System Operating Manual R d e s u e . e s b u n for o o t ti with t ua o N it S l For use with Lists: 12391, 20679-04, l a a ONLY) and above and 11971-04 (-03u c i n Options/ Back Ma lin B C A Prime t a Vol Inf f a in r D HOSPIRA, INC., LAKE FOREST, IL 60045, USA 430-95520-001 (Rev.
Change History Change History Title 430-95520-001 (Rev. 04/05) Description of Changes Pages Affected First Release All d e s D u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 430-95520-001 (Rev.
Contents Section 1, Descriptive Information . . . . . . . . . . . . . . . 1-1 PRODUCT DESCRIPTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 INDICATIONS FOR USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 user qualification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 CONVENTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 warnings, cautions, and notes . . . . . . . . . . . . . . . . . . . . . 1-3 PRECAUTIONS .
Contents REAR CASE CONTROLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6 ADMINISTRATION SETS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7 PREPARING THE ADMINISTRATION SET . . . . . . . . . . . . . . . . . . . . 3-7 PRIMING THE ADMINISTRATION SET . . . . . . . . . . . . . . . . . . . . . . 3-8 LOADING THE CASSETTE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9 PREPARING THE SECONDARY LINE . . . . . . . . . . . . . . . . . . . . .
RATE, AND LIGHTING/CONTRAST . . . . . . . . . . . . . . . . . . . . . . . . 6-6 VARIABLE RATE CAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10 EXAMPLES OF AUTOMATIC CALCULATION . . . . . . . . . . . . . . . . . 6-10 at startup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10 while running (titration) . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10 at kvo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7 Section 10, Supplies and Accessories . . . . . . . . . . . . 10-1 ADMINISTRATION FLUIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1 administration fluids . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1 enteral and high viscosity fluids . . . . . . . . . . . . . . . . . . . 10-1 containers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1 ACCESSORIES . .
Plum A+ Infusion System SECTION 1 Descriptive Information The Plum A+ Volumetric Infusion System is designed to meet the fluid delivery requirements of today’s evolving healthcare environments. The infuser is a cassette based multi-function infusion system. The Plum A+ allows two lines in and one line out. The infuser can be used for standard, piggyback, or concurrent delivery.
02.11b local area networking capabilities. This allows the Hospira MednetTM networked application software for drug library downloads and Auto-programming to the infuser. Indications for Use USER QUALIFICATION The Plum A+ is intended for use at the direction or under the supervision of licensed physicians or certified healthcare professionals who are trained in the use of the infuser and the administration of parenteral, enteral, and epidural fluids and drugs and whole blood or red blood cell components.
Plum A+ Infusion System CONVENTION APPLICATION EXAMPLE [BRACKETED ALL CAPS] Keys or buttons on the device are displayed in [BRACKETED ALL CAPS] or with a graphic. [START] V [Italic] Softkey Options V [Choose] Initial Caps lowercase Screen displays and device labels (as appropriate) Program Bold Emphasis ...sets are supplied Sterile and are for.... or Dose Calculation WARNINGS, CAUTIONS, AND NOTES Alert messages used throughout this manual are described below.
NOTE: A Note highlights information that helps explain a concept or procedure. This symbol directs the user to consult accompanying documents. When visible on the display, this symbol informs the user to use CAUTION because the specified drug has NOT been programmed with specified safety limits. NOTE: Figures are rendered as graphic representations to approximate the actual product. Therefore, figures may not exactly reflect the product.
Plum A+ Infusion System • Although unlikely, failure of certain robust mechanical components such as the anti-free flow mechanism or valve control springs could cause fluid delivery limited to the contents of the fluid container. Single fault failure of certain electronic/motor control components would result in no more than 5 mL of unexpected fluid delivery. • A small amount of fluid is expelled from the set (less than 0.05 ml) each time the door is opened or closed with a set installed.
• If the critical drug (with half-life less than 6 minutes) is to be infused at 2.0 to 5.0 mL/hr the other infusion should be no faster than ten times the critical drug’s rate. Dopamine, for example, delivered at 3.5 ml/hr should not be accompanied by an infusion programmed any faster than 35 mL/hr. • If the critical drug (with half-life less than 6 minutes) is to be infused at 5.1 mL/hr or greater, the other infusion can be programmed at any desired rate.
Plum A+ Infusion System CRITICAL DRUGS Examples of drugs with a short half-life (approximately 6 minutes or less when given IV) include: Dobutamine Lidocaine Dopamine Nitroglycerin Epinephrine Nitroprusside Epoprostenol Norepinephrine Esmolol Oxytocin Isoproterenol Procainamide For these drugs, the concurrent flow guidelines should be followed when the infusion rate of the drug will be 5 mL/hr or less.
• Administration of drugs via the epidural route should be limited to personnel familiar with associated techniques and patient management problems. Proper epidural placement of the catheter is essential since catheter migration could result in intravascular or intrathecal administration. Facilities practicing epidural administration must be equipped with resuscitative equipment, oxygen, naloxone, and other resuscitative drugs. Adequate monitoring equipment (e.g.
Plum A+ Infusion System SETS AND ACCESSORIES • Only compatible LifeCare PlumSets can be used with the Plum A+. See individual set instructions for additional information. • Administration sets should be changed per CDC guidelines or healthcare provider policy. Discard after use. • LifeCare IV infusion sets with integral nonblood filters are not for use in the administration of blood, blood products, emulsions, suspensions, or any medications not totally soluble in the solution being administered.
• Do not place Plum A+ in service if it fails the self-test. • Do not operate the Plum A+ with the case opened. • Keep the cassette door securely closed while the infuser is not in use, to avoid cassette door damage. • Values beyond a fields maximum hard limit will be diplayed as dashes (-- -- --). The user must clear these fields using the [CLEAR] key prior to entering new values. CLEANING For more information on cleaning the infuser, see Section 8.
Plum A+ Infusion System • Open the flow regulator briefly to dissipate the pressure and then close it. • Eliminate the source of occlusion (closed clamp). • Reinsert the cassette and close the cassette door. • Open all clamps and resume infusion. NOTE: When troubleshooting an occlusion where all clamps are in the OPEN position, use care to avoid delivery of a bolus by opening the flow regulator to release any built-up pressure.
or microcomputer might be disrupted. Even in this event, the outcome would likely be a false alarm or detected system malfunction and would not result in a hazard to patient or operator. • This equipment has been tested and found to comply with the EMC limits for the Medical Device Directive 93/42/EEC (EN 55011 Class B and IEC/EN 60601-1-2:2001). These limits are designed to provide reasonable protection against harmful interference in a typical medical installation.
Plum A+ Infusion System • Maintaining a minimum separation distance of 2 ½ ft between the Infusion pump system and portable/ mobile RF communications equipment • List Numbers 12391 and 11971 are compliant to IEC/EN 60601-1-2 (1993) List Number 20679 is compliant to IEC/EN 60601-1-2 (2001) and have been tested and found to comply with EMC limits for the Medical Device Directive 93/42/EEC (EN 55011 Class B and EN 60601-1-2:2001).
with other equipment, monitor the devices to verify normal operation. • USE ONLY components specifically labeled for use with the Plum A+ Infusion System to help ensure the device operates as intended. • If you suspect external RF sources or other equipment are influencing device operation, contact the biomedical engineering department for additional guidelines concerning electromagnetic immunity.
Plum A+ Infusion System to radio or television reception, which can be determined by turning the equipment off and on, the user is encouraged to try and correct the interference by one or more of the following measures: • Reorient or relocate the receiving antenna. • Increase the distance between the equipment and the receiver. • Connect the equipment to an outlet on a circuit different from that to which thereceiver is connected. • Consult the dealer or an experienced radio/TV technician for help.
LAN device has been evaluated with zero inches separation of human body from the antenna and found to be compliant with FCC RF exposure limits. 1- 16 430-95520-001 (Rev.
Plum A+ Infusion System SECTION 2 Principles of Operation Features The Plum A+ is a dual-line volumetric infusion system designed to meet the growing demand for hospital-wide, as well as alternate site and home healthcare, standardization. With its primary line, secondary line, and piggyback fluid delivery capability, the Plum A+ is suited for a wide range of medical/ surgical and critical care applications.
PLUMSET CAPABILITIES • Anti Free-Flow Protection • Direct Connection for syringe delivery AIR MANAGEMENT • Air Trap • Air Removal/Backpriming • Air Detection-Proximal • Air Detection-Distal BATTERY • Battery Gauge • Less than 8-Hour Battery Recharge Time • Long battery life (3 hours) for emergency backup and temporary portable operation BIOMEDICAL • Upgradability (Field) • Variable Rate Cap • Alarm History • Nurse Call Relay Connector OPTIONS • Volumes Infused (A, B, Total Volume) • KVO at dose end (1 m
Plum A+ Infusion System • Panel back illumination on mains power • Lockout switch • Standard syringe use • Parenteral and nonparenteral (enteral) fluid delivery • Blood and blood products delivery • Wide range of Standard and Specialty administration sets • Password protected keypad lock COMMUNICATION • Networked Communication (Ethernet & Wireless) • Autoprogramming • Drug Library Download Definitions TERM DEFINITION Administration Set The sterile, disposable assembly with flexible tubing that connects
TERM DEFINITION Auto-Program A physician order sent to the infuser. Auto-Program (new) An auto-program is considered “new” if either of the following conditions are met: A) There is no program on the associated line. B) The drug and concentration in the auto-program is different from a currently-programmed drug and concentration. Auto-Program (titration) An auto-program is considered a “titration” if the drug and concentration in the auto-program match the currentlyprogrammed drug and concentration.
Plum A+ Infusion System TERM DEFINITION Bolus A single uninterrupted discrete volume of fluid delivered over a discrete period of time. Cassette A Hospira standard Plum Macro Cassette that contains the actual pumping chamber with inlet and outlet valves. It also contains access ports to diaphragms for proximal and distal line pressure sensing and chambers for air trapping and air quantity measurement.
TERM DEFINITION Concurrent Delivery Simultaneous delivery of two fluids at independent flow rates. Concurrent Mode The Line B control selection mode that allows either Line A or Line B (or both) of the Mechanism to be programmed for delivery that completes with KVO or CR. Line A operation is unaffected by Line B delivery. Connectivity Engine (CE) A component of the infuser that controls ethernet and wireless communication between the MMU and Infuser processor.
Plum A+ Infusion System TERM DEFINITION Distal Downstream (output) from the Cassette portion of the Administration Set. Door The lever-operated, bottom-hinged, Cassette holder on the front of the Mechanism. Dose (Rate) Delivery rate times drug concentration. Dose Calculation Allows programming Dose Rates in alternative units of measure. Dose Calculation can be used in Simple Delivery, Loading Dose, and Multistep.
TERM DEFINITION Filling Head Height (FHH) The gravity induced Proximal Line pressure due to fluid height in source container above the Distal Line output level. Flow Rate The resulting rate of fluid flow. (See Rate and Dose.) Fluid Delivery Begin The time required, measured from the initial start of a keypad press, for a digit in the third decimal place of a scale measuring grams to change when pumping water, the delivery tube is fluid filled, and the end of the delivery tube is immersed.
Plum A+ Infusion System TERM DEFINITION Line B Inlet connector on the top right of Cassette when viewed after it has been loaded in Mechanism Door. Loading Dose Allows programming of an initial infusion rate for a specific volume, followed automatically by a maintenance rate from the same container (e.g., a fluid challenge). If Dose Calc is used, the Loading Dose and Maintenance Dose are in the same unit of measure, over the same period of time (mcg/min), from the same container.
TERM DEFINITION Multistep Allows a sequential program to deliver up to 10 steps; fluid volumes and delivery rates may be programmed for each step. The program may be entered based on Rate and Volume or Volume and Time. If Dose Calc is used, the delivery steps are in the same unit of measure, over the same period of time, from the same container. MMS Medication Management Suite- a product suite that will be used to support safe and efficient caregiver administration of intravenous medications.
Plum A+ Infusion System TERM DEFINITION Patient Weight The Alternate Units Parameter whose value entry is required with Dose rates (quantity/time) having the third parameter of weight, such as mcg/kg/min. Piggyback Delivery Infusion will stop Line A and infuse Line B until VTBI completes. Piggyback Mode The Line B control selection mode that requires Line A delivery suspension while Line B delivers and then its resumption when Line B VTBI completes.
TERM DEFINITION Programs A Concentration-based extension to basic Volume/Rate delivery for Dose Rate applications. Softkey-selected types are: 1) Standard Program for single rate delivery; 2) Loading Dose for up to two steps of delivery at differing rates; 3) Multistep for up to ten steps of delivery at differing rates. Loading Dose and Multistep include the basic Delivery Rate option. Protocol In the medical field, hospital-approved procedures.
Plum A+ Infusion System TERM DEFINITION Soft Limit The dosing amount (upper and/or lower amount) that when assigned to a drug can be overridden based on confirmation. Defined by the hospital for each drug in its Drug Library. The soft limits for a particular drug entry may vary across CCAs. Standard Programming (see Basic Delivery) Standby A delivery program state that resembles a delayed start for a line in all respects, but status display of STANDBY instead of DELAYED.
TERM DEFINITION Warning Audible indication at the defined Warning sound level, often accompanied by a brief message, to advise operator that: 1. Input was attempt to use a function in wrong sequence, with wrong values, or at wrong time (resulting in an Invalid Key Warning); 2. Input was properly related to a function (resulting in a Valid Key Warning). (The Low Battery Warning is an exception, using the Alarm Indication sound level.
Plum A+ Infusion System SECTION 3 Equipment Description Line B Flow Indicator Line A Flow Indicator d e s u LCD be n.
Operating Keys The [ON/OFF] key is used to control the power of the Plum A+. NOTE: All deliveries must be stopped in order to turn the power off. NOTE: To confirm proper shutdown of infuser, do not unplug until “double beep” is heard (approximately 5 seconds). If “double beep” is not heard, the infuser will turn itself back ON sensing the AC power was lost and revert to battery back-up power. d e s u be n. to tio t ua o N it S l l The [START] key is used to uabegin ca infusion.
Plum A+ Infusion System The [SILENCE] key is used to silence an audible alarm during actions to correct its cause. The [SELECT] key (or ) is used to move the highlighting cursor between the programming fields. d e s u be n. to tio t ua o N it S l l a a u center The numeric keys are used to i n values for anya highlighted in field l requiring numeric M data. C t f[CLEAR] a The key will cause a a n r i numeric field to be D highlighted cleared in preparation for data entry.
Softkeys are located at the bottom of the main display and serve a variety of functions. What each key does is indicated by the text in the display above the actual softkey. Indicators The Charge/Line Indicator is illuminated to indicate the battery is currently charging. Standby Enter Cancel/ Back d e s u e . b n NOTE: If the device is plugged o o into AC power, with a battery t ti installed, and the Charge t ua Indicator is not illuminated, o N it contact technical support.
Plum A+ Infusion System Display Symbols Battery Capacity Symbol (located on right side of message region on display) indicates relative charge with number of white boxes from left to right. Cautionary Symbol is displayed to alert the user that the infuser is being operated without rule sets (soft or hard limits). Read the drug package insert for information on proper usage. D d e s u be n.
It may appear on any Main Delivery A STOPPED PUMPING B Screen whether pumping or stopped. It DOPamine Lidocaine Dose Calculation Dose Calculation also may appear regardless of AutoRate 26.3 30 mL/hr Programming. However, in a wireless Vol Inf 1 0.1 network environment, AutomL 2 Dose Programming will not be successful if mcg/kg/min mg/min MedSurg the icon is not visible during the AutoOptions/ Program transfer.
Plum A+ Infusion System NOTE: Pressing of a key while lockout is active results in the display of the lockout enabled message. This action is recommended to confirm each lockout activation. NOTE: If the lockout switch is put in the “Locked” position while the infuser is off, the [ON/OFF] key allows the unit to turn on. The connector located below the lockout switch is the Nurse Call Relay Connector, for providing remote notification of a nurse call event. d e s u be n.
Preparing the Administration Set NOTE: For detailed instructions, see administration set packaging. WARNING ARRANGE TUBING, CORDS, AND CABLES TO MINIMIZE THE RISK OF PATIENT STRANGULATION OR ENTANGLEMENT. d e s u be n. Make sure flow regulator is closed. to tio t ua o N it S l l a aoutlet with Insert piercing pin into container u c i n a twisting motion.
Plum A+ Infusion System Priming the Administration Set 1Invert the cassette. d e s 2Turn the flow regulator counter-clockwise until a drop of fluid is seen in the pumping chamber. u be n. o io 3 Turn the cassette upright, then primetthe t remainder of the administration t set. a o tu N - l Si l a a u c i n n to close. Confirm 4 Push in thea flow regulator there is Mno flow.Cli t a f a in r D Loading the cassette To load the primed cassette into the plum A+, proceed as follows.
2Insert cassette into door guides. Close the cassette door. Confirm there is no flow and no kinks appear in tubing. NOTE: If flow is observed, close the tubing clamps and replace the administration set. d e s NOTE: The administration set should be changed per CDC guidelines or healthcare provider policy. Discard after use. u e . b Preparing the Secondary o Line on t ti CAUTION: C t ua, , , o N it ( ) S l .
Plum A+ Infusion System cassette. Use of a syringe adapter may decrease the occurrence of proximal occlusion alarms. • When using a syringe adapter, retract the plunger to draw approximately 1 mL of fluid into the syringe to clear air from the adapter filter. To prepare the secondary line, use aseptic technique and proceed as follows: 1 With cassette door closed: Loosen and d e s u e . 2 Open all proximal clamps before pressing b n o o [START]. t ti t ua 3 Set up per operating instructions.
maintain fluid flow in a gravity mode (see the following graphics). . 1 PRESS STOP STOP d e s u be n.
sec04.fm Page 1 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System SECTION 4 Basic Operation Getting Started d e s UNPACKING CAUTION: PRODUCT DAMAGE MAY OCCUR UNLESS PROPER CARE IS EXERCISED DURING UNPACKING AND INSTALLATION. DO NOT USE THE PLUM A+ IF IT APPEARS DAMAGED IN ANY WAY. THE BATTERY MAY NOT BE CHARGED UPON RECEIPT. u be n. Inspect the Plum A+ packaging for possible o shipping iodamage. If t damage is found, contact the deliverytcompany immediately.
sec04.fm Page 2 Monday, April 11, 2005 8:34 AM BE DISRUPTED . O PERATION OF THE INFUSER UNDER THESE CONDITIONS SHOULD BE AVOIDED. TANDEM CARRIER INSTRUCTIONS The Plum A+ may be safely and conveniently mounted on an IV stand or on a tandem carrier mounted on an IV stand. Always mount the tandem carrier (List# 12270-01) to the pole before attaching the infuser(s) to the tandem carrier. d e s u e . b Make sure infusers are firmly n io attached to tandem tocarrier.
sec04.fm Page 3 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System Press the [ON/OFF] key to turn the power on. Check screen display and listen for a beep to indicate the audio is working. Wait for the self-tests to complete. If successful, put a fully primed macro cassette into the cassette door and close the door. See Loading Cassette in Section 3 for details of correct procedure.
sec04.fm Page 4 Monday, April 11, 2005 8:34 AM Power On 1 Press to Power On the Plum A+ and the System SelfTests Screen is displayed. After self-testing successfully completes, the display will proceed to the next screen. HOSPIRA Plum A+ 13.X Jan 31 2005 12:30:30 Copyright Hospira, Inc. 2005 System Self Test In Progress d e s u Programming the infuser may ** be n. begin during the cassette o io ’ t t ** check phase of the start-up t a testing.
sec04.fm Page 5 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System The Area Selection screen will appear if your system has been programmed with the Hospira MedNet accessory. Use to choose. If only one CCA has been entered, it becomes the default and this screen is skipped. Area Selection Any Hospital, USA MM/DD/YY XXYYZZ- 123456 ICU MedSurg OR Cardio Urology Psych Recov L&D 5 West Renal Neo ICU OB/GYN Oncol Ad ICU ER 7 South 3 North 4 North Select, then Enter Enter d e s u be n.
sec04.fm Page 6 Monday, April 11, 2005 8:34 AM Simple Delivery Example of MedNet Main Delivery Screen (with cleared settings). The selected area is displayed at the bottom. A STOPPED STOPPED B 0 Rate mL/hr 0 0 Vol Inf mL 0 **SCREENS SHOWN IN THIS MANUAL ARE EXAMPLES ONLY AND DON’T d e s MedSurg NECESSARILY REFLECT CURRENT ACTUAL PRACTICE** u NOTE: For clarity, whole number font be n. sizes will appear larger than fractional number font sizes (numbers on the right-side io toof thetdecimal).
sec04.fm Page 7 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System 5 Use to move down to the DURATION field. If auto-calculated Duration is acceptable, skip to step 9. 6 Use keypad to change/enter the hours part of duration if desired. A PROGRAM d e 0. s u NOTE: When all parameters are 00:05 e displayed, changing any one b n. parameter will result in other o io parameters automatically being t t computed. To understand the t a Automatic Calculation feature,o see tu N Section 6.
sec04.fm Page 8 Monday, April 11, 2005 8:34 AM Example of Main Delivery Screen just after being programmed and started. A PUMPING STOPPED B 5.5 Rate mL/hr 0 0.1 Vol Inf mL 0 ! NOTE: The Line A Fluid Flow Indicator also will flash to indicate pumping. MedSurg B A Options/ d e s Vol Inf NOTE: VTBI (volume to be infused) values over 100 mL are displayed truncated. This means that the number displayed rounds-down to the last whole number (e.g., 105.7 would be displayed as 105).
sec04.fm Page 9 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System 2 Enter the desired Rate using the keypad. NOTE: When Rate is changed, the duration is automatically recomputed using the current VTBI. To understand the Automatic Calculation feature, see Section 6.7 Examples of Automatic Calculation. A PROGRAM MedSurg Rate 15 mL/hr VTBI 50 mL 03:20 Duration hr : min Enter Value using keypad Program Options Cancel/ Back Drug List d e s u be n. CAUTION: V ALL VALUES .
sec04.fm Page 10 Monday, April 11, 2005 8:34 AM Example of changed rate. A PROGRAM MedSurg 4 From the Main Delivery Screen, select [A]. Rate 15 mL/hr VTBI 50 mL Duration 5 Use keypad to change the RATE value. 03:20 hr : min Enter Value using keypad Program Options Drug List Cancel/ Back d e s NOTE: The display time is only accurate to ± one minute. As shown in this example, the delivery shows 3 hours and 20 minutes (not 3 minutes and 20 seconds). u be n. to tio 6 Press .
sec04.fm Page 11 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System Calculation feature, see Section 6.7 Examples of Automatic Calculation. 9 Press . Program Confirmation screen will appear. If correct, press [Yes] to begin infusion. d e s NOTE: [START] accepts the change. Delivery is changed to the new VTBI and DURATION and the display brings up the Confirmation screen before returning to the Main Delivery Screen. u be n. Example of changed to tio DURATION field.
sec04.fm Page 12 Monday, April 11, 2005 8:34 AM NOTE: [START] accepts the change. Delivery is changed to the new DURATION and RATE and the display brings up the Confirmation screen before returning to the Main Delivery Screen. Piggyback Delivery PIGGYBACK DELIVERYInfusion will stop Line A and infuse Line B until VTBI completes. Line A will automatically restart. d e s A PUMPING STOPPED B u be n. o io t t 1 With Line A pumping, to t a o tu program a Piggyback delivery, N select [B].
sec04.fm Page 13 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System 3 Select to highlight the RATE field. Mode Piggyback Rate 4 To enter delivery rate, use numeric keypad. VTBI Duration 200 0 00:00 mL/hr mL hr : min Enter value using keypad Program Options 5 B PROGRAM MedSurg Cancel/ Back Drug List d e s Use to move down to the VTBI field. u be n. 6 To enter VTBI amount, use keypad.
sec04.fm Page 14 Monday, April 11, 2005 8:34 AM 7 B PROGRAM Use to move down to the DURATION field. MedSurg Mode Piggyback 133 100 00:45 Rate (Optional) Use keypad to change duration. VTBI Duration mL/hr mL hr : min Enter value using keypad When all parameters are displayed, changing any one parameter will result in other parameters automatically being computed. Program Options Drug List Cancel/ Back d e s u be n. o io t t 8 Press . t a o tu CAUTION: V ALL VALUES .
sec04.fm Page 15 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System Concurrent Delivery CONCURRENT DELIVERYSimultaneous delivery of two fluids at independent flow rates. CAUTION: CONSULT DRUG LABELING TO CONFIRM DRUG C O MP AT I BI L IT Y , C O N CE NT R A TI O N , DELIVERY RATES, AND VOLUME ARE ALL SUITABLE FOR CONCURRENT AND PIGGYBACK DELIVERY MODES . S EE S ECTION 8 FOR INFORMATION ON CONCURRENT FLOW, SEE SECTION 9 FOR DELIVERY RATE RANGES. A PUMPING STOPPED B 5.5 Rate mL/hr 0 0.
sec04.fm Page 16 Monday, April 11, 2005 8:34 AM Verify change to “Concurrent” mode. B PROGRAM MedSurg Mode Concurrent 2 Rate Use to highlight Rate field. VTBI Duration 0 0 00:00 mL/hr mL hr : min Change using Change Mode Program Change Options Mode 3 Drug List Cancel/ Back d e s u be10 n. NOTE: When Rate for Line A plus 0 to tio Rate for Line B is greater than valid t 00:00 a rate ranges, a “Concurrency violation” o tu message will explain why second line N i did not start. See Section 9.
sec04.fm Page 17 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System understand the Automatic Calculation feature, see Section 6.7 Examples of Automatic Calculation. 6 Use to move down to the DURATION field. (Optional) Enter values for desired hours and minutes. d e s NOTE: When Duration is entered, Rate is automatically computed. u e . b n 7 Press . o o t ti CAUTION: V ALL VALUES . t a o willtuappear. If correct, Program ConfirmationN screen i - infusion.
sec04.fm Page 18 Monday, April 11, 2005 8:34 AM Stop and Start with only 1 Line Pumping 1 Press at the Main Delivery Screen. A PUMPING STOPPED B 100 Rate mL/hr 0 8.5 Vol Inf mL 0 ! NOTE: If [A] (or [B]) is selected prior to pressing [STOP], the display will return to the programming screen. Select [Cancel/Back] to return to the Main Delivery screen. d e s u be n. o io t t Example of STOPPED t a o tu delivery. N - l Si l 2 To discontinue infusion, a press a u c i n .
sec04.fm Page 19 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System Stop and Start with Both Lines pumping 1 Press at the Main Delivery Screen. A PUMPING PUMPING B 25 Rate mL/hr 3 Vol Inf mL ! 50 ! d e s 20.4 u be n. o io 2 Select [Stop A], [Stop B], t t t a or [Stop All]. o tu N i - is selected NOTE: If [A] (or l [B]) S prior to [STOP], thea display willl show a u the programming screen.c Select i n [Cancel/Back] to return to the Main n a Delivery screen.
sec04.fm Page 20 Monday, April 11, 2005 8:34 AM 3 To resume infusion, press A STOPPED STOPPED B . 25 Rate mL/hr 50 3 Vol Inf mL 20.4 ! 4 Select [Start A], [Start B], or [Start All]. Or, to discontinue infusion, press ! MedSurg Choose line(s) to start: Start All Start A Start B . Cancel d e s u be n. to tio 6 Open door, remove set and close door. t ua o N it Backpriming S l l a a u BACKPRIMING- Removal icair or n nofand fluid from the a proximal line cassette airtrap.
sec04.fm Page 21 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System 2 Select and hold [Back Prime] until fluid pumped from line A to line B has expelled the air from cassette air trap into Secondary container. A B BACKPRIMING 5.5 Rate mL/hr 0 8.9 Vol Inf mL 0 ! MedSurg Release Backprime to Stop Back Prime NOTE: Fluid flow is at maximum rate possible. A B Options/ Vol Inf d e s u be n. to tiodelivery.
sec04.fm Page 22 Monday, April 11, 2005 8:34 AM 2 Select Line [A] (or B if active) from the stopped Main Delivery Screen. NOTE: If Line A or B is programmed with a Therapy (i.e., Dose Calculation), Rate, VTBI and Duration will not display values. The values to be cleared may be viewed in applicable programming screen under [Drug List]. A STOPPED STOPPED B 5.5 Rate mL/hr 0 8.9 Vol Inf mL 0 ! MedSurg Back Prime A B Options/ Vol Inf d e s u be n. 3 Select [Yes].
sec04.fm Page 23 Monday, April 11, 2005 8:34 AM Plum A+ Infusion System Updating Drug Library If a new Drug Library is available, the New Drug Library Install screen will be displayed. 1 Library Install New Drug Library Available The Installation may take up to an hour. Select [Yes] to begin the installation (It may take up to an hour). Select [No] to skip the installation and continue using the current library. d e s Ensure pump is connected to AC power. Install Now? u be n.
sec04.fm Page 24 Monday, April 11, 2005 8:34 AM NOTES d e s D u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 4- 24 430-95520-001 (Rev.
Plum A+ Infusion System SECTION 5 Advanced Programs Standard Program (Dose Calculation) Allows programming Dose Rates in alternative units of measure. Dose Calculation can be used in Simple Delivery, Loading Dose, and Multistep. d e s u be n. to tio Loading t ua Dose o N it S l l a a u c program to deliver up to 10 Allows a sequential i n n volumes and delivery rates may be asteps;lifluid M programmed for each step. The program may C t be entered based on Rate and Volume or aVolume and Time.
Dose Calc (mcg/kg/min on A) DOSE CALCULATION- Allows programming Dose Rates in alternative units of measure. Dose Calculation can be used in Simple Delivery, Loading Dose, and Multistep. Clear ALL settings when changing patients or multiple programming parameters. The Area Selection screen will appear if your system has been programmed with the MedNet accessory. d e s u be n. to tio t ua Use to select CCA and o bring you to the Main Delivery N it Screen.
Plum A+ Infusion System The Line A Programming screen appears. 2 A PROGRAM MedSurg Select [Drug List] for Dose Calculation programming. Rate 0 mL/hr VTBI 0 mL 00:00 Duration hr : min Enter Value using keypad Program Options The Drug List Screen appears, in mainly alphabetical order. Drug List d e s u be n. NOTE: Default entry is “No Drug Selected”. to tio t ua o N it S l l a a u c i 3 Use atonhighlight desired in drugM name.
Soft upper limit of 8 mcg/kg/min Hard upper limit of 12 mcg/kg/min NOTE: The SOFT and HARD limits are not displayed. However, the limit is provided if a value is programmed outside the acceptable range. Typically, the pharmacy will set the limit. The Select Therapy screen for Line A appears. 5 A PROGRAM DOPamine d e s u be n. to tio t ua If selected drug has been o programmed with established N it dosing units and concentration, S l l skip to step 8.
Plum A+ Infusion System The Container Concentration Selection screen appears whenever the selected Dose Units are gram-based (e.g., grams, mg, mcg, or ng), otherwise this screen is skipped. Program Dose Calc A DOPamine Drug Conc in Container mcg mg grams Select, then Choose Choose Back d e s NOTE: Cursor defaults to package insert (or hospital) recommended concentration units associated with the selected drug. u be n. o o 7 Select [Choose] to continue.
9 Continue to enter values using the keypad, and advancing to the next field using . A Program Dose Calc DOPamine Conc Weight 400 mg 70 kg Dose VTBI Duration Rate NOTE: As the Dose value is entered, the Rate is automatically calculated. To understand the Automatic Calculation feature, see Section 6.7 Examples of Automatic Calculation. 10 0 00: 00 26.3 250 mL mcg/kg/min mL hr : min mL/hr Enter value using keypad Program Options Cancel/ Back d e s u 10 Use to scroll down to the be n.
Plum A+ Infusion System Because the Dose falls outside the soft limits, the infuser beeps three times (Invalid Key Warning), and generates the error message: “Dose > 8. Override?” A Conc Weight 400 mg 70 kg Dose VTBI Duration Rate 10 250 09: 30 26.3 250 mL mcg/kg/min mL hr : min mL/hr Dose > 8. Override? Yes 13 Select Program Dose Calc DOPamine [Yes]. No d e s u e . b n This will bring up the PROGRAM o o t ti CONFIRMATION screen. t ua o N &it 14 If Dose, Drug, Conc.
The Main Delivery screen appears displaying the information just entered. NOTE: The Program Type and Drug are displayed as well as the Dose Rate and Dose Units. A PUMPING STOPPED B DOPamine Dose Calculation 10 Rate mL/hr Vol Inf mL Dose mcg/kg/min MedSurg 26.3 0 A D B 0 0 Options/ Vol Inf d e s u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 5- 8 430-95520-001 (Rev.
Plum A+ Infusion System Dose Calc (mg/min on B) DOSE CALCULATION- Allows programming Dose Rates in alternative units of measure. Dose Calculation can be used in Simple Delivery, Loading Dose, and Multistep. Clear ALL settings when changing patients or multiple programming parameters. d e s u be n. to tio t ua o N it S l l a a u n nic The LineaB Programming li screen Mappears. C t a f 0 2a Select [Drug List]. n r 0 i D 1 Select [B] at the Main Delivery Screen.
The Drug List Screen appears, in mainly alphabetical order. NOTE: Default entry is “No Drug Selected”. B MedSurg No Drug Selected 25 grams/500 mL Albumin 5% 2.6 mg/50 mL Aldesleukin 10 mg/250 mL Alfentanil 50 mg/50 mL Alteplase 100 mg/100 mL Alteplase 100 mL Amikacin 150 mg/100 mL Amiodarone Select, then Enter Page Up Page Down Enter Cancel/ Back d e s u be n.
Plum A+ Infusion System If selected drug has been programmed with established dosing units and concentration, skip to step 8. The Program Dose Calc screen appears. NOTE: Cursor defaults to package insert (or hospital) recommended dose units associated with the selected drug. Program Dose Calc B Lidocaine mL/hr mcg/kg/min mcg/kg/hr mcg/min mcg/hr mg/kg/hr mg/min mg/hr grams/hr ng/kg/min mmol/min mmol/hr mEq/hr d e s u 6 Select [Choose] to continue. be n.
The next page of the Program Dose Calc screen appears to provide for entry of delivery program parameters. 8 Use keypad to enter desired values. Once entered, use to highlight the next field. Program Dose Calc B Lidocaine Conc Mode Dose VTBI Duration Rate 2 grams 500 mL Piggyback 0 0 00: 00 0 mg/min mL hr : min mL/hr Enter value using keypad Program Options Cancel/ Back d e s u be n.
Plum A+ Infusion System NOTE: The Duration field temporarily changes to dashes when the computed value is larger than what can be displayed. 11 Continue entering the RATE value, if desired. NOTE: As Rate is entered, the Duration and Dose are automatically adjusted as individual numbers are entered. d e s NOTE: If the Duration value is changed, the Rate and Dose are automatically adjusted. u be n. o io t CAUTION: V ALL VALUES t t a No itu 12 To start the delivery,- press S l l a a .
Upon , the Main Delivery Screen shows delivery status for both A and B lines. NOTE: See Delivery Rate Range in Section 9. The ratio of concurrent rates has recommendations specified in Section 1.4. D A STOPPED PUMPING B DOPamine Dose Calculation Lidocaine Dose Calculation 26.3 Rate mL/hr 30 1 Vol Inf mL 0.1 mcg/kg/min 2 Dose MedSurg A B mg/min Options/ Vol Inf d e s u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 5- 14 430-95520-001 (Rev.
Plum A+ Infusion System Loading Dose LOADING DOSE- Allows programming of an initial infusion rate for a specific volume, followed automatically by a maintenance rate from the same container (e.g., a fluid challenge). If Dose Calc is used, the Loading Dose and Maintenance Dose are in the same unit of measure, over the same period of time (mcg/min), from the same container. d e Clear ALL settings when changing patients ors u multiple programming parameters. be n.
The selected Line (A or B) Programming screen appears. 2 Select A PROGRAM MedSurg [Drug List]. Rate 0 mL/hr VTBI 0 mL 00:00 Duration hr : min Enter Value using keypad Program Options The Drug List Screen appears, in mainly alphabetical order. Drug List Cancel/ Back d e s u be n. NOTE: Default entry is “No Drug Selected”. This process will guide you to tio through a “fluid challenge”, so “No t ua Drug Selected” will be entered.
Plum A+ Infusion System 4 5 Use to scroll down to Loading Dose. A PROGRAM Standard Program Loading Dose Select [Choose] to continue. Multistep Select, then Choose Choose Back d e s u be n. 6 Select [Choose] to continue.to io t t a Or, use to change theo units u N it to use in the delivery. S l l a a If desired, select u i[Page c n Down] to see more a lin units of measure. The M LoadingCDose t a screen appears. fProgramming a r in The next page of the Program Loading Dose screen appears.
8 Enter value using keypad. A Program Loading Dose 1 2 Rate mL/hr 0 0 VTBI mL 250 0 Duration hr : min 00 : 00 00 : 00 Enter value using keypad Program Options Cancel/ Back d e s u e . b n 9 Use to highlight the next o o t ti field. t ua o N it 10 Enter Duration using keypad. S l The Rate value is automatically l a athe calculated. To understand u c i n Automatic Calculation feature, in of see Sectiona 6.7 Examples l M C Automatic Calculation.
Plum A+ Infusion System 12 Enter the set of desired values A Program Loading Dose for Step-2 of the program. 13 Select [Program Options] to select a Delayed Start or Standby. 1 2 Rate mL/hr 500 75 VTBI mL 250 750 Duration hr : min 00 : 30 10 : 00 Enter value using keypad Program Options Cancel/ Back d e s NOTE: At this point, programming is complete unless [Program Options] are desired. See Section 6, Additional Features, for more information. u be n.
NOTE: [Cancel/Back] returns the fields to their original value and displays the previous screen. 16 To start the delivery, press This will bring up the PROGRAM CONFIRMATION screen. CAUTION: VERIFY ALL BEFORE STARTING INFUSION. VALUES . Program Loading Dose A MedSurg Delivery will be: d e s No Drug Selected 500 mL/hr 250 mL Drug Rate VTBI u 17 If Drug and Rate appear be n. correct, select [Yes] to begin program. to tio t ua The Main Delivery Screen o N it appears.
Plum A+ Infusion System After the Step-1 has completed, the Main Delivery Screen changes to the second step. Maintenance Dose NOTE: A flashing “Callback Line A” message and the audio alarm sound indicates activation of that option. N105 Callback Line A A PUMPING STOPPED B 75 Rate mL/hr 0 250 Vol Inf mL 0 MedSurg B A 18 The user should acknowledge Options/ Vol Inf d e s u be n. pressing .
Multistep Programming MULTISTEP- Allows a sequential program to deliver up to 10 steps; fluid volumes and delivery rates may be programmed for each step. The program may be entered based on Rate and Volume or Volume and Time. If Dose Calc is used, the delivery steps are in the same unit of measure, over the same period of time, from the same container. d e s u be n. The Area Selection screen will appear if your system has been to io t programmed with the MedNet t a o u accessory.
Plum A+ Infusion System The Line A Programming screen appears. 2 Select A PROGRAM MedSurg [Drug List]. Rate 0 mL/hr VTBI 0 mL 00:00 Duration hr : min Enter Value using keypad Program Options Cancel/ Back Drug List d e s u be n. o io NOTE: Default entry is “No Drug t t Selected”. t a o tu N - l Si l a a u c i n a lin desired 3 Use M to highlight C drug name. t a f a When list does not contain n i drug Dr desired name or drug The Drug List Screen appears, in mainly alphabetical order.
The Select Program screen for Line A (or B) appears. A PROGRAM VinCRIStine Standard Program NOTE: This example shows line A being programmed. Loading Dose Multistep Select, then Choose Choose Back d e s u be n. 5 Use to scroll down to Multistep. to tio t ua o 6 Select [Choose] to continue. N it l lS If selected drug hasabeen a programmed with uestablished c i n dosing unitsa and concentration, n skip to step M 9. Cli tProgramaMultistep screen The f a appears.
Plum A+ Infusion System measure. The Multistep Programming screen appears. 9 Rate is the default field. Enter value using keypad. Program Multistep A VinCRIStine 1 2 3 4 Rate VTBI Duration mL/hr 50 0 0 0 mL 0 0 0 0 hr : min 00 : 00 00 : 00 00 : 00 00 : 00 Enter value using keypad Program Options d e s More Steps u e . b n 10 Use to highlight the o o t ti Duration or VTBI field. t ua o NOTE: The VTBI value is N it automatically computed-when theS l If VTBI l is Duration value is entered.
NOTE: When Step-4 is programmed, using [SELECT] to advance will highlight another item on this screen. 13 When Step-4 is programmed, select [More Steps] to program up to 10 Steps. Program Multistep A VinCRIStine 1 2 3 4 Rate VTBI Duration mL/hr 50 100 75 50 mL 50 825 75 50 hr : min 01 : 00 08 : 15 01 : 00 01 : 00 Enter value using keypad Program Options Cancel/ Back More Steps d e s NOTE: Using [SELECT] will not advance you to the additional steps. u e .
Plum A+ Infusion System The Main Delivery Screen displays Step-1 in the upperleft corner. A PUMPING STOPPED B VinCRIStine Step 1 NOTE: In units other than mL/hr, the Dose rate and units also will be displayed. 50 Rate mL/hr 0 27.5 Vol Inf mL 0 B A Example of Multistep Screen Pumping on Step-2. Options/ Vol Inf d e s u be n. 16 To change a program to tio parameter while pumping, t ua select [A].
If Rate value is changed, the Duration will automatically change. Program Multistep A VinCRIStine d NOTE: Only the current delivering step and future steps can be changed. 3 4 Rate VTBI Duration mL/hr 50 125 75 50 mL 50 825 75 50 hr : min 01 : 00 06 : 36 01 : 00 01 : 00 Enter value using keypad Program Options 18 To start the delivery, press Cancel/ Back More Steps d e s u . be n. o io This will bring up the t t Confirmation screen. t a o tu CAUTION: V ALL VALUES N i .
Plum A+ Infusion System SECTION 6 Additional Features Simple Delivery Using Delayed Start 1 Before or after entering the simple delivery program, select [Program Options]. d e s u be n5 . o io250 NOTE: To program a Delayed Start t t 50:00 using an advanced program (i.e.,t a o u Dose Calc) you must first select N which line you want (A or B), next it - thenl S select [Drug List], and l a If youaprogram [Program Options].
2 Enter values for desired hours and/or minutes. Program Options B Delay Start for 01:00 hr:min 3 Select [Enter] to confirm delayed start. Callback No Enter Value using keypad CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION. 4 Standby Enter Cancel/ Back d e s u be n. o io Line B is delayed for the time t t entered. t a o tu N NOTE: Delayed line drip indicator - lis Si solid, not flashing. It will begin l flashing when actually a pumping.
Plum A+ Infusion System The default screen for Program Options appears. Program Options B Delay Start for 00:00 hr:min Use to highlight “Callback” field and select [Yes/No], if necessary to obtain “Yes”, then select [Enter]. Callback Yes Change using Yes/No Yes/No Cancel/ Back Enter d e s u e . b n CAUTION: V ALL VALUES o o t ti t ua 2 Press to confirm o N to it program setting and return S l Main Delivery screen.
Possible Non-Delivery Programmed NOTE: Whenever a valid [START] key is pressed, the device checks the delivery program(s) for non-delivery conditions (such as Line B Piggyback without Line A or delayed start) that could permit a period of non-delivery. If so, the display presents this warning screen. B PROGRAM Attention: Line A is stopped or delayed. Line B in piggyback mode gives no KVO or alarm at dose end. Continue anyway? d e s u 1 Select [Yes] to continue with be n. delivery.
Plum A+ Infusion System 4 Confirm the information displayed is correct, then select [Yes] to place program on Standby mode. NOTE: This example screen shows a Dose Calculation Program with a Standby. It looks similar to the Program Confirmation screen with the substitution of “Put delivery in Standby” replacing “Confirm Program”. Selecting [Yes] confirms both the Program and the Standby.
Select Option- Volumes Infused, Pressure/Post Infusion Rate, and Lighting/Contrast 1 To select Options Screen, select [Options/Vol Inf]. A PUMPING STOPPED B DOPamine Dose Calculation 5.5 d e s Rate mL/hr 0 Vol Inf mL 0 u be n. to tio t ua o N it S 2 Use to highlightaanl option. l u ica n 3 Select [Choose] a ltoinselect the VolumesM Infused Cscreen. t a f a n Dr i 393 MedSurg B Options/ Vol Inf OPTIONS B A A Release 13.
Plum A+ Infusion System 5 To reset Line A (or B) Volume A B OPTIONS DOPamine Dose Calculation Infused,use and press 6 to highlight . To restore the cleared quantity, select [Cancel/Back]. Volumes Infused Line A Line B Total Vol 0 mL 0 mL 393 mL Press CLEAR to clear value Enter d e s u be n. . to tio t ua o Nselectit 8 To restore all quantities, S l [Cancel/Back] softkey.
9 When clearing of quantities is completed, select [Enter] to return to the Main Delivery screen. 10 Select [Options/Vol Inf] from the Main Delivery screen to return to the Options screen. A B OPTIONS Release 13.x - xx/xx/xx Volumes Infused Pressure/Post Infusion Rate d e s Lighting/Contrast 11 Use to highlight the Pressure/Post Infusion Rate option. Any Hospital, USA MM/DD/YY XXYYZZ-123456 u be n. o io 12 Select [Choose] to continue.
Plum A+ Infusion System enter value between 1.0 and 15.0 psi. 16 Select [Enter] to keep changes and return to the Main Delivery screen, or [Cancel/Back] to restore original values and return to the Options screen. NOTE: Continue Rate default of KVO or Rate must be configured using the Hospira MedNet software. d e s u be n. to tio t ua 18 Use to highlight Lighting/ o N it Contrast Option. S l l a to continue. u 19 Select [Choose] ca i n a lin M 20 Press toC highlight Backlight t a f or Display Contrast.
Variable Rate Cap NOTE: Variable Rate Cap is used to set the maximum rate values to be accepted by the device. The clinician cannot change it once it has been programmed. It must be configured using the Hospira MedNet software. d e s Examples of Automatic Calculation AT STARTUP u be n.
Plum A+ Infusion System NOTE: VTBI will not be re-calculated if the Rate and Duration are changed. VTBI must be cleared and then the new VTBI reentered. The new VTBI will automatically calculate a new Rate.
Changing CCA While Infusing 1 Select [Options/Vol Inf] from the Main Delivery screen. A PUMPING STOPPED B DOPamine Dose Calculation 26.3 Rate mL/hr 0 0.2 0 10 Vol Inf mL Dose mcg/kg/min ER d e s u be n. 2 Select [Change CCA]. to tio t ua o N it S l l a a u c i n n a M Cli f t toahighlight desired 3 a Press then in select [Enter] to DrCCA, confirm the change. B Options/ Vol Inf OPTIONS B A A Release 13.
Plum A+ Infusion System The message bar informs the user of the changed CCA. A PUMPING STOPPED B DOPamine Dose Calculation 26.3 Rate mL/hr 0 0.3 0 10 Vol Inf mL Dose mcg/kg/min ICU Line A using prior CCA A B Options/ Vol Inf d e s u be n. to tio t ua o key. N it S l l a a u c i n n a Auto-Programming M Cli t a is a new feature for the Hospira Plum A+ Auto-Programming f of infusion pumps.
NOTE: It is important that biomed personnel ensure that the barcode identification label affixed to each infuser corresponds to the correct Connectivity Engine Identification Number. This way the correct order will be sent to the appropriate infuser. 1 2 Power On the pump as described in Section 4.2. A STOPPED STOPPED B After the CCA has been selected, the pump is ready for auto-programming. 0 Rate mL/hr 0 0 Vol Inf mL 0 d e s u e .
Plum A+ Infusion System 7 8 Programming screen is autofilled. Verify ALL parameters. If changes are desired, the infusion parameters can be manually changed using the keypad on the pump. A Program Dose Calc DOPamine Conc Weight 400 mg 70 kg Dose VTBI Duration Rate 10 250 09: 30 26.3 250 mL mcg/kg/min mL hr : min mL/hr Enter value using keypad Program Options Cancel/ Back d e s u be n. 10 Select [Yes] to confirm to tio t ua programming and begin o infusion.
NOTES d e s D u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 6- 16 430-95520-001 (Rev.
Plum A+ Infusion System SECTION 7 Alarms and Troubleshooting Warning Messages CORRECTIVE ACTION d e Stop all lines, then Stop delivery then turn Attempting to turn the sturn infuser off. u off infuser off while a delivery is in progress. bebattery.n. Replace Warning: Replace The battery current Battery charge is greater than o t tio 200 mA/hr. tis ua o The battery voltage less than N the depletedit S threshold and charge l l a level is higher than the athreshold.
problem. All such messages will be cleared or replaced by another message upon the next valid input key press. Response to Alarms 1 Disable Lockout by confirming back switch is in the down position or press the decimal key followed by 9, 6, & 3 on the keypad. 2 Press [SILENCE] key. d e s u 3 Identify/Observe Alarm condition. be n. 4 Correct Alarm condition (see following tables). to tio t ua o 5 Press [START] to resume infusion.
Plum A+ Infusion System General Alarms D CODE MESSAGE POSSIBLE CAUSE CORRECTIVE ACTION N100 Unrecognized cassette Attempting to use unrecognized cassette. Turn off or insert recognized cassette. N101 No Action Alarm Pump programming incomplete. Press [START] or continue programming. low. See page 1-14 for detailed instructions for avoiding a bolus following a distal occlusion. d e Begin programming N102 Infuser Idle 2 Pump is ON without s or turn infuseru OFF. Minutes operator input.
CODE MESSAGE POSSIBLE CAUSE CORRECTIVE ACTION N250 Door open while pumping Pump door opened while operating. Close door with cassette inserted. N251 Cassette Test Failure Faulty cassette, proximal or distal occlusion or air in cassette detected at start up. Check clamps, manually reprime set, close door. Backprime into line B tubing or syringe if appropriate. If alarm recurs on retest, replace set. If alarm repeats, replace infuser. d e s u be n.
Plum A+ Infusion System Line A Alarms MESSAGE POSSIBLE CAUSE N105 Callback Line A Alarm programmed by user. Change in delivery for Loading Dose to Maintenance Step or for any step in “Multistep” program provided the step is not the last step. Press [SILENCE]. VTBI complete on line A. Program new VTBI. d e s u be n. N185 Prox Occl A At Proximal line o Examineioline A for tor closed kinks Startup obstructed, line A t t ua clamps.
CORRECTIVE ACTION CODE MESSAGE POSSIBLE CAUSE N184, N190, N191 Prox Occl A / Air Proximal line obstructed, line A container disconnect or obstruction. Examine line A for kinks, closed clamps, or air in cassette. N232 Prox Air A, Backprime When proximal air detected exceeds the limit for the line. Check for clamps, or empty container. Correct as necessary. Backprime into line B tubing or syringe. D d e s u be n.
Plum A+ Infusion System Line B Alarms D CODE MESSAGE POSSIBLE CAUSE N104 Callback Line B Alarm programmed by user. Change in delivery for piggyback delivery, Loading Dose to Maintenance Step, or for any step in “Multistep” program provided the step is not the last step. CORRECTIVE ACTION Press [SILENCE]. d e s u e . b n N160 Line B VTBI VTBI complete on line oProgram new VTBI. o t ti complete B. a line B for kinks Examine N183 Prox Occl B Proximal lineot u clamps.
CODE MESSAGE POSSIBLE CAUSE N182, N188, N189 Prox Occl B / Air Proximal line obstructed, line B container disconnected or obstructed. CORRECTIVE ACTION Examine line B for kinks, closed clamps, or air in cassette. Occlusion caused by empty container, backprime into line B tubing or syringe. d e s u be n. to tio t ua o Malfunctions N it S l l a a C u A C M P C c i n E300 or Malfunction n has occurred Record Malfunction a A ifailure error code. Pump must higher the infuser’s internal M Clinsystems.
Plum A+ Infusion System General Messages MESSAGE POSSIBLE CAUSE Cannot Standby in Piggyback Selection of [Standby] when Line B is in Piggyback Mode. Cannot Standby with Delay Selection of [Standby] when Delay time was entered for program. Change Vol clears entries A program delivery which has been stopped and diluent value is selected. This is displayed before any screen or field message. CORRECTIVE ACTION Select [Cancel/ Back]. d e s [Cancel/Back]. u e .
MESSAGE POSSIBLE CAUSE Concurrency alert Attempt to start a multistep or loading dose delivery whose later steps would exceed concurrent delivery limit if delivery proceeds. CORRECTIVE ACTION User can enter new values using number keypad, or use [SELECT] arrows to move to another field to change the entry. User can also press [CLEAR]. d e Concurrency violation Attempt to start a second User can enter new s u values using number line with a delivery rate keypad, or e use that would exceed .
Plum A+ Infusion System D CORRECTIVE ACTION MESSAGE POSSIBLE CAUSE Dose > [X.xx]. Override? Attempt to start program with parameter that has caused the Dose (or Rate, if mL/hr program) to be greater than the upper soft limit [uuuuuuuu] for the selected drug and CCA. Also includes placing program in Standby, and re-starting a stopped program. May be overridden by selecting [Yes]. Cleared by pressing of [NUMERIC KEYS], [.], [SELECT], [CLEAR] or [STOP] hard keys, or [Yes/No] softkeys.
CORRECTIVE ACTION MESSAGE POSSIBLE CAUSE Input digits > max allowed Attempt to input digit that would exceed the number of decimal places allowed for defined value except Dose and Rate. Press [CLEAR] hardkey. Input value > max allowed Attempt to input number that would cause field to exceed its defined limit.
Plum A+ Infusion System MESSAGE POSSIBLE CAUSE Soft Lockout Enabled While the Soft Lockout is enabled and no Alarm is active, either 1) any key besides Stop is pressed during delivery, or 2) any key is pressed while stopped. CORRECTIVE ACTION Disable the Soft Lockout. (See Section 3) d e Use number keypad VTBI must be > 0 Delivery attempt when us to enter a value. rate is non-zero but VTBI is zero. e .
CORRECTIVE ACTION MESSAGE POSSIBLE CAUSE Minimum Rate X mL/hr Attempt to start mL/hr program with Rate less than lower hard Dose limit nn.n. Use number keypad to enter a value. Maximum Rate X mL/hr Attempt to start mL/hr program with Rate greater than the upper Hard Limit or CCA Maximum Volumetric Rate n. The Software will display ‘---‘, and the user must press the [CLEAR] hard key and input a valid value. D d e s u e .
Plum A+ Infusion System SECTION 8 Cleaning, Maintenance, and Storage The cleaning, maintenance, and storage of the Plum A+ are described in this section. d e s u be n. tocleaningtitheoinfuser.
CLEANING SOLUTION MANUFACTURER PREPARATION CoverageTMHBV Steris Corporation, A division of Calgon Vestal Laboratories Per manufacturer's recommendation Formula C TM Diversey Corporation Per manufacturer's recommendation Caltech Industries Per manufacturer's recommendation d e s u Dispatch be n.
Plum A+ Infusion System CAUTION: TO AVOID MECHANICAL OR ELECTRONIC DAMAGE, DO NOT IMMERSE THE P LUM A+ IN ANY FLUIDS OR CLEANING SOLUTIONS. CAUTION: DO NOT SPRAY CLEANING SOLUTIONS TOWARD ANY OPENING IN THE INSTRUMENT. CAUTION: CERTAIN CLEANING AND SANITIZING SOLUTIONS MAY SLOWLY DEGRADE COMPONENTS MADE FROM SOME PLASTIC MATERIALS. USING ABRASIVE CLEANERS OR CLEANING SOLUTIONS NOT RECOMMENDED BY HOSPIRA MAY RESULT IN PRODUCT DAMAGE.
The battery charges whenever connected to AC (mains) power. If the infuser is switched OFF, recharge takes approximately six hours. Recharge takes longer if the infuser is turned ON. As a general rule, the more often the battery is partially discharged and recharged, the sooner it will need to be replaced. Consult a qualified biomedical technician for battery replacement if necessary.
Plum A+ Infusion System SECTION 9 Specifications Physical Dimensions: Approximately 8” X 8” X 6”, excluding pole clamp protrusion and power cord storage. Weight: Approximately 9.5 lbs. with battery. Casing: High-impact plastic. Electrical Power Requirements: 120 V~, 50-60 Hz, 35 VA. Meets UL 60601-1. Fuses: F1, F2, 250V~, 0.5 A. (internal) Power Cord: Hospital-grade AC cord. 10 ft long, with transparent plug and retainer plate.
NURSE-CALL System: NURSE-CALL alarm is factory set for NormallyOpen (NO) Contact the Technical Services Center to make an internal adjustment to change the device from Normally-Open (NO) to Normally Closed (NC) system. Circuitry Ratings: Voltage-30 VDC Max Current- 0.25 Amps Max Contact Rating- 3 Watts Max Wireless Lan Device Standards: IEEE802.11b Radio Technology: IEEE802.11b Direct Sequence Spread Spectrum Data Transfer Rate: 11, 5.5, 2, 1 Mbps (auto sense) FREQUENCY RANGE IEEE802.
Plum A+ Infusion System Environment Operating Temperature: 5° to 40° C Storage Temperature: -20° to 60° C Atmospheric Pressure: 0 - 10,000 feet (0 - 3,000m) or equivalent pressure Relative Humidity: 10 - 90% (40° C Max) Delivery Rate Range Lines A and B: 0.1 - 99.9 mL/hr (in 0.1 mL increments) 100 - 999 mL/hr (in 1 mL increments) Concurrent Delivery: 0.5 mL/hr minimum for each line 500 mL/hr cumulative (A+B) maximum PlumSet: KVO: 1.
Occlusion Alarm and Limits 9- 4 Distal Occlusion: The DISTAL OCCLUSION alarm sounds after the distal set tubing or set outlet fitting becomes occluded. Proximal Occlusion: The PROXIMAL OCCLUSION alarm sounds if the tubing proximal to the cassette becomes occluded. Distal Pressure Limit (without alarm): 1 to 15 psig. The maximum pressure is userselectable. Factory default setting is 6 psig. Maximum Infusion Pressure: 20 psig 430-95520-001 (Rev.
Plum A+ Infusion System Time To Detect Downstream Occlusions RATE OCCLUSION ALARM PRESSURE SETTING TYPICAL TIME TO ALARM (MACRO) MAXIMUM TIME TO ALARM (MACRO) 25 mL/hr 6 psig 38 seconds 47 seconds 15 psig 98 seconds 106 seconds 6 psig 17 minutes 22 minutes 15 psig 45 minutes 49 minutes 1 mL/hr * Baseline backpressure is 0 psig * Bolus Volume Released After Downstream Occlusions Are Corrected RATE OCCLUSION ALARM PRESSURE SETTING TYPICAL BOLUS VOLUME (MACRO) MAXIMUM BOLUS VOLUME (MAC
Delivery Accuracy The Plum A+ Infuser was designed and manufactured to maintain a volumetric delivery rate error of the total fluid delivered of less than or equal to ± 5% over the course of 48 hours at a programmed rate of 1 to 999 mL/hr during normal operating conditions. For use of the device at rates below 1 mL/hr, the delivery rate error is less than or equal to ± 10%. Backpressure Effect- Positive backpressure on the distal line may affect delivery accuracy by no more than 0.
Plum A+ Infusion System suspended air in the solution, and using an Hospira Plum enteral set. ENTERAL/HIGH VISCOSITY FLUIDS Dextrose 20% to 50% concentration Isomil Powder Similac Powder Ensure Plus HN Twocal HN Jevity Trumpet Curves The Trumpet Curve Graphs following the Example show representative maximum and minimum percent flow rate deviation from the programmed rate over time. This information was developed in accordance with IEC 60601-2-24: 1998, SubClause 50.102.
the nominal rate. The average delivery rate error over the entire 2nd hour was +1.6% (D). For other time intervals look at other points at the horizontal axis and determine corresponding limits as above. 25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP A PERCENT ERROR (%) 15.0% 10.0% B Max Positive Error over 5 Minute Interval = +2.8% 5.0% + + 0.0% + + + C Max Negative Error over 5 Minute Interval = -0.5% -5.0% -10.0% D Average Delivery Rate Error = +1.6% -15.
Plum A+ Infusion System 25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP (Typical) 50 45 40 Rate (ml/hr) 35 30 25 20 15 10 5 0 -5 -10 0 10 20 30 40 50 60 70 80 90 100 110 120 Time (minutes) Actual Rate Programmed Rate 25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP (Typical) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.0% 0 5 10 15 20 25 30 Observation Interval (minutes) Max Min Mean 25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP (Composite of 3 Pumps) Percent Error (%) 15.0% 10.
25 ML/HR, 0 mm Hg DELIVERY HEAD , 96 HOURS (Typical) 50 45 Rate (ml/hr) 40 35 30 25 20 15 10 5 0 0 10 20 30 40 50 Time (minutes) Actual Rate Programmed Rate 25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS (Typical) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.0% 0 5 10 15 20 25 30 Observation Interval (minutes) Max Min Mean 25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS (Composite of 3 Pumps) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.
Plum A+ Infusion System Rate (ml/hr) 1 ML/HR, 0 mm Hg DELIVERY HEAD, START UP (Typical) 2.0 1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0.0 -0.2 -0.4 0 10 20 30 40 50 60 70 80 90 100 110 120 Time (minutes) Actual Rate Programmed Rate 1 ML/HR, 0 mm Hg DELIVERY HEAD, START UP (Typical) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.
Rate (ml/hr) 1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS (Typical) 2.0 1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0.0 0 10 20 30 40 50 Time (minutes) Actual Rate Programmed Rate 1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS (Typical) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.0% 0 5 10 15 20 25 30 Observation Interval (minutes) Max Min Mean 1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS (Composite of 3 Pumps) Percent Error (%) 15.0% 10.0% 5.0% 0.0% -5.0% -10.0% -15.
Plum A+ Infusion System SECTION 10 Supplies and Accessories Administration Fluids ADMINISTRATION FLUIDS • All parenteral fluids • Whole Blood • Blood fractions ENTERAL AND HIGH VISCOSITY FLUIDS • Dextrose 20% to 50% concentration • Isomil Powder • Similac Powder • Ensure plus HN • TwoCal HN • Packed red cells CONTAINERS • Dual Chamber Parenteral flexible container (Nutrimix) • Large Volume Parenteral flexible plastic containers, including premixed • Large Volume Parenteral glass containers, including pre
Accessories GENERAL • Syringe Adapter- List# 11986-48 • Mini Pole- List# 12096-04 • Secondary Container Support- List# 12095-03 • Tandem Carrier- List# 12270-01 NETWORKED APPLICATION • Hospira MedNetTM Medication Management Server Suite (MMSS) List# 20676-04 • *Hospira MedNetTM Plug ‘n Play Module List# 20677 * = For use with Hospira Plum A+ Infusers Lists 11971-04-03 & above, 12391-04, & 20679-04 NOTE: Contact Technical Support Operations at 1-800-241-4002 for current listing of accessories.
Plum A+ Infusion System SECTION 11 Warranty Subject to the terms and conditions herein, Hospira, Inc., herein referred to as Hospira, warrants that (a) the product shall conform to Hospira's standard specifications and be free from defects in material and workmanship under normal use and service for a period of one year after purchase, and (b) the replaceable battery shall be free from defects in material and workmanship under normal use and service for a period of 90 days after purchase.
replacement of accessory items such as batteries and detachable mains power cords. In providing any parts for repair or service of the product, Hospira shall have no responsibility or liability for the actions or inactions of the person performing such repair or service, regardless of whether such person has been trained to perform such repair or service. It is understood and acknowledged that any person other than an Hospira representative performing repair or service is not an authorized agent of Hospira.
Plum A+ Infusion System SECTION 12 Default Drug Library (DDL) NOTE: This list is only accurate if no custom drug library has been developed using the Hospira MedNetTM accessory. Once a custom drug library has been developed, this list will no longer be accessable. Only Hospira personnel can re-install the DDL. d e The information contained in this manual is current as of s11/01/ 02. User must assure themselves that drug prescribing u information has not changed since the publication of this manual. be n.
DRUG NAME DEFAULT DOSE RATE DEFAULT CONCENTRATION Bleomycin mL/hr N/A Blood Products mL/hr N/A Bretylium mg/min Carboplatin mL/hr N/A Cefazolin mL/hr Cefepime mL/hr CefoPERAZONE mL/hr d e s Cytarabine mL/hr Diltiazem mg/hr mg/mL DOBUTamine mcg/kg/min mg/mL Docetaxel mL/hr DOPamine mcg/kg/min DOXOrubicin mL/hr Epinephrine mcg/min mg/mL Epoprostenol ng/kg/min mg/mL Eptifibatide mcg/kg/min mg/mL mg/mL N/A N/A u N/A CefoTAXIME mL/hr e N/A.
Plum A+ Infusion System DRUG NAME DEFAULT DOSE RATE DEFAULT CONCENTRATION Erythromycin mL/hr Esmolol mcg/kg/min Etoposide mL/hr N/A Famotidine mL/hr N/A Fentanyl mL/hr Fluconazole mL/hr Flumazenil mL/hr N/A mg/mL d e N/A s N/A u Fluorouracil mL/hr e .
DRUG NAME DEFAULT DOSE RATE DEFAULT CONCENTRATION Midazolam mL/hr Milrinone mcg/kg/min mg/mL Morphine mg/hr mg/mL Nafcillin mL/hr NitroGLYCERIN mcg/min mg/mL NitroPRUSSIDE mcg/kg/min mg/mL Norepinephrine mcg/min mg/mL Propofol mcg/kg/min mg/mL Ranitidine mL/hr STREPTOkinase units/hr units/mL Theophylline mg/kg/hr mg/mL Ticar-clavulanate mL/hr Tirofiban mcg/kg/min Tobramycin mL/hr N/A UROkinase mL/hr N/A Vancomycin mL/hr N/A N/A N/A d e s u Ofloxacin mL/hr e N
Plum A+ Infusion System DRUG NAME DEFAULT DOSE RATE DEFAULT CONCENTRATION Verapamil mL/hr N/A VinCRIStine mL/hr N/A d e s D u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 430-95520-001 (Rev.
NOTES d e s D u be n. to tio t ua o N it S l l a a u c i n n a M Cli t a f ra in 12- 6 430-95520-001 (Rev.
Plum A+ Infusion System For customer service within the United States, contact: 1-877-9-HOSPIRA (1-877-946-7747) For technical assistance, product return authorization, and to order parts, accessories, or manuals within the United States, contact Hospira, Inc. Technical Support Operations: 1-800-241-4002 To order parts using the online eCatalog, download technical publications, technical training courses, and additional services, visit the website at: www.hospiraparts.
CAUTION: FEDERAL (USA) LAW RESTRICTS THIS INFUSER TO SALE BY OR ON THE ORDER OF A PHYSICIAN OR OTHER LICENSED PRACTITIONER. WARNING POSSIBLE EXPLOSION HAZARD EXISTS IF THE INFUSER IS USED IN THE PRESENCE OF FLAMMABLE ANESTHETICS. Plum A+ Infusion Pump is a registered trademark of Hospira, Inc. Hospira MedNet, LifeShield, and E.L.I. are trademarks of Hospira Incorporated. CLAVE, Teflon, Formula C, Manu-Klenz, Super Edisonite, Coverage, Sporicidin, Dispatch, and Precise are not trademarks of Hospira.
