CURLIN MEDICAL User’s Manual for use with the 4000 Plus and 4000 CMS Ambulatory Infusion Systems 0050 CURLIN MEDICAL, LLC 15751 Graham Street Huntington Beach, CA 92649 Phone 714 893-2200 • Fax 714 894-2602 www.curlinmedical.com For 24-hour Clinical or Technical Support call toll free: 1-888-287-5999 (888-CURL-999) Covered by U.S. Patents 5,575,631 5,683,233 5,791,881 5,924,852 6,164,921 6,371,732 B1 Des. 408,911 Des. 437,547 S. Other U.S.
TABLE OF CONTENTS INTRODUCTION .................... 1 Delivery Modes ................................ 1 Indications for Use ..........................2 Special Features of the 4000 Series Pump ...................................2 Regulatory Agency Approvals .........3 Warnings, Cautions, Notices...........4 Pump Illustrations and Features .....8 Disposable Administration Set Illustrations and Features .............. 10 Preparing Medication for Infusion/Changing IV Bags...........
TABLE OF CONTENTS Entering or Changing Data Fields.............................................. 40 CONTINUOUS THERAPY ... 41 Prescription Menus........................ 41 Continuous Pre-Prescription Menu Screen...................................... 41 Continuous Delay Start Setting ...... 42 Run Options Screen ......................... 42 Continuous Titration Limit Screen ................................................. 43 Continuous Prescription Menu ...... 44 Run Options Screen ........................
TABLE OF CONTENTS TPN Pre-Prescription Menu Screen ................................................. 71 TPN Delay Start Setting .................. 71 Run Options Screen ......................... 72 TPN Prescription Screen................. 73 Run Options Screen ......................... 74 Prime.............................................. 74 Prime Direction Screen.................... 75 Options .......................................... 76 TPN Options Menu ......................... 76 Hourly Totals Screen.
TABLE OF CONTENTS Prime.............................................106 Prime Direction Screen.................. 106 Options .........................................107 Variable Options Menu ................. 107 Hourly Totals Screen...................... 108 Clear Hourly Totals Screen ........... 108 Air-In-Line Sensor Off Message Screen ............................................... 109 Air-In-Line Sensor Set at 2.0ml Alert Screen .....................................
TABLE OF FIGURES FIGURE 1.1 CURLIN MEDICAL AMBULATORY PUMP—FRONT, TOP AND LEFT VIEW .... 8 FIGURE 10.1 AC ADAPTER/CHARGER............. 139 FIGURE 10.2 BATTERY PACK ............................. 140 FIGURE 1.2 CURLIN MEDICAL AMBULATORY PUMP—BACK, BOTTOM, AND RIGHT VIEW.................................................................. 9 FIGURE 10.3 DETACHABLE POLE CLAMP ......141 FIGURE 10.4 REMOTE BOLUS CORD................141 FIGURE 1.3 SAMPLES OF CURLIN MEDICAL ADMINISTRATION SETS......................
1 Chapter The Curlin Medical Infusion Pumps have been designed with the user in mind and have the latest in friendly, simple-to-learn technology to allow fast and easy access to the features of these pumps. With a little introduction and training, an operator will quickly be able to program and use these pumps to deliver the therapies prescribed. Note: Throughout this Manual the text will refer to the Curlin Medical pump.
Indications for Use The Curlin Medical pump can be used for intravenous, epidural, or subcutaneous therapies. It can be used to deliver medications from the specially designed Curlin Medical medication reservoir, syringes1 or from IV bags. A physician or a certified, licensed, healthcare practitioner must oversee any therapy. Patients and caregivers using the Curlin Medical pump should be instructed in its use by a qualified clinician and demonstrate an adequate level of proficiency in the use of the pump.
independence of lifestyle. Backpack will accommodate pump, AC Adapter, and up to fourliter IV bag. Retained memory features that allow the pump to easily resume a therapy exactly from where it left off when it is interrupted before completion or to repeat a therapy using the same programmed prescription. • Compact, lockable safety shells that provide additional security when needed and that are designed to be free standing, pole mounted, or placed in the convenient, soft, carry case.
Warnings, Cautions, Notices EXPLANATION FOR SYMBOLS on the Curlin Medical Pump with the Classified UL 2601-1 and CSA C22.2 No. 601-1 Label. The meanings for the symbols on the pump are as follows: Attention, consult ACCOMPANYING DOCUMENTS. ♥ Type CF Equipment IPX1 Protected against dripping water. INFUSION PUMP WITH RESPECT TO ELECTRIC SHOCK, FIRE AND MECHANICAL HAZARDS ONLY IN ACCORDANCE WITH UL2601-1/CAN/CSA C22.2 NO. 601.
WARNINGS Use only Curlin Medical administration sets in your Curlin Medical pump. Use of nonproprietary administration sets may alter accuracy in delivery of fluids and could result in over or under infusions, leading to possible patient injury or death. • Do not use this pump with a pressure cuff applied to the IV bag or medication reservoir bag, and do not unduly squeeze or compress the bag during a running infusion.
• If any signs or symptoms of infiltration or inflammation are noted at the infusion site, stop the infusion and report it to the appropriate healthcare provider. • Always use the slide clamp on the administration set as an additional precaution to occlude the tubing before opening the door of the pump. • Do not subject the pump to dropping or hitting against a hard surface. If at any time the pump is dropped or hit, inspect it for signs of damage.
The soft carry packs are intended for single patient use. They may be cleaned in the gentle cycle of a washing machine using cold water, no chlorine bleach, and line dried. (They cannot be dried in a clothes dryer.) • The Bolus/Data connector is to be used by the patient only for the connection of the bolus cord with remote switch. Other accessory equipment connected to this digital interface must be certified to the respective IEC/EN standards (i.e.
Pump Illustrations and Features Pump Door Pump Door Instruction Label LED Status Indicator Display Screen Door Latch Run/Pause Key On /Off Key Help/Option Key Down Arrow Data Interface/ Bolus Cord Port Yes/Enter Key Prime/Bolus Key Up Arrow No/Change Key Decimal Point/ Silence Key Numeric Keys Figure 1.
Introduction Serial Number Label Battery Compartment Door with Caution Label Recessed release Pin for Battery Door External Power Jack Port (2 Pin Port) Right View Pump Door Figure 1.
Disposable Administration Set Illustrations and Features Male Luer Lock Integral FlowStop with breakaway tab Slide Clamp Tubing Guide Bag Spike These drawings are NOT to scale. Note: An important feature of the Curlin Medical administration set is the unique design of the set-based “Integral Flow-Stop.” When the set is new, the “Integral Flow-Stop” has a breakaway tab that keeps the “Integral Flow-Stop” open and allows the tubing to be gravity primed.
Preparing Medication for Infusion/Changing IV Bags Holding the bag with fill ports down allows fluid to fill tubing and displace the air in the line. Be sure all air has been removed from the IV bag as well. Air in the line moves down through the tubing as the fluid fills. OPEN Notice the breakaway tab on the “Integral Flow-Stop” has been removed. The set can be gravity primed by intentionally squeezing the “Integral Flow-Stop” and thus releasing the clamping action. ( See Figures 1.5 & 1.
Twist and remove breakaway tab from “Integral Flow-Stop” Figure 1.5 Curlin Medical Administration set “Integral Flow-Stop” with breakaway tab Squeeze “Integral Flow-Stop” between thumb and forefinger as shown to allow fluid to flow through tubing after the breakaway tab has been removed. Figure 1.
Door Latch (Lift to open) 1 Latch Hook 2 Latch Pins To open the pump door: 1 Pull the door latch up, releasing the latch hooks from the latch pins. 2 Grasp the door latch and pull upwards and to the right to open the entire door mechanism. Full range access is now available for installing the Curlin Medical Administration set. (See figures 1.9 and 1.10). Figure 1.
Choosing and installing the Curlin Medical Administration Set A number of distinctively designed Curlin Medical administration sets are available to deliver each prescription accurately. (See Curlin Medical “Product Catalog”.) Each set is designed to meet the requirements of specific therapies, therefore, if a basic bag-spike set or a set with a medication reservoir is needed, with or without air eliminating filters, etc., there are several configurations from which to choose.
Flow Stop Handle (Yellow) Note: Open the slide clamp before closing the pump door Pumping Fingers Tubing Guide Receptacle Flow Stop Receptacle Note: The Administration Set tubing is always placed in front of the door hinge Figure 1.9 shows the Curlin Medical pump with a cut-away of the display screen allowing you to visualize the receptacles for the small blue “Tubing Guide” on the right side of the pump and yellow the larger “Integral Flow-Stop” on the left side of the pump.
Flow-Stop handle 1 Insert blue “Tubing Guide” on right side of pump with tubing in front of the door. The Blue arrow on the background surface of the pump head indicates direction and location for the blue Tubing Guide. 2 Important: Center the tubing horizontally over the pumping fingers covering the yellow dot. 3 Insert yellow “Integral Flow-Stop” on the left side of the pump. The yellow arrow on the background surface of the pump head indicates the direction and location for the “Integral Flow-Stop.
Installing the Batteries and Using External Power The “C” size batteries will last approximately 30 hours at a rate of 125 ml/hour and over 85 hours at rates of 2 ml/hr or less. Factors that influence battery life are the number of times the screen is illuminated with a key press, the viscosity of the fluid being delivered, the age and temperature at which the batteries have been stored. To extend the life of the batteries, patients can use the AC adapter whenever they are stationary, e.g., at night.
The battery compartment door is located on the back of the Curlin Medical pump. To open the door, depress the recessed release pin (it may be helpful to use a small coin to depress the pin), slide the battery door down, and remove it. Replace the old batteries with two new “C” size alkaline batteries. Install them by depressing the coil spring with the bottom of the battery and sliding the top in place. Note: both positive poles are at the top as shown in Figure 1.11. Always replace both batteries.
External Power Sources Note: Pause the pump and then turn it off before connecting the Battery Pack. Note also that the connector is keyed with a “notch” at this red-dot location to guide alignment. To remove, pull back on the locking sleeve to unlock and then pull gently to remove the connector from the pump’s port. Illustration of the bottom of the Curlin Medical Pump Recharging Port Align the red dots and the notches.
AC Adapter/Charger This accessory (Universal AC Adapter 340-2022) becomes the external power source when plugged directly into the Curlin Medical pump (see Figure 1.2 for external power port location on the bottom of the pump). The AC Adapter can also be used to recharge the portable battery pack by plugging the connecting cable into the recharging port on the battery pack (see Figure 1.12). The two-pin connector on the end of the cable plugs into the receptacles correctly by aligning the red dots on each.
Bolus/Data Port on Left side of Pump Remote bolus access port Locking Sleeve Four-pronged adapter plugs into access port on left side of pump as shown. To remove bolus cord, pull back on locking sleeve and pull cord straight out of access port. Figure 1.14 Attaching and removing the remote Bolus Cord 21 Introduction Attaching and Removing the Bolus Cord When the PCA therapy is used, patient bolus dosing can be programmed.
22
2 Chapter Learning Pump Features F irst, examine the key pad and the functions of the individual keys. Knowing how the keys, especially the dual function keys, work will allow you to give commands to the pump. 7 Display Screen 7 LED Indicators 2 1 4 3 6 5 8 10 9 Figure 2.1 Key Pad 23 Learning Pump Learning to operate the Curlin Medical pump requires a few basic points of understanding that remain constant in every therapy.
Keypad Function 1 2 ON/OFF: Used to turn the pump on and off. When the pump is running, however, the “PAUSE” key must be used to stop the infusion first and then the “OFF” key can be pressed to turn the pump off. This requirement prevents the interruption of an infusion by a single accidental press of the “OFF” key. RUN/PAUSE: Used to start or pause the motor of the pump, which, in turn, starts or pauses fluid delivery. When the pump is running, pressing this key will pause the pump.
Audio Indicator An audible alarm or “beep” is used to alert you to a change in the status of the pump or a situation requiring user action or notification. A message will appear on the display screen describing the situation. The rate, number of beeps, and volume further specify status. This pump offers nine different volume levels from which to select for the audio feature; however, the “beep” cannot be totally disabled.
The screen also has a cursor or highlight bar to tell you which field is being considered. Use the up and down arrow keys to move the cursor. When the pump is running, a specially designed “running screen” appears to provide information regarding the status of that particular infusion. In the following chapters, each display screen will be explained. Identifier bar with down arrow indicator Text field with highlight bar or cursor appearing on first field. Figure 2.
3 Chapter Basics of Programming The Curlin Medical pump allows the operator to customize this device to meet the specific infusion needs of each individual patient. This chapter will explain the customizing features along with the programming steps. P Several different types of screens and fields may appear on the displays. Each of the different types of screens is explained below. Whenever you are required to interact with the pump, a highlight bar or cursor will be present on the screen.
3 “Data entry screens” are used to specify prescription parameters. Sampl e of a Dat a Ent ry Scre en In the above example, the cursor rests on a field requiring numeric data entry for specific prescription information, e.g., the volume in the IV bag. The operator enters the correct information using the numeric keys and decimal point key.
messages and how to resolve them). The audio alarm also beeps and the LEDs blink whenever an alarm or error code occurs. In the event of an error code, user directions will be displayed on the screen, most often, this will require turning the pump off and back on again. Using “Help” Help screens are available for data entry/selection screens, during “action field” screens, and at the “infusion complete” screen. To access help, press the “HELP” key.
When the Curlin Medical pump successfully passes it’s self-test, a brief message of “System OK” appears, and the display moves to the next screen: Power S t atu s Scr een This screen displays the active power source of the pump, whether internal (batteries) or external power. If the active source is the C-size batteries, a bar graph will indicate the amount of power remaining in the batteries.
Access Code Cl i ni ci an Acce s s Code S cre en The clinician enters a four-digit personal identification number followed by the five-digit access code; and, if the code is valid, the display will automatically move to the requested screen or field. The four-digit personal identification number appears on the screen but the access code numbers do not; instead five asterisks appear. The personal identification number is recorded in the history file for the purpose of providing an audit trail.
I M P O R T A N T I N F O R M A T I O N 1 You may skip any of these functions by using the down arrow to move the cursor to only the desired selection. When the desired selection is highlighted, press the “YES/ENTER” key. A secondary screen will be displayed. When all BIOMED SETUP functions are completed, move the cursor to the last field, “DONE? YES,” and press the “YES/ENTER” key to exit this menu.
to all pump functions. Each level higher limits the options available to the patient or caregiver (see each lock option screen in the individual therapy sections and/or the lock level table in the chapter entitled Clinician Information and Access Code.) If the desired lock does not appear on the display, press the “NO/CHANGE” key until the correct lock does appear. Then, press the “YES/ENTER” key to accept and move the cursor to the next field.
Note: The patient history log should be printed before clearing occurs if a hard copy record is required. The history log, when printed, lists the most recent event first. Clearing the history log does not affect the saved patient information. When printed, the patient history log includes a heading at its beginning and a footer at its end. The heading includes the pump serial number, the patient history log title and revision number information of the software and hardware of the pump.
8 PRINT PATIENT HISTORY: To print the patient history log, connect the Data Interface Cable to the communication port on left side of the pump before selecting this command. (FOLLOW DIRECTIONS THAT ACCOMPANY THE DATA INTERFACE CABLE.) The pump will display: When you select “YES,” the display will read “Printing Patient History Record.” When the printing is completed, the pump display returns to the BIOMED SETUP Menu.
11 CLEAR Pt. DATA: Selecting this feature clears all data programmed and resets the pump to its default settings. The history log is NOT cleared. All disabled therapies are reenabled. When you select “YES/ENTER” at this field, the following screen displays: When you select “YES,” all patient data clears and the display returns to the BIOMED SETUP Menu. Selecting “NO” aborts the feature and also returns to the menu. 12 CHANGE CONTRAST: The contrast on the display screen can be adjusted.
a. Time Format: You have the option of selecting twelve-hour or twenty-four-hour time format. Press the “NO” key until the correct selection appears on the field and then press the “YES/ENTER” key to accept the selection and move the cursor to the next field. b. AM/PM: The second field allows you to select AM or PM when the twelve-hour time format is selected in the previous field. If the twenty-four-hour format was selected, this field will not appear.
Resum e/ Repe at Rx/ New Prog ram Menu There are three different ways that you can start a therapy: • RESUME: Should be used if a therapy is interrupted. The pump picks up where it left off, and continues the therapy. • REPEAT Rx: Should be used to hang a new bag and repeat the same therapy over again. The infusion history displayed is reset (volume infused, boluses requested, boluses received, etc). Shift Totals and Hourly Totals continue to accrue.
If only one therapy is programmed and REPEAT Rx is selected, the cursor will automatically advance through the prescription menus. You can stop the auto-advance function by pressing any key (except ON/OFF) and then complete the confirmation of the prescription by pressing the “YES” key at the remaining fields. Note: REPEAT Rx does not allow any changes to the Pre-Prescription Menu. If changes need to be made in Pre-Prescription selections (units, concentration, etc.
only one therapy is enabled, this screen will not display, and the pump will automatically move to the first screen for specific therapy programming. Entering or Changing Data Fields When prescription data fields appear, use the numeric keys to enter specific patient prescription information and, when correct, press the “YES/ENTER” key to accept.
4 Chapter Continuous Therapy Continuous Therapy is designed to allow a constant programmed rate of infusion. B egin programming a Continuous Therapy by selecting “Continuous” from the “Select Therapy Screen”. The following display screen appears and requires you to enter information needed to program this therapy: Prescription Menus Conti n uo us Pr e- Pres cri p t i on Menu Scre en These menu items allow you to customize the program to match each individual prescription.
be delayed until a later time, press the “NO/CHANGE” key. The delay start will change from “OFF” to “ON”. Press the “YES/ENTER” to accept and the following screen will appear: C onti n uo us D el ay S tar t S etti n g The time format (12 hr AM/PM or 24 hr Military) selected in the BIOMED SETUP Menu will apply in this table; and, if Military was selected, the AM/PM field will not appear here. If the entire delay start screen is to be aborted, press the “NO” key at the ACCEPT field.
If the KVO rate is set to 0, the pump will beep ten minutes prior to the beginning of the Continuous Therapy start time. To stop the audible beep, press the “Silence” key. I M P O R T A N T I N F O R M A T I O N 4 During the delay start period, if the KVO rate is set to 0, no fluid is infusing. Be sure the patient’s access device is patent and has been flushed per facility policy to maintain patency during this time period.
Conti n uo us 1 Pr esc ri pti on Menu BAG Vol (IV Bag Volume): Use the numeric keys to enter the amount of fluid in the IV Bag or Medication Reservoir (include the overfill volume). Note: The volume used for priming via the pump or for KVO is deducted from the Bag Volume. Therefore, Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion. When the correct amount has been entered, press the “YES/ENTER” key to accept this field and move on to the next.
6 DONE?: If any changes are to be made, use the up or down arrow keys to locate the field to be changed, use the numeric keys to enter the corrected information, and press “YES/ENTER” to accept the new data. If all the fields are acceptable, move the cursor to the “DONE?” field and press the “YES/ENTER” key to move on to the next screen.
4 Release any clamps on the administration set. 5 Press and hold the “PRIME” key. Fluid will be pumped at a rate of 300 ml/hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped. The pump will then beep once and require repressing and holding the “PRIME” key again until 6 more milliliters is delivered. Continue this process until all air has been purged from the IV bag and the administration set.
The following screen displays the Continuous Therapy “Options” available. When you open this menu, use the up and down arrows to move the highlight bar to the desired option. Lock settings may require an access code before the option can be changed. Any new setting, except “CLEAR HOURLY” screen acceptance becomes effective when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.
d. To exit this screen, press the NO/CHANGE key. 3 CLR HRLY (Clear Hourly Totals): To clear Hourly Totals press the “NO/CHANGE” key to change OFF to ON and then press “YES/ENTER”. The following screen will appear: Cl ear Ho url y To t al s Scr e en a. To clear the Hourly Totals, press the “YES/ENTER” key. All Hourly Totals will be cleared and the cursor will return to the Options Menu. b. To maintain the Hourly Totals, press the “NO/CHANGE” key.
detects in-line pressures at 400 mmHg ±150 (8 ±3 psi “pounds per square inch”), or the “High” setting alarms when it detects in-line pressures at 900 mmHg ±150 (18 ±3 psi). Press “NO/CHANGE” to change the selection. When the correct pressure setting appears, press the “YES/ENTER” key to accept it and move the cursor to the next field. 6 AIR SENS (Air In Line Sensor): This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state.
When you select a number, the pump will beep at that audio level. Press the “NO” key and enter a new setting (1 – 9). Repeat until the desired setting is reached, and then press “YES/ENTER” to select it and move the cursor to the next field. 8 PWR CK? (Power Check): This feature allows you to periodically recheck the battery charge. It will display the active power source of the pump, whether internal batteries or external power.
In CMS-enabled pumps, the graphic bar will toggle with Line Pressure (“L Press”) which displays the current patient side (downstream) pressure in the administration set in millimeter of mercury (mmHg) units. 3 The third line displays the total volume infused and, if mg or mcg is the selected unit, this field will toggle to display the total (mg or mcg) infused as well. 4 The last line displays the remaining time to the completion of the infusion toggled with the remaining amount to be infused.
Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, press the “YES/ENTER” key at this field. The pump will return to the Run Options Screen, and you can resume the therapy. Note: If you wish to hang a new container, move the cursor to REPEAT Rx (see following section). Run Op ti ons Sc re en a. Press the “RUN” key to resume the therapy. b.
be displayed, then press “YES” and the Run Options screen will be displayed. To resume the unfinished therapy, press “RUN”. Entering a New Program 3 NEW PROGRAM: To program an entirely new prescription or a different therapy, press the “YES/ENTER” key at this field (the ability to change these parameters may be controlled by the lock setting). The display will return to the “Select Therapy Screen” if more than one therapy mode is enabled, or to the “Pre-Prescription Screen” of the single therapy mode.
This screen displays: 1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the smaller “dot” configuration (shown here) if a KVO RATE is programmed. 3 TOT Vol (Total Volume): If units are mg or mcg, this field will also toggle to give the Total Infused. 4 KVO Rate: The preset KVO rate displays.
5 Chapter PCA or Patient Controlled Analgesia is designed for therapies requiring a continuous rate of infusion, patient controlled demand boluses, or both. B egin programming a PCA Therapy by selecting “PCA” from the “Select Therapy Screen”. The following display screen will appear, requiring you to enter information needed to program this therapy. Prescription Menus PCA Pr e- Pres cri p ti on Men u Scr een These menu items allow you to customize the program to match each individual prescription.
3 ADMIN Rt (Administration Route): Allows a selection from three routes of administration: the default setting of IV (intravenous), EPI (epidural), and SQ (subcutaneous). If Epidural is selected, the Therapy Identifier bar in the Prescription Menu will display EPI instead of PCA.
b. ∆Rate (Delta Rate): Some prescriptions include incremental levels or delta limitations (e.g., “Do not raise the rate more than 1 ml in 12 hours”). If the prescription has these components, use the ∆Rate field and the ∆ Time field to enter those limits. Example: Enter the incremental titration amount level of 1 ml on this field, and press “YES/ENTER” to move to the next field. c. ∆Time (Delta Time): Enter the incremental or delta time limit. (Example: Enter 12:00 hours.
PCA Pr e scri p ti o n Menu Note: The PCA therapy can be programmed for Basal Rate (continuous infusion) only, for Bolus (patient demand dose) only, or for both. At least one of these settings must be entered, though, before this menu can be accepted at the “DONE?” prompt. 1 BAG Vol (IV Bag Volume): Using the numeric keys, enter the amount of fluid in the IV Bag or Medication Reservoir (include the overfill volume). Note: The volume used for priming via the pump is deducted from the Bag Volume.
using the numeric keys and, when correct, press the “YES/ENTER” key to accept and move the cursor to the next field. # BOLS/hr (Number of Bolus Doses per hour): Using the numeric keys, enter the number (0 to 15) of boluses allowed per hour and, when correct, press the “YES/ENTER” key to accept and move to the last field.
I M P O R T A N T I N F O R M A T I O N Priming with the set connected to the patient could result in overdose and may cause injury or even death to the patient. 4 Release any clamps on the administration set. 5 Press and hold the “PRIME” key. Fluid will be pumped at a rate of 300 ml/hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped. The pump will then beep once and require repressing and holding the “PRIME” key again until 6 more milliliters is delivered.
The following screen displays the PCA Therapy “Options” available. When you open this menu, use the up and down arrows to move the highlight bar to the desired option. Lock settings may require an access code before the option can be changed. Any new setting, except “CLEAR HOURLY” screen acceptance and “SHIFT TOTAL” clear screen acceptance becomes effective when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.
Note: If a lock setting of 1, 2 or 3 is selected, an access code will be requested. If you wish to give a clinician dose at this time, change OFF to ON and press YES key. Enter the amount of clinician dose to be delivered. Press YES to accept the clinician dose menu. The Clinician Dose will begin when the options screen is accepted and the pump is running.
d. To exit the shift total feature without clearing the totals, press the “YES” key at the highlighted EXIT field. 4 HRLY TOT (Hourly Totals): To view hourly infusion totals press the “NO/CHANGE” key to change OFF to ON and then press “YES/ENTER”. Either of the following two screens will appear: H ourl y T otal s S c ree n or The screen displays hourly infusion delivery for each hour (00-23) of the last 24 hours of therapy in the unit selected. a.
c. A lock level of 2 or 3 will require an access code entry before allowing “Hourly Totals” reset. 6 TitrRx (Titrate Prescription): If this feature was not selected in the Pre-Prescription Menu, it will not appear on the Options menu.
8 AIR SENS (Air In Line Sensor): This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state. The choices are 0.1 ml, 0.5 ml (the default setting), 2.0 ml, and OFF. Press the “NO/CHANGE” key to change the options until the desired setting appears on the display, and then press “YES/ENTER” to select and move the cursor to the next line.
enter a new setting (1 – 9). Repeat until the desired setting is reached, and then press “YES/ENTER” to select and move the cursor to the next field. 10 PWR CK? (Power Check): This feature allows you to periodically recheck the battery charge. It will display the active power source of the pump, whether internal batteries or external power. If the active source is the batteries, a graph will indicate approximately how much charge remains in the batteries.
CMS-enabled pumps, the graphic bar will toggle with Line Pressure (“L Press”) which displays the current patient side (downstream) pressure in the administration set in millimeter of mercury (mmHg) units. The third line displays the total volume “TOT Vol” infused and, if mg or mcg is the selected unit, this field will toggle to display the total mg or mcg infused “TOT INF” as well. 4 The fourth line displays the number of boluses delivered and number of boluses attempted per bag volume.
The screen offers the user three options: Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, press the “YES/ENTER” key at this field. The pump will return to the Run Options Screen, and you can resume the therapy. Note: If you wish to hang a new container, move the cursor to REPEAT Rx (see following section). Run Op ti ons Sc re en a. Press the “RUN” key to resume the therapy. b.
b. If the incomplete therapy is to be continued, press “NO” and the Pause Menu screen will be displayed, then press “YES” and the Run Options screen will be displayed. To resume the unfinished therapy, press “RUN”. 3 NEW PROGRAM: To program an entirely new prescription or different therapy, press the “YES/ENTER” key at this field (the ability to change these parameters may be controlled by the lock setting).
This screen displays: 1 “INFUSION COMPLETE.” 2 A completely filled in bar graph indicating infusion complete. 3 TOT Vol (Total Volume): If units are mg or mcg, this field will also toggle to give the Total Infused. 4 Infusion Complete is considered an alarm status, and the audio alarm will beep periodically every 3 seconds to alert the user to this condition. Additionally, the red LED light blinks to indicate that the “Infusion Complete” alarm exists.
6 Chapter TPN Therapy with Automatic Ramping B egin programming a TPN Therapy by selecting “TPN” from the “Select Therapy Screen”. The following display screen will appear, requiring you to enter information needed to program this therapy. Prescription Menus TPN Pre- Pres cri p ti on Men u Scr een This menu item allows you to customize the program to match each individual prescription. The pump’s default setting is displayed in the left screen.
will apply in this table; and, if Military was selected, the AM/PM field will not appear here. If the entire delay start screen is to be aborted, press the “NO” key at the ACCEPT field. When the start time and date are entered and the data is accepted after the “YES/ENTER” key is pressed, the infusion is set to start at the programmed time. The display then returns to the next field in the Pre-Prescription Menu.
At the following screen, the prescription information is entered to complete the programming of the pump: TPN Pre scri p ti o n Scr een 1 BAG Vol (IV Bag Volume): Use the numeric keys to enter the amount of fluid in the IV Bag or Medication Reservoir (include the overfill volume). Note: The volume used for priming via the pump or for KVO is deducted from the Bag Volume. Therefore, Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion.
time period using the numeric keys, and when correct, press the “YES/ENTER” key to accept and move the cursor to the next field. Since this field is optional, “0” may be entered and accepted. The range for this field is 0:00 to 9:00 HH:MM. 6 TotTime (Total Time): This field displays the entire time period over which the infusion will be delivered, including up and down ramp times.
before they are connected to the access site. Priming may have been done by gravity when the administration set was first connected to the bag (see Chapter 1, “Preparing Medication for Infusion”). However, if it was not done then or if there are any remaining air bubbles to be removed, the pump’s “PRIME” function will assist in this process. To prime the set by using the pump, follow the directions below. Note: The lock setting may restrict the ability to prime using the pump.
7 To continue priming, press the PRIME key again. If priming is complete, press “YES/ENTER” to exit and return to the Run Option screen. The total amount of solution used in this priming session displays on the bottom field. Note: The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient.
pump has been set into a locked condition, any subsequent request to change the lock will require a clinician access code. (See “Clinical Information and Access Code” chapter for access code information, lock setting table and available features for each lock setting). 2 HRLY TOT (Hourly Totals): To view hourly infusion totals press the “NO/CHANGE” key to change OFF to ON and then press “YES/ENTER”. The following screen will appear: H ourl y T otal s S c ree n a.
Note: Whatever Down Ramp time was accepted in the prescription menu will appear as the DN Ramp time on this screen. This time can be changed using the numeric keys or accepted as already displayed. When correct, press the “YES/ENTER” key. When the new time is accepted, the screen returns to the Options menu. The Early Down Ramp phase begins when the Options menu is exited and the pump is running.
Also, when the Air-In-Line sensor is completely disabled and the infusion goes to an “Infusion Complete” or “Empty Bag” status, the Air Sensor setting will automatically change to 2.0 ml. AUDIO (Audio Volume): This feature allows you to adjust the audio volume of the pump’s alarm setting. You can enter a number from 9 (the loudest setting) to 1 (the quietest setting). When you select a number, the pump will beep at that audio level. Press the “NO” key and enter a new setting (1 – 9).
1 The first field displays the “RATE” of the infusion. If the therapy is in a ramp up or down phase, the rate will change accordingly to reflect the gradual increase or decrease in rate. The Rate toggles with the Volume to Be Infused. 2 The second field is a graphic bar representing the percentage of the completed infusion. It also depicts the up or down ramping phase with gradually taller or shorter lines on the bar graph.
The screen offers the user three options: 1 Resuming the Current Container RESUME: To resume the therapy in progress from where it left off, press the “YES/ENTER” key at this field. The pump will return to the Run Options Screen, and you can resume the therapy. Note: If you wish to hang a new container, move the cursor to REPEAT Rx (see following section). Run Op ti ons Sc re en b.
be displayed, then press “YES” and the Run Options screen will be displayed. To resume the unfinished therapy, press “RUN”. Entering a New Program 3 NEW PROGRAM: To program an entirely new prescription or different therapy, press the “YES/ENTER” key at this field (the ability to change these parameters may be controlled by the lock setting). The display will return to the “Select Therapy Screen” if more than one therapy mode is enabled, or to the “Pre-Prescription Screen” of the single therapy mode.
1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the smaller “dot” configuration (shown here) if a KVO RATE is programmed. 3 TOT Vol (Total Volume): Displays the total volume infused. 4 KVO Rate: The preset KVO rate displays. 5 Infusion Complete is considered an alarm status, and the audio alarm will beep periodically (every 3 seconds if there is no KVO, every 20 minutes if there is a KVO) to alert the user to this condition.
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7 Chapter Intermittent Therapy Intermittent Therapy is designed to deliver programmed intervals and rates of specified amounts of infusates and to optionally deliver small amounts of the infusate between doses to keep the access site patent. B egin programming an Intermittent Therapy by selecting “Intermittent” from the “Select Therapy Screen”. The following display screen will appear, requiring you to enter information needed to program this therapy.
screen will appear: I nterm i t ten t D el ay S t art S etti n g The time format (12 hr AM/PM or 24 hr Military) selected in the BIOMED SETUP Menu will apply in this table; and, if Military was selected, the AM/PM field will not appear here. If the entire delay start screen is to be aborted, press the “NO” key at the ACCEPT field. When the start time and date are entered and the data is accepted after the “YES/ENTER” key is pressed, the infusion is set to start at the programmed time.
I M P O R T A N T I N F O R M A T I O N 4 During the delay start period, if the KVO rate is set to 0, no fluid is infusing. Be sure the access device is patent and has been flushed per facility policy to maintain patency during this time period. If a KVO rate is programmed, then that KVO rate will be used in the Delay Start period.
Note: You may elect to skip the dose rate and enter the dose time first to let the pump automatically calculate the dose rate. 4 DOSE Time: Using the numeric keys, enter the amount of time over which each dose is to be infused. The range for this field is 0:01 to 99:59 HH:MM. When correct, use the “YES/ENTER” key to accept this field, and to move on to the next. Note: If you have entered the dose amount and rate, the pump will automatically calculate the dose time.
10 DONE?: If there are any changes to be made, use the up or down arrow keys to locate the field to be changed, use the numeric keys to enter the corrected information, and press “YES/ENTER” to accept the new data. (Remember that if a field is changed, subsequent fields will need reconfirmation to verify accuracy.) If all the fields are acceptable, move the cursor to the “DONE” field, and press the “YES/ENTER” key to move on to the next screen.
4 Release any clamps on the administration set. 5 Press and hold the “PRIME” key. Fluid will be pumped at a rate of 300 ml/hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped. The pump will then beep once and require repressing and holding the “PRIME” key again until 6 more milliliters is delivered. Continue this process until all air has been purged from the IV bag and the administration set.
The following screen displays the Intermittent Therapy “Options” available. When you open this menu, use the up and down arrows to move the highlight bar to the desired option. Lock settings may require an access code before the option can be changed. Any new setting, except “CLEAR HOURLY” screen acceptance becomes effective when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.
3 CLR HRLY (Clear Hourly Totals): To clear Hourly Totals press the “NO/CHANGE” key to change OFF to ON and then press “YES/ENTER”. The following screen will appear: Cl ear Ho url y To t al s Scr e en a. To clear the Hourly Totals, press the “YES/ENTER” key. All Hourly Totals will be cleared and the cursor will return to the Options menu. b. To maintain the Hourly Totals, press the “NO/CHANGE” key. Hourly Totals will be maintained and the cursor will return to the Options menu. c.
This message alerts you to the Air-In-Line Sensor being set to “OFF.” The message will require answering “yes” or “no” to whether the administration set being used has an aireliminating filter. If you press the “YES” key to indicate that there is an air-eliminating filter in use, the Air-In-Line sensor will be completely disabled and the pump will start the infusion.
Reviewing or Changing the Program To review or make any changes in the prescription programming, press the “NO/CHANGE” key at the Run Options screen, and the prescription screens will reappear (Changes may be inhibited by lock setting.) Changes to the prescription can be made before the start of the therapy; however, once a therapy has started, no changes can be made to the Pre-Prescription Screen. It will appear only for review purposes.
I ntermi t ten t I nf orma ti on Scre ens The infusion can be paused at any time by pressing the “PAUSE” key. The yellow “Standby” LED light blinks, and the following screen displays: Paus e Menu Sc re en The screen offers the user three options: Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, press the “YES/ENTER” key at this field. The pump will return to the Run Options Screen, and you can resume the therapy.
Run Op ti ons Sc re en a. Press the “RUN” key to resume the therapy. b. Press the “NO” key to go back to the programming screen to make changes in the therapy program (this feature may be blocked by a security lock, thus not allowing changes to the program unless an access code is given). Also, remember that no changes are allowed in the first prescription menu if an infusion is in progress. c. Press the “OPTIONS” or “PRIME” keys if either of these functions is desired at this time.
I ntermi t ten t Dos i ng Sche dul e The dosing schedule of the previous container is retained and displayed on this screen. In Lock setting 0 and 1, you can change the time. In lock 2 or 3, the next dose time is displayed but requires an access code before allowing a change. When the next dose time is correct, press the “YES/ENTER” key. The cursor will move to the “DONE?” field, press the “YES/ENTER” key again and the “Run Options” screen will display.
Timing Rules when Interrupting Intermittent Therapies I M P O R T A N T I N F O R M A T I O N Remember, this therapy is time dependent, and the following rules apply for interruptions in the therapy. For the Intermittent Therapy the pump automatically cycles through dosing and KVO. A single beep alerts the user to the change in the cycle. If the KVO rate is set at “0” the pump can be off between those doses.
This screen displays: 1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the smaller “dot” configuration (shown here) if a KVO RATE is programmed. 3 TOT Vol (Total Volume): If units are mg or mcg, this field will also toggle to give the Total Infused. 4 KVO Rate: The preset KVO rate displays.
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8 CHAPTER Variable Therapy This therapy is designed to allow twenty-four specified programs of varying amounts, rates, and times of delivery. B egin programming a Variable Therapy by selecting “Variable” from the “Select Therapy Screen”. The following display screen will appear, requiring you to enter information needed to program this therapy.
“ON.” Now, when you press the “YES/ENTER” to accept, the following screen will appear: Vari abl e Del ay S tar t Se t ti ng The time format (12 hr AM/PM or 24 hr Military) selected in the BIOMED SETUP Menu will apply in this table; and, if Military was selected, the AM/PM field will not appear here. If the entire delay start screen is to be aborted, press the “NO” key at the ACCEPT field.
I M P O R T A N T I N F O R M A T I O N 4 During the delay start period, if the KVO rate is set to 0, no fluid is infusing. Be sure the access device is patent and has been flushed per facility policy to maintain patency during this time period. If a KVO rate is programmed, then that KVO rate will be used in the Delay Start period.
“YES/ENTER’ to accept the new data. If all the fields are acceptable, move the cursor to the “NEXT?” field and press the “YES/ENTER” key to move on to the next screen. At the following screens, the dose information is entered to complete the programming of the pump for a Variable Therapy. Each variable dose will have its own prescription screen: Vari abl e Pres cri pti on Me nu 2 Pres cri pti on Me nu 3 Note: One dose per screen is entered.
5 NEXT?: If there are any changes to be made, use the arrow keys to locate the field to be changed, use the numeric keys to enter the corrected information, and press “YES/ENTER” to accept the new data. If all fields are acceptable, move the cursor to the “NEXT?” field and press the “YES/ENTER” key to accept and move on to the next dose programming screen. When the total number of doses is programmed, the pump will display the Variable Summary screen.
Prime The IV bag and administration set should be inspected and be free of all air and air bubbles before they are connected to the access site. Priming may have been done by gravity when the administration set was first connected to the bag (see Chapter 1, “Preparing Medication for Infusion”). However, if it was not done then or if there are any remaining air bubbles to be removed, the pump’s “PRIME” function will assist in this process. To prime the set by using the pump, follow the directions below.
7 To continue priming, press the PRIME key again. If priming is complete, press “YES/ENTER” to exit and return to the Run Options screen. The total amount of solution used in this priming session displays on the bottom field. Note: The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient.
1 LOCK: When the lock is set to “OFF, ” the clinician has access to all of the pump functions. After the pump is completely programmed, change the lock to meet the security needs of this therapy. There are four choices: OFF, 1, 2, or 3. Each level higher limits the available options. To change the lock setting, press the “NO/CHANGE” key until the correct lock setting appears. Then, press “YES/ENTER” key to accept the new lock selection.
4 DN Occlu (Down Occlusion): This feature allows the pump to sense an occlusion pressure in the line between the pump and the access site— e.g., a kink in the tubing between the pump and the patient, a blockage in the access site, a clamp left on the distal tubing.
Also, when the Air-In-Line sensor is completely disabled and the infusion goes to an “Infusion Complete” or “Empty Bag” status, the Air Sensor setting will automatically change to 2.0 ml. 6 AUDIO (Audio Volume): This feature allows you to adjust the audio volume of the pump’s alarm setting. You can enter a number from 9 (the loudest setting) to 1 (the quietest setting). When you select a number, the pump will beep at that audio level. Press the “NO” key and enter a new setting (1 - 9).
Vari abl e Run Scr een 2 This screen displays as long as the infusion is running. Notice the information on each field: 1 The first field displays the “RATE” of the infusion in whichever units/hour has been selected. This field toggles to also display the current dose # of total doses programmed. 2 The second field is a graphic bar representing the percentage completed of the current dose.
Interrupting an Infusion The infusion can be paused at any time by pressing the “PAUSE” key. The yellow “Standby” LED light blinks, and the following screen displays: Paus e Menu Sc re en The screen offers the user three options: Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, press the “YES/ENTER” key at this field. The pump will return to the Run Options Screen, and you can resume the therapy.
stop the auto-advance function by pressing any key (except ON/OFF) and then complete the confirmation of the prescription manually by pressing the “YES” key at the remaining fields. When the program is accepted, the display returns to the above “Run Options Screen.” If the current therapy is still in progress when the “REPEAT Rx” function is selected, the following screen will appear: a. This screen is a reminder that the infusion is not complete.
Note: Selecting “NEW PROGRAM” will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually. Infusion Complete When the infusion is complete, the following screen will display: Vari abl e I nf usi on Compl ete This screen displays: 1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the smaller “dot” configuration (shown here) if a KVO RATE is programmed.
The pump will then display the program screens with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus. You can stop the auto-advance function by pressing any key (except ON/OFF) and then complete the confirmation of the prescription manually by pressing the “YES” key at the remaining fields.
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9 Chapter This section assists in identifying and resolving alert and alarm conditions that may occur during the use of the Curlin Medical pump. Alerts, Alarms, and Error Codes I M P O R T A N T I N F O R M A T I O N Alerts, Alarms, and Error Codes are classes of events that are relayed to the user and logged into the history file. The screen will display messages, the LED status lights will blink, and the audio alarm will sound. The backlight feature will illuminate the screen during an alert or alarm.
If no air-eliminating filter is being used, press NO. The infusion will start/resume and the Air In Line sensitivity will be set to 2 ml for the remainder of the infusion. Note: If the screen is not acknowledged with a YES or NO key press, the Air In Line sensitivity will be set to 2 ml when the screen is cleared (i.e. alarm occurs while screen is displayed).
Note: Access to the programming screens is lock level restrictive. Note: If the infusion is continued without sufficient volume, air-in-line or up occlusion alarms may occur later in the infusion. LCD Display: Alert: Cause: Resolution: LCD Display: Alert: Cause: Resolution: ALERT AMT TBI LESS THAN AMT INFUSED Unable to change amount to be infused to an amount less than what has already infused.
LCD Display: Alert: Cause: Resolution: ALERT CALCULATED RATE OUT OF RANGE Invalid calculated rate of infusion The calculated rate for the infusion, based on the values entered for Volume/Amount and Time, exceeds either the minimum or maximum rate limit of the pump or the maximum rate programmed in titration limits. Recheck data entry for Rx.
LCD Display: Alert: Cause: Resolution: ALERT DATE/TIME INVALID Unable to enter invalid date or time Date or time entry is not in a valid format. Recheck data entry. An invalid date or time will not be accepted. LCD Display: Alert: Cause: ALERT DELAY START TIME NOT VALID Delay Start time not valid Delay start time entered is less than one minute or greater than 24 hours from the current system time. Reset Delay Start Time to fall within pump limits.
Alert: Cause: Resolution: LCD Display: Alert: Cause: Resolution: LCD Display: Alert: Cause: Resolution: LCD Display: Alert: Cause: Resolution: Cancellation of a Clinician Dose is pending and can only be processed with the pump running. Clinician Dose in progress is cancelled while the infusion is paused; and the user attempts to enter a new Clinician Dose, prior to resuming the infusion Resume the infusion and then program the desired Clinician Dose.
Recheck the field and accept it by pressing the “YES/ENTER” key. LCD Display: Alert: Cause: Resolution: ALERT GREATER THAN MAX FIELD LIMIT, MAX = _____ Unable to program a field with a value that exceeds the maximum limit Value entered is greater than the allowable limit. Recheck data entry. A value entered cannot exceed the field limit.
LCD Display: Alert: Cause: Resolution: ALERT KVO RATE IS GREATER THAN INF RATE Unable to enter KVO rate that is greater than infusion rate Occurs when user enters a KVO rate that is greater than infusion rate. Recheck data entry. KVO rate must be less than programmed or calculated infusion rate.
Cause: Resolution: ALERT NEW DOSE IS LESS THAN CURRENT DOSE Unable to program a lower number of doses than number of doses already infused While the Variable or Intermittent therapy is in progress, a lower number of doses to be delivered is entered than the number already infused. Wait until current therapy in progress is complete, or “PAUSE” pump and, using the REPEAT Rx function, modify the number of doses. Note: Selecting to repeat the therapy in progress will terminate the current therapy.
Resolution: Wait until the dose in progress completes before modifying field. LCD Display: Alert: Cause: Resolution: ALERT NOT in PCA. NO BOLUS ALLOWED Bolus requested when therapy is not PCA Remote Bolus button or BOLUS key is pressed when not in PCA therapy. Remove the remote bolus cord from the pump if connected. Refrain from pressing the BOLUS key.
Press “PAUSE” key before pressing “OFF” key to stop an infusion. LCD Display: Alert: Cause: Resolution: ALERT Rx IN PROGRESS, YES to Repeat – NO to Return REPEAT Rx selected while a therapy is already in progress REPEAT Rx was selected and there is a therapy currently in progress. To terminate the current therapy in progress, press YES. Resume will no longer be available. The Select Therapy menu will be displayed (if only one therapy is in programmed, the pre Rx menu for the therapy will be displayed).
figures 1.9 and 1.10 of the User’s Manual for proper installation of the administration set. LCD Display: Alert: Cause: Resolution: ALERT SYSTEM CLOCK NOT SET System Clock Not Set The clock for the pump is not set Use the BIOMED SETUP menu Date and Time option to set the date and time.
129 Troubleshooting the error is in a previously programmed dose. If the therapy is in progress or this is a repeat program that has not started and the error is in a previously programmed dose, turn the pump off and then on. Choosing to resume or repeat the therapy will display the last prescription that was completely programmed.
ALARMS Alarms are conditions that require correction by the user and may be a safety issue but are not system errors of the pump. All alarm conditions stop the infusion. The only exception to this rule is at the “Infusion Complete” alarm, which allows the KVO rate, when programmed, to continue infusing. When an alarm occurs, a message is displayed on the screen, the audio alarm is sounded, and the red LED light flashes. The message stays on the screen until the pause key is pressed.
LCD Display: Alarm: Cause: Resolution: LCD Display: Alarm: Cause: Resolution: LCD Display: Alarm: Cause: Resolution: LCD Display: Alarm: Cause: Resolution: ALARM HIGH UP PRESSURE High positive pressure between the pump and IV reservoir The pump has detected excessive positive pressure between the pump and the IV Source. Press Pause to clear alarm screen. Check for excessive pressure on the IV bag and relieve it. When ready to begin infusion, select RESUME.
LCD Display: Alarm: Cause: Resolution: LCD Display: Alarm: Cause: Resolution: LCD Display: Alarm: Cause: Resolution: ALARM UP OCCLUSION Negative pressure detected between the pump and IV reservoir Pump has detected excessive negative pressure in the administration set between the medication reservoir or IV bag (“up stream”) and the pump. Pause the pump. Check administration set from IV bag to pump for potential causes of occlusion.
Resolution: UPLOAD CkSum ERR CMS Upload experienced a Check Sum Error At the completion of an upload of a CMS script the Check Sum signature from the CMS system did not match the signature calculated by the pump A second attempt to upload the script should be made. If the second attempt fails, then a new script should be created for the desired prescription. (See CMS User’s Manual).
ERROR CODES If a pump goes into an error code, a numeric code will appear on the display screen. If this has occurred, turn the pump off and back on. If the error code message does not reappear, continue using the pump. If the pump passes its start-up diagnostic tests, resume the therapy. If an error code recurs, turn the pump off, replace it, and report the error code to the healthcare provider.
LCD Displayed Message Probable Cause Corrective Action 34 Turn Pump OFF Call Provider History File Turn pump OFF/ON Bad Cal Data Turn pump OFF Call Provider Turn Pump OFF Call Provider Turn Pump OFF Call Provider Turn Pump OFF Call Provider Turn Pump OFF Call Provider Bad Cal Range Turn Pump OFF Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON Call Provider Turn pumpOFF/ON C
Error Code LCD Displayed Message Probable Cause Corrective Action 162 Stuck 0 Key Turn pump OFF/ON or Call Provider Stuck 1 Key Turn pump OFF/ON or Call Provider Stuck 2 Key Turn pump OFF/ON or Call Provider Stuck 3 Key Turn pump OFF/ON or Call Provider Stuck 4 Key Turn pump OFF/ON or Call Provider Stuck 5 Key Turn pump OFF/ON or Call Provider Stuck 6 Key Turn pump OFF/ON or Call Provider Stuck 7 Key Turn pump OFF/ON or Call Provider Stuck 8 Key Turn pump OFF/ON or Call Provider Stuck 9 Key Turn pump O
LCD Displayed Message Probable Cause Corrective Action 204 Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF/ON Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn pump OFF Call Provider Turn
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Chapter Accessories 10 There are a number of helpful accessories for use with the Curlin Medical pumps, and their descriptions and diagrams for use are included in this chapter. Locking Sleeve Two-Pin Adapter plugs into port on bottom of the pump for AC power or can be used to recharge the battery pack by plugging into the recharging port on the battery pack (see Figure 1.12). Note the connector notched keying and red dot alignment. To remove, pull back on the locking sleeve. Figure 10.
Battery Pack (340-2006) This accessory is an external, rechargeable, lead-acid battery pack than can be used as an additional, long-life, portable, external source of power. It is recharged with the AC Adapter. (Plug the AC Adapter into a wall receptacle and then into the recharging port of the battery pack). The battery pack is connected to the pump via the two-hole port located on the bottom of the pump (as shown below).
Detachable Pole Clamps The pole clamps attach to the Lockable Safety Shells or the Pump Holster and can accommodate a pole of .75 to 1.25-inch diameter. There is a Standard Pole Clamp (340-0104) as well as a Lockable Pole Clamp (340-0125) available. Remote Bolus Cord (340-2005) This five-foot flexible cable offers a remote push button switch for the patient’s use in administering bolus dosing in the PCA therapy.
Lockable Safety Shells These accessories are hard-plastic, durable cases that are lockable with a key. The small safety shell (340-0106) will secure the 150 ml medication bag administration set and the pump, and yet allow access to the pump’s keypad, controls, communication connectors, and battery compartment door.
Additional graphics below show how to install the Pole Clamp on the Lock Box. Figure 10.6 Pole Clamp and Safety Shell Installation Pump Holster (340-0111) This accessory is a simple “slide pump in” case with a pole clamp-mounting bracket on the back, allowing the pump to securely be mounted onto a pole and yet allow the user easy access to the display, keypad, controls, battery compartment, and connectors for external power or communications.
Data Interface Cable (340-2011) The data interface cable is used to download the history file of the pump into a PC with “Windows” 95 or greater using the Hyperterminal communications program of MS Windows® 1. An instruction booklet is shipped with the Interface Cable. It is also used for communications between the Curlin Medical CMS pump and the PC running the CMS program. Figure 10.
Chapter Cleaning, Environmental Conditions, and Maintenance 11 Following the guidelines for care listed below will assure the best appearance and longest life of the Curlin Medical pump.
Transport and Storage During transport or storage, the batteries should be removed, the pump should be cleaned and kept in its hard-shell packing case. The environmental conditions should be within the range of: • • • An ambient temperature -20° F to 140°F A relative humidity range of 10% to 95% An atmospheric pressure range of 500 Hpa to 1060 Hpa All accessories should be stored in their original packing containers to ensure the longest service.
PARTIES COVERED BY THIS WARRANTY: This warranty extends only to the Original Purchaser of the Pump. This warranty does not extend to subsequent purchasers. The Original Purchaser may be a patient, medical personnel, or a medical facility that purchases the Pump for treatment of patients. The Original Purchaser should retain the invoice or sales receipt as proof as to the actual date of purchase.
Procedure for Checking Pumps Between Patients Purpose This Pump Test Procedure is for use by Technicians to inspect, test and prepare a pump for use by a new patient. It checks volumetric delivery accuracy and all pump safety systems. Also initialization is performed for various parameters. This procedure is intended to be used by Technicians familiar with operation of the Curlin Medical Infusion Pump. Note: This procedure does not replace the recommended Annual Preventive Maintenance.
d Program the following CONTINUOUS Infusion: Pre Rx: UNITS: ml DELAY: OFF Titrate: OFF NEXT? YES Prescription: BAG VOL: VOL TBI: RATE: TIME: KVO Rate: DONE? ml ml ml/hr HH:MM ml/hr e Start the continuous therapy running by pressing RUN button. f When the 10 ml infusion is over, observe the amount volume infused as measured on the measurement device. Passing measurement is: 9.5 g to 10.50 g (9.5ml to 10.5ml).
Adapter eliminator and remove one C-Cell battery.) Observe that the Auxiliary Alarm System is activated, with the Red LED and Beeper on constant (not intermittently beeping). With the battery still out of the pump, press the ON/OFF button to turn off the auxiliary alarm. Replace the battery in the battery compartment and turn on the pump. Resume the therapy and confirm that the infusion continues where it stopped due to Auxiliary Alarm occurrence.
Chapter Technical Specifications 12 The following specifications apply to the Curlin Medical Ambulatory Infusion Pump: ITEM SPECIFICATION Pumping Mechanism: Curvilinear peristaltic finger action Pump Size: Height: 5 inches Width: 4 inches Depth: 2.5 inches Weight: 17.
ITEM SPECIFICATION Operating Time with Full Charge Batteries: Nominal 10 hours at a rate of 400 ml/hr Nominal 30 hours at a rate of 125 ml/hr Nominal 85 hours at a rate of 2 ml/hr Internal Memory Battery 5 years life Display Graphic LCD, 4 text fields, 16 characters per field Flow Rates 0.1 to 400 ml/hr KVO Rates 0 to 10 ml/hr.
ITEM SPECIFICATION Programmable Time (HH:MM) Continuous TPN Intermittent Variable 00:01 to 288:00 HH:MM 00:01 to 288:00 HH:MM 00:01 to 288:00 HH:MM 00:01 to 288:00 HH:MM PCA Bolus Volumes Microbore tubing with occlusion at distal Luer No time limit Low Pressure: <0.1 ml High Pressure: <0.
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Chapter Clinician Information and Access Code This chapter should be removed before initial patient training and instruction on the Curlin Medical pump so the intended locked functions or secured functions of the pump cannot be accessed except by a trained clinician. Removal of this chapter will assist in patient safety.
Lock Setting Table The following table illustrates which features are controlled under which lock settings: Pump Operation Active Therapy All Change Lock Settings Turn Pump Off/On Pause/Run Therapy Access Help/Options Check Power Source Resume Therapy View Rx Screens at “No to Review” Repeat Therapy Prime Pump Change Audio Level Change Rx screen information Change Rx screen at “No to Review” Access New Program Change Air in Line Setting Change Down Pressure Change KVO Rate Delay Start Change Units (New Pr
