with FLASH TIPS CONTENTS Definitions....................................2, 3, 4 Setup PlumSet...................................5 Clinical Care Area...................................5 Simple Delivery using Hospira MedNet Software..........6 Titrate Rate using Hospira MedNet Software.............7 Simple Delivery without Hospira MedNet Software........8 Titrate Rate without Hospira MedNet Software...........8 Stop & Start with Only 1 Line Pumping..................9 Stop & Start when Line A and B are Pumping.............9 Backprime........................................9 Clear Volume Delivered (Total, Line A, Line B).............9 Clearing Settings..................................10 Discontinue Infusion...............................10 Delay Start (to delay infusion for a specific time period)....10 Set or Cancel Nurse Callback........................11 Standby.........................................11 Select Drug Name.................................12 Functions........................................13 Programming.....................................14 Program Dose Calculation...........................15 Program Loading Dose.............................16 Program Multistep.................................17 Alarms.......................................18, 19 444-95536-002 (06/05) FLASH TIPS PLUM A+ INFUSION SYSTEM OPERATING INSTRUCTIONS REFER TO SYSTEM OPERATING MANUAL FOR COMPLETE OPERATING INSTRUCTIONS 444-95536-002 Page 1 of 20 4-COLOR PROCESS - KEYLINE DOES NOT PRINT
FLASH TIPS DEFINITION OF TERMS Hospira MedNet Software Network based application software used to upload event logs and download the custom Drug Library to the infuser Hard Limit The dosing value (upper and/or lower amount) that when assigned to a drug cannot be overridden. Defined by the hospital for each drug in its Drug Library. The hard limits for a particular drug may vary across different CCAs Soft Limit The dosing value (upper and/or lower amount) that when assigned to a drug can be overridden based on hospital policy. Defined by the hospital for each drug in its Drug Library. The soft limits for a particular drug may vary across different CCAs Auto-Programming Complete or partial program received from a barcode enabled point of care system requiring clinician confirmation prior to administration DEFINITION OF HARD KEYS AND ICONS used to control power on the infuser used to begin confirmation of programming used to stop the current delivery on one line; used in conjunction with soft keys to stop delivery on both lines used to move the highlighting cursor between the programming fields - down/right, up/left used to clear values highlighted on screen used to silence an audible alarm during actions to correct its cause used to indicate that the upper soft limit has been overridden for a particular drug infusion parameter used to indicate that the lower soft limit has been overridden for a particular drug infusion parameter! the infuser is being operated without drug rule sets the Wireless Connection Available icon is displayed when the device is receiving a wireless signal. The infuser will connect to the network if a wireless network access point is recognized. 2 3 Page 2 of 20 444-95536-002 Page 3 of 20
DEFINITION OF SOFT KEYS PROGRAMMING OPTIONS DISPLAYED ABOVE THE ACTUAL SOFT KEYS STOP used in combination with to stop delivery START used in combination with to begin delivery CHOOSE used to choose between several alternatives presented on the screen ENTER used to enter and retain desired programming data on the screen CANCEL to cancel programming data on the screen prior to entering and to return the user to a previous screen BACK return to previous screen CHANGE MODE used to change between piggyback and concurrent mode on LINE B YES/NO used to change between yes and no when programming a callback KVO/RATE used to change between rate and KVO when programming Continue Rate NOTE: Hard limits will be either minimum or maximum dose values. Infuser will beep 3 times with message of min/max dose allowed. Value in dose field changes to dashes ( ---- ). Press before entering another value. TO MAINTAIN BATTERY CHARGE, KEEP PLUGGED IN AT ALL TIMES. SOME 10CC SYRINGES MAY REQUIRE USE OF A SYRINGE ADAPTER. TO SETUP PLUMSET 1. Prime set according to package instructions 2. Push in flow regulator to close 3. Insert primed cassette into infuser, close door 4. Press to power on infuser 5. Select YES to clear settings or NO to retain settings* 6. Confirm drip chamber is filled to halfway mark 7. Confirm NO FLOW in drip chamber * NOTE: Infuser will retain its memory for 4 hours when turned off. NOTE: Clear all settings when changing patients or multiple programming parameters. NOTE: Use CLEAR PROGRAM when changing only line A or B. NOTE: For Plum A+ 3 the Lockout Switch controls all three devices. CLINICAL CARE AREA (CCA) SELECTION 1. Use the to select and highlight the desired Clinical Care Area (CCA) at AREA SELECTION screen 2. Select ENTER to confirm the selection NOTE: Infuser will retain the last CCA selected when turned off. CHANGING CCA WHILE INFUSING 1. Select OPTIONS/VOL INF 2. Select CHANGE CCA 3. Use the to select desired CCA 4. Select ENTER to confirm the selection NOTE: The delivery continues until VTBI equals 0 or the program is stopped and settings cleared. 4 5 Page 4 of 20 444-95536-002 Page 5 of 20
SIMPLE DELIVERY USING HOSPIRA MEDNET SOFTWARE (Manual Programming) to select line to program 2. Select DRUG LIST to display available drugs 3. Use the to highlight the desired drug on the Program Drug List screen 4. Select ENTER to indicate selection (is used for maintaining drug identification). Select STANDARD PROGRAMMING and select CHOOSE to go to PROGRAM screen 5. Enter RATE using keypad 6. Use the to highlight the VTBI or DURATION field 7. Enter value 8. VERIFY rate, VTBI, and duration 9. Press to begin program 10.If a program parameter exceeds a soft limit, select YES to override the soft limit if appropriate, select NO to return to programming screen NOTE: Hard limits cannot be overridden. See page 4 for additional information. 11.Confirmation screen will appear - if all information is SIMPLE DELIVERY TITRATE RATE USING HOSPIRA MEDNET SOFTWARE (Manual Programming) 2. Use the to select programming field 3. Enter numeric value 4. Press to begin titration 5. If a program parameter exceeds a soft limit, select YES to override the soft limit if appropriate, select NO to return to programming screen NOTE: Hard limits cannot be overridden. See page 4 for additional information. 6. Confirmation screen will appear - if all information is NOTE: When changing the duration, the rate will change, but VTBI will not. When changing the rate, VTBI will not change, but duration will. When changing VTBI, duration will change, but the rate will not. For additional information refer to System Operating Manual. PROGRAM OPTIONS 6 444-95536-002 (06/05) 444-95536-002 (06/05) 7 Page 6 of 20 444-95536-002 Page 7 of 20
SIMPLE DELIVERY WITHOUT HOSPIRA MEDNET SOFTWARE NOTE: Use drug manufacturer recommendations for IV administration when using the Plum A+ Infusion System. 2. Enter RATE using keypad 3. Use the to highlight the VTBI or DURATION field 4. Enter value 5. VERIFY rate, VTBI, and duration 6. Press to begin infusion 7. Confirmation screen will appear - if all information is If Programming Line B 1. Use the to highlight Mode 2. Choose Piggyback or Concurrent using CHANGE MODE NOTE: Piggyback infusion will delay Line A and infuse Line B until VTBI Complete. Line A will automatically restart. WARNING! Before infusing drugs in concurrent mode, consult the System Operating Manual. SIMPLE DELIVERY TITRATE RATE WITHOUT HOSPIRA MEDNET SOFTWARE 2. Enter numeric value 3. Press to begin titration 4. Confirmation screen will appear - if all information is NOTE: When changing the duration, the rate will change, but VTBI will not. When changing the rate, VTBI will not change, but duration will. When changing VTBI, duration will change, but the rate will not. For additional information refer to System Operating Manual. STOP & START WITH ONLY 1 LINE PUMPING 1. Press 2. Press to resume infusion STOP & START WHEN LINE A AND B ARE PUMPING To stop infusion 1. Press 2. Select STOP A or STOP B or STOP ALL To resume infusion 1. Press 2. Select START ALL, START A or START B if both lines were stopped BACKPRIME 1. Stop infusion on all lines 2. Secondary container or syringe is necessary to receive the air 3. Select and hold BACK PRIME until air is cleared from cassette into secondary container 4. Release when complete 5. Restart infusion CLEAR VOLUME DELIVERED (TOTAL, LINE A, LINE B) 1. Select OPTIONS/VOL INF at main delivery screen 2. Select CHOOSE to select Volumes Infused 3. Use to highlight desired value 4. Select CLEAR, repeat as desired 5. Select ENTER to confirm change and to return to main delivery screen 8 9 Page 8 of 20 444-95536-002 Page 9 of 20
CLEARING SETTINGS 1. Specific line must be STOPPED prior to clearing the settings 2. Select LINE A or B at main delivery screen 3. Select YES to clear settings 4. Select CANCEL/BACK to return to main delivery screen or enter a new program NOTE: Clear all settings when changing patients or multiple programming parameters. DISCONTINUE INFUSION 1. Press 2. Select STOP ALL if both lines are pumping 3. Press 4. Clamp secondary tubing if connected 5. Open door, remove set and close door DELAY START (To delay infusion for a specific time period) 1. Specific line must be STOPPED prior to programming DELAY START 2. Prior to starting infusion, select PROGRAM OPTIONS LINE A or B programming screen 3. Enter values for desired hours and/or minutes 4. Select ENTER to confirm delayed start 5. Press to begin infusion 6. Confirmation screen will appear - if all information is SET OR CANCEL NURSE CALLBACK (An alarm to alert the completion of the infusion) 1. Prior to starting infusion, select PROGRAM OPTIONS LINE A or B programming screen 2. Use to highlight CALLBACK 3. Select YES/NO to change between yes and no 4. Select ENTER to begin program option 5. Press to begin infusion 6. Confirmation screen will appear - if all information is NOTE: Nurse callback cannot be changed while a delivery is in progress. STANDBY 1. Specific line must be PROGRAMMED to put in standby 2. Select PROGRAM OPTIONS 3. Select STANDBY key 4. Answer confirmation of programming question - device placed in standby 5. To remove standby status press 6. To return to standby select LINE A or B, select PROGRAM OPTIONS, select STANDBY, confirm by selecting YES 10 11 Page 10 of 20 444-95536-002 Page 11 of 20
SELECT DRUG (Manual Programming) NOTE: If DRUG LIST is chosen, the drug library will automatically appear. 2. Select DRUG LIST 3. Use PAGE UP or PAGE DOWN to scroll alphabetically to appropriate screen 4. Use to highlight desired drug 5. Select ENTER to select 6. Select CHOOSE to return to the line Programming Screen 7. Enter value 8. VERIFY rate, VTBI, and duration 9. Press to confirm programming 10.Confirmation screen will appear - if all information is NOTE: If in auto-programming environment, the drug may already be selected. See System Operating Manual for auto-programming. FUNCTIONS UNDER OPTIONS/VOL INF Volumes Infused - LINE A, LINE B, and Total Volume Pressure/Post Infusion Rate Continue Rate -The rate programmed will continue instead of reverting to KVO of 1mL/hr when VTBI complete Distal Pressure Limit - Set between 1-15 PSI Distal Pressure - Actual pressure on distal line Lighting/Contrast Backlight Intensity Display Contrast Change CCA FUNCTIONS UNDER PROGRAM OPTIONS Delayed Start of LINE A or B Callback - alarm to call user back to infuser Standby PROGRAMMING 12 13 Page 12 of 20 444-95536-002 Page 13 of 20
AVAILABLE PROGRAMS Standard Programming - ml per hour or alternative unit of measure for programming rate Loading Dose - Program an initial infusion rate for a specific volume followed automatically by a maintenance rate from the same container Multistep - Allows programming to deliver up to 10 steps from the same container NOTE: Dose calculation can be used in Standard Programming, Loading Dose, and Multistep. NOTE: Clear all settings when changing patients or multiple programming parameters. NOTE: The container concentration selection screen appears whenever the selected dose unit is gram based (grams, mg, mcg, or ng) ADVANCED PROGRAMMING (Auto-Programming) 1. Scan required elements. Program screen is auto-filled 2. Verify all parameters 3. Press to confirm programming 4. Confirmation screen will appear - if all information is NOTE: Auto-programming not available for Loading Dose and Multistep. NOTE: If an auto-program is received and is incomplete, use manual programming to change or complete the order prior to the start of infusion. WARNING! Plum A+ 3 users must be aware that changing the weight on one device does not change the weight on the other two devices. Patient weight must be changed on each device when delivering weight based therapy dependent on medication requirements. PROGRAM DOSE CALCULATION WITH OR WITHOUT HOSPIRA MEDNET SOFTWARE (Manual Programming) 2. Select DRUG LIST 3. Use to highlight drug, use PAGE UP or PAGE DOWN for more drugs and ENTER 4. STANDARD PROGRAMMING will be highlighted and CHOOSE to select. If drug selected has rule sets, go to #8, if it has NO rule sets, continue with #5 5. UNIT OF DELIVERY associated with drug chosen is highlighted and CHOOSE to select 6. CONTAINER CONCENTRATION unit to use in delivery is highlighted and CHOOSE to select 7. Use keypad to enter desired drug concentration and container volume if necessary 8. Use to highlight patient weight if required. Use keypad to enter patient weight. Once entered, use to highlight next programming field 9. Continue by entering dose values using keypad 10. Use to scroll down to the VTBI field 11.Use keypad to enter desired VTBI value 12. VERIFY dose, rate, VTBI and duration 13. Press to begin infusion 14.If a program parameter exceeds a soft limit, select YES to override the soft limit if appropriate, select NO to return to programming screen NOTE: Hard limits cannot be overridden. See page 4 for additional information. 15.Confirmation screen will appear - if all information is NOTE: Any auto-program received for a drug not listed in the active CCA will be entered as no drug selected. 14 15 Page 14 of 20 444-95536-002 Page 15 of 20
PROGRAM LOADING DOSE 2. Select DRUG LIST 3. Use to highlight drug, use PAGE UP or PAGE DOWN for more drugs and ENTER 4. Use to scroll down to LOADING DOSE and CHOOSE to select. If drug selected has rule sets, go to #8, if it has NO rule sets, continue with #5 5. UNIT OF DELIVERY associated with drug chosen is highlighted and CHOOSE to select 6. CONTAINER CONCENTRATION unit to use in delivery is highlighted and CHOOSE to select NOTE: If unit of delivery selected is other than ml/hour, follow prompts to enter drug parameters and dose value. 7. Enter rate using keypad 8. After desired value has been entered, use to highlight VTBI 9. Using keypad enter VTBI 10. After the values for LOADING DOSE Step-1 are entered, use to highlight maintenance dose values Step-2 11. Using keypad enter rate 12. Use to highlight the VTBI 13. Using keypad enter VTBI 14. VERIFY dose, rate, VTBI and duration 15. Press to begin infusion 16.If a program parameter exceeds a soft limit, select YES to override the soft limit if appropriate, select NO to return to programming screen NOTE: Hard limits cannot be overridden. See page 4 for additional information. 17.Confirmation screen will appear - if all information is PROGRAM MULTISTEP 1. Select LINE A at main delivery screen 2. Select DRUG LIST 3. Use to highlight drug, use PAGE UP or PAGE DOWN for more drugs and ENTER 4. Use to scroll down to MULTISTEP and CHOOSE to continue 5. UNIT OF DELIVERY associated with drug chosen is highlighted and CHOOSE to select. If drug selected has rule sets, go to #8, if it has NO rule sets, continue with #6 6. CONTAINER CONCENTRATION unit to use in delivery is highlighted and CHOOSE to select NOTE: If unit of delivery selected is other than ml/hour, follow prompts to enter drug parameters and dose value. 7. Enter rate using keypad 8. Use to highlight the duration or VTBI. Enter either value using keypad 9. Use to highlight next steps and complete as above 10.When Step-4 is programmed, select MORE STEPS to program up to 10 steps as above 11.VERIFY dose, rate, VTBI and duration 12.Press to begin infusion 13.If a program parameter exceeds a soft limit, select YES to override the soft limit if appropriate, select NO to return to programming screen NOTE: Hard limits cannot be overridden. See page 4 for additional information. 14.Confirmation screen will appear - if all information is See WARNING on page 14. See WARNING on page 14. 16 17 Page 16 of 20 444-95536-002 Page 17 of 20
RESPONSE TO ALARMS 1. Disable Lockout by confirming back switch is in down position 2. Press MESSAGE POSSIBLE CAUSE(S) CORRECTIVE ACTION(S) Distal Distal line kinked, IV site Check distal tubing Occlusion clotted or positional, Check IV site pressure limit set too low Reset pressure limit Prox Occl Proximal line obstructed Examine line A (B) for A (B) at (line A (B) container (or kinks or closed clamps Startup syringe) disconnected or Open any closed obstructed during startup) proximal clamps Open and close door For syringe, select [BACKPRIME] Prox Occl Proximal line obstructed Examine line A (B) for A (B) Air (line A (B) container kinks, closed clamps disconnected or obstructed) or air in cassette Open any closed proximal clamps Press [START] Prox Air Empty container or Check for clamps or A (B) excess air in line empty container Backprime Backprime into line B container or syringe Distal Air Air detected distally due Remove and reprime to excess air in air trap, cassette using standard incomplete priming technique If alarm recurs, replace the set No Action Infuser programming Press [START] Alarm incomplete Continue programming Infuser Idle Infuser is ON without Resume programming 2 Minutes operator input or turn infuser OFF 18 444-95536-002 (06/05) 3. Identify/Observe alarm condition 4. Correct alarm condition (see chart below) 5. Press to resume infusion MESSAGE POSSIBLE CAUSE(S) CORRECTIVE ACTION(S) Line A (B) VTBI is complete Program new VTBI VTBI Complete Depleted Too much time on Plug into AC power Battery battery power Cassette Faulty cassette, proximal Check clamps, manually Test or distal occlusion or air reprime set, close door Failure in cassette detected at Backprime into Line B startup container or syringe If alarm recurs on retest, replace set If alarm repeats, replace infuser Door Infuser door opened Close door with Opened while operating cassette inserted While Infusing Lockout The use of the stop key Unlock lockout switch Violation during delivery, or opening Unlock using the door while lockout keypad enabled Lockout Pressing of any key except Unlock lockout switch Enabled stop during delivery while Unlock using any alarm is active and keypad lockout is enabled Malfunction A failure has occurred in Record malfunction Message the infuser internal systems error code Infuser must be turned OFF to clear malfunction If alarm repeats, replace infuser 444-95536-002 (06/05) 19 ALARMS Page 18 of 20 444-95536-002 Page 19 of 20
For customer information or technical assistance call: Hospira 1-800-241-4002 HOSPIRA, INC. Lake Forest, IL 60045 USA www.hospira.com 2005 Printed in USA 444-95536-002 (06/05) Page 20 of 20 444-95536-002