Volumetric Infusion Pump Instruction Manual 2 35 Operating the pump Graseby Medical Ltd SSS SSS I 2 36 Volumetric Infusion Pump Instruction Manual Options Chapter 3 Graseby Medical Ltd Options Introduction This chapter describes the Options that are available for the Volumetric pump Some of the optional features allow the pump to meet the requirements of special clinical situations The Options available for the Volumetric pump are listed on the Start up instruction label on the side of the pump If your pump does not display the Option you require return the pump to your Biomedical department to have the feature enabled by a suitably trained person Options 1 2 and 4 are always available on the pump and cannot be disabled The other Options listed below can be enabled or disabled by a suitably trained person using the Technician Menu see the Technical User Manual Do not use any o
97. ndicate the approximate battery capacity unless the pump is in Dose Rate Calculation Recovery or Rate Taper mode Using the Battery Test option The Battery Test option can only be used if the AC cord is disconnected from the AC mains supply and the pump is on Hold If the pump is disconnected from the AC mains supply whilst it is infusing it continues to infuse and automatically switches to use the internal battery Battery test Press to begin LOW battery FULL This would indicate a battery approximately half charged In this case you may use the Battery Test Option described here to test the battery This way you can find out the approximate battery capacity without switching off the pump 1 Press Hold and ensure that the pump is disconnected from the AC mains supply 2 Press the Options key and then press numeric key 4 or press the Options key until the Message Display shows the Battery Test screen 3 Press the key to start the Battery Test The pump measures the battery voltage After 5 seconds it displays a Battery Gauge showing the approximate battery capacity WARNING Correct management of battery charging as described in the documentation is essential to ensure that the pump can operate on batteries for the time specified Failure to do so may result in compromised function of the product or patient injury Volumetric Infusion Pump Instruction M
98. ned to service personnel for repair before being returned to use Failure to do so may result in compromised function of the product patient injury or user injury WARNING Do not open the pump housing Refer all service faults only to qualified technical personnel Opening the pump housing may cause electric shock leading to patient or user injury or death Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Troubleshooting Pump Messages Messages are divided into those where an alarm sounds and those which just display a message Programming Messages with alarms Message display Possible causes Action Preset Limits Rate or VTBI limits Correct the value or change the Exceeded have been set and you limits if appropriate are trying to program a value outside these limits or You have entered a Correct the value Bolus VTBI greater than the Primary VTBI Warning Messages with alarms Continuous back up alarms When a continuous alarm occurs the pump automatically stops the fluid delivery Message display Possible causes Action Pume needs Electrical or Do not use service mechanical problem Pump needs to be repaired by a qualified technician or returned to Graseby Medical System check Potential pump Turn pump off then on Turn off then on problem detected If alarm persists remove pump from use Pump needs to be repaired by a suitably qualifie
99. ning Rate limit settings also affect Quick Rate changes When the pump detects a value which is outside the set limits it sounds an alarm and the Message Display shows Preset Limits Exceeded Silence the alarm and enter a value which is valid for the limits The previous value is restored to the LED display If are using Quick Rate change and try to move outside the rate limits the pump will alarm with the limits exceeded message and the rate LED will show the limit setting If you are changing the rate while the pump is running the infusion will continue at the limit rate 3 32 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options KVO rate The pump automatically switches to a KVO infusion when the programmed infusion ends The default rate for KVO is 3 0 mL h or the programmed infusion rate if that was less than 3 0 mL h The KVO option if enabled in the Technician Menu allows you to seta different KVO rate The pump remembers the value entered as described here and uses it as the KVO rate You cannot set the KVO rate to zero The range for the KVO rate must be within the following limits 500 0 1 to 10 0 mL h Micro 505 0 1 to 3 0 mL h When you set the KVO rate if the Max Primary Rate is also enabled and set below these limits then that will define the maximum KVO value you can enter If the programmed infusion rate is less than the set
100. njury or death Volumetric Infusion Pump Instruction Manual 3 19 Options Graseby Medical Ltd To enter or exit Dose Rate Calculation To enter Dose Rate Calculation To enter the Dose Rate Calculation display press Options and numeric key 8 or press the Options key until you see the following screen Dose Rate Cale Press to set Press the key to program the infusion To exit Dose Rate Calculation To exit Dose Rate Calculation press the Options key until you see the following screen Exit Dose Calc Press to exit Press the key to return to the Standard Message display Dose Rate Calculation steps This section looks at each Dose Rate Calculation step in programming order e Programming the dosing rate e Programming the body weight e Programming the drug amount e Programming the volume A complete programming example is described on page 3 22 Programming the dosing rate When you enter the Dose Rate Calculation option you see a display similar to the following asking you to confirm the current dosing rate 1 me3rkgzmin Press when set You can confirm the current rate by pressing or e change the dosing rate mode or e enter a new value for the dosing rate Changing the dosing rate mode The pump can be configured in the Technician Menu to display either pg or mcg micrograms To change the dosing rate mode that is the rate
101. o review the settings the display will take you through steps 2 to 8 again If you pressed the Run key the Rate Taper infusion will start The display will count up the volume infused from zero Volumetric Infusion Pump Instruction Manual 3 11 Options Graseby Medical Ltd To program a Rate Taper by Maximum Rate If you want to set the maximum rate at which the pump delivers the Rate Taper infusion choose the Maximum Rate taper method Rate Tarer Press to set Volume 1958 mL Press when set 1 For total time 2 For max rate Maximum 225 mlh Press when set In this example for maximum rate we have chosen the following values to program a volume of 1950 mL to be infused at a maximum rate of 225 mL h taper up time for 1 hour and 30 minutes taper down time for 30 minutes Press the Options key and numeric key 6 or press the Options key repeatedly until the Message Display shows the Rate Taper option then press the key to program your settings Enter the volume to be infused If an error is made while entering the new volume press the Volume to be Infused key and re enter the correct setting or alternatively press the Volume to be Infused key twice to return to previous setting When the correct volume is entered press the key Press numeric key 2 to select maximum rate Enter the maximum rate at which the infusion
102. on Manual Graseby Medical Ltd Operating the pump TT E Lower the Primary solution container Open the packaging around the This should lower the Primary Secondary administration set and find container by approximately 20 cm the hanger that looks something like eight inches Make sure that the drip this chamber on the Primary container is still at least 15 cm six inches above e one GMO0166 0010 GB A Take the Primary container from the IV pole and use the hanger to suspend it from the IV pole Prime the Secondary administration set You must always follow the Instructions for Use that accompany the particular administration set to be primed Each set contains specific priming instructions and also gives details of any warnings concerning the use of the administration set WARNING Do not run parallel infusion lines below the pump Delivering a Secondary infusion means running a second line above the pump Failure to do so may result in an inaccurate delivery of medication resulting in patient injury or death Volumetric Infusion Pump Instruction Manual 2 27 Operating the pump Graseby Medical Ltd Connect the Secondary to the Primary administration set If you are using the combined Primary Secondary 8C 6200 IV Administration set from Graseby Medical product code 591 096 follow its accompanying Instructions for Use If you are using a separate Primary and Secondary set then go through
103. on Maximum e Primary Max Volume to be infused e Secondary Bolus Minimum e Secondary Bolus Maximum e Secondary Bolus Max Volume to be infused e KVO Rate e Drug Library to allow selection and display of a drug label New features The new menu and new options in version 0 71 software provide a number of new features These fall into the following broad areas e Infusion mode features e Safety features e Display features e Servicing features Infusion mode features Using the Technician Menu the pump can be configured e to stop at the end of a Secondary infusion or to continue infusing and automatically switch to the programmed Primary rate Volumetric Infusion Pump Instruction Manual v Contents Graseby Medical Ltd e to allow a Bolus infusion to be programmed where the volume infused is deducted from the primary infusion volume to be infused to highlight this feature the key previously called Secondary is now called Secondary Bolus e to allow the user to set a KVO rate for an infusion or remain at the default rate configured for the particular pump e to use the Occlusion Alarm level specified for an infusion or remain at the configured default alarm level e to allow access to a previously programmed Dose Rate Calculation infusion when the pump is switched on Dose Rate Calculation recovery or display the standard messages Safety features e atimeout safety feature
104. ondary infUSion ccceecceeceeeeeeeeeeeeeeseeeseeeeeeeeeieesneeeeneeseeeenreres 2 14 Volumetric Infusion Pump Instruction Manual i Contents Graseby Medical Ltd The effect of Options settings ON INFUSIONS cccsseeeeeeseeeeeeeeeeeeeeeeeeeee 2 15 Infusing with Rate and VTBI limits enabled cece eeeeeeeeneeeeeneeeeeneeereees 2 15 Setting up a Primary INFUSION ccc seeee esses eeeeeeeeeeneeeeneeaeeeneeeeeeenneneeeee 2 16 Prepare the Solution ipes ceina a araneae E aaa aE EEEO 2 16 Prime the administration set Example ccceeseeeeeeeeeeeneeeeeeeeeesneeeeeneeeeeaaes 2 17 Load the cassette into the pump eee eeeeeeeeeeeeeeneeeeeeeeeeeneeeeenaeeteneeeteneeeeees 2 18 Setting the Occlusion Ala Miserere aa Gi 2 18 Primary infusion 5 or 6 Step Setup eecececeeeeeeeeeeeeeeeeeeeeeeeseeeseeeeseeeseeeeereees 2 19 During the infusion cceceeeee cee eneeeeeee eee eneeeneeeseeeneseneeeseeeneseneeeseeeneeenenennes 2 20 If the infusion will Not Start running eee eee eeeeeeeeneeeeeeeeeeeeeeteneeeeeeateeeeaees 2 20 Infusion information displays sirni A ets 2 21 Running Rate Change Rate titration ceeceeeeeeeeeeeeeeeeeeeeeeeeeeeeneeseeeeeneee 2 21 Security ON the PUMP ce ceeeseseeesceeseeceeeeeeeteaeeeeeeceaeeesaeeeaeeeseeseaeeeeeteaeeseeeeeaees 2 22 Display the Drug Label siccis tasi 2 23 Stop the intUSIONM swiss tern cenaertenivans insincere ete ard events 2 23 If an occlu
105. ons What this chapter covers These sections describe physical These sections explain how to program aspects of the Volumetric an infusion e front of the pump indicators and e types of infusion displays e setting up a Primary infusion e front of the pump programming e about Secondary infusions keys eth e running a Bolus infusion e reat ortae pump This chapter does not cover the types of infusion that may be run if the pump e switching the pump on and off has optional features enabled These e using the pump on battery are described in Chapter 3 Options e attaching the pump to an IV pole e sounds on the pump Volumetric Infusion Pump Instruction Manual a4 Operating the pump Graseby Medical Ltd SS ae Front of a 500 series pump Indicators and displays Carry handle Message display Pumping Rate display indicator for Primary Secondary or Bolus n to n the 13 8 mL infusion depending solution is being this infusion on indicator infused Primary 7 ii Noe ee ay infusion for Primary indicator im a Ee Secondary or Bolus aa a infusion depending gt Volume on indicator Secondary Tola Nisa Bolus Run indicator indicator ON when pump is infusing Ambient Flashing when light sensor infusing at KVO automatically rate adjusts brightness of message Hold display indicator ON when pump is not infusing Flashing when alarm sounds Mains indicator gre
106. p s normally displayed message when an alternative option is not selected 2 Time Remaining This option displays the time remaining until completion of the current infusion To use the time remaining display press the Options key and then press numeric key 2 or press the Options key until the Message Display shows 18 hrs 14 mins remaining The Standard Message display is similar to the screen below B A mL this infusion If the pump is on hold the time remaining is displayed until another active key is pressed If the pump is running time remaining is displayed for 5 seconds The time remaining is displayed and relates to the operating mode the pump is running in Primary Secondary Bolus Rate Taper or Dose Rate Calculation if enabled Volumetric Infusion Pump Instruction Manual Options Graseby Medical Ltd 3 Message Display Light The Message Display has a backlight that normally turns off one minute after the pump begins running or if the pump is left on Hold while using battery power It turns on automatically with any keypress or if the alarm sounds This option if enabled on the Technician Menu allows you to keep the Message Display s backlight on constantly whilst the pump is in use Battery operation and backlight use When using the pump on battery power the backlight normally turns off after one minute If you turn the light on as described here
107. ppropriate Servicing features On the Technician Menu the pump can be programmed with a pump ID to suit the hospital protocol and a service due date e the ID for example the serial number of the pump or an alphanumeric pump name is displayed each time the pump is turned on e when a Service Date is set the date is displayed each time the pump is switched on An alarm sounds when the date is reached vi Volumetric Infusion Pump Instruction Manual Introduction Chapter 1 Graseby Medical Ltd Introduction Introduction to the 500 505 pumps The Graseby Medical 500 and 505 Volumetric pumps are designed for use in infusion therapy in both venous and arterial infusions They offer both standard and optional features bringing accurate fluid delivery to the patient This makes them ideal for use in general care home care and intensive critical care areas The Model 500 and Micro 505 pumps are very similar in design The differences are in colour graphics and in the maximum rate and volume to be infused that can be programmed for an infusion The main features of the pumps are described starting on page 1 3 For full details on the differences between the 500 and 505 see the Specification section at the end of this manual Read the entire contents of this manual carefully before using the pump Model 500 Volumetric pump The Model 500 is designed for use in all areas as it can be
108. programmed with an infusion rate of up to 999 millilitres per hour and a maximum volume to be infused of 9999 millilitres Micro 505 Volumetric pump The Micro 505 is designed for use in paediatric neonatal environments and for fluid restricted patients It can only be programmed with an infusion rate below 100 millilitres per hour and the maximum volume to be infused is 999 9 millilitres Volumetric Infusion Pump Instruction Manual Introduction Graseby Medical Ltd Epidural administration Both the Model 500 and the Micro 505 pumps may be used for epidural administration Anaesthetics Epidural administration of anaesthetics is limited to short term not to exceed 96 hours infusion with indwelling catheters specifically indicated for short term delivery of anaesthetic drugs Analgesics Epidural administration of analgesics is limited to use with indwelling catheters that are specifically indicated for short or long term delivery of analgesic drugs WARNING When delivering drugs in the epidural space use only those medications specifically indicated for epidural use Epidural administration of other drugs could result in serious patient injury or death To prevent infusion of drugs not indicated for epidural use and to avoid inappropriate delivery rates when using the pump for epidural applications e use the pump s Maximum Rate option to set a maximum infusion rate of 20 mL h on a pump to
109. pump if the calculated rate is greater than 100 mL h the rate will be rounded to the nearest 1 mL h Volume and time value rates If the selected volume and time values calculate a rate which must be rounded the pump calculates a revised time appropriate to the rounded rate For example if the volume entered is 14 mL and the time entered is 8 hours the actual rate calculated will be 1 75 and then rounded to 1 8 The time then automatically changes to 7 hours 47 minutes and the following display appears 14 ml in fh4 n To accert time Press the key to accept time To enter Volume Over Time With the pump on hold press the Options key then press numeric key 7 or press the Options key until the Volume Over Time option appears Volume over Time Press to set To exit Volume Over Time To exit Volume Over Time when programming the volume or time press the Options key The following Message Display appears OPTIOWS to exit To review Press the Options key to exit or press to continue setting Volume Over Time When the pump is switched off Volume Over Time is cancelled When next switched on the pump resumes normal operation Minimum and maximum infusion time Infusion time is entered as hours and minutes Minimum infusion time 00 hrs 01 min Maximum infusion time 48 hrs 00 min For time less than 10 hours enter 0 before the hours digit for example 09 h
110. red which could cause serious patient injury or death WARNING Correct management of battery charging as described in this documentation is essential to ensure that the pump can operate on battery for the time specified Failure to do so may result in compromised function of the product or patient injury WARNING If a backup alarm sounds the pump should be immediately removed from the patient and sent to be repaired by a Graseby Medical qualified technician Failure to do so may cause patient injury or death WARNING Failure to use the power cord retainer means that the pump may be accidentally or erroneously disconnected from 24 25 26 27 Graseby Medical Ltd the mains Although there is a battery backup in case this happens the battery may not be charged sufficiently Consequently there is a risk of the pump not functioning which could lead to patient injury or death WARNING Do not open the pump housing Refer all service faults only to qualified technical personnel Opening the pump housing may cause electric shock leading to patient or user injury or death WARNING When the pump is carrying out an infusion to ensure that electrical safety is maintained only items of equipment that conform to EN60950 are to be connected to the RS232 connector situated at the back of the pump otherwise patient safety may be compromised WARNING While Graseby Medical Limited have taken all reasonable steps to ensure tha
111. repaired by a suitably qualified technician or returned to Graseby Medical at the address on the back cover of this Instruction Manual in order to have the fault rectified What s in this chapter The chapter contains two sections e warning messages with alarms divided into Continuous backup alarm Insistent alarms and Non insistent alarms e warning messages with no alarms The chapter lists the possible causes and recommended action to take for each of the warning messages The chapter does not contain details of the Volumetric pump System errors or warnings that indicate a problem that can only be solved by the Biomedical engineering department or by returning to the distributor factory These are described in the Volumetric Service Manual Who should read this chapter You should read this chapter to find out how to solve any problems that arise whilst you are using the Volumetric pump You are likely to be in one of the following groups e Biomedical engineering department needing to find out what alarms may arise during the normal operation of the pump e People being trained who have access to the Instruction Manual as additional training material e People who have been trained who need a concise summary to remind them of the Volumetric pump s alarms and a description of what to do if the pump sounds an alarm Volumetric Infusion Pump Instruction Manual Troubleshooting Graseby
112. rol Alternating current Nurse call option only if rw ii option is fitted Inside battery door symbols Attention dangerous voltages risk of electric shock if the housing is opened Equipotential point Internal battery Dispose of in an environmentally safe manner Battery symbols ons Recycle battery Dispose of in an me environmentally safe manner Volumetric Infusion Pump Graseby Medical Ltd Specification L C rSSS SSS ESS Standards Electrical Safety y Classified as Internally Powered Equipment Class 1 Type CF Cardiac Floating insulation on all inputs Design Standards EN 60601 1 EN 60601 1 2 IEC 601 2 24 Draft Fluid Ingress Protection IPX 1 Drip proof CE Marking C The CE mark demonstrates that the pump conforms to the requirements in the European Council Directive 93 42 EEC concerning medical devices 0473 The number 0473 identifies the Notified Body under which the Quality Systems operated within Graseby Medical Ltd are assessed Disposal When the time comes to dispose of the pump its batteries or any of its accessories do so in the best way to minimise any negative impact on the environment You may be able to use special recycling or disposal schemes To find out about these contact your local waste disposal service Separate any other parts of the equipment where arrangements can be made
113. ruction Manual Options Graseby Medical Ltd Using options There are two ways to select an Option e sequential access to view all available options e fast access to take you to directly to an option You use fast access as described below using a number from 1 to 8 for the numbered options in the list on the previous page The numbers are also shown in the Options list on the Start up label on the right hand side of the pump Viewing sequentially To view each available Option press the Options key Each time you press it will take you to the next available option After the final option the next screen is the Standard Message Display If you press the Option key again at the Standard Message you re display the Options Options without a number in the list on the previous page can only be viewed by using this method Fast Access To go directly to one of the numbered items first press the Options key and then its number on the numeric keypad using the one shown in the list on the previous page or on the side of the pump For example if you press the Options key and then numeric key 4 you are taken directly to the option to test the battery If a numbered option has been disabled nothing will happen Press the Options key again to see the next available option Values in the Message Display When you see a Message Display where you need to change enter or confirm a numerical value the pr
114. s 0 ccccccceeeeeeeeseeeeeeeneeeeeseeeeesneeeeeeseesseeeeenees 3 29 Minimum and Maximum Infusion Rates cceeeeeeeseeeeeseeeeeseeeeeeneeeeeneeeeeaas 3 29 To set the minimum and maximum infusion rate o oo cece ee eeeeeeeeneereeeeees 3 30 Maximum VIB aiccsaretcesnnitl cen ieee ee ee 3 31 Volumetric Infusion Pump Instruction Manual iii Contents Graseby Medical Ltd To set the maximum INFUSION volume eee eeeeeeeeeneeeeeeeeteeeeeenaeeeeneeeteaeees 3 31 Programming and running infusions with limits 0 eceeeeeeeeeeeeeeeteeeeeeeeeee 3 32 VO Wate e chet cs coer nestad Pertenece E E E E 3 33 Setting a KVO Tate ieir Aldi Shes eR ae eee ae 3 33 Druga el ccicceiocicccccseccssec ate canes cccanes saeeedevexd seveectecseseetecedveedeereanevesctecersncerys 3 34 Drug Library isi ceechectiiet neti cde diva hedieaves aa aa Ea EA a a E ig aes 3 34 Checking the current drug label sis ses nei iihicneneaeiiki nines 3 35 Selecting a new drug label eee eeeceeeeeeeeeeeeeeeeeeeeeeseeeeeeeseeeseaeeseeeseaeeseeeennees 3 35 Clearing the drug label ceeeceeeceseseeeseeseaeeeeeseaeeesaeseaeeeseeseaeeeaeeseaeeeeeeteates 3 36 Chapter 4 Troubleshooting Introductio occ esccececiccccedbeccceesiececsnced teeetdenectteceecuteescoccceesueddeesstucvessedecvessaeeviee 4 1 What s in this CRADTCr isicetvins ssacccctbecdiaes Mensehiciebtcieess hectesacceeetecdessdeteepedl chanel 4 1 Who should read this
115. s this infusion option has been selected Tarer eee ML The Rate taper See Chapter 3 Options this infusion option has been selected Cannot infuse To review The rate taper program or volume over time program cannot be infused as entered Infusion values must be changed see Chapter 3 Options Programming a rate taper or Programming volume over time Cannot infuse Reviews Dosing Dose rate calculation program cannot be infused as entered The infusion values must be changed see Chapter 3 Options Programming dose rate calculation Volumetric Infusion Pump Instruction Manual Troubleshooting Graseby Medical Ltd Instrument Care Periodic cleaning of the pump housing and inside surface of the door is recommended Unplug the power cord and use a sponge or cloth lightly dampened with a solution of warm water and a mild non staining disinfectant cleaner Do not use cleaning agents which could damage the outer pump housing The Service Manual contains information on which cleaning agents may or may not be used and how to perform cleaning CAUTION Carry out periodic cleaning following the detailed instructions in the Volumetric Infusion Pumps Service Manual Do not use unapproved cleaning agents 4 8 Volumetric Infusion Pump Instruction Manual 9ecifications Standards Graseby Medical Ltd Specification Specifications Gener
116. se will apply when you program the Rate Taper or if you modify a program Setting limits is described on page 3 29 Before you enter Rate Taper It is worthwhile checking what values are set for Min and Max Primary Rate limits and for Max VTBI before you enter Rate Taper If they are inappropriate for the prescription you can then adjust them and not have the Rate Taper infusion halt as described below If you program outside the limits The pump tests whether the entered or calculated values are within the limits when you press Run This also applies if you change values as described on the previous page If the pump detects that the calculated rate is outside the limits or the VTBI is too high then the alarm sounds and the Message Display shows this warning Preset Limits Exceeded Note This happens when the calculated rate is valid but not acceptable because of the VTBI or infusion rate limits set on the pump It is not the same as the cannot infuse message displayed because the rate calculation is invalid To silence alarm and leave Rate Taper If you see the Preset Limits message when you are programming or reprogramming a Rate Taper infusion e Press the Silence key to silence the alarm The pump automatically leaves Rate Taper and displays the Standard Message Bw mL this infusion This is so that you can use the Options key to check and if appropriate adjust the preset
117. seconds If the new dosing rate or infusion rate is entered but the Run key is not pressed within 10 seconds or if another function key is pressed the new rate is discarded and the Message Display reverts to the previous values a non insistent alarm sounds and one of the following displays appear Rate change not completed Dose change not comMPleted Press the Silence key to silence the alarm The pump now continues infusing at the old rate If you still need to change the dosing rate press the key to take you back to step 1 of Changing the dosing rate without stopping the infusion on page 3 25 or Changing the infusion rate without stopping the infusion on page 3 26 Dose or Rate change not accepted If the dosing rate or infusion rate is changed but the resultant calculated rate is incorrect the displays revert to their previous values the non insistent alarm sounds and one of the following displays appear Dose change not accerted Preset Limits Exceeded Press the Silence key to silence the alarm The pump now continues infusing at the old rate If you still need to make a change press the key to take you back to step 1 of Changing the dosing rate without stopping the infusion on page 3 25 or Changing the infusion rate without stopping the infusion on page 3 26 Check values you want to change before entering them to ensure that they will result in a valid ca
118. shing Maximum Primary rate Enter a new rate then press to set the value Just press if you want to leave the maximum rate unchanged You can now do one of the following press the Options key once to move on to the next Option press the Options key repeatedly to move through all the Options that have been enabled on the pump You can stop when the Standard Message is displayed on the screen indicating that the pump is ready to be programmed or carry on until you reach the Min Rate screen again where you can make further changes turn the pump off then on again to see the new primary minimum and Min Rate 1 maximum values in the messages displayed in the power up sequence 3 30 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Maximum VTBI This Option is to limit the volume that The Max Secondary Bolus VTBI is not may be programmed for a single displayed even if it is enabled infusion The Max VTBI is 9999 on a Model 500 or 999 on a Micro 505 There is no lower limit for the VTBI If the Primary Maximum VTBI is enabled the current setting is displayed when you switch on the pump If the default has not been changed on The example here shows how to set a Model 500 the screen looks like this the Maximum VTBI for the Primary infusion The process is the same for Max WTBI 9999 setting the Maximum VTBI for the Secondary Bolus infusion To set the maxi
119. should be run If an error is made while entering the maximum rate press the Rate key and re enter the correct value or alternatively press the Rate key twice to recall the previous setting When the correct maximum rate is entered press the key 3 12 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Tarer uF 1h 3am Press when set Ter down Bh 36m Press when set Total B9h 48m Press when set Cannot infuse To review RUM to infuse Resets Tarer Tarer A mL this infusion Options Enter the hours and minutes for the taper up period enter zero hours and minutes if you do not want to taper up When the correct Taper up time period is entered press the key Enter the hours and minutes for the taper down period enter zero hours and minutes if you do not want to taper down When the correct Taper down time period is entered press the key The pump calculates the length of time in hours and minutes required to complete the infusion with the maximum rate entered If the total time is correct press the key If you need to change the total time press the key twice to take you back to step 2 and adjust the program a higher or lower maximum rate may be required If was pressed and this display appears then you need to review the program you have set You will ha
120. sion is detected ssiri iiiaae nsa Siia 2 23 Change the Occlusion alarm Setting eccceceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeeenees 2 24 Ending the Primary infusion cccscccsseeeeeeseseeeeeeeeeeeseeeessseaeeeesseeeeneeees 2 25 KVO IMIUSION iknin a ative een ond eins ats ieee 2 25 About Secondary INFUSIONS cceccseseeeeeeteeeeneeeeeesneeeeeeeeesseeeeeeensneeeeeeeas 2 26 Setting up a Secondary infUSION 00 2 eeeeeeeeteeeeeceneeeseeeeeeeeeeteaeeeeeteaeeteeeaees 2 26 Lower the Primary Solution container ee eee eee eeeneeeeeeneeeeeneeeteneeeeeeeeeeees 2 27 Prime the Secondary administration set c ceeceeeeeeeeeeeeeeeeeeeeeeeeneeteaeeeneene 2 27 Connect the Secondary to the Primary administration Set cceeeeeees 2 28 About the Secondary Volume to be Infused cesccecesseeeeeeeeeseeeeeseesseeeees 2 28 Program the Secondary infUSiOn cecceeeeseseeeneeeeeeseeeeceeeeeeeseeeeeeeseneeeeeees 2 29 Secondary infusion Bolus enabled cecceeeeeeeeeeeeeeeeeeeeeeeeeeseeeeeneeseeeeenees 2 30 Running a Bolus infUSiON 0 ccssccceeseceeseeeeeeeeneeeeneeeeseseeeeeessnaeeeeseeeeeneneees 2 31 Ending a Secondary infUSion ccceecceeseceeeeeeeeseeeseeeeeeeeeaeeseeseaeesieeteneeeneeees 2 32 Ending a Bolus Infusion 2 csienesHidi r 2 32 Checking infusion totals ccccceeeeeeeeteeeeeeeeeeeeneeeeseeeseeseeeeesneeeeeeeeeeseeeeees 2 33 Total Volume infused 5 cecisicidvest
121. sonnel for repair before being returned to use Failure to do so may result in compromised function of the product patient injury or user injury 4 WARNING Do not use the pump if you detect any cracks chips and loose or bent parts or if the buttons do not move in and out freely when they are pressed Failure to do so could cause inadvertent disconnection of the pumps 5 WARNING Do not push or pull on the pumps or the IV pole may tip over or the pumps fall to the floor Do not try to remove modular connected pumps from the IV pole whilst they are joined together Either of these could cause the administration set to separate from the fluid container thus spilling the medication or the pumps themselves could be damaged 6 WARNING Correct entry of data is essential in order to ensure that the intended infusion is performed Before confirming any displayed data when setting up an infusion you should ensure that it is correct Failure to do so may result in compromised function of the product patient injury or user injury 7 WARNING Dose rate calculation requires care in entering data Refer to specific product drug labelling for information on appropriate administration techniques and dosages Entering incorrect data may result in patient injury or death 10 11 12 13 14 15 16 17 Warnings and Cautions WARNING When delivering drugs in the epidural space use only those medications specifically
122. t the pump operates correctly while under remote control it is the responsibility of the person who designs and implements the controlling device to ensure that the resulting system pump and controlling device is fit for its intended purpose Failure to do so may result in compromised function of the product patient injury or user injury WARNING Use only Graseby Medical administration sets with this product Failure to do so may result in compromised system accuracy leading to complications resulting in patient injury or death Cautions Cautions tell you about dangerous conditions that can occur and cause damage to the pump if you do not obey all of the instructions in this manual 1 CAUTION Refer all service repair and calibrations only to qualified technical personnel Unauthorised modifications to the pump must not be carried out CAUTION Do not autoclave steam sterilize ETO sterilise or subject the pump to temperatures in excess of 55 C 131 F Excessive temperatures may cause damage to the pump CAUTION To prevent serious damage to the pump it must not be immersed in any liquids or exposed to strong organic solvents Wipe off spills immediately Do not allow fluid or residues to remain on the pump Additionally the pump is not designed to allow it to be sterilised Failure to observe these cautions may cause internal damage to the pump CAUTION Carry out periodic cleaning following the detai
123. the following steps 1 Insert the needle from the Secondary set into the injection site on the Primary set 2 Keep the Secondary clamps closed until you are ready to start the Secondary infusion 3 Check that the roller clamp below the pump is closed and go on to program the Secondary infusion The position of the two solution containers and administration sets is shown on the diagram on page 2 13 About the Secondary Volume to be Infused Because the Secondary container hangs on the IV pole at a higher level than the Primary the entire contents of the Secondary container may be infused at the end of the Secondary infusion This can happen even though the Secondary Volume to be Infused is zero On a pump where Secondary Stop is not enabled in the Technician Menu you must ensure that the amount that you enter as the Secondary Volume to be Infused is equal to the volume of fluid in the Secondary container WARNING Check the Secondary set carefully since an occlusion above the pump on the Secondary line could cause the Primary fluid to be delivered instead of the Secondary infusion Administering the wrong medication may cause serious patient injury or death If the Secondary Stop feature is enabled the pump stops infusing and sounds an alarm when the Secondary infusion is complete and the Secondary Volume to be Infused has been delivered You can then clamp the Secondary set to prevent any more fluid from be
124. to resume the infusion or e press the Options key then press to review or reprogram the Rate Taper settings Repeat a completed Rate Taper After completing a Rate Taper program you can repeat the program from its beginning 1 Press the Volume to be Infused key twice The previous volume to be infused appears in the display 2 Press the Run key to start the infusion using the previous values Modify previous Rate Taper volume If you need to repeat a Rate Taper program but need to change the Volume 1 Press the Volume to be Infused key and enter the new volume The total time and or the maximum rate changes automatically 2 Check that the correct volume is displayed then press the Run key to start the infusion Modify other Rate Taper values If you need to change any other programmed Rate Taper values total time maximum rate taper up time or taper down time you must press the Options key and follow the steps for either programming Total time or Maximum rate in this chapter Any limits set with options such as Rate or VTBI limits will apply You will be able to program Rate Taper as normal but you will be prevented from running the infusion For more details see page 3 16 Volumetric Infusion Pump Instruction Manual 3 15 Options Graseby Medical Ltd Programming or reprogramming the Rate Taper with Limits set If any limits are set for the Primary Rate or Max VTBI then the
125. tre mounted pump Left mounted pump Right mounted pump GM0166_0004 GB A Inspecting the modular connections Before connecting the pumps you must check that the modular connection parts are all in good condition 1 Carefully inspect the modular connection system for damage including cracks chips loose or bent parts 2 Press the disconnect buttons several times to make certain that the buttons move in and out freely WARNING Do not use the pump if you detect any cracks chips and loose or bent parts or if the buttons do not move in and out freely when they are pressed Failure to do so could cause inadvertent disconnection of the pumps Volumetric Infusion Pump Instruction Manual Operating the pump How to connect pumps together Once you have inspected the modular connection system as described in the previous section connect the pumps as follows 1 Clamp the first pump to the IV pole This is now the centre pump Note As you tighten the screw on the pole clamp you automatically adjust the modular connection hook and disconnect button Once the pump is securely attached to the pole the hook is in the correct position to allow you to connect further pumps 2 Take the second pump grasping it by the handle and hold it so that the modular connector rails are directly above or below the connector rails of the centre pump 3 Engage the edges of the modular
126. ulation and displays the Standard Message HA mL this infusion This is so that you can use the Options key to check and if appropriate adjust the preset limits which you cannot do when you are in Dose Rate Calculation Troubleshooting Limits in a DRC program To find out why the Dose Rate Calculation program exceeds the limits check the following 1 Check the prescription volume the volume in the bag against the VTBI limit and adjust the limit if it is incompatible with the prescription 2 The rate calculated will remain in the LED display when you are taken out of Dose Rate Calculation Check this against the Rate limit setting 3 Check the value for the VTBI since you may have accepted all values for a previous Dose Rate calculation program and this will not have updated the VTBI from the bag volume 4 Ifthe VTBI or Rate limits are acceptable note all limits that are set by using the Options key Re enter Dose Rate Calculation and check if you have made a mistake in programming the prescription If you change the rate while running If you change the rate either the dosing rate or the pump infusion rate while running and exceed the limits then press Run the pump alarms but continues at the programmed rate 3 28 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options Setting Rate and VTBI limits You can limit the infusion Rates and VTBI volume to be
127. ume To clear the Total Volume on the pump for example to reset the pump before programming an infusion for a new patient e press Hold to stop the infusion if the pump is infusing e press Total Volume The Message Display shows the total volume as in this example 16 5mL eh 7m Press to clear e press to reset the Total Volume and Time to zero Volumetric Infusion Pump Instruction Manual 2 33 Operating the pump Primary totals Whilst a Primary infusion is running the Message and Volume to be Infused Displays show the volumes for the Primary infusion Volume infused so far During an infusion the Message Display counts up to show the volume infused so far for example 1 4 mL this infusion Graseby Medical Ltd Volume to be Infused The Volume to be Infused display counts down to show the remaining volume to be infused for this infusion for example Volume to be Infused At the end of an infusion the Volume to be Infused is zero Secondary totals Whilst a Secondary infusion is running the Message and Volume to be Infused Displays show the volumes for the Secondary infusion To view Secondary volumes after completing a Secondary infusion 1 Press the Secondary Bolus key 2 Ifthe Bolus feature is enabled press 1 to choose the Secondary volume 3 The Message Display shows the infused volume for the Secondary infusion as shown in this example
128. unning you can change the infusion rate For example you may need to adjust the initial rate once the infusion is established You can also stop the infusion and then change the rate but the ability to change without stopping the delivery of the solution is especially important with some drugs for example vasoactive drugs You can carry out a running rate change on Primary or Secondary infusions Once the infusion has started to enter a running rate change 1 Press Rate 2 Enter the new rate using the numeric keypad 3 Press Run within 10 seconds If you do not complete the rate change within 10 seconds an alarm sounds and the rate reverts to the previous running rate followed by a message to tell you the change has not been completed If rate limits are enabled and you enter a rate that is outside those set an alarm sounds and you see Preset Limits Exceeded The pump continues at the previous rate Silence the alarm and check the current settings using the Options key If you need to change the rate limit you must first put the pump on hold Volumetric Infusion Pump Instruction Manual 2 21 Operating the pump Security on the pump To prevent any tampering with the keypad during the infusion there are two ways to secure the keypad e manual locking e automatic locking Manual keypad locking This safety feature is always available on the pump whether or not the auto
129. use If you see this message when you press Run then you have entered a time volume combination that resulted in an invalid rate Cannot infuse To review 1 Press the key to return to step 2 and enter the correct volume and time values 2 Press the key then press Run 3 18 Volumetric Infusion Pump Instruction Manual Graseby Medical Ltd Options 8 Dose Rate Calculation This option if enabled in the Technician Menu allows the automatic calculation of the infusion rate when the following parameters are set e dosing rate for example mcg min or mcg kg min e patient weight in kg or lbs if required in dose mode selected e drug amount in fluid container MG milligrams Gm grams mcg micrograms or units e volume of fluid in container mL Dose Rate Calculation can be used with the pump on hold or while running It is only available for a Primary infusion When in Dose Rate Calculation mode all values for the current infusion are stored when the pump is switched off During a Dose Rate Calculation infusion if the Drug List feature is enabled you can press twice to view the selected Drug Label Minimum Maximum Rate or VTBI limits set in Options apply to a Dose Rate Calculation program For more details see page 3 28 ug may be displayed instead of meg in Dose Rate Calculation displays see the Technical User Manual Dose Rate Calculation Recovery
130. usion with Bolus enabled The pump can be configured using the Technician Menu to offer a Bolus infusion as an alternative to the Secondary infusion If the Bolus feature vince is enabled you can e run a Secondary infusion where the volume infused is not deducted from the Primary Volume to be Infused or e runa Bolus infusion where the volume infused is deducted from the Primary Volume to be Infused Volumetric Infusion Pump Instruction Manual 2 13 Operating the pump Primary and Bolus With the pump configured to offer the Bolus feature you can carry out a Bolus infusion as an alternative to the Secondary infusion A Bolus infusion may be administered at a different rate with the volume to be infused entered separately to the Primary volume just as for a Secondary infusion However for a Bolus infusion the Volume infused is deducted from the Primary Volume to be Infused At the end of the Bolus the pump reverts to the Primary infusion at the previously programmed Primary rate The Secondary Stop feature if enabled has no effect at the end of a Bolus Graseby Medical Ltd When the Bolus feature is configured each time you press the Secondary Bolus key the Message Display shows Secondary Bolus Press 1 oor 3 At this point you would press 3 to enter Rate and Volume to be Infused for the Bolus or to view the totals for the Bolus infusion For ful
131. ve to adjust to the volume time and or maximum rate value Press the key This takes you back to step 2 again to review the program values If ready to start the Rate Taper infusion press the Run key or press the key to review your settings If you pressed the key to review the settings the display will take you through steps 2 to 8 again Ifyou pressed the Run key the Rate Taper infusion will start The display will count up the volume infused from 0 Volumetric Infusion Pump Instruction Manual 3 13 Options Graseby Medical Ltd Using the End Early feature If it is necessary for a patient s Rate Taper infusion to end earlier than planned this feature provides an alternative to stopping the pump abruptly when it is infusing at a high If the infusion ends early the patient does not receive the full infusion as initially programmed flow rate Tarer oF mL 1 With the Rate Taper infusion this infusion running press the Hold key 2 Press the Options key twice to view na mins the time remaining for the Rate Taper 3 Press the Options key again to Eng zp l TEA m a access the end early display This ress WER Se shows the actual time remaining or 30 minutes whichever is less If the displayed time is acceptable for the infusion rate to taper down press the key If you need to change the time displayed any number of minutes from 01 to 99 can be enter
132. vered to your patient since the totaliser was last cleared to be viewed also displayed with the total volume is the total time hours and minutes that the pump has been in use since the totaliser was last cleared Using configurable displays e the backlight may be activated when the keypad is touched or kept on permanently e optionally one of 30 preset drug labels may be selected and viewed as required during an infusion Occlusion Pressure features These features increase safety in infusing fluid particularly in critical care areas such as neonatal and paediatric care when setting occlusion alarms three standard occlusion alarm settings between 100 and 500 mmHg can be made see the Specification section at the end of this manual for full details of the occlusion alarm values e the occlusion pressure alarm setting when the pump switches on is configurable you can change the setting for a particular infusion using the Occlusion Alarm Setting key e when an occlusion alarm sounds the pumping mechanism backs off to reduce downline back pressure and bolus potential bolus potential is approximately 0 3 mL regardless of the rate and the administration set used e when an occlusion is detected the pump does not give an occlusion alarm immediately but only alarms if the occlusion pressure continues to exceed the occlusion threshold for up to 10 seconds however if such temporary occlusions persist then
133. y and then press numeric key 5 or press the Options key until the Rate Change message appears 2 Press the key to begin changing the rate The Message Display shows this screen for 10 seconds 3 Change the rate e press the 1 key to decrease the infusion rate by 1 mL h or to decrease by 0 1 mL hif the original rate was set in 10ths mL h or e press the 3 key to increase the infusion rate by 1 mL h or to increase by 0 1 mL h if the original rate was set in 10ths mL h 4 After 10 seconds the Message Display changes to show the volume infused so far The arrows are displayed as a reminder that the Quick Rate Change option is still selected You can repeat step 3 as required 5 When you have finished with Quick Rate Change to exit and redisplay the Standard Message e press the Options key to display this screen then e press Volumetric Infusion Pump Instruction Manual Options Graseby Medical Ltd 6 Rate Taper This option if enabled allows automatic tapering of the infusion rate either up or down for the administration of Total Parenteral Nutrition TPN Rate taper is programmed by setting four infusion variables 1 Volume 2 Total time or Maximum rate 3 Taper up time 4 Taper down time The pump then makes the necessary calculations and performs the rate changes at the required times A Rate Taper infusion can be repeated exactly as the previous infusion or changes can be m

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