Volumed µVP5005 Infusion Device Training

INDEX OF CONTENTS Section

Page

1.

Applications and Configuration

3–5

2.

Administration sets

6

3.

Features

7–9

4.

Alarm displays/procedures

10 – 11

5.

Start up checks/set up

12 – 13

6.

Running/Occlusion Pressures

14

7.

Micro mode Operation

15

8.

Rate Calculation

16

9.

Recalling Information

17

10.

Titration

18

11.

Bolus Administration

19 – 20

12.

Primary and Secondary Infusions

21 – 22

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1. APPLICATIONS AND CONFIGURATION

Suitable for: ! General and critical applications ! Large infusions at medium to high flow rates ! Operation in macro-mode and micro-mode

Medical Device Agency Classification: ! Category ‘A/B’

Consumable items: (Stock items ordered by requisition via Arcomedical Infusion Ltd) Administration set – ! Volumed VP5005 administration set ! Make and model of pump shown on packaging o Blue packaging – general infusions (15 micron filter) o Red packaging – blood transfusions (200 micron filter)

Infusion rates: ! Macro-mode ! Micro-mode

– –

1-999 ml/hr (1ml/hr increments) 0.1-99.9 ml/hr increments

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Battery operation: Approximately 4 hours operation from fully-charged battery Approximately 15-20 hours to fully recharge battery Flashing green battery symbol – indicates low battery (approx. 30 mins) Flashing red battery symbol – battery is exhausted

Occlusion alarm settings: ! Variable – can be set up to 999 mm Hg ! Default macro-mode: 400 mm Hg micro/neonatal mode: 100 mm Hg

Bolus rates: ! Variable (set by user) ! Able to programme faster bolus rate and for pump to then return to normal rate

Accuracy: ! Rate 5ml/hr ! 1 min. ! 5 mins. ! > 5 mins.

: : :

+/- 15% +/- 6% +/- 5%

! Rate > 25 ml/hr

:

+/- 5%

History log: ! Yes ! Memory of up to 300 events (software version 2.30 upward) ! User able to recall previous infusion settings

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Air-in-line detection: ! Yes ! Ultrasonic sensor ! Detects individual air bubbles ≥ 20 microlitre Anti-free flow mechanism: ! Yes ! Additional safety measure to reduce risk siphonage

Keep Vein Open (KVO): ! Enabled ! Rate: o Macro-mode: 3 ml/hr {if rate is less than KVO rate o Micro-mode: 0.3 ml/hr {KVO will run at that rate ! KVO operation activated when pump is on and infusion has been stopped and in certain alarm conditions

Drop Detector: ! Yes ! Infra-red optical sensor – o Calculates drops per volume o >30 drops/ml – alarm activates

Software variations: ! Older model – version 2.20: Unable to perform certain operations (primary and secondary infusion titration) ! Newer model – version 2.39: Able to perform above functions

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2. ADMINISTRATION SETS

! ONLY recommended administration sets must be used for VP5005 pump or the mechanism will be unable to occlude tubing (risk of free flow) and accurately deliver the pre-set rate of infusion. !

Variety of administration sets available for differing circumstances: o General infusion set (blue packaging) – 15 micron filter o Blood infusion set (red packaging) – 200 micron filter o Primary and secondary line sets o Needle-less additives port set o Burette set 20 drop/150ml

! All giving sets contain: o Additives port o Air inlet ! Device companies that manufacture the administration sets recommend changing sets after a maximum of 24 hours to maintain accuracy.

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PUMP FEATURES

5

6

8

7

1

4

3

2

10

9 11

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Key/Symbol On/Off key Start/Stop key Alarm mute key Information Window: ! Battery symbol ! Plug symbol ! Inf. Complete ! Fluid drop symbol

Purpose To turn pump on/off To start, stop or hold infusion Silences alarm for 2 minutes

5

“ML/H” window

6

“Total ML” window

7

Also “ML INFUSED” window

8

Also “Alarm” window

Displays infusion rate in ml/hr. May be increased/decreased using up and down arrow keys (macro-mode : units, tens, hundreds) (micro-mode : fractions-units, tens) ! Displays total volume of fluid to be infused ! May be increased/decreased using up and down arrow keys ! May be used in macro or micro mode ! When preset fluid volume is reached, pump indicates “INFCOMPL”, audible alarm sounds, continues operation at KVO rate. Displays default pressure (alarm mute X2) ! Displays running total of mls infused ! Resets to zero when pump is turned off and re-started Displays working pressures accessed by pressing alarm mute key (x1) ! Contains symbols (prompts) indicating cause for alarm ! Symbols will illuminate continuously in conjunction with intermittent, audible alarm ! Covering pump mechanism ! Infra-red, optical drop sensor

1 2 3 4

9 10 11

Latched door Drip chamber holder/drop detector sensor Air in line detector

! Illuminates with battery operation ! Illuminates with mains operation ! Illuminates when pre-set infusion complete ! Illuminates with each fallen fluid drop

! Ultrasonic air sensor

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12 13

Features 12 Stop flow lever 13 Extension line guides 14 Pressure transducer (below stop flow lever)``

14

Purpose Prevents “free flow” To assist in correct positioning of administration set Detects excessive infusion pressures

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4. ALARM DISPLAYS AND PROCEDURES

! Alarms are activated by the built-in supervision system that continually monitors pump operation. In the event of a malfunction: Infusion is immediately suspended Audible alarm is activated Corresponding alarm signal illuminates ! Knowledge of alarm codes and remedial actions to be taken allows the user to easily deal with most alarm conditions. ! NEVER IGNORE DEVICE ALARMS as this may result in adverse consequences. ! An alarm and its cause may be recognisable by 2 features: 1. Audible Alarm: Continuous Intermittent

Indicates internal defect Pump must NOT be used but sent to EBME for investigation Indicates change in status of infusion Operation will continue at KVO rate unless cause is due to occlusion or air inline

Audible alarms may be suppressed for 2 minutes by pressing alarm mute key. 2. Visual Alarm: Displays message/symbol in alarm window Interpretation of symbols is usually displayed on the side casing of the pump.

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ALARM DISPLAYS Symbol Air in line

Occlusion (downstream)

Container empty (upstream occlusion)

DEFECT

RATE

!

Description ! Indicates air bubble greater than 200 microlitres or that extension line is not/incorrectly fitted into air sensor connection ! Intermittent, audible alarm ! Symbol illuminates continuously then blinks when air in line has resolved ! Indicates occlusion in line at IV site or that roller clamp is closed ! Intermittent, audible alarm ! Symbol illuminates continuously then blinks when occlusion resolved ! Indicates empty, over-filled drip chamber or that drip chamber has not been connected to sensor or is incorrectly placed ! Intermittent, audible alarm ! Symbol illuminates continuously then blinks when problem has been resolved ! Indicates internal malfunction ! Indicates audible alarm ! Symbol illuminates continuously ! Pump must be removed from service and sent to EBME for investigation Indicates need to select rate or that rate has been changed Attention symbol Accompanies alarm codes

NB: To cancel alarm conditions after rectifying cause, press start key to resume infusion.

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5. INITIAL START-UP CHECKS AND SET UP 1

Check device

2

Mount device

3

Consumables

4

Prime admin. set

5

Loading

6

Switch on pump

7

Observe self-test sequence

! Observe casing/cable for signs of damage/spillage ! Ensure EBME labels are present – inventory number and last service date ! Check infra-red drop sensor operation (by running finger past sensor) ! Securely clamped to drip stand ! Height recommended approx. no greater than 60cm above infusion site ! Display screens clearly visible ! Bag/container (as prescribed on medication sheet) ! Administration set: Arcomed, Volumed VP5005 set ! Aseptic technique ! No air in line ! Drip chamber ¼ to ⅓ full ! Close roller clamp ! Solution: hooked on pump’s container support (insert drip chamber into drop sensor/holder – not on white rim) ! Open latched door and push back red stop-flow lever ! Insert administration set ! Close door ! Insert administration set into air-in-line sensor to the right of pump (must be fully inserted) ! Open roller clamp and observe that there is no free flow ! Using on/off at front of pump (check mains power symbol is illuminated) ! Audible alarm will beep once ! Displays visual codes in windows – o ! in alarm window o software versions/configuration briefly light up “TOTAL ML”

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8

Set rate

9

Set volume to be infused (VTBI)

10 Start infusion

! Using up/down arrow keys in the top left “ML/H” window ! Using up/down arrow keys in the top right window (when pre-ser VTBI is reached, audible alarm will sound and pump will switch to KVO rate) ! Press “start/stop” key ! Observe for the following to confirm operation – o Flashing drop symbol o Left to right moving spot in “ML/INFUSED” window

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6. RUNNING & OCCLUSION PRESSURES ! The VP5005 when switched on will have a preset occlusion alarm activation setting of 400mmHg (Normal/Macro-mode) and 100mmHg (Neonatal/Micro-mode). ! In the event of an occlusion, the line pressure will increase until it exceeds the preset occlusion alarm setting and the pump will then stop operation, an audible alarm will sound and the alarm window will display the occlusion symbol. ! When an occlusion has been released, the audible alarm will continue and the occlusion symbol will blink until the ‘start/stop’ key is pressed. ! The VP5005 will also allow the user to adjust the preset occlusion alarm setting and monitor running pressure levels: 1. Press ‘alarm/2min’ key once to display running pressure (in mmHg) in the ‘ML INFUSED’ window (for 20 seconds). 2. Press ‘alarm/2min’ key twice and pump will also display alarm pressure limit I ‘TOTAL ML’ window. 3. Use rate selection arrows to adjust occlusion pressure alarm limit as required. When the pump is switched off and back on again it will automatically return to original preset levels.

L 4 0 0 3.

P

1. Page 1 of 22

0

2.

7. USING VP5005 IN MICRO-MODE ! The VP5005, when switched on, operates in “macro-mode”, allowing rates of 1 – 999 ml/hr. ! May be programmed to operate in “micro-mode”, allowing rates of 0.1 – 99.9 ml/hr. ! Micro-mode operation is particularly suitable for paediatric neonatal use and more critical, high risk applications. ! Accuracy +/- 5% at > 1 ml/hr (approx. 6 minutes from start) ! Pump will automatically change occlusion pressure limit to 100 mmHg in micro-mode (occlusion will take longer to detect at lower flow rates). Method: 1.

Press, simultaneously, “ON/OFF” key and bottom right arrow key in “ML/H”------------. “ML/H” and ML infused windows will display 0.0 to confirm micro-mode operation.

0.0 0.0

1.

NB: When pump is switched off and back on again, operation will automatically return to “macro-mode”.

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8. USING VP5005 TO CALCULATE RATE (E.G.) 1 unit of blood to be given over 4 hours (volume 382 ml) 1. Press simultaneously “ON/OFF” key and alarm mute key……..ML INFUSED window will display “h 0”. 2. Enter in “total ml” window volume of fluid to be infused.

3 8 2 h

2.

0

1. 3.

Adjust “ML/H” values until “ML INFUSED” display shows desired time duration.

95 h4.01

Therefore, 1 unit of blood (vol. 382 ml) given at 95 ml/hr will run over a time period of 4 hr 1 min.

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9. RECALLING INFORMATION

! VP5005 pump is capable of recalling 300 events (via computer) and to return to previous reading by the user. ! Useful for: o Investigation in the event of an error/malfunction o Recalling previous data if pump has been accidentally switched off and values returned to zero. Method: Press “START/STOP” key and “ON/OFF” keys simultaneously

Display windows will run through previous reading and then stop at the last infusion settings (allowing continuation of that infusion if desired).

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10. TITRATION

! VP5005 may be programmed to allow the user to adjust/titrate an infusion whilst running. ! As a safety measure, titration may only be applied in single units.

Method: 1. Press “ON/OFF” key and “ML/H” left increase keys simultaneously.

1.

2. ! Pump rate/volume to be set by usual method and infusion started. ! Dose may now be increased or decreased in single units during operation. 2.

When dose is changed the “ML/H” display will flash. Press “START” to confirm alteration (if change is not confirmed within approx. 30 seconds, pump will default to previous rate setting).

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11. BOLUS ADMINISTRATION

VP5005 may be programmed to allow the user to administer a bolus of fluid at a faster rate and then return to normal running rate required. e.g. saline: loading bolus 100 ml in 15 mins : 400 ml/hr saline: rest of fluid 400 ml in 4 hrs : 100 ml/hr

Method: 1.

Press and hold middle increase arrow in “ml/h” and “on/off” key (“ml infused” window will display “bol” (bolus)

! Programme rate and volume to be infused for bolus (i.e. 100 ml at 400 ml/hr)

4 0 0

1 0 0

1. b o l

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2.

Press “2 min” key to switch to primary infusion settings “ml infused” window will display “prI”.

! Programme rate and volume to be infused for primary infusion (i.e. 400 ml at 100 ml/hr). 3.

Press “start” to commence infusion (“ml infused” window will indicate operation of primary (prI) of bolus infusion (bol)).

1 0 0

4 0 0 p r I

3. 2. ! When bolus has been administered pump will automatically switch to primary rate.

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