ICU Medical 20678-04-01 Infusion System with Hospira MedNet (TM) Software User Manual Cover

Hospira, Inc. Infusion System with Hospira MedNet (TM) Software Cover

Contents

Users Manual Part II

Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 7Because the Dose falls outside the soft limits, the infuser beeps three times (Invalid Key Warning), and generates the error message:“Dose > 8. Override?”13 Select  [Yes].NOTE: A SOFT limit override will be recorded in the History Events Log.This will bring up the PROGRAM CONFIRMATION screen.14 If Dose, Drug, Conc., Weight & Rate appear correct, select  [Yes] to begin program.NOTE: If the selected drug has been pre-programmed with dosing units and concentration, the concentration drug amount or diluent volume cannot be changed whether delivering or stopped. The only way to change to a different concentration is to clear the program.However, if selected drug has not been pre-programmed (or still operating with the DDL), the concentration can be changed for a program.AProgram Dose CalcYes NoDose > 8. Override?ConcWeight40070mgkg250 mLDoseVTBIDurationRate1025009: 3026.3mcg/kg/minmLhr : minmL/hrDOPamineAProgram Dose CalcYes NoDoseDrugConcWeightRateDelivery will be:104007026.3mcg/kg/minmgkgmL/hrConfirm Program?DOPamine250 mLMedSurgsec05.fm Page 7 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 8 430-95597-001 (Rev. 06/05) 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.AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf26.300010mcg/kg/minDOPamineMedSurgDoseDose Calculationsec05.fm Page 8 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 9Dose 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.1Select  [B] at the Main Delivery Screen.The Line B Programming screen appears.2Select  [Drug List].AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf26.300010mcg/kg/minDOPamineMedSurgDoseDose CalculationBPROGRAMModeRateVTBIDurationmL/hrmLhr : minProgramOptionsChangeModeCancel/BackChange using Change ModePiggyback0000:00MedSurgDrug Listsec05.fm Page 9 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 10 430-95597-001 (Rev. 06/05) The Drug List Screen appears, in mainly alphabetical order.NOTE: Default entry is “No Drug Selected”.3Use to highlight desired drug name.When list does not contain desired generic drug name or group name select  [Page Down] (or  [Page Up]) until it shows, then use to highlight choice.4Select  [Enter] to indicate selection and advance to the Program Selection screen.The Select Program screen for Line B appears.5Select  [Choose] to continue.BMedSurgPageUpPageDownCancel/BackEnterSelect, then EnterNo Drug SelectedAlbumin 5%AldesleukinAlfentanilAlteplaseAlteplaseAmikacinAmiodarone25 grams/500 mL2.6 mg/50 mL10 mg/250 mL50 mg/50 mL100 mg/100 mL100 mL150 mg/100 mLBMedSurgPageUpPageDownCancel/BackEnterSelect, then EnterLabetalolLepirudinLidocaineLidocaineLidocaineLiposyn 10%Liposyn 20%Milrinone200 mg/200 mL100 mg/250 mL1 grams/250 mL2 grams/500 mL4 grams/500 mL100 mL500 mL200 mcg/100 mLBPROGRAMChoose BackSelect, then ChooseStandard ProgramLoading DoseMultistepLidocainesec05.fm Page 10 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 11If 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.6Select  [Choose] to continue. Or, use to change the units to use in the delivery.If desired, select  [Page Down] to see more units of measure.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.NOTE: Cursor defaults to package insert recommended concentration units associated with the selected drug.7Select  [Choose] to continue. Or, use to change the Container Concentration units to use in the delivery.BProgram Dose CalcChoose BackSelect, then ChooseLidocainemL/hrmcg/kg/minmcg/kg/hrmcg/minmcg/hrmg/kg/hrmg/minmg/hrgrams/hrng/kg/minmmol/minmmol/hrmEq/hrPageUpPageDownBProgram Dose CalcChoose BackSelect, then ChooseDrug Conc in ContainermcgmggramsLidocainesec05.fm Page 11 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 12 430-95597-001 (Rev. 06/05) The next page of the Program Dose Calc screen appears to provide for entry of delivery program parameters.8Use keypad to enter desired values. Once entered, use to highlight the next field.NOTE: If selected drug has established Rule Sets (e.g., non-blank concentration), the Mode field will be highlighted upon entry to this screen.9To change the Piggyback Delivery Mode default, scroll down to Mode using , then select  [Change Mode].NOTE: Delivery Mode Option is available on Line B, its default is Piggyback, and the Weight field is gone.10 Continue entering desired values using the keypad. Use to advance to the next field.NOTE: When entering the RATE, with a VTBI value entered, the DOSE and DURATION fields are automatically updated. To understand the Automatic Calculation feature, see Examples of Automatic Calculation on page 6-10.BProgram Dose CalcProgramOptionsCancel/BackEnter value using keypadConc2500gramsmLDoseVTBIDurationRate0000: 000mg/minmLhr : minmL/hrMode PiggybackLidocaineBProgram Dose CalcProgramOptionsCancel/BackEnter value using keypadConc 2500gramsmLDoseVTBIDurationRate250016 : 4030mg/minmLhr : minmL/hrMode ConcurrentLidocainesec05.fm Page 12 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 13NOTE: 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.NOTE: If the Duration value is changed, the Rate and Dose are automatically adjusted.NOTE: At this point, programming is complete unless [Program Options] are desired. See Section 6, Additional Features, for more information.CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.12 To start the delivery, press .This will bring up the PROGRAM CONFIRMATION screen.13 If Dose, Drug, Conc., Weight, & Rate appear correct, select  [Yes] to begin program.NOTE: If the selected drug has been pre-programmed with dosing units and concentration, the concentration drug amount or diluent volume cannot be changed whether delivering or stopped. The only way to change to a different concentration is to clear the program.However, if selected drug has not been pre-programmed (or still operating with the DDL), the concentration can be changed for a program.BProgram Dose CalcYes NoDoseDrugConcWeightRateDelivery will be:227030mg/mingramskgmL/hrConfirm Program?Lidocaine500 mLMedSurgsec05.fm Page 13 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 14 430-95597-001 (Rev. 06/05) 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 on page 1-7.AABBSTOPPED PUMPINGRatemL/hrVol InfmLOptions/Vol Inf26.310.130Dose2mg/minmcg/kg/minMedSurgLidocaineDose CalculationDOPamineDose Calculationsec05.fm Page 14 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 15Loading DoseLOADING 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.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. Use to select CCA and bring you to the Main Delivery Screen.NOTE: To change CCA while infusing, see Changing CCA While Infusing on page 6-12.1Select  [A] (or  [B]) at the Main Delivery screen.Area SelectionEnterSelect, then EnterAny Hospital, USAMM/DD/YY XXYYZZ- 123456ICUMedSurgORCardioUrologyPsychRecovL&D5 WestRenalNeo ICUOB/GYNOncolAd ICUER7 South3 North4 NorthAABBSTOPPED STOPPEDRatemL/hrVol InfmLOptions/Vol InfBackPrime0000MedSurgsec05.fm Page 15 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 16 430-95597-001 (Rev. 06/05) The selected Line (A or B) Programming screen appears.2Select  [Drug List]. The Drug List Screen appears, in mainly alphabetical order.NOTE: Default entry is “No Drug Selected”. This process will guide you through a “fluid challenge”, so “No Drug Selected” will be entered.3Select  [Enter] to indicate selection and advance to the Program selection screen.The Select Program screen for Line A (or B) appears.NOTE: This example shows line A being programmed.APROGRAMRateVTBIDurationmL/hrmLhr : minProgramOptionsCancel/BackDrug ListEnter Value using keypad0000:00MedSurgAMedSurgPageUpPageDownCancel/BackEnterSelect, then EnterNo Drug SelectedAlbumin 5%AldesleukinAlfentanilAlteplaseAlteplaseAmikacinAmiodarone25 grams/500 mL2.6 mg/50 mL10 mg/250 mL50 mg/50 mL100 mg/100 mL100 mL150 mg/100 mLAPROGRAMChoose BackSelect, then ChooseStandard ProgramLoading DoseMultistepsec05.fm Page 16 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 174Use to scroll down to Loading Dose.5Select  [Choose] to continue.The next page of the Program Loading Dose screen appears.6Select  [Choose] to continue. Or, use to change the units to use in the delivery.If desired, select  [Page Down] to see more units of measure.The Loading Dose Programming screen appears.7The default field is Rate. Since a “Fluid Challenge” is being performed in this example, press to advance to the VTBI field.APROGRAMChoose BackSelect, then ChooseStandard ProgramLoading DoseMultistepAProgram Loading DoseChoose BackSelect, then ChoosemL/hrmcg/kg/minmcg/kg/hrmcg/minmcg/hrmg/kg/hrmg/minmg/hrgrams/hrng/kg/minmmol/minmmol/hrmEq/hrPageUpPageDownAProgram Loading DoseCancel/BackProgramOptionsEnter value using keypadDurationhr : min00 : 0000 : 00VTBImL00mL/hr00Rate12sec05.fm Page 17 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 18 430-95597-001 (Rev. 06/05) 8Enter value using keypad.9Use to highlight the next field.10 Enter Duration using keypad. The Rate value is automatically calculated. To understand the Automatic Calculation feature, see Examples of Automatic Calculation on page 6-10.11 After the values for loading dose Step-1 are entered, use to highlight the maintenance dose, Step-2.NOTE: The Loading Dose program has two steps. The first is the loading dose followed by the maintenance dose. These words will appear on the main screen as each step is delivered.AProgram Loading DoseCancel/BackProgramOptionsEnter value using keypadDurationhr : min00 : 0000 : 00mL/hr00Rate12VTBImL2500AProgram Loading DoseCancel/BackProgramOptionsEnter value using keypadmL/hr5000Rate12VTBImL2500Durationhr : min00 : 3000 : 00AProgram Loading DoseCancel/BackProgramOptionsEnter value using keypadDurationhr : min00 : 3000 : 00mL/hr50075Rate12VTBImL2500sec05.fm Page 18 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 1912 Enter the set of desired values for Step-2 of the program.13 Select  [Program Options] to select a Delayed Start or Standby.NOTE: At this point, programming is complete unless  [Program Options] are desired. See Section 6, Additional Features, for more information.NOTE: Nurse Callback enables an alarm when a change in the delivery on a line occurs such as completing Step-1 and starting Step-2. Or on line B, a piggyback delivery is completed and line A is starting its delivery.14 Enter a delay time (less than 24 hours) using the keypad.NOTE: Not available if a delivery is taking place on the line.NOTE: Nurse Callback cannot be changed while a delivery is taking place on the line.15 Select  [Enter] to accept the changes and return to the Program Loading Dose screen.AProgram Loading DoseCancel/BackProgramOptionsEnter value using keypadDurationhr : min00 : 3010 : 00mL/hr50075Rate12VTBImL250750AProgram OptionsCancel/BackEnterStandbyEnter Value using keypadDelay Start for 00:00 hr:minCallback NoLoading DoseAProgram OptionsCancel/BackEnterYes/NoChange using Yes/NoDelay Start for 00:05 hr:minCallback YesLoading Dosesec05.fm Page 19 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 20 430-95597-001 (Rev. 06/05) 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 VALUESBEFORE STARTING INFUSION.17 If Drug and Rate appear correct, select  [Yes] to begin program.The Main Delivery Screen appears.NOTE: The words “DELAYED” and “Loading Dose” appear in the upper-left corner. These indicate the options which have been selected.After the programmed delay period has expired, the Plum A+ starts “Pumping”. This is indicated where “Delayed” previously was displayed.AProgram Loading DoseDrugRateVTBIDelivery will be:500250mL/hrmLConfirm Program?No Drug Selected!Yes NoMedSurgAABBDELAYED STOPPEDRatemL/hrVol InfmLOptions/Vol Inf500000Loading DoseMedSurg!AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf500000Loading DoseMedSurgsec05.fm Page 20 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 21After the Step-1 has completed, the Main Delivery Screen changes to the second step.NOTE: A flashing “Callback Line A” message and the audio alarm sound indicates activation of that option.18 The user should acknowledge the Callback message and stop the audio alarm by pressing . Upon completion of delivery, the screen shows a flashing “Line A VTBI complete” message and the audible alarm sounds.NOTE: The KVO rate will change to the rate of 1 mL/hr or less depending on delivery rate and “Pumping” mode changes to “KVO”. If Continue Rate option was selected, pumping continues at original rate.19 Press to stop alarm sound.NOTE: Warning message continues to flash and audio alarm will return after a two minute period of silence, unless delivery is stopped or VTBI of last line is changed.AABBSTOPPEDOptions/Vol InfN105 Callback Line APUMPINGRatemL/hrVol InfmL75250 00Maintenance DoseMedSurgAABBSTOPPEDOptions/Vol InfN161 Line A VTBI completeKVORatemL/hrVol InfmL11000 00Maintenance DoseMedSurgsec05.fm Page 21 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 22 430-95597-001 (Rev. 06/05) Multistep ProgrammingMULTISTEP- 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.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. Use to select CCA and bring you to the Main Delivery Screen.NOTE: To change CCA while infusing, see Changing CCA While Infusing on page 6-12.1Select  [A] at the Main Delivery screen.Area SelectionEnterSelect, then EnterAny Hospital, USAMM/DD/YY XXYYZZ- 123456ICUMedSurgORCardioUrologyPsychRecovL&D5 WestRenalNeo ICUOB/GYNOncolAd ICUER7 South3 North4 NorthAABBSTOPPED STOPPEDRatemL/hrVol InfmLOptions/Vol InfBackPrime0000MedSurgsec05.fm Page 22 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 23The Line A Programming screen appears.2Select  [Drug List].The Drug List Screen appears, in mainly alphabetical order.NOTE: Default entry is “No Drug Selected”.3Use to highlight desired drug name.When list does not contain desired drug name or drug class name, select  [Page Down] (or  [Page Up]) until it shows, then use to highlight choice.4Select  [Enter] to indicate selection and advance to the Program Selection screen.APROGRAMRateVTBIDurationmL/hrmLhr : minProgramOptionsCancel/BackDrug ListEnter Value using keypad0000:00MedSurgAMedSurgPageUpPageDownCancel/BackEnterSelect, then EnterNo Drug SelectedAlbumin 5%AldesleukinAlfentanilAlteplaseAlteplaseAmikacinAmiodarone25 grams/500 mL2.6 mg/50 mL10 mg/250 mL50 mg/50 mL100 mg/100 mL100 mL150 mg/100 mLAMedSurgPageUpPageDownCancel/BackEnterSelect, then EnterTirofibanTobramycinTobramycinVancomycinVinCRIStineVinCRIStine5 mg/100 mL40 mg/50 mL80 mg/100 mL500 mg/100mL100 mL50 mLsec05.fm Page 23 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 24 430-95597-001 (Rev. 06/05) The Select Program screen for Line A (or B) appears.NOTE: This example shows line A being programmed.5Use to scroll down to Multistep.6Select  [Choose] to continue.If selected drug has been programmed with established dosing units and concentration, skip to step 9.The Program Multistep screen appears.NOTE: Cursor defaults to package insert recommended dose units associated with the selected drug.7Use key to highlight the units to use in the delivery.8Select  [Choose] to continue.If desired, select  [Page Down] to see more units of APROGRAMChoose BackSelect, then ChooseStandard ProgramLoading DoseMultistepVinCRIStineAPROGRAMChoose BackSelect, then ChooseStandard ProgramLoading DoseMultistepVinCRIStineAProgram MultistepChoose BackSelect, then ChooseVinCRIStinemL/hrmcg/kg/minmcg/kg/hrmcg/minmcg/hrmg/kg/hrmg/minmg/hrgrams/hrng/kg/minmmol/minmmol/hrmEq/hrPageUpPageDownsec05.fm Page 24 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 25measure.The Multistep Programming screen appears.9Rate is the default field. Enter value using keypad.10 Use to highlight the Duration or VTBI field.NOTE: The VTBI value is automatically computed when the Duration value is entered. If VTBI is entered, the Duration value is automatically computed.11 Use to drop down to Step-2, Rate field.12 Enter the set of desired values for Step-2 of the program. Continue process for each additional Step.AProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min00 : 0000 : 0000 : 0000 : 00VTBImL0000500001234VinCRIStineAProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min01 : 0000 : 0000 : 0000 : 00VTBImL50000500001234VinCRIStineAProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min01 : 0000 : 0000 : 0000 : 00VTBImL5000050100001234VinCRIStinesec05.fm Page 25 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 26 430-95597-001 (Rev. 06/05) 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.NOTE: Using [SELECT] will not advance you to the additional steps.14 To set up Steps 5 through 10, enter desired values as performed for Steps 1 through 4. To see the previous steps, select  [Prev Steps].15 To start the delivery, press .This will bring up the Confirmation screen.CAUTION: VERIFY ALL VALUESBEFORE STARTING INFUSION.AProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min01 : 0008 : 1501 : 0001 : 00VTBImL5082575505010075501234VinCRIStineAProgram MultistepCancel/BackEnter value using keypadProgramOptionsPrevStepsRatemL/hrDurationhr : min00 : 0000 : 0000 : 0000 : 0000 : 0000 : 00VTBImL0000000000005678910VinCRIStineAProgram MultistepDrugRateVTBIDelivery will be:5050mL/hrmLConfirm Program?VinCRIStine!Yes NoMedSurgsec05.fm Page 26 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 5- 27The Main Delivery Screen displays Step-1 in the upper-left corner.NOTE: In units other than mL/hr, the Dose rate and units also will be displayed.Example of Multistep Screen Pumping on Step-2.16 To change a program parameter while pumping, select  [A].NOTE: The “*” in a Step number field indicates the step is delivering or “d” indicates each completed step.17 Enter a value using the keypad.AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf5027.500 VinCRIStineStep 1AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf100652 00 VinCRIStineStep 2AProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min01 : 0008 : 1501 : 0001 : 00VTBImL508257550501007550d34VinCRIStinesec05.fm Page 27 Wednesday, June 8, 2005 8:31 AM
For Systems With Hospira MedNetTM Software5- 28 430-95597-001 (Rev. 06/05) If Rate value is changed, the Duration will automatically change.NOTE: Only the current delivering step and future steps can be changed.18 To start the delivery, press .This will bring up the Confirmation screen.CAUTION: VERIFY ALL VALUESBEFORE STARTING INFUSION.NOTE: The Values are now updated on the Main Delivery Screen.The infuser reverts to KVO when last Step completes.The last step can be restarted by entering a new VTBI value.AProgram MultistepCancel/BackEnter value using keypadProgramOptionsMoreStepsRatemL/hrDurationhr : min01 : 0006 : 3601 : 0001 : 00VTBImL508257550501257550d34VinCRIStineAProgram MultistepDrugRateVTBIDelivery will be:125825mL/hrmLConfirm Program?VinCRIStine!Yes NoMedSurgAABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf125658 00 VinCRIStineStep 2sec05.fm Page 28 Wednesday, June 8, 2005 8:31 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 1SECTION 6Additional FeaturesSimple Delivery Using Delayed Start1Before or after entering the simple delivery program, select  [Program Options].NOTE: To program a Delayed Start using an advanced program (i.e., Dose Calc) you must first select which line you want (A or B), next select  [Drug List], and then  [Program Options]. If you program the Delayed Start first, it will be cleared upon entry into Select Program mode.The Default screen for Program Options appears.BPROGRAMModeRateVTBIDurationmL/hrmLhr : minProgramOptionsChangeModeCancel/BackDrugListChange using Change ModeConcurrent525050:00MedSurgBProgram OptionsCancel/BackEnterStandbyEnter Value using keypadDelay Start for 00:00 hr:minCallback Nosec06.fm Page 1 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 2 430-95597-001 (Rev. 06/05) 2Enter values for desired hours and/or minutes.3Select  [Enter] to confirm delayed start.CAUTION: VERIFY ALL VALUESBEFORE STARTING INFUSION.4Press to confirm programming.Line B is delayed for the time entered.NOTE: Delayed line drip indicator is solid, not flashing. It will begin flashing when actually pumping.Piggyback with Nurse Callback1After programming in desired values for both lines, select  [Program Options].NOTE: To set a nurse callback, the infuser must be stopped. This function can be selected either before or after entering the Piggyback delivery program.BProgram OptionsCancel/BackEnterStandbyEnter Value using keypadDelay Start for 01:00 hr:minCallback NoAABBPUMPING DELAYEDRatemL/hrVol InfmLOptions/Vol Inf125850 05!!MedSurgBPROGRAMModeRateVTBIDurationmL/hrmLhr : minProgramOptionsCancel/BackEnter value using keypadPiggyback20010000:30MedSurgDrug Listsec06.fm Page 2 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 3The default screen for Program Options appears.Use to highlight “Callback” field and select  [Yes/No], if necessary to obtain “Yes”, then select  [Enter].NOTE: Callback default of Yes or No is a biomedical setting and must be configured using the Hospira MedNet accessory.CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.2Press to confirm program setting and return to Main Delivery screen.At end of Piggyback delivery, with Callback enabled for the line, Callback alarm is issued.3Press to clear alarm.BProgram OptionsCancel/BackEnterYes/NoChange using Yes/NoDelay Start for 00:00 hr:minCallback YesBPROGRAMModeRateVTBIDurationmL/hrmLhr : minProgramOptionsCancel/BackEnter value using keypadPiggyback20010000:30MedSurgDrug ListAABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf5.50.3100200N104 Callback Line BMedSurg! !sec06.fm Page 3 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 4 430-95597-001 (Rev. 06/05) Possible Non-Delivery ProgrammedNOTE: 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.1Select  [Yes] to continue with delivery. Or, select  [No] to cancel.Using the Standby FeatureStandby is a feature that enables the clinician to program the infuser up to 23: 59 minutes in advance of Starting.1If Line A is infusing, select  [A] or  [B] to access program screen of line to be placed on Standby.2Select  [Program Options].3Select  [Standby].BPROGRAMYes NoAttention: Line A is stopped ordelayed. Line B in piggyback modegives no KVO or alarm at dose end.Continue anyway?AProgram Dose CalcProgramOptionsCancel/BackEnter value using keypadConcWeight40070mgkg250 mLDoseVTBIDurationRate1025009: 3026.3mcg/kg/minmLhr : minmL/hrDOPaminesec06.fm Page 4 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 54Confirm 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.5Press to remove Standby and start the infusion.AProgram Dose CalcYes NoDoseDrugConcWeightRateDelivery will be:104007026.3mcg/kg/minmgkgmL/hrPut delivery in Standby?DOPamine250 mLMedSurg!AABBSTANDBY STOPPEDRatemL/hrVol InfmLOptions/Vol Inf26.300010mcg/kg/min MedSurgDOPamineDose Calculationsec06.fm Page 5 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 6 430-95597-001 (Rev. 06/05) Select Option- Volumes Infused, Pressure/Post Infusion Rate, and Lighting/Contrast1To select Options Screen, select  [Options/Vol Inf].2Use to highlight an option.3Select  [Choose] to select the Volumes Infused screen.This will bring up the Volumes Infused screen which defaults to Total Volume. 4Use to scroll to Line A or B.AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf5.5393 0 0MedSurgDOPamineDose CalculationABOPTIONSChooseChange CCA BackSelect, then ChooseRelease 13.x - xx/xx/xxVolumes InfusedPressure/Post Infusion RateLighting/ContrastAny Hospital, USAMM/DD/YY XXYYZZ-123456ABOPTIONSEnter Cancel/BackPress CLEAR to clear valueVolumes InfusedLine ALine BTotal VolmLmLmL00393DOPamineDose Calculationsec06.fm Page 6 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 75To reset Line A (or B) Volume Infused,use to highlight and press .6To restore the cleared quantity, select  [Cancel/Back].7To reset all volumes, use to highlight Total Vol, then press .8To restore all quantities, select  [Cancel/Back] softkey.ABOPTIONSEnter Cancel/BackPress CLEAR to clear valueVolumes InfusedLine ALine BTotal VolmLmLmL00393DOPamineDose CalculationABOPTIONSEnter Cancel/BackPress CLEAR to clear valueVolumes InfusedLine ALine BTotal VolmLmLmL000DOPamineDose Calculationsec06.fm Page 7 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 8 430-95597-001 (Rev. 06/05) 9When 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.11 Use to highlight the Pressure/Post Infusion Rate option.12 Select  [Choose] to continue.NOTE: Prior to changing Pressure/Post Infusion Rate, infuser must be stopped.13 Use to highlight Continue Rate or Distal Pressure Limit field.14 Continue Rate allows a choice when VTBI is completed. Select  [KVO/Rate].• KVO- The infuser will revert to a fixed KVO of 1 mL/hr or the last programmed Rate, whichever is less.• Rate- The infuser will continue at the Rate programmed.NOTE: Option will be for both line A and line B selections.15 To change Distal Pressure Limit when highlighted, ABOPTIONSChooseChange CCA BackSelect, then ChooseRelease 13.x - xx/xx/xxVolumes InfusedPressure/Post Infusion RateLighting/ContrastAny Hospital, USAMM/DD/YY XXYYZZ-123456ABOPTIONSEnter Cancel/BackChange using KVO/RatePressure/Post Infusion RateContinue RateDistal Pressure LimitDistal PressureKVO60psipsiKVO/RateDOPamineDose Calculationsec06.fm Page 8 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 9enter value between 0.1 and 15 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.17 Select  [Options/Vol Inf] from the Main Delivery screen to return to the Options screen.18 Use to highlight Lighting/Contrast Option.19 Select  [Choose] to continue.20 Press to highlight Backlight Intensity or Display Contrast.21 While viewing display for desired effect, select either  [Increase Setting] or  [Decrease Setting] to change level.22 Select  [Enter] to keep change(s) and return to the Main Delivery screen, or  [Cancel/Back] to restore previous settings and return to the Options screen.ABOPTIONSChooseChange CCA BackSelect, then ChooseRelease 13.x - xx/xx/xxVolumes InfusedPressure/Post Infusion RateLighting/ContrastAny Hospital, USAMM/DD/YY XXYYZZ-123456ABOPTIONSEnter Cancel/BackUse Inc/Decrease SettingsLighting/ContrastBacklight IntensityDisplay ContrastDecreaseSettingIncreaseSettingsec06.fm Page 9 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 10 430-95597-001 (Rev. 06/05) Variable Rate CapNOTE: 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.Examples of Automatic CalculationAT STARTUPInitial programming allows the clinician to enter two of the three programming parameters (Rate, VTBI, or Duration) and the third is automatically calculated. (Refer to table below)WHILE RUNNING (TITRATION)Changing two parameters after startup of the infusion will allow for the re-calculation of the third parameter.1st Action 2nd Action [AUTOCALC]enter RATE enter VTBI [DURATION]enter VTBI enter DURATION [RATE]enter RATE enter DURATION [VTBI]sec06.fm Page 10 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 11NOTE: VTBI will not be re-calculated if the Rate and Duration are changed. VTBI must be cleared and then the new VTBI re-entered. The new VTBI will automatically calculate a new Rate.AT KVOAudible KVO alarm will sound, clinician will need to re-set the appropriate settings.1st Action 2nd Action [AUTOCALC]change RATE keep VTBI [DURATION]change RATE change VTBI [DURATION]change VTBI keep RATE [DURATION]change DURATION keep VTBI [RATE]change VTBI change DURATION [RATE]change RATE change DURATION Recalculates [RATE] based on previous VTBI and new DURATION1st Action 2nd Action [AUTOCALC]enter VTBI keep RATE [DURATION]enter DURATION keep RATE [VTBI]change RATE enter VTBI [DURATION]enter DURATION enter VTBI [DURATION]enter VTBI enter DURATION [RATE]change RATE change DURATION [VTBI]sec06.fm Page 11 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 12 430-95597-001 (Rev. 06/05) Changing CCA While Infusing1Select  [Options/Vol Inf] from the Main Delivery screen.2Select  [Change CCA].3Press to highlight desired CCA, then select  [Enter] to confirm the change.The delivery continues until VTBI equals zero, or you stop the program and clear the settings.AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf26.30.20010mcg/kg/minDOPamineDose CalculationERDoseABOPTIONSChooseChange CCA BackSelect, then ChooseRelease 13.x - xx/xx/xxVolumes InfusedPressure/Post Infusion RateLighting/ContrastAny Hospital, USAMM/DD/YY XXYYZZ-123456Area SelectionEnterSelect, then EnterAny Hospital, USAMM/DD/YY XXYYZZ- 123456ICUMedSurgORCardioUrologyPsychRecovL&D5 WestRenalNeo ICUOB/GYNOncolAd ICUER7 South3 North4 Northsec06.fm Page 12 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 13The message bar informs the user of the changed CCA.When VTBI reaches zero (infusion is competed), VTBI may no longer be incremented. To program, the user must first select  [Back], then press the key.Auto-ProgrammingAuto-Programming is a new feature for the Hospira Plum A+ line of infusion pumps. It can only be used if the feature has been installed in conjunction with your Hospital Information System (HIS) and Barcode Point-Of-Care (BPOC) Unit. It works by scanning barcode labels for the patient, pump, and IV bag using a BPOC Unit, such as a PDA. This information is then transferred to the pump utilizing either it’s wireless antenna or RJ-45 Ethernet connector. The feature reduces the number of steps needed to program an infusion.NOTE: If the physician’s order for an auto-program therapy exceeds the capabilities of the pump or is above a hospital defined hard drug limit, the infusion parameters for auto-programming will be rejected and the order will need to be re-checked.AABBPUMPING STOPPEDRatemL/hrVol InfmLOptions/Vol Inf26.30.30010mcg/kg/minDOPamineDose CalculationICUDoseLine A using prior CCAAPROGRAMBackPress Back,then press STOP key.This program was started under aprevious CCA.sec06.fm Page 13 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 14 430-95597-001 (Rev. 06/05) 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.NOTE: The wireless icon will not appear if an Ethernet cable is used to connect to the BPOC system.1Power On the pump as described in Section 4.2.2After the CCA has been selected, the pump is ready for auto-programming.NOTE: The Auto-Program feature must begin on the Main Delivery Screen (with the desired line STOPPED).3Following your hospital’s procedure, activate your BPOC Unit.4Scan the patient wristband to pull up the patient’s task list on the BPOC Unit.5Scan the IV bag. IV Task and documentation with Order Details is displayed on the BPOC.6Scan the barcode of the available pump channel that is not currently infusing (A or B).NOTE: If the scanned medication does not exist in the Hospira MedNet Rx Rules medication library, no medication will be AABBSTOPPED STOPPEDRatemL/hrVol InfmLOptions/Vol InfBackPrime0000MedSurgsec06.fm Page 14 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 6- 15displayed on the pump and “No Drug Selected” will be seen on the subsequent Confirmation and Main Delivery Screens.7Programming screen is auto-filled.8Verify ALL parameters. If changes are desired, the infusion parameters can be manually changed using the keypad on the pump.9Press to display the Confirmation screen.10 Select  [Yes] to confirm programming and begin infusion.The BPOC will reconfirm that the pump parameters match the order.11 Complete the transaction on the BPOC Unit or document the process per hospital procedure.AProgram Dose CalcProgramOptionsCancel/BackEnter value using keypadConcWeight40070mgkg250 mLDoseVTBIDurationRate1025009: 3026.3mcg/kg/minmLhr : minmL/hrDOPamineAProgram Dose CalcYes NoDoseDrugConcWeightRateDelivery will be:104007026.3mcg/kg/minmgkgmL/hrConfirm Program?DOPamine250 mLMedSurgsec06.fm Page 15 Wednesday, June 8, 2005 8:35 AM
For Systems With Hospira MedNetTM Software6- 16 430-95597-001 (Rev. 06/05) NOTESsec06.fm Page 16 Wednesday, June 8, 2005 8:35 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 1SECTION 7Alarms and TroubleshootingWarning MessagesNOTE: Other error and warning messages will occur when appropriate for the current selection context. For instance, when a change to a required parameter would result in clearing some delivery settings, the warning message will appear when that field is selected. When an input error has just been made, the three quick beeps of an Invalid Key Warning will sound and an appropriate warning message will be shown to explain the MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONStop delivery then turn offAttempting to turn the infuser off while a delivery is in progress.Stop all lines, then turn infuser off.Warning: Replace BatteryThe battery current charge is greater than 200 mA/hr.The battery voltage is less than the depleted threshold and charge level is higher than the low charge threshold.Replace battery.Warning: Charger ServiceThe charging circuitry is not behaving as expected (charge voltage is not changing) and can reduce battery life.Silence key is pressed.Warning: Low Battery Pump not plugged in to AC power.Plug into AC power, only about 30 minutes of battery life remains.sec07.fm Page 1 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 2 430-95597-001 (Rev. 06/05) problem. All such messages will be cleared or replaced by another message upon the next valid input key press.Response to Alarms1Disable Lockout by confirming back switch is in the down position or press the decimal key followed by 9, 6, & 3 on the keypad.2Press [SILENCE] key.3Identify/Observe Alarm condition.4Correct Alarm condition (see following tables).5Press [START] to resume infusion.NOTE: Alarm messages begin with an alphanumeric code for tracking purposes only. If troubleshooting does not correct the problem, record the code number and contact technical support.sec07.fm Page 2 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 3General AlarmsCODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONN100 Unrecognized cassetteAttempting to use unrecognized cassette.Turn off or insert recognized cassette.N101 No Action AlarmPump programming incomplete.Press [START] or continue programming.N102 Infuser Idle 2 MinutesPump is ON without operator input.Standby time has elapsed.Begin programming or turn infuser OFF.Re-enter all programmed data.N103 Memory Failure The infuser did not accept the previous programmed data.Re-enter all programmed data.N230 Prox Air, BackprimeWhen the total proximal air detected exceeds the limit.Check for clamps, or empty containers on line A or B. Correct as necessary. Backprime into line B tubing or syringe.N180, N181, N186 Distal OcclusionDistal line kinked, IV site clotted or positional, pressure limit set too low.Check distal tubing, check IV site, reset pressure limit.See page 1-10 for detailed instructions for avoiding a bolus following a distal occlusion.N187 Neg Distal OcclusionPump too high above patient or defective set.Lower infuser or replace set.N233, N234Distal Air When air is detected at the distal sensor and exceeds the limit.Remove and reprime cassette using standard technique.sec07.fm Page 3 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 4 430-95597-001 (Rev. 06/05) N250 Door open while pumpingPump door opened while operating.Close door with cassette inserted.N251 Cassette Test FailureFaulty 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.N252 Depleted BatteryToo much time on battery power.Plug into AC (mains) power.N253 Hard lockout ViolationThe use of the [STOP] key during delivery, or opening the door, while lockout is enabled.Unlock lockout switch.N254 Hard lockout EnabledPressing of any key except [STOP] during delivery while any alarm is active and lockout is enabled.Unlock lockout switch.N255 Soft lockout ViolationThe use of the [STOP] key during delivery, or opening the door, while lockout is enabled.Unlock lockout by pressing the decimal key, followed by 9, 6, & 3 on the keypad.N256 Soft lockout EnabledPressing of any key except [STOP] during delivery while any alarm is active and lockout is enabled.Unlock lockout by pressing the decimal key, followed by 9, 6, & 3 on the keypad.CODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 4 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 5Line A AlarmsCODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONN105 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].N161 Line A VTBI completeVTBI complete on line A.Program new VTBI.N185 Prox Occl A At StartupProximal line obstructed, line A container (or syringe) disconnected or obstructed during non-delivery (startup).Examine line A for kinks or closed clamps. If there are closed clamps, open the clamps. Then, open and close door. Continue programming. Replace set if problem persists.If clamps are not opened prior to completion of cassette test, peak proximal occlusion may recur.For syringe, select  [Backprime].sec07.fm Page 5 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 6 430-95597-001 (Rev. 06/05) N184, N190, N191Prox Occl A / AirProximal line obstructed, line A container disconnect or obstruction.Examine line A for kinks, closed clamps, or air in cassette.N232 Prox Air A, BackprimeWhen 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.CODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 6 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 7Line B AlarmsCODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONN104 Callback Line BAlarm 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.Press [SILENCE].N160 Line B VTBI completeVTBI complete on line B.Program new VTBI.N183 Prox Occl B At StartupProximal line obstructed, line B container (or syringe) disconnected or obstructed during non-delivery (startup).Examine line B for kinks or closed clamps. If there are closed clamps, open the clamps. Then, open and close door. Continue programming. Replace set if problem persists.If clamps are not opened prior to completion of cassette test, peak proximal occlusion may recur.For syringe, select [Backprime].sec07.fm Page 7 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 8 430-95597-001 (Rev. 06/05) MalfunctionsN182, N188, N189 Prox Occl B / AirProximal line obstructed, line B container disconnected or obstructed.Examine line B for kinks, closed clamps, or air in cassette.Occlusion caused by empty container, backprime into line B tubing or syringe.N231 Prox Air B, BackprimeWhen 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.CODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONE300 or higherMalfunction A failure has occurred in the infuser’s internal systems.Record Malfunction error code. Pump must be turned OFF to clear malfunction. If alarm malfunction repeats, replace infuser.CODE MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 8 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 9General MessagesMESSAGE POSSIBLE CAUSECORRECTIVE ACTIONCannot Standby in PiggybackSelection of  [Standby] when Line B is in Piggyback Mode.Select  [Cancel/Back].Cannot Standby with DelaySelection of  [Standby] when Delay time was entered for program.  [Cancel/Back].Changing CCA clears programDisplays when other than last-used Care Area is highlighted.N/AChange Conc clears entriesA program delivery which has been stopped and drug amount value is selected. This is displayed before any screen or field message.User can enter new Concentration using keypad, or press [CLEAR] then make new entry.Change units clears entriesA program delivery which has been stopped and user highlights another concentration unit for the same line.User can select  [Back] to exit, or use [SELECT] arrows to highlight a new value.Change Vol clears entriesA program delivery which has been stopped and diluent value is selected. This is displayed before any screen or field message.User can enter new Concentration volume using keypad, or press [CLEAR] then make another entry.sec07.fm Page 9 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 10 430-95597-001 (Rev. 06/05) Concurrency alert Attempt to start a multistep or loading dose delivery whose later steps would exceed concurrent delivery limit if delivery proceeds.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].Concurrency violation Attempt to start a second line with a delivery rate that would exceed concurrent delivery upper limit immediately. Or, concurrent delivery attempt and rate for the second line is less than concurrent delivery lower limit. Takes precedence over “Rate must be > n mL/hr” message. The combined delivery rate must fall within the range of 1.0 mL/hr – 500 mL/hr or CCA-specific Maximum Volumetric Rate, with 0.5 mL/hr minimum per line.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].Decimal point not allowedAttempt to input Decimal point when either not used in field or a three-digit whole number already input.Press [CLEAR] Hardkey.MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 10 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 11Dose > [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. Also cleared by the [ON/OFF] key when the line is stopped.Dose < [X.xx]. Override? Attempt to start program with parameter that has caused the Dose (or Rate, if mL/hr program) to be less than the lower soft limit [llllllll] 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. Also cleared by the [ON/OFF] key when the line is stopped.Hard Lockout Enabled The Lockout Switch has been enabled, no Alarm is active, and any key besides Stop is pressed. Disable the Lockout switch located on the back of the device. (See Section 3)Illegal when Line DeliveringAttempt to select program other than Dose Calculation while a Basic program is delivering on this line.Select  [Cancel/Back] or press [CLEAR]. Pressing [CLEAR] invokes another message.MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 11 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 12 430-95597-001 (Rev. 06/05) Input digits > max allowedAttempt 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 allowedAttempt to input number that would cause field to exceed its defined limit. In the Drug amount, Diluent amount, VTBI, Duration, Patient Weight, Distal pressure, and Delayed Start time fields, the Software shall display ‘---‘, and the user must press the Clear hard key and input a valid value.Press [CLEAR] hardkey.Maximum value reached The display contrast/intensity has reached its maximum value.User can select  [Enter] or  [Cancel/Back].Minimum value reached The display contrast/intensity has reached its minimum value.User can select  [Enter] or  [Cancel/Back].No delivery programmed Delivery attempt at Main Delivery Screen when A and B have both Rate and VTBI equal to zero (no delivery programmed).Select a line to program, or  [Options] or  [Backprime].Rate must be > 0 mL/hr Delivery attempt when VTBI is non-zero but rate is zero.Use number keypad to enter a value.MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 12 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 7- 13Soft 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.Disable the Soft Lockout.(See Section 3)VTBI must be > 0 Delivery attempt when rate is non-zero but VTBI is zero.Use number keypad to enter a value.Value is too high Attempt to move cursor from field whose input value is too high.Use number keypad to enter a value.Value is too low Attempt to move cursor from field requiring a non-default value.Use number keypad to enter a value.Weight change affects Line A/BSelecting the weight field on line while a weight-based program is entered on other line.Use number keypad to enter a value.Minimum Dose X.xx Attempt to start program with Dose less than lower hard Dose limit n.nn.Use number keypad to enter a value.Maximum Dose X.xx Attempt to start program with Dose greater than upper hard Dose limit n.nn. Attempt to input a Dose greater than the upper Hard Limit.The Software will display ‘---‘, and the user must press the [CLEAR] hard key and input a valid value.MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 13 Wednesday, June 15, 2005 8:05 AM
For Systems With Hospira MedNetTM Software7- 14 430-95597-001 (Rev. 06/05) 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.Attempt to input a 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.MESSAGE POSSIBLE CAUSECORRECTIVE ACTIONsec07.fm Page 14 Wednesday, June 15, 2005 8:05 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 8- 1SECTION 8Cleaning, Maintenance, and StorageThe cleaning, maintenance, and storage of the Plum A+ are described in this section.CLEANING AND SANITIZINGFor proper maintenance of the Plum A+, observe the following cleaning and sanitizing guidelines.Establish a routine weekly schedule for cleaning the infuser. To clean, proceed as follows:• Turn the Plum A+ off using the [ON/OFF] switch• Disconnect from AC (mains) powerThe exposed surfaces of the Plum A+ may be cleaned with a lint-free cloth dampened by one of the recommended cleaning solutions in the following list or mild, nonabrasive soapy water.Clean the cassette door with a soft, lint-free cloth, dampened with one of the cleaning agents listed in the following table, or a mild solution of soapy water. Use a small non-abrasive brush to aid in cleaning the infusion system housing and subsystem chassis components. To thoroughly clean the cassette receptacle, disengage the cassette door from the door latch by pressing the door release tab.CAUTION: DO NOT ALLOW CLEANING SOLUTIONS TO SATURATETHE AIR-IN-LINE DETECTORS OR ENTER THE DEVICE WHEN CLEANINGTHE AIR-IN-LINE DETECTORS.sec08.fm Page 1 Wednesday, June 8, 2005 8:38 AM
For Systems With Hospira MedNetTM Software8- 2 430-95597-001 (Rev. 06/05) The rubber pad on the Plum A+3 pole clamp, as well as the IV poles for both instruments, may be cleaned using isopropyl alcohol.On a routine basis, clean all of the elements behind the cassette door using cotton-tipped swabs saturated with cleaning solution. The cassette door may be unlatched from the door handle to facilitate cleaning. CLEANING SOLUTION MANUFACTURER PREPARATIONCoverageTMHBV Steris Corporation, A division of Calgon Vestal LaboratoriesPer manufacturer's recommendationFormula C TM Diversey Corporation Per manufacturer's recommendationDispatch®Caltech Industries Per manufacturer's recommendationPrecise®Caltech Industries Per manufacturer's recommendationHousehold bleach Various Per hospital procedures; do not exceed one part bleach in ten parts waterManu-Klenz®Calgon Vestal LaboratoriesPer manufacturer's recommendationSporicidin®Sporicidin International Per manufacturer's recommendationSuper Edisonite®S. M. Edison Co. Per manufacturer's recommendationsec08.fm Page 2 Wednesday, June 8, 2005 8:38 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 8- 3To unlatch the cassette door from its handle, tilt the device back, open the cassette door, then push the door release tab to open the door fully.CAUTION: TO AVOID MECHANICAL OR ELECTRONIC DAMAGE, DONOT IMMERSE THE PLUM A+ IN ANY FLUIDS OR CLEANINGSOLUTIONS.CAUTION: DO NOT SPRAY CLEANING SOLUTIONS TOWARD ANYOPENING IN THE INSTRUMENT.CAUTION: CERTAIN CLEANING AND SANITIZING SOLUTIONS MAYSLOWLY DEGRADE COMPONENTS MADE FROM SOME PLASTICMATERIALS. USING ABRASIVE CLEANERS OR CLEANING SOLUTIONSNOT RECOMMENDED BY HOSPIRA MAY RESULT IN PRODUCT DAMAGE.DO NOT USE COMPOUNDS CONTAINING COMBINATIONS OFISOPROPYL ALCOHOL AND DIMETHYL BENZYL AMMONIUM CHLORIDE.CAUTION: NEVER USE SHARP OBJECTS SUCH AS FINGERNAILS,PAPER CLIPS, OR NEEDLES TO CLEAN ANY PART OF THE INFUSER.CAUTION: DO NOT STERILIZE BY HEAT, STEAM, ETHYLENE OXIDE(ETO), OR RADIATION. CAUTION: TO AVOID INFUSER DAMAGE, CLEANING SOLUTIONSSHOULD ONLY BE USED AS DIRECTED. THE DISINFECTINGPROPERTIES OF CLEANING SOLUTIONS VARY; CONSULT THEMANUFACTURER FOR SPECIFIC INFORMATION.BATTERY MAINTENANCECAUTION: DO NOT OPERATE THE INFUSER ON PATIENTS WITH THEBATTERY REMOVED. USE OF A PROPERLY MAINTAINED ANDCHARGED BATTERY HELPS CONFIRM PROPER OPERATION. CAUTION: IF THE LOW-BATTERY ALARM SOUNDS, CONNECT TOAC (MAINS) POWER IMMEDIATELY.The Plum A+ is battery powered for emergency backup and temporary portable operation. A fully charged, new battery provides 3 hours of operation at 125 mL/hr, or delivers 250 mL total volume if pumping at a rate of 126 mL/hr or greater, whichever occurs first. sec08.fm Page 3 Wednesday, June 8, 2005 8:38 AM
For Systems With Hospira MedNetTM Software8- 4 430-95597-001 (Rev. 06/05) NOTE: For optimum battery life, the Plum A+ should be operated on battery power for three continuous hours at least once every six months and then charged for a minimum of six hours.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.To maintain maximum battery charge and to prolong battery life, connect the infuser to AC (mains) power whenever possible.When the infuser is used without wireless, the operation times may be proportionally longer.STORAGETo prolong the life of the Plum A+, observe the following storage precautions:• Store the away from excessive heat, cold, and humidity• Store connected to AC (mains) power• Switch the infuser OFF using the [ON/OFF] keySERVICEAll servicing or adjustments to the Plum A+ should be referred to qualified technical personnel. A technical service manual may be ordered from the local Hospira sales office.sec08.fm Page 4 Wednesday, June 8, 2005 8:38 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 1SECTION 9SpecificationsNOTE: Specification information applies to both systems (Plum A+ & Plum A+3) unless otherwise noted.PhysicalElectricalDimensions: Plum A+- Approximately 8” X 8” X 6”, excluding pole clamp protrusion and power cord storage.Plum A+3- Approximately 19” X 15” X 14”, including pole clamp, barcode wand holder, and power cord.Weight: Plum A+- Approximately 9.5 lbs. with battery.Plum A+3- Approximately 28 ibs. with (3) batteries.Casing: High-impact plastic.Power Requirements:Plum A+- 120 V~, 50-60 Hz, 35 VA. Meets UL 60601-1.Plum A+3- 120 V~, 50-60 Hz, 120 VA.Fuses: F1, F2, 250V~, 0.5 A. (internal)Power Cord: Hospital-grade AC cord. 10 ft long, with transparent plug and retainer plate.Battery: Plum A+- One sealed, lead-acid, rechargeable 6 V battery, internal to device.Plum A+3- Three sealed, lead-acid, rechargeable 6 V batteries, internal to device.sec09.fm Page 1 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 2 430-95597-001 (Rev. 06/05) Wireless Lan DeviceBattery Life: With a new fully charged battery, the infuser operates for a minimum of three hours at 125 mL/hr or less, or delivers 250 mL if > 126 mL/hr. (Time is measured from initial pumping to Depleted Battery Alarm)Recharge: The battery charges whenever the infuser is connected to AC power. The recharge time is approximately six hours with the device operating at 125 mL/hr on one line.Electrical Leakage:Meets IEC 60601-1 standard: Medical Electronic Equipment, Part 1: General Requirements for Safety.NURSE-CALL System:Circuitry Ratings:NURSE-CALL alarm is factory set for Normally- Open (NO)Contact the Technical Services Center to make an internal adjustment to change the device from Normally-Open (NO) to Normally Closed (NC) system.Voltage-30 VDC MaxCurrent- 0.25 Amps MaxContact Rating- 3 Watts MaxStandards: IEEE802.11bRadio Technology: IEEE802.11b Direct SequenceSpread SpectrumData Transfer Rate:11, 5.5, 2, 1 Mbps (auto sense)sec09.fm Page 2 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 3VTBI RangeEnvironmentDelivery Rate RangeFREQUENCY RANGEIEEE802.11b Channels:Transmit Power:Antenna:Certifications:2412 - 2462 MHz1-11 (FCC)100mW (+20dBm) maxIntegrated surface mount antennaFCC Part 15.247IC RSS-210, RSS-102FCC ID: STJ-20677IC: 5627A-20677VTBI Range: 0.1 to 99.9 mL (in 0.1 mL increments)100 to 9999 mL (in 1 mL increments)Operating Temperature:5° to 40° CStorage Temperature:-20° to 60° CAtmospheric Pressure:0 - 10,000 feet (0 - 3,000m) or equivalent pressureRelative Humidity: 10 - 90% (40° C Max)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:PlumSet:0.5 mL/hr minimum for each line500 mL/hr cumulative (A+B) maximumsec09.fm Page 3 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 4 430-95597-001 (Rev. 06/05) Air-in-Line AlarmOcclusion Alarm and LimitsKVO: 1.0 mL/hr or the last primary delivery rate, whichever is lessPlumSet (Distal): Bolus 0.1 mL (100 microliters) or larger for delivery rates less than 500 mL/hr.Bolus 0.5 mL (500 microliters) or larger for delivery rates equal to or greater than 500 mL/hr.Cumulative 0.25 mL out of 2.6 mL for delivery rates less than 500 mL/hr.Cumulative 0.50 mL out of 5.3 mL for delivery rates equal to or greater than 500 mL/hr.PlumSet (Proximal):Bolus at 0.5 mL, Total 1.0 mL 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 user-selectable. Factory default setting is 6 psig.Maximum Infusion Pressure:20 psigsec09.fm Page 4 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 5Time To Detect DownstreamOcclusionsBolus Volume Released After Downstream Occlusions AreCorrectedRATEOCCLUSION ALARM PRESSURE SETTINGTYPICAL TIME TO ALARM (MACRO)MAXIMUM TIME TO ALARM (MACRO)25 mL/hr 6 psig15 psig38 seconds98 seconds47 seconds106 seconds1 mL/hr 6 psig15 psig17 minutes45 minutes22 minutes49 minutes* Baseline backpressure is 0 psig *RATEOCCLUSION ALARM PRESSURE SETTINGTYPICAL BOLUS VOLUME (MACRO)MAXIMUM BOLUS VOLUME (MACRO)25 mL/hr 6 psig15 psig0.23 mL0.55 mL0.28 mL0.63 mL1 mL/hr 6 psig15 psig0.24 mL0.59 mL0.30 mL0.70 mL* Baseline backpressure is 0 psig *sec09.fm Page 5 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 6 430-95597-001 (Rev. 06/05) Delivery AccuracyThe 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 0.5% per psig (2% per psig for rates between 0.1 and 0.9 mL/hr) for backpressures up to 15 psig. A typical deviation under these conditions is 0.3%. Negative backpressure may affect delivery accuracy no more than 2% for pressures up to -2 psig (56 inches of water). A typical deviation under these conditions is 0.3%. Filling Head Effect- Variations in filling head (such as container height) may affect delivery accuracy by no more than 2% for variations in the range -15 to +28 inches. A typical deviation under these conditions is 0.5%.Concurrent Delivery Effect- When both lines (A & B) are delivering, the ratio of delivery for the fluid with the lowest rate may be affected by as much as 5% for ratios up to 9 to 1. For higher ratios, the absolute percentage of delivery for the lowest rate may be affected by no more than 0.5%. When air is present in the bubble trap, the absolute percentage of delivery for the lowest rate may be affected by up to 2.0%. When variations in container height are present, the absolute percentage of delivery for the lowest rate may be affected by up to 2.5% for up to 24 inches of container height differences.Enteral & High Viscosity Fluids EffectsSystem delivery accuracy limits for each Enteral and High Viscosity Fluid, such as those listed in the following table, can be degraded by an additional maximum of 5%. System accuracy for Enteral Fluids is defined only for rates of 1 to 200 mL/hr, with no sec09.fm Page 6 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 7suspended air in the solution, and using an Hospira Plum enteral set.Trumpet CurvesThe 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, Sub-Clause 50.102. Refer to this standard for detailed information.How to read a Trumpet Curve Graph (Refer to example on the following page): The graphs following the Example plot flow rates at 30 second intervals for the first 2 hours and for the 96th hour of delivery. The graph plots mean delivery rate error (Average of 3 infusers) for the 2nd hour and the 96th hour as a straight line. The graph also presents maximum and minimum average delivery rate error for this interval plotted by averaging delivery errors over intervals of 2, 5, 11, 19 and 31 minutes (“Trumpet Curve”).EXAMPLEFrom the Trumpet Curve Graph sample that follows, find the 5 minute interval (A) at the horizontal axis and read the corresponding points (B) and (C) on the vertical axis. The values are approximately +2.8% and -0.5%.This means that at the rate of 25 mL/hr the average maximum flow rate fluctuation for any 5 minute time interval during the 2nd hour of operation was within the limits of +2.8% and -0.5% from ENTERAL/HIGH VISCOSITY FLUIDSDextrose 20% to 50% concentrationIsomil PowderSimilac PowderEnsure Plus HNTwocal HNJevitysec09.fm Page 7 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 8 430-95597-001 (Rev. 06/05) 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.A trained professional can use the resulting graphs to select a infuserwith the appropriate startup and flow characteristics to suit the clinicalapplication.NOTE: As an example of how the trumpet curves can be used, consider the maximum and minimum deviations at the 5 minute average interval. The upper curve provides the maximum expected delivery rate error over a 5 minute interval, the lower curve provides the minimum expected delivery rate error over a 5 minute interval. An example would be Dopamine administered at 5 µgm/kg/min. At 5 minutes, the average drug delivery error would be within the range of +2.8% and -0.5% of the expected nominal rate.0510 15 20 25 3015.0%10.0%5.0%0.0%-5.0%-10.0%-15.0%25 ML/HR, 0 mm Hg DELIVERY HEAD, START UPPERCENT ERROR (%)Observation Interval (minutes)+++++Max Mean+MinAverage DeliveryRate Error = +1.6%ADMax Negative Error over 5Minute Interval = -0.5%CMax Positive Error over 5Minute Interval = +2.8%Bsec09.fm Page 8 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 925 ML/HR, 0 mm Hg DELIVERY HEAD, START UP(Typical)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Mean25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP(Typical)-10-5051015202530354045500 10 20 30 40 50 60 70 80 90 100 110 120Time (minutes)Rate (ml/hr)Actual RateProgrammed Rate25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP(Composite of 3 Pumps)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Meansec09.fm Page 9 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 10 430-95597-001 (Rev. 06/05) 25 ML/HR, 0 mm Hg DELIVERY HEAD , 96 HOURS(Typical)051015202530354045500 1020304050Time (minutes)Rate (ml/hr)Actual RateProgrammed Rate25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS(Typical)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Mean25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS(Composite of 3 Pumps)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Meansec09.fm Page 10 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 9- 111 ML/HR, 0 mm Hg DELIVERY HEAD, START UP(Typical)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Mean1 ML/HR, 0 mm Hg DELIVERY HEAD, START UP(Typical)-0.4-0.20.00.20.40.60.81.01.21.41.61.82.00 10 20 30 40 50 60 70 80 90 100 110 120Time (minutes)Rate (ml/hr)Actual Rate Programmed Rate1 ML/HR, 0 mm Hg DELIVERY HEAD, STARTUP(Composite of 3 Pumps)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Meansec09.fm Page 11 Wednesday, June 8, 2005 8:39 AM
For Systems With Hospira MedNetTM Software9- 12 430-95597-001 (Rev. 06/05) 1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS(Typical)0.00.20.40.60.81.01.21.41.61.82.00 1020304050Time (minutes)Rate (ml/hr)Actual Rate Programmed Rate1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS(Typical)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Mean1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS(Composite of 3 Pumps)-15.0%-10.0%-5.0%0.0%5.0%10.0%15.0%0 5 10 15 20 25 30Observation Interval (minutes)Percent Error (%)Max Min Meansec09.fm Page 12 Wednesday, June 8, 2005 8:39 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 10- 1SECTION 10Supplies and AccessoriesAdministration FluidsADMINISTRATION FLUIDS• All parenteral fluids• Whole Blood• Blood fractionsENTERAL AND HIGH VISCOSITY FLUIDS• Dextrose 20% to 50% concentration• Isomil Powder• Similac Powder• Ensure plus HN• TwoCal HN• Packed red cellsCONTAINERS• Dual Chamber Parenteral flexible container (Nutrimix)• Large Volume Parenteral flexible plastic containers, including premixed• Large Volume Parenteral glass containers, including premixed and nutritional• Part Fill Parenteral flexible plastic containers, including ADD-Vantage• Part Fill Parenteral glass containers• Small Volume Parenterals• Syringes (may require special adapters)• Top Filled Enteral bags• Ready to hang Enteral solution containerssec10.fm Page 1 Wednesday, June 8, 2005 8:41 AM
For Systems With Hospira MedNetTM Software10- 2 430-95597-001 (Rev. 06/05) AccessoriesGENERAL• Syringe Adapter- List# 11986-48• Mini Pole- List# 12096-04• Secondary Container Support- List# 12095-03• Tandem Carrier- List# 12270-01• Plum A+3 IV Pole (upright)- 12577-04-01• Plum A+3 IV Pole (base)- 12576-04-01NETWORKED APPLICATION• Hospira MedNetTM Medication Management Server Suite (MMSS)List# 20676-04• *Hospira MedNetTM Plug ‘n Play ModuleList# 20677* = For use with Hospira Plum A+ Infusers Lists 11971-04-03 & above, 12391-04, & 20679-04NOTE: Contact Technical Support Operations at 1-800-241-4002 for current listing of accessories.sec10.fm Page 2 Wednesday, June 8, 2005 8:41 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 11- 1SECTION 11WarrantySubject 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. Hospira makes no other warranties, express or implied, as to merchantability, fitness for a particular purpose, or any other matter.Purchaser's exclusive remedy shall be, at Hospira's option, the repair or replacement of the product. In no event shall Hospira's liability arising out of any cause whatsoever (whether such cause be based in contract, negligence, strict liability, other tort, or otherwise) exceed the price of such product, and in no event shall Hospira be liable for incidental, consequential, or special damages or losses or for lost business, revenues, or profits. Warranty product returned to Hospira must be properly packaged and sent freight prepaid.The foregoing warranty shall be void in the event the product has been misused, damaged, altered, or used other than in accordance with product manuals so as, in Hospira's judgment, to affect its stability or reliability, or in the event the serial number or lot number has been altered, effaced, or removed.The foregoing warranty shall also be void in the event any person, including the Purchaser, performs or attempts to perform any major repair or other service on the product without having been trained by an authorized representative of Hospira and using Hospira documentation and approved spare parts. For purposes of the preceding sentence, "major repair or other service" means any repair or service other than the sec11.fm Page 1 Wednesday, June 8, 2005 8:41 AM
For Systems With Hospira MedNetTM Software11- 2 430-95597-001 (Rev. 06/05) 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.sec11.fm Page 2 Wednesday, June 8, 2005 8:41 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 12- 1SECTION 12Default Drug Library (DDL)NOTE: This list is only accurate if no custom drug library has been developed using the Hospira MedNet accessory. Once a custom drug library has been developed, this list will no longer be accessable. Only Hospira personnel can re-install the DDL.Use drug manufacturer recommendations for IV administration when using the Plum A+ infusion infuser.DRUG NAMEDEFAULT DOSE RATEDEFAULT CONCENTRATIONNo Drug Selected mL/hr N/AAbciximab mcg/kg/min mg/mLAcyclovir mL/hr N/AAlbumin mL/hr N/AAldesleukin mL/hr N/AAlfentanil mcg/kg/min mcg/mLAlteplase (rt-PA) mg/kg/hr mg/mLAmikacin mL/hr N/AAminophylline mg/hr mg/mLAmiodarone mg/min mg/mLAmphotericin B mL/hr N/AAmpicillin mL/hr N/AAtracurium mL/hr N/AAzithromycin mL/hr N/ABleomycin mL/hr N/ABlood Products mL/hr N/ABretylium mg/min mg/mLCarboplatin mL/hr N/Asec12.fm Page 1 Wednesday, June 8, 2005 8:45 AM
For Systems With Hospira MedNetTM Software12- 2 430-95597-001 (Rev. 06/05) Cefazolin mL/hr N/ACefepime mL/hr N/ACefoPERAZONE mL/hr N/ACefoTAXIME mL/hr N/ACefoTETAN mL/hr N/ACefoXITIN mL/hr N/ACeftAZIDime mL/hr N/ACeftIZOXime mL/hr N/ACeftriaxone mL/hr N/ACefuroxime mL/hr N/ACimetidine mL/hr N/ACiprofloxacin mL/hr N/ACisplatin mL/hr N/AClindamycin mL/hr N/ACotrimoxazole mL/hr N/ACytarabine mL/hr N/ADiltiazem mg/hr mg/mLDOBUTamine mcg/kg/min mg/mLDocetaxel mL/hr N/ADOPamine mcg/kg/min mg/mLDOXOrubicin mL/hr N/AEpinephrine mcg/min mg/mLEpoprostenol ng/kg/min mg/mLEptifibatide mcg/kg/min mg/mLErythromycin mL/hr N/AEsmolol mcg/kg/min mg/mLEtoposide mL/hr N/AFamotidine mL/hr N/ADRUG NAMEDEFAULT DOSE RATEDEFAULT CONCENTRATIONsec12.fm Page 2 Wednesday, June 8, 2005 8:45 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05) 12- 3Fentanyl mL/hr N/AFluconazole mL/hr N/AFlumazenil mL/hr N/AFluorouracil mL/hr N/AFurosemide mL/hr N/AGatifloxacin mL/hr N/AGentamicin mL/hr N/AHeparin units/kg/hr units/mLHydromorphone mL/hr N/AIfosfamide mL/hr N/AInsulin units/hr units/mLLabetalol mg/min mg/mLLepirudin mg/kg/hr mg/mLLeucovorin mL/hr N/ALevofloxacin mL/hr N/ALidocaine mg/min grams/mLLorazepam mL/hr N/AMagnesium grams/hr grams/mLMannitol grams/hr grams/mLMesna mL/hr N/AMethoHEXITAL mL/hr N/AMethoTREXATE mL/hr N/AMetoclopramide mL/hr N/AMetronidazole mL/hr N/AMidazolam mL/hr N/AMilrinone mcg/kg/min mg/mLMorphine mg/hr mg/mLNafcillin mL/hr N/ADRUG NAMEDEFAULT DOSE RATEDEFAULT CONCENTRATIONsec12.fm Page 3 Wednesday, June 8, 2005 8:45 AM
For Systems With Hospira MedNetTM Software12- 4 430-95597-001 (Rev. 06/05) NitroGLYCERIN mcg/min mg/mLNitroPRUSSIDE mcg/kg/min mg/mLNorepinephrine mcg/min mg/mLOfloxacin mL/hr N/AOndansetron mL/hr N/AOxacillin mL/hr N/AOxytocin mUn/min units/mLPaclitaxel mL/hr N/APantoprazole mg/min mg/mLPenicillin mL/hr N/APentobarbital mL/hr N/APhenylephrine mcg/min mg/mLPiperacillin mL/hr N/APotassium mEq/hr mEq/mLProcainamide mg/min grams/mLPropofol mcg/kg/min mg/mLRanitidine mL/hr N/ASTREPTOkinase units/hr units/mLTheophylline mg/kg/hr mg/mLTicar-clavulanate mL/hr N/ATirofiban mcg/kg/min mg/mLTobramycin mL/hr N/AUROkinase mL/hr N/AVancomycin mL/hr N/AVerapamil mL/hr N/AVinCRIStine mL/hr N/ADRUG NAMEDEFAULT DOSE RATEDEFAULT CONCENTRATIONsec12.fm Page 4 Wednesday, June 8, 2005 8:45 AM
Plum A+® Infusion Systems430-95597-001 (Rev. 06/05)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:1-800-241-4002To order parts using the online eCatalog, download technical publications, technical training courses, and additional services, visit the website at:www.hospiraparts.comAfter authorization, ship prepaid product returns to the following address:Hospira, Inc.Technical Support Operations755 Jarvis DriveMorgan Hill, CA 95037Outside the U.S., contact your local Hospira, Inc. sales office.back.fm Page 1 Wednesday, June 8, 2005 8:49 AM
For Systems With Hospira MedNetTM Software430-95597-001 (Rev. 06/05) CAUTION: FEDERAL (USA) LAW RESTRICTS THIS INFUSER TOSALE BY OR ON THE ORDER OF A PHYSICIAN OR OTHER LICENSEDPRACTITIONER.WARNINGPOSSIBLE EXPLOSION HAZARD EXISTS IF THE INFUSERIS USED IN THE PRESENCE OF FLAMMABLEANESTHETICS.Plum A+ Infusion Pump is a registered trademark of Hospira, Inc.Hospira MedNet, LifeShield, and E.L.I. are trademarks ofHospira Incorporated. CLAVE, Teflon, Formula C, Manu-Klenz, SuperEdisonite, Coverage, Sporicidin, Dispatch, and Precise are nottrademarks of Hospira.®C USClass 1 Mains supply equipment using protective earthIPX1Drip ProofMedical Equipment Protected against dripping waterType CFEquipment providing adequate degree of protection againstelectrical shock and suitable for application to patientUL 60601-1CSA 601.1MCN 160992back.fm Page 2 Wednesday, June 8, 2005 8:49 AM

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