Code Alarm 4000 Instrukcja Użytkownika

Revision H.3 Use with Software Rev. R5(x) for Curlin Medical 4000 Series Pumps Reorder Number 350-9009 CURLIN MEDICAL User’s Manual for use with

4 4 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

94Reviewing or Changing the Program To review or make any changes in the prescription programming, press the “NO/CHANGE” key at the Run Options scre

95Intermittent Information Screens Interrupting an Infusion The infusion can be paused at any time by pressing the “PAUSE” key. The yellow “Standby

96Run Options Screen 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 t

97Intermittent Dosing Schedule The dosing schedule of the previous container is retained and displayed on this screen. In Lock setting 0 and 1, you

98Timing Rules when Interrupting Intermittent Therapies Remember, this therapy is time dependent, and the following rules apply for interruptions in

99This screen displays: 1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the sm

100

101Variable Therapy This therapy is designed to allow twenty-four specified programs of varying amounts, rates, and times of delivery. egin progr

102“ON.” Now, when you press the “YES/ENTER” to accept, the following screen will appear: Variable Delay Start Setting The time format (12 hr AM/

103During 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

5 5WARNINGS • Use only Curlin Medical administration sets in your Curlin Medical pump. Use of nonproprietary administration sets may alter accuracy

104“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

1055 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

106Prime 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.

1077 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

1081 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

1094 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.

110Also, when the Air-In-Line sensor is completely disabled and the infusion goes to an “Infusion Complete” or “Empty Bag” status, the Air Sensor se

111Variable Run Screen 2 This screen displays as long as the infusion is running. Notice the information on each field: 1 The first field displays

112Interrupting an Infusion The infusion can be paused at any time by pressing the “PAUSE” key. The yellow “Standby” LED light blinks, and the foll

113stop the auto-advance function by pressing any key (except ON/OFF) and then complete the confirmation of the prescription manually by pressing th

6 6• If any signs or symptoms of infiltration or inflammation are noted at the infusion site, stop the infusion and report it to the appropriate hea

114Note: Selecting “NEW PROGRAM” will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must b

115The pump will then display the program screens with the last programmed values of the therapy and the cursor will automatically advance through t

116

117Troubleshooting This section assists in identifying and resolving alert and alarm conditions that may occur during the use of the Cu

118If 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

119Note: Access to the programming screens is lock level restrictive. If the actual amount in the source bag/container is sufficient to complete th

120 LCD Display: ALERT CALCULATED RATE OUT OF RANGE Alert: Invalid calculated rate of infusion Cause: The calculated rate for the infusion, ba

121If it is not necessary to preserve the therapy in progress or any other programmed therapy, use the “CLEAR Rx” feature of the Clinician Biomed me

122Alert: Cancellation of a Clinician Dose is pending and can only be processed with the pump running. Cause: Clinician Dose in progress is canc

123Resolution: Recheck the field and accept it by pressing the “YES/ENTER” key. LCD Display: ALERT GREATER THAN MAX FIELD LIMIT, MAX = _____ Ale

7 7• 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 ch

124 LCD Display: ALERT KVO RATE IS GREATER THAN INF RATE Alert: Unable to enter KVO rate that is greater than infusion rate Cause: Occurs when

125 LCD Display: ALERT NEW DOSE IS LESS THAN CURRENT DOSE Alert: Unable to program a lower number of doses than number of doses already infused

126Resolution: Wait until the dose in progress completes before modifying field. LCD Display: ALERT NOT in PCA. NO BOLUS ALLOWED Alert: Bolus r

127Resolution: Press “PAUSE” key before pressing “OFF” key to stop an infusion. LCD Display: ALERT Rx IN PROGRESS, YES to Repeat – NO to Return

128figures 1.9 and 1.10 of the User’s Manual for proper installation of the administration set. LCD Display: ALERT SYSTEM CLOCK NOT SET Alert:

129the 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

130ALARMS 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 cond

131 LCD Display: ALARM EMPTY BATTERY Alarm: Empty Battery Cause: The battery no longer has sufficient power to run the pump. (If the battery

132LCD Display: ALARM UP OCCLUSION Alarm: Negative pressure detected between the pump and IV reservoir Cause: Pump has detected excessive neg

133 LCD Display: UPLOAD CkSum ERR Alarm: CMS Upload experienced a Check Sum Error Cause: At the completion of an upload of a CMS script the Ch

8 8 Pump Illustrations and Features Figure 1.1 Curlin Medical Ambulatory Pump—Front, top and left view Door Latch On /Off Key Run/Pause

134ERROR 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

135Error Code LCD Displayed Message Probable Cause Corrective Action 34 Turn Pump OFF Call Provider Audio Auxiliary Speaker High Report error cod

136Error Code LCD Displayed Message Probable Cause Corrective Action 162 Stuck 0 Key Turn pump OFF/ON or Call Provider Stuck 0 Key If key was pre

137Error Code LCD Displayed Message Probable Cause Corrective Action 204 Turn pump OFF/ON Call Provider Bad run state Report error code to factor

138

139Accessories There are a number of helpful accessories for use with the Curlin Medical pumps, and their descriptions and diagrams for use are inc

140Battery Pack (340-2006) This accessory is an external, rechargeable, lead-acid battery pack than can be used as an additional, long-life, portabl

141Detachable 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 di

142 Lockable Safety Shells These accessories are hard-plastic, durable cases that are lockable with a key. The small safety shell (340-0106) will s

143Additional graphics below show how to install the Pole Clamp on the Lock Box. Figure 10.6 Pole Clamp and Safety Shell Installation Pump Holst

9 9 Figure 1.2 Curlin Medical Ambulatory Pump—Back, bottom, and right view Introduction Recessed release Pin for Battery Door External Power J

144Data 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

145Cleaning, Environmental Conditions, and Maintenance Following the guidelines for care listed below will assure the best appearance and longest li

146Transport and Storage During transport or storage, the batteries should be removed, the pump should be cleaned and kept in its hard-shell packing

1471 PARTIES COVERED BY THIS WARRANTY: This warranty extends only to the Original Purchaser of the Pump. This warranty does not extend to subseque

148Procedure for Checking Pumps Between Patients Purpose This Pump Test Procedure is for use by Technicians to inspect, test and prepare a pump for

149d Program the following CONTINUOUS Infusion: Pre Rx: UNITS: ml DELAY: OFF Titrate: OFF NEXT? YES Prescription: BAG VOL: 100 ml VOL TBI:

150Adapter eliminator and remove one C-Cell battery.) Observe that the Auxiliary Alarm System is activated, with the Red LED and Beeper on constant

151Technical Specifications The following specifications apply to the Curlin Medical Ambulatory Infusion Pump: ITEM SPECIFICATION Pumping Mechanism

152ITEM 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

153ITEM SPECIFICATION Programmable Time (HH:MM) Continuous TPN Intermittent Variable PCA 00:01 to 288:00 HH:MM 00:01 to

10 10Disposable Administration Set Illustrations and Features CAUTION: USE ONLY CURLIN MEDICAL ADMINISTRATION SETS WITH THI

154

155 Clinician Information and Access Code This chapter should be removed before initial patient training and instruction on the Curlin Medical pump

156Lock Setting Table The following table illustrates which features are controlled under which lock settings: Pump Operation Active Therapy Lock O

11 11Preparing Medication for Infusion/Changing IV Bags Figure 1.4 Spiking the fluid container, gravity priming the set and using the slide clam

12 12 Figure 1.5 Curlin Medical Administration set “Integral Flow-Stop” with breakaway tab Figure 1.6 Intentionally Opening the “Integral Fl

13 13Door Latch (Lift to open) 12 To open the pump door: 1 Pull the door latch up, releasing the latch hooks from the latch pins. 2 Grasp the doo

TABLE OF CONTENTS IINTRODUCTION ... 1 Delivery Modes ... 1 Indications for Use ...

14 14Choosing and installing the Curlin Medical Administration Set A number of distinctively designed Curlin Medical administration sets are availabl

15 15Figure 1.9 Proper installation of the Curlin Medical Administration set into the pump Steps in Installing Administration Set into Curlin Medical

16 16 Figure 1.10 Top cutaway view of the Curlin Medical pump with Curlin Medical Administration set in proper installation position U

17 17Installing the Batteries and Using External Power The Curlin Medical pump can be powered solely with the use of two “C” size alkaline batteries

18 18 Figure 1.11 Installing batteries into the Curlin Medical Ambulatory pump Whenever an external source is powering the pump, it is still importa

19 19External Power Sources Battery Pack The battery pack is an external, rechargeable, lead acid battery pack than can be used as an additional, lo

20 20 AC Adapter/Charger This accessory (Universal AC Adapter 340-2022) becomes the external power source when plugged directly into the Curlin Medic

21 21Attaching and Removing the Bolus Cord When the PCA therapy is used, patient bolus dosing can be programmed. To facilitate ease of patient self-

22 22

23 23Learning Pump Features Learning to operate the Curlin Medical pump requires a few basic points of understanding that remain constant in every

TABLE OF CONTENTS IIEntering or Changing Data Fields... 40 CONTINUOUS THERAPY ... 41 Prescription Menus...

24 24 Keypad Function 1 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 infus

25 25LED Light Indicators This “three-light” feature gives the user feed back on the current status of the pump. 1 Green indicates a RUNNING status

26 26The 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. W

27 27Basics of Programming The Curlin Medical pump allows the operator to customize this device to meet the specific infusion needs of each individ

28 283 “Data entry screens” are used to specify prescription parameters. Sample of a Data Entry Screen In the above example, the cursor rests on a

29 29messages 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 err

30 30When the Curlin Medical pump successfully passes it’s self-test, a brief message of “System OK” appears, and the display moves to the next scre

31 31Access Code Clinician Access Code Screen The clinician enters a four-digit personal identification number followed by the five-digit access code

32You 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 highl

33to all pump functions. Each level higher limits the options available to the patient or caregiver (see each lock option screen in the individual

TABLE OF CONTENTS IIITPN Pre-Prescription Menu Screen ... 71 TPN Delay Start Setting ...

34Note: The patient history log should be printed before clearing occurs if a hard copy record is required. The history log, when printed, lists th

358 PRINT PATIENT HISTORY: To print the patient history log, connect the Data Interface Cable to the communication port on left side of the pump be

3611 CLEAR Pt. DATA: Selecting this feature clears all data programmed and resets the pump to its default settings. The history log is NOT cleared

37a. Time Format: You have the option of selecting twelve-hour or twenty-four-hour time format. Press the “NO” key until the correct selection app

38Resume/Repeat Rx/New Program Menu There are three different ways that you can start a therapy: • RESUME: Should be used if a therapy is interr

39 If only one therapy is programmed and REPEAT Rx is selected, the cursor will automatically advance through the prescription menus. You can stop t

40only one therapy is enabled, this screen will not display, and the pump will automatically move to the first screen for specific therapy programmi

41Continuous Therapy Continuous Therapy is designed to allow a constant programmed rate of infusion. egin programming a Continuous Th

42be 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 t

43If 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

TABLE OF CONTENTS IVPrime...106 Prime Direction Screen... 106 Options ...

44Continuous Prescription Menu 1 BAG Vol (IV Bag Volume): Use the numeric keys to enter the amount of fluid in the IV Bag or Medication Reservoir (

456 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 corre

464 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 admin

47The following screen displays the Continuous Therapy “Options” available. When you open this menu, use the up and down arrows to move the highligh

48d. 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 O

49detects 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

50When 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 se

51In CMS-enabled pumps, the graphic bar will toggle with Line Pressure (“L Press”) which displays the current patient side (downstream) pressure in

52Resuming 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

53be displayed, then press “YES” and the Run Options screen will be displayed. To resume the unfinished therapy, press “RUN”. Entering a New Progra

TABLE OF FIGURES VFIGURE 1.1 CURLIN MEDICAL AMBULATORY PUMP—FRONT, TOP AND LEFT VIEW ... 8 FIGURE 1.2 CURLIN MEDICAL AMBULATORY PUMP—BACK, BOTTOM,

54This screen displays: 1 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the sm

55 PCA Therapy PCA or Patient Controlled Analgesia is designed for therapies requiring a continuous rate of infusion, patient controlled demand bol

563 ADMIN Rt (Administration Route): Allows a selection from three routes of administration: the default setting of IV (intravenous), EPI (epidura

57a. MxRATE (Maximum Rate) limits: Use the numeric keys to enter the upper limits of the infusion rate. When the correct maximum titration rate i

58PCA Prescription Menu Note: The PCA therapy can be programmed for Basal Rate (continuous infusion) only, for Bolus (patient demand dose) only, or

59using the numeric keys and, when correct, press the “YES/ENTER” key to accept and move the cursor to the next field. 5 # BOLS/hr (Number of Bolus

60Priming 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 o

61Note. After the infusion has started, any changes made through the OPTIONS menu involving: • “Clin DOSE”, • “SHFT TOT” • “HRLY TOT”, and • “

62Note: 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 O

63d. To exit the shift total feature without clearing the totals, press the “YES” key at the highlighted EXIT field. e. To clear the Shift Totals,

1 1Introduction The Curlin Medical Infusion Pumps have been designed with the user in mind and have the latest in friendly, simple-to-learn technolo

64c. A lock level of 2 or 3 will require an access code entry before allowing “Hourly Totals” reset. 6 TitrRx (Titrate Prescription): If this fea

65pressures at 400 mmHg ±150 (8 ±3 psi “pounds per square inch”), or the “High” setting (default setting) alarms when it detects in-line pressures

66enter 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 fi

67CMS-enabled pumps, the graphic bar will toggle with Line Pressure (“L Press”) which displays the current patient side (downstream) pressure in th

68The screen offers the user three options: Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, pres

69b. 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 scr

70This screen displays: 1 “INFUSION COMPLETE.” 2 A completely filled in bar graph indicating infusion complete. 3 TOT Vol (Total Volume): If uni

71TPN Therapy with Automatic Ramping This therapy is designed to allow a level rate of infusion of parenteral nutritional products with the option

72will 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,

73At the following screen, the prescription information is entered to complete the programming of the pump: TPN Prescription Screen Note that the sc

2 2Indications for Use The Curlin Medical pump can be used for intravenous, epidural, or subcutaneous therapies. It can be used to deliver medicatio

74time 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

75before they are connected to the access site. Priming may have been done by gravity when the administration set was first connected to the bag (s

767 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 to

77pump has been set into a locked condition, any subsequent request to change the lock will require a clinician access code. (See “Clinical Informat

78Note: 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 usin

79 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 s

801 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

81The screen offers the user three options: Resuming the Current Container 1 RESUME: To resume the therapy in progress from where it left off, pre

82be displayed, then press “YES” and the Run Options screen will be displayed. To resume the unfinished therapy, press “RUN”. Entering a New Progra

831 “INFUSION COMPLETE.” 2 A graphic representation (completely filled in bar graph) indicating infusion complete, or the smaller “dot” configurat

3 3independence of lifestyle. Backpack will accommodate pump, AC Adapter, and up to four-liter IV bag. • Retained memory features that allow the pu

84

85Intermittent Therapy Intermittent Therapy is designed to deliver programmed intervals and rates of specified amounts of infusates and to optiona

86screen will appear: Intermittent Delay Start Setting The time format (12 hr AM/PM or 24 hr Military) selected in the B

87During 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 f

88Note: 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: Usin

8910 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 th

904 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 admin

91The following screen displays the Intermittent Therapy “Options” available. When you open this menu, use the up and down arrows to move the highli

923 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 followin

93This message alerts you to the Air-In-Line Sensor being set to “OFF.” The message will require answering “yes” or “no” to whether the administrat