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Abbott Omniflow - Elite Medical Equipment

1. Household bleach Various Per hospital procedures do not exceed one part bleach in ten parts water Per manufacturer s recommendation use undiluted Manufactured for Abbott Laboratories LifeCare Germicidal Towelette subject to availability Omni Fiow 4000 Plus IV Medication Management System 8 1 430 06371 C04 Rev 8 96 SYMPTOM UNDEFINED PROBLEM THE SCREEN HAS AN UNREADABLE MESSAGE UNIT IS STUCK IN ONE FUNCTION I E FLUSH UNRESOLVED SYMPTOM 4000 PLUS PROBLEM COULD NOT BE RELATED TO CAUSE AND OR CORRECTIVE ACTION DID NOT RESOLVE SITUATION PRINTER OPTIONAL INOPERATIVE Omni Flow 4000 Plus IV Medication Management System PROBABLE CAUSE CASSETTE OR 4000 PLUS IS DAMAGED 4000 PLUS IS SUBJECTED TO AN EXCESSIVE ELECTROMAGNETIC FIELD OR ELECTROSTATIC DISCHARGE AND THE ELECTRONICS ARE DAMAGED RANDOM INTERNAL SYSTEM FAILURE PRINTER NOT SET UP CORRECTLY CABLING IS DAMAGED OR PRINTER IS DAMAGED 7 5 7 1 TROUBLESHOOTING GUIDE CORRECTIVE ACTION IF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM A CASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE 4000 PLUS CYCLE POWER TURN POWER OFF TURN POWER ON RESUME PREVIOUS PROGRAMMING AND
2. ALARM MESSAGE CORRECTIVE ACTION CASSETTE UNLOCKED POSSIBLE GRAVITY FLOW DEVICE SERVICE CODE SERVICE Tum power OFF then ON Restore REQUIRED previous programming and press RESUME then ENTER If failure repeats remove from service OCCLUSION IN PATIENT LINE Check patient line for closed clamp or kinks Note Low occlusion pressure settings may cause patient line occlusion alarms when infusing fluids through microbore tubing at higher rates FULL COLLECTION BAG OR Check all lines for closed clamps or kinks OCCLUSION ON LINE A Check fill capacity of collection bag Confirm IV bag is a minimum of 17 inches above the device AIR IN LINE OR OCCLUSION LINE A Check for air bubbles in cassette Check Line A for closed clamp or kinks Check IV container volume on Line A Confirm IV bag is a minimum of 17 inches above the device 430 0637 1 804 Rev 7 95 6 2 System Operating Manual 6 2 PUMPING ALARMS 6 2 PUMPING ALARMS The following table details conditions which may cause pumping alarms ALARM MESSAGE CORRECTIVE ACTION AJR IN LINE OR OCCLUSION Check for air in cassette Check alarm line Lines B C D for closed clamp or kinks Check IV container volume on alarm line Confirm IV bag is a minimum of 17 inches above the device UNABLE TO PUMP AT Check patient line for closed clamp or PROGRAMMED RATE kinks Check all lines for closed clamps or kinks Confirm IV bag is a minimum of 17 inches above the device
3. Omni Flow 4000 Plus IV Medication Management System 1 3 430 06371 004 Rev 4 93 Section 1 INTRODUCTION 1 4 2 INSPECTION Inspect the packing container for visible shipping damage Should any damage be found contact the delivering carrier immediately Freight claims or insurance claims must be filed within seven days Inspect the device for damage Do not use the device if it appears to be damaged contact the Abbott Laboratories Technical Service Center CAUTION If device appears to be damaged do not operate return for service Plug the power cord into a 110 120 volt AC outlet The device is ready for immediate AC use Do not operate the device on battery power until it has been plugged into an electrical outlet for at least 24 hours Locate the ON CHARGE switch on the back of the device and toggle the switch to the ON position Unlock the cassette locking lever and remove the shipping cassette See Section 3 5 Removing the Cassette from the Device for additional information on removing a cassette Discard the shipping cassette do not use 1 4 3 4000 PLUS SELF TEST Do not place the 4000 Plus in service until the self test has been conducted See Section 3 1 Setup Procedures for detailed information on the device self test 1 4 4 PRINTER SETUP The 4000 Plus allows the user to print history report information The device works with several serial printers The user should become thoroughly familiar with the syst
4. 1 0 to 99 9 mL hr Patient line occlusion alarm 1 to 12 psi in 1 psi increments Units of temperature degrees Centigrade or Fahrenheit Callbacks Local display of IV History Report on LCD Display SAFETY FEATURES The 4000 Plus maximizes safety and reliability with the following features m a The device automatically performs a self test of its electrical and mechanical components when the ON CHARGE switch is placed in the ON position If the ON CHARGE switch is turned to CHARGE during infusion the device retains the most recent programming and infusion data in a nonvolatile memory The data is reinstated during power up see Section 3 1 Setup Procedures The device maintains duplicate programming memory If the duplicate programming information does not match the device alarms A two step procedure is required to remove the cassette from the device To change pumping instructions rates volume stopping lines two keys must be pressed in order A comprehensive self test identifies a variety of potential malfunctions within the device cassette and interface This 36 second cassette test is activated every time the PRIME PATIENT LINE ENTER key sequence is pressed Note The user can bypass the cassette test however Abbott Laboratories recommends the routine use of this test 430 0637 1 004 Rev 4 93 1 2 System Operating Manual 1 3 WARNINGS CAUTIONS AND NOTES 1 3 WARNINGS CAUTIONS AND NOTES
5. 4 2 CONTINUOUS INFUSIONS 4 2 2 2 CHANGING AN ALTERNATE UNIT OF MEASURE INFUSION To change an alternate unit of measure infusion MCG KG MIN proceed as follows 1 ES Press the CONTINUOUS INFUSION key for the line used For example when using line B the following screen is displayed B gt RATE 16 9ML HR VOL 250ML WT 75 0KG 3 00MCG KG MIN 200MG IN 250ML ENTER Since the line has previously been programmed in Alternate units of Measure the cursor will appear in the MCG KG MIN field Confirm that global body weight is to remain unchanged Note If programming in MCG MIN is desired enter a body weight of one 1 Enter new MCG KG MIN rate Use the NEXT key to move the cursor to the MG field and enter the medication dose Use the NEXT key to move the cursor to the ML field Enter the diluent volume Note If no entry is made in the Volume field the volume entered in the ML field becomes the default container volume Note The calculated delivery rate in ML HR appears in the ML HR Rate field To start the infusion press the ENTER key The following screen is displayed A INF B ON C OFF D OFF TOTAL 12 30PM 35 0 16 9 0 0 51 9 ML HR In this example the base screen shows Line A has been programmed as a maintenance at 35 mL hr Line B runs at 16 9 mL hr in a continuous mode of operation and continues until stopped The mL hr rate for Line B is the calculated result of the MCG KG MIN program
6. At power on the device performs its self test diagnostics The self test lasts approximately six seconds during which time the screen displays the following message gt gt gt gt gt gt gt gt SELF TEST IN PROGRESS lt lt lt lt lt lt lt ABBOTT 4000 PLUS Upon successful completion of the self test the Restore Previous Programming screen displays the following setup questions RESTORE PREVIOUS PROGRAMMING Y N NO CLEAR IV HISTORY Y N NO CENTER Omni Flow 4000 Plus IV Medication Management System 3 1 430 06371 B04 Rev 7 95 Section 3 SETUP Note The Restore Previous Programming screen displays two setup questions Select YES or NO to each query before pressing the ENTER key The ENTER key enters all setup instructions into device memory 3 1 1 RESTORE PREVIOUS PROGRAMMING To restore previous programming at the Restore Previous Programming screen proceed as follows 1 Select YES to Restore Previous Programming Y N Previous programming is restored to the device When YES is selected to Restore Previous Programming Y N the following data is restored Q IV Flow Sheet A Line Programming Any lines that were not OFF are put on HLD 2 Select NO to Clear IV History Y N Previous IV history is retained Note Select YES to Clear IV History Y N to remove previous patient IV history 3 Press the ENTER key to enter all setup instructions into device memory Note During a power shut down programmed start tim
7. DB 9 connector set to 9600 baud Note RS 232 DB 25 connector not active on some models Cassette Unlocked Air In Line Upstream Occlusion Occlusion in Patient Line Possible Empty Container Low Battery Voltage Possible Faulty Cassette Callback Requested Device Failure Service Required Unable to Pump at Programmed Rate Possible Full Collection Bag Transfer to Battery Operation Communications Fault Preset at 10 psi User selectable from 1 12 psi 12 2 System Operating Manual mE Section 13 KEYPAD DESCRIPTION Section 13 describes the front panel of the 4000 Plus 10 11 12 13 14 Omni Flow 4000 Plus IV Medication Management System 13 1 430 0637 1 004 Rev 4 93 DISPLAY SCREEN The 80 character backlit liquid crystal display provides instructions programming information alarm messages and status information NUMERIC KEYS 0 9 Use these keys to input infusion rates volumes and times PRINT KEY Press this key to print either the IV Flow Sheet or the IV History selected with SPECIAL FUNCTION I7 SPECIAL FUNCTION KEY Press this key followed by the appropriate numeric key to access any of the special functions IV FLOW SHEET KEY Press this key to display a running total of the volume infused on each of the lines and the total volume for all four lines PRIME CASSETTE KEY Press and hold this key to clear air from the upstream tubing and the cassette into t
8. ON CHARGE SWITCH ALARM VOLUME KNOB EQUIPOTENTIAL POST SOME MODELS POWER CORD NURSE CALL WARNING LABEL 93044001 430 0637 1 004 Rev 4 93 IA Section 2 EQUIPMENT DESCRIPTION The 4000 Plus incorporates a number of programming aids to simplify the setup and operation of the device While performing setup or programming functions it may be helpful to refer to Section 13 Keypad Description Figure 13 1 4000 Plus Front View details the keypad Note In text references to device keypad are shown in uppercase letters corresponding text on keypad may be in lowercase letters Note Figures are rendered as graphic representations to approximate actual product therefore figures may not reflect the product exactly 2 1 BACKLIT DISPLAY SCREEN The 80 character display screen is backlit to aid visibility in dim or dark areas The light comes on and stays on for two minutes when any key on the keypad is pressed The display screen provides prompting messages programming information infusion status information and alarm messages to aid in the setup and use of the device 2 2 ESCAPE FUNCTION The ESCAPE key can be utilized any time the user is unsure of the next step or is unable to exit a particular display screen Press the ESCAPE key to return the display to the base screen and restart a programming sequence 2 3 BASE SCREEN The base screen appears during the normal device operation and shows which lin
9. 004 Rev 4 93 4 8 System Operating Manual 4 3 INTERMITTENT INFUSIONS To answer YES to any of the queries Callback Y N Syringe Y N or Dilution Y N press the NEXT key to move to the desired field Press the YES NO key to change the selection When selections are correct proceed to Step 7 CALLBACK To be called to the device each time the line starts and stops select YES to Callback Y N When called to the device stop the alarm by pressing the MUTE key twice Callback can be canceled in two ways stop the line re enter the screen and select NO to Callback Y N or use SPECIAL FUNCTIONI 5 see Section 5 4 Special Functions for more information about use of special functions SYRINGE If infusing directly from a syringe select YES to Syringe Y N Note Failure to select YES to Syringe Y N may cause an occlusion alarm due to a sticking syringe plunger DILUTION To dilute a concentrated medication with the solution running on Line A select YES to Dilution Y N All dilutions are made with the solution on Line A The only infusions that can be programmed for dilution are intermittent infusions B C or D The screens necessary to perform a dilution are accessible during the programming of an intermittent infusion If YES is selected to Dilution Y N press the ENTER key The following screen is displayed DILUTION VOLUME OML FROM LINE A DILUTION RATE OML HR CENTER Input either a per dose dilution volume or a dil
10. 4 Use the NEXT key to position the cursor in the maximum occlusion pressure field Maximum occlusion pressure thresholds from 1 to 12 psi can be selected in 1 psi increment Note The maximum occlusion pressure threshold is the pressure at which the device reports a patient line occlusion See Section 6 Alarm Conditions and Displays for further information regarding alarms KVO RATE 1 0 ML HR MAX OCCLUSION 10 PSI ENTER 430 0637 1 B04 Rev 7 95 5 8 System Operating Manual 5 4 SPECIAL FUNCTIONS 5 The default values set at the factory are 1 0 mL hr for KVO rate and 10 psi for maximum occlusion pressure Press the ENTER key to accept these values Note Two asterisks appear in the lower right corner of the base screen to indicate that either of these default values has changed The following screen is displayed ENABLE ALL CALLBACKS Y N NO TEMPERATURE UNITS C NO F YES ENTER 6 Use the YES NO key to toggle the desired default Select YES to Enable All Callbacks Y N and the 4000 Plus will callback after any line stops starts or intermittent delivery is completed 7 Press the NEXT key to position the cursor over the Temperature Units C NO F YES Use the YES NO key to toggle the desired units of temperature 8 Press ENTER to accept the values displayed The values are retained in memory Note Values are preserved when the device power is cycled and the memory is checked when the device is powered ON I
11. INFUSIONS ees 4 2 4 2 1 ML HRINFUSIONS e 4 2 4 2 1 1 PROGRAMMING OR CHANGING AN ML HR INFUSION 4 2 4 2 1 2 CHANGING AN ML HR INFUSION TO AN ALTERNATE UNIT OF MEASURE INFUSION 4 3 4 2 2 ALTERNATE UNITS OF MEASURE MCG KG MIN INFUSIONS 4 4 4 2 2 1 PROGRAMMING A NEW ALTERNATE UNIT OF MEASURE INFUSION 4 4 4 2 2 2 CHANGING AN ALTERNATE UNIT OF MEASURE INFUSION 4 5 4 2 2 3 CHANGING AN ALTERNATE UNIT OF MEASURE INFUSION TO ML HR INFUSION 4 5 4 2 3 CHANGING THE GLOBAL BODY WEIGHT 4 6 4 2 4 CONCURRENT FLOW 4 7 43 INTERMITTENT INFUSIONS ees 4 8 Section 5 ADDITIONAL OPERATING FEATURES e 5 1 5 1 TO STOP ANY OF THE LINES 2 eee ee ee es 5 1 5 2 HOLD AND RESUME FUNCTIONS eee ees 5 2 5 2 1 HOLD INDIVIDUAL LINES OR ALL LINES 5 2 5 2 2 RESUME INFUSIONS AFTER HOLD 5 3 5 3 LINE STATUS FUNCTION 2 ee ee eee et tes 5 3 5 4 SPECIAL FUNCTIONS aasa 2 eee et ee es 5 4 5 4 1 DESCRIPTION OF SPECIAL FUNCTIONS 5 5 5 5 AUTOMATIC AIR DETECTION AND ELIMINATION 5 11 5 6 EMPTYING THE COLLECTION BAG 2 2 ee ee et tes 5 11 5 7 BATTERY OPERATION 022 2 ee ee ee ee et ts 5 12 5 8 ACCESSING HISTORY REPO
12. MUTE CAUTION If the LOW BATTERY alarm sounds connect the device to AC power immediately Press the MUTE key to silence the audible alarm for two minutes After two minutes the warning screen and alarm tone return The device should not be operated on battery power after the LOW BATTERY alarm sounds When the battery can no longer provide the necessary power to support the device operation ceases Recharging occurs any time the device is connected to AC power It takes 24 hours to fully recharge the battery pack when device operation has stopped The ON CHARGE switch does not have to be in the ON position for the battery pack to recharge It is strongly recommended that the 4000 Plus be connected to AC power whenever possible to ensure a fully charged battery pack is available for patient ambulation or emergency power outage conditions If the device is used frequently for portable operation battery life may be significantly reduced and battery alarms may increase Reduced battery life also increases the battery recharge time As a general rule the more often the battery is discharged and recharged the sooner it need to be replaced Leaving the battery in a less than a fully charged state for any period of time is a primary cause of damage Battery damage can occur in a matter of hours resulting in a permanent loss of battery capacity Note A permanently damaged battery cannot be recharged to full capacity 430 0637 1 B04 Rev 7
13. Note Pending alarms must be cleared before reprogramming over Line A if an error or alarm causes Line A to revert to KVO 6 3 WARNING ALARMS The following table details conditions which may cause warning alarms CORRECTIVE ACTION POSSIBLE EMPTY CONTAINER NONE Check bag or syringe volume LOW BATTERY WARNING Connect device to AC power and recharge device for a minimum of 24 hours MUTE HOLD TIME EXCEEDED RESUME or STOP tor all lines on hold WARNING POSSIBLE FAULTY CASSETTE Reprime cassette and repeat test If alarm recurs replace cassette and repeat CASSETTE TEST TIMEOUT cassette test Omni Flow 4000 Plus IV Medication Management System 6 3 430 06371 B04 Rev 7 95 ALARM MESSAGE Press ENTER to repeat test Press ESCAPE to abort test Irene Section 7 TROUBLESHOOTING Certain system operating conditions do not result in audible alarms however if not corrected these conditions could cause device malfunction These operating conditions are easily identifiable and correctable Refer to the Troubleshooting Guide for detailed information regarding no alarm operating symptoms probable causes and corrective actions 7 1 TROUBLESHOOTING GUIDE The following table identifies probable causes specific to overdelivery or underdelivery in italics Omni Fiow 4000 Plus IV Medication Management System 7 1 430 0637 1 004 Rev 4 93 Section 7 TROUBLESHOOTING SYMPTOM SUSPECTED OVE
14. RESTART INFUSION IF THE RESTART DOES NOT CLEAR THE PROBLEM REMOVE THE 4000 PLUS FOR SERVICING IF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM ACASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE DEVICE REFER TO PRINTER OPERATING MANUAL FOR TROUBLESHOOTING AND PRODUCT SERVICING INFORMATION CONFIRM PAPER IS LOADED POWER IS ON AND PRINTER IS ON LINE 430 0637 1 004 Rev 4 93 Section 9 WARNINGS CAUTIONS AND PRECAUTIONS Section 9 is a comprehensive listing of the warnings cautions and precautions detailed throughout this manual 9 1 WARNINGS Warnings contain special safety emphasis and must be observed at all times Failure to observe a warning is potentially life threatening a O a Product damage may occur unless proper care is exercised during the unpacking and installation process The battery pack may not be fully charged upon receipt Do not place the device in service if it fails the self test Do not connect line to patient while priming patient line Removing cassette from device without closing line clamps may result in unrestricted flow All clamps must be closed to prevent flow to patient and or mixing of drugs Continuous infusions are
15. an air in line alarm See Section 6 Alarm Conditions and Displays for information on this alarm condition Note If air in line or upstream occlusion occurs on Line B C or D only the affected line is placed on hold HLD If no other lines are infusing Line A infuses at the selected KVO rate If the upstream occlusion is detected on Line A all the lines currently infusing are put on hold Subsequent intermittent infusions change from programmed PGM to delayed DLY Note If air has entered the cassette from a completely empty container the device puts the line on hold and activates an air in line alarm If the hold occurs on Line A all lines go into the hold state CAUTION When infusing short half life drugs at a low flow rate automatic air elimination interrupts the delivery of medication to the patient This medication interruption is dependent upon the infusion rate and may cause a change in patient parameters 5 6 EMPTYING THE COLLECTION BAG It is important that during device operation the collection bag be checked periodically and emptied or changed if necessary The collection bag should be changed or emptied if more than half full or bulging Should the collection bag be completely filled during pumping the following alarm condition results POSSIBLE FULL COLLECTION BAG OR OCCLUSION LINE A RESUME Omni Flow 4000 Plus IV Medication Management System 5 11 430 0637 1 004 Rev 4 93 Section 5 ADDITIONAL OPERATING
16. and time 3 Upon data entry completion press the ENTER key The KVO Rate screen is displayed KVO RATE 1 0ML HR MAX OCCLUSION 10PSI ENTER 4 Confirm that the correct information displays on the KVO Rate screen 5 If the default values are to be changed use the NEXT and LAST keys to position the cursor aS appropriate Enter values for KVO and Maximum Patient Line Occlusion Pressure The values entered become the default settings for the device Note Default settings remain in device memory when the device is turned off or on Omni Flow 4000 Plus IV Medication Management System 3 3 430 06371 A04 Rev 4 94 Section 3 SETUP 6 Press the ENTER key to accept the default values The Enable All Callbacks screen is displayed ENABLE ALL CALLBACKS Y N NO TEMPERATURE UNITS C NO F YES ENTER 7 Determine if the default settings shown on the Enable All Callbacks screen are appropriate 8 To change the Callbacks or Temperature Units option use the NEXT and LAST keys to position the cursor as appropriate Press the YES NO key to toggle to the desired setting 9 Press the ENTER key The Insert Cassette and Lock in Place screen is displayed INSERT CASSETTE AND LOCK IN PLACE 30 OCT 92 PRESS ENTER 11 30 AM 3 2 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET To prime the 4000 Plus with a primary administration set proceed as follows 1 Select the desired Omni Flow Primary Set Remove set from package
17. close the upper clamp for Line A and confirm that all luer lock connections on cassette are secure CAUTION Use only Abbott Omni Flow Primary Sets on the device Refer to the administration package insert for complete instructions 2 Prepare IV container close all clamps remove spike protector insert spike through outlet hole in container and squeeze drip chamber to adjust fluid level until approximately half full Hang the container 3 Confirm fluid level is correct Grasp cassette so that the collection bag and patient line are at the top and the luer lock connectors are pointing to the right 4 Confirm that the ON CHARGE switch is ON and the cassette lever is in the unlocked position Insert cassette into holster located along the right side of device see Figure 3 1 Inserting the Cassette Slowly turn the cassette locking lever to the locked position The cassette is locked in place To secure press down on the cassette lever see Figure 3 2 Locking the Cassette in Place 430 0637 1 A04 Rev 4 94 3 4 System Operating Manual 3 2 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET CAUTION Turn the cassette locking lever slowly to lock cassette in place Note Confirm the cassette locking lever is in the locked position The cassette lever must be locked in place and properly secured before any operation can continue 5 Open all clamps on the set and confirm no fluid is flowing in drip chamber Attach collection bag to ha
18. default response is YES 2 Press the YES NO key to select or deselect the preprogram function Press the ENTER key again to return to the base screen Note When selected all lines and subsequent programming are placed in a hold condition as each line of programming is completed A hold condition is indicated as follows HLD for continuous infusions DLY for intermittent infusions PGM for a maintenance infusion The hold condition remains in effect without the usual two minute warning for lines on hold The preprogram function should only be selected when all lines including patient line are primed If at least one infusion has already been programmed the preprogram function can be deselected by stopping all lines If no infusions have been programmed SPECIAL FUNCTIONI 8 must be used to deselect preprogram mode 3 To initiate infusion once lines have been preprogrammed press the RESUME key then the ENTER key SPECIAL FUNCTION 9 Records IV Flow Sheet data into IV History and clears the IV Flow Sheet To record IV Flow Sheet data into IV History and clear the IV Flow Sheet proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 9 CLEAR IV FLOW SHEET CENTER 2 To clear the IV Flow Sheet press the ENTER key SPECIAL FUNCTION AM PM Prints IV Flow Sheet requires AC power To print the IV Flow Sheet proceed as follows 1 Press the SPECIAL FUNCTION key followed by the AM PM ke
19. listings 430 0637 1 A04 Rev 4 94 11 2 System Operating Manual Ey Section 12 SPECIFICATIONS Pumping Mechanism Dimensions Weight Power Requirements Fuse AC Line Leakage Plug Case Material Battery Type Battery Life Battery Pack Recharge Time Omni Flow 4000 Plus IV Medication Management System 12 1 Piston Diaphragm Height 11 1 4 inches Width 12 inches Depth 7 1 2 inches Approximately 15 Ibs 50 Watts 120 VAC 50 60 Hz Slow blow 0 6 A 250 VAC Less than 20 Micro Amps Hospital Grade 3 pin Structural Foam 12 Volt Sealed Lead Acid Rechargeable 5 hours at 125 mL hr Low Battery alarm activated with 30 minutes of battery life remaining 24 hours with device OFF 430 06371 A04 Rev 4 94 Section 12 SPECIFICATIONS Delivery Rate Range Container Volume and Dose Range KVO Rate Fluid Types Nurse Call Jack External Communications Occlusion Pressure 430 0637 1 A04 Rev 4 94 1 0 mL 100 mL per hour in 0 1 mL hr increments up to 100 mL then in 1 mL hr increments from 100 700 mL hr 600 mL hr maximum for 3 4 lines 500 mL hr maximum for single line with syringe 1 0 mL 3000 mL in 1 mL increments up to 100 mL then in 1 mL increments from 100 3000 mL Preset at 1 0 mL hr Selectable from 1 0 mL 99 9 mL per hour All standard IV fluids including lipid emulsions blood and packed cells 1 4 inch phono jack RS 232
20. operating in the continuous mode press the CONTINUOUS INFUSION key Use the NEXT and LAST keys to move the cursor to the desired field that requires a change Any change may be made while the line is operating there is no need to stop the flow After making a change press the ENTER key and the device begins operating at the new rate and or volume immediately Note Continuous infusions may not be programmed over Maintenance or Intermittent infusions without first stopping the Maintenance or Intermittent infusion Note Concurrent flow exists when two or more drugs are given simultaneously see Section 4 2 4 Concurrent Flow Note Continuous infusions are rate specific and alarm when dose is complete The infusion does not stop The device keeps pumping at programmed rate and does not go to KVO 4 2 1 ML HR INFUSIONS The following sections detail the required steps to program an mL hr infusion and the steps to change an mL hr infusion 4 2 1 1 PROGRAMMING OR CHANGING AN ML HR INFUSION To program a new mL hr infusion or change an existing mL hr infusion proceed as follows 1 Press the CONTINUOUS INFUSION key for the line used The following screen is displayed B gt RATE OML HR VOL OML WT OKG OMCG KG MIN OMG IN OML ENTER Note If CONTINUOUS INFUSION was pressed in error or there is a need to begin again press the ESCAPE key to return to the base screen 2 The cursor appears in the RATE field Enter the de
21. rate specific and alarm when dose is complete The infusion does not stop The device keeps pumping at programmed rate and does not go to KVO When administering critical medications monitor device performance frequently The use of the callback feature is recommended for intermittent infusions dilutions and flushes Callback allows confirmation of successful completion of the intended therapy Near the end of an intermittent infusion with dilution a small amount of medication may be delivered without being diluted The dilution from line A may complete before the medication Medication that could potentially cause patient harm if delivered undiluted e g potassium chloride should be diluted appropriately before administration Repeated operation of device to low battery condition affects charge capacity of the battery pack Deep battery discharge may render the battery pack unusable A possible explosion hazard exists if the device is used in the presence of flammable anesthetics Arrange tubing cords and cables to minimize the risk of patient strangulation or entanglement Omni Flow 4000 Plus iV Medication Management System 9 1 430 06371 A04 Rev 4 94 Section 9 WARNINGS CAUTIONS AND PRECAUTIONS 9 2 CAUTIONS A caution usually appears in front of a procedure or statement It contains information that could prevent irreversible damage or hardware failure Neglecting to pay attention to a caution could result in serious inju
22. to the device as a line is starting and when it stops This feature can only be used with intermittent infusions B C or D The feature can be selected during the programming of each of those lines To select or cancel intermittent mode CALLBACK proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 5 PROGRAM CALLBACKS Y N B NO C NO D NO CENTER 2 Press the YES NO key then press the NEXT and LAST keys to either select or deselect a CALLBACK on a line by line basis 3 Press the ENTER key to return to the base screen SPECIAL FUNCTION 6 Selects or changes preset values The device maintains preset values when powered down To select or change preset values proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 6 The following screen is displayed RESET TO MANUFACTURER S SETTINGS Y N N CENTER 2 To reset the KVO rate maximum occlusion pressure enable callbacks and set temperature units to manufacturer s factory settings use the YES NO key to toggle the desired response If YES is selected press ENTER to reset the values and return to the base screen Otherwise press ENTER and proceed to Step 3 3 Use the numeric keys to adjust the KVO rate from 1 0 to 99 9 mL hr Note The device delivers at the KVO rate as a result of certain alarm conditions See Section 6 Alarm Conditions and Displays for further information regarding alarms
23. 2 INITIATE NEW PROGRAMMING ee ee eee 3 2 3 1 3 RESPONSE TO LOW BATTERY CONDITION 3 3 3 2 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET 3 4 3 2 1 CASSETTE PRIMING MODES 3 6 3 2 1 1 CASSETTE POWER PRIME LINEA 3 6 3 2 1 2 GRAVITY PRIME ee ee 3 6 3 2 2 PRIMING THE CASSETTE 0202 ee eee 3 6 3 2 3 PATIENT LINE PRIMING MODES 25 3 7 3 2 3 1 PATIENT LINE POWER PRIME 3 7 3 2 3 2 PATIENT LINE GRAVITY PRIME ees 3 7 3 2 4 PRIMING THE PATIENT LINE e eee 3 7 3 25 CASSETTE TEST oror ria So ee ee RO es we a a 3 8 3 2 5 1 CASSETTE TEST FAILED 3 8 3 2 5 2 CASSETTE TEST SATISFACTORY 3 9 3 3 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET WITH GRAVITY FLOW PREVENTION VALVE e eee 3 9 3 4 PRIMING PROCEDURES SECONDARY ADMINISTRATION SET 3 10 3 5 CONNECTING A SYRINGE TO THE CASSETTE 3 11 3 6 CONNECTING A SYRINGE AND SYRINGE ADAPTOR TO THE CASSETTE 3 12 3 7 REMOVING THE CASSETTE FROM THE DEVICE 2 3 13 Omni Flow 4000 Plus IV Medication Management System iii 430 0637 1 004 Rev 4 93 Contents Section 4 PROGRAMMING e e 2 ee ee ee ee ee ee ee te ee 4 1 4 1 MAINTENANCE INFUSIONS eee eee ee ees 4 1 4 2 CONTINUOUS
24. 95 12 System Operating Manual 5 8 ACCESSING HISTORY REPORTS CAUTION Do not operate a device with an insufficiently charged or depleted battery pack If the device should be disconnected or if power fails an insufficiently charged battery pack may not maintain device operation Connect the device to AC power whenever practicable to assure maximum battery capacity during patient transport or ambulation WARNING REPEATED OPERATION OF DEVICE TO LOW BATTERY CONDITION AFFECTS CHARGE CAPACITY OF THE BATTERY PACK DEEP BATTERY DISCHARGE MAY RENDER THE BATTERY PACK UNUSABLE ce 5 8 ACCESSING HISTORY REPORTS Section 5 8 provides information on accessing history reports with and without a printer 5 8 1 ACCESSING HISTORY REPORTS WITHOUT A PRINTER History reports may be accessed without a printer through the use of the IV Flow Sheet The 4000 Plus tracks the total volume infused on each line and the cumulative total Access to these totals is obtained by pressing the IV FLOW SHEET key The following screen is displayed A LOG B LOG C LOG D LOG TOTAL EDIT NO 350 75 0 0 25 0 450 CENTER To clear the entry of a specific line or the cumulative total proceed as follows 1 To edit line values press the YES NO key in the Edit field 2 Use the NEXT key to position the cursor to clear each desired line and the total 3 Press the CLEAR ENTRY key Move cursor to next line and repeat Clearing the individual lines does
25. AMI mll gt Wi i nz FLOUE m om aia mem pp ge 400 IV Medication Management System For use with list 40051 04 System Operating Manual C Abbott Laboratories VERSION North Chicago IL 60064 sA 11 a 430 0637 1 C04 Rev 8 96 s s ERIE Contents Section 1 INTRODUCTION bi Whe A A Bick i es Ea Ad 1 1 1 1 FEATURES OF THE IV MEDICATION MANAGEMENT SYSTEM 1 1 1 2 SAFETY FEATURES coa a a A e AS 1 2 1 3 WARNINGS CAUTIONS AND NOTES o 1 3 1 4 INSTRUMENT INSTALLATION PROCEDURES 2 1 3 1 4 1 UNPACKING INSTRUCTIONS see 1 3 142 INSPECTION a a Bre A ra e a a 1 4 1 4 3 4000 PLUS SELF TEST ee eee 1 4 1 4 4 PRINTERSETUP ee eee eens 1 4 Section 2 EQUIPMENT DESCRIPTION o 2 1 2 1 BACKLIT DISPLAY SCREEN 2 1 2 2 ESCAPE FUNCTION teen 2 1 2 3 BASE SCREEN ety rs a Soe a a a wh 2 1 2 4 PROGRAMMING INPUT INDICATOR CURSOR e665 2 2 2 5 LED STATUS INDICATORS ee ee ee es 2 3 2 6 NOTATION AREAS e 0 2 3 9 7 PRINTERS o a a dd a Bee Fee a Se 2 4 Section 3 SETUP vu tira jain Gace a Meh a ae Se a T A A eet Y 3 1 3 1 SETUP PROCEDURES eee ee eee o 3 1 3 1 1 RESTORE PREVIOUS PROGRAMMING eee 3 2 3 1
26. DAMAGED AND DEVICE CASSETTE VALVE INTERFACE IS NOT CLOSING DURING DEVICE DELIVERY STROKE LUER CONNECTIONS ARE NOT PROPERLY SEATED FLUID SPILL ACCUMULATIONS CAUSE VALVES TO FUNCTION IMPROPERLY SECONDARY TUBING IS RESTRICTING FLUID FLOW 7 3 7 1 TROUBLESHOOTING GUIDE CORRECTIVE ACTION CLOSE TUBING CLAMPS ON ALL LINES RESULTS IF MORE THAN ONE LINE IS OPEN IN GRAVITY MODE IF DAMAGE IS SUSPECTED TO THE CASSETTE REPLACE CASSETTE IF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM A CASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE 4000 PLUS IF FLUID SPILL ACCUMULATION IS A PROBABLE CAUSE OF MALFUNCTION REPLACE DEVICE AFTER A FLUID SPILL REMOVE DEVICE AS SOON AS POSSIBLE TO PERMIT CLEANING CHECK TO ENSURE THAT LUER CONNECTIONS ARE SECURE iF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM A CASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE 4000 PLUS CHECK TO ENSURE THAT LUER CONNECTIONS ARE SECURE IF FLUID SPILL ACCUMULATI
27. E DD MMM YY 21 FEB 92 ENTER Note To display military 24 hour time press the NEXT key then press the YES NO key 4 Set the date month and year by pressing the appropriate numeric key Use the LAST and NEXT keys to position the cursor in the required field CURRENT TIME 10 00 AM 24HR TIME Y N NO DATE DD MMM YY 21 FEB 92 ENTER After setting time and date the display screen appears as follows CURRENT TIME 11 00 AM 24HR TIME Y N NO DATE DD MMM YY 20 MAR 92 ENTER 5 Press the ENTER key and the base screen is displayed A OFF B OFF C OFF D OFF TOTAL 11 00AM 0 0 0 0 0 ML HR Note If the battery pack has become fully discharged cycle the device Toggle the ON CHARGE switch to CHARGE then ON Reset the time with the SPECIAL FUNCTION 1 keys The internal self check of the real time clock may have been missed while the battery pack was depleted 430 06371 004 Rev 4 93 5 6 System Operating Manual Section 5 ADDITIONAL OPERATING FEATURES 3 To restart any line press the infusion type key for the line Press the ENTER key to page through and review the programming screens Make changes as each screen is reviewed Note If a flush is programmed to occur after an intermittent infusion and all lines are stopped using the SPECIAL FUNCTION 4 key the flush will not start SPECIAL FUNCTION 5 Selects or cancels intermittent mode CALLBACK The 4000 Plus has the capability to call the user
28. FEATURES To empty the collection bag proceed as follows 1 Close the collection bag tubing clamp 2 Carefully remove the collection bag line from the cassette by turning the luer lock connector counterclockwise 3 Dispose of the collected fluid as prescribed by hospital policy The collection bag may be re used if permitted by hospital policy by opening the tubing clamp and gently squeezing and emptying the contents 4 Althoughit is recommended that the collection bag be replaced it may be reused Connect the collection bag line to the cassette by turning the luer lock connector clockwise Open the tubing clamp and hang the collection bag on the collection bag hanger 5 7 BATTERY OPERATION Note Prior to placing the device in service fully recharge the battery by connecting the device to AC power for at least 24 hours The 4000 Plus is intended to be used on battery power only for emergency backup i e AC power failure or inadvertent disconnection from AC power or temporary portable operation i e patient moving from one location to another The yellow battery indicator illuminates when the device is operating on battery power The 4000 Plus can operate on battery power for up to five hours at a cumulative delivery rate of 125 mL hr Approximately 30 minutes prior to battery pack depletion a LOW BATTERY alarm sounds and a Warning screen is displayed WARNING LOW BATTERY PLUG POWER CORD INTO ELECTRICAL OUTLET OR
29. ING OF DRUGS To remove a cassette from the 4000 Plus proceed as follows 1 Confirm that the ON CHARGE switch is ON and all lines are OFF 2 Close clamps on all lines to prevent free flow and or mixing of drugs 3 Lift cassette locking lever and turn counterclockwise Allow approximately 3 seconds for the piston to retract 4 Pull cassette from holster If a cassette becomes jammed or a Pump Service Code 0800 occurs while inserting or removing the cassette proceed as follows Cycle the device power Toggle the ON CHARGE switch to CHARGE then ON Push the cassette completely down in the holster until it is securely seated Confirm the self test completes Proceed with programming gt Y NA Omni Flow 4000 Plus IV Medication Management System 3 13 430 06371 A04 Rev 4 94 BENE Section 4 PROGRAMMING When programming the 4000 Plus listen for the device response audible confirmatory beep during programming CAUTION After programming the device ensure that pumping has begun by verifying flow into the drip chamber on each appropriate fill stroke for each line in use 4 1 MAINTENANCE INFUSIONS The 4000 Plus can infuse on Line A in either the continuous mode of operation device continues to deliver when an intermittent line is infusing or in the maintenance mode device stops delivering when an intermittent line is infusing and restarts when the intermittent line stops infusing If an intermittent with d
30. Inserting the Cassette Slowly turn the cassette locking lever to the locked position The cassette is locked in place To secure press down on the cassette lever see Figure 3 2 Locking the Cassette in Place Omni Flow 4000 Plus IV Medication Management System 3 9 430 06371 A04 Rev 4 94 Section 3 SETUP 10 11 12 13 CAUTION Turn the cassette locking lever slowly to lock cassette in place Note Confirm the cassette locking lever is in the locked position The cassette lever must be locked in place and properly secured before any operation can continue Open all clamps on the set and confirm no fluid is flowing in drip chamber Attach collection bag to hanger located on the bottom right corner of the device see Figure 1 1 4000 Plus Rear Vieu Prime the cassette using the Line A PRIME CASSETTE key until all air is cleared from the cassette into the collection bag Press the ENTER key Attach any extension set or other devices to the gravity flow prevention valve located at the distal end of the patient line do not attach to a venipuncture device Press the Line A PRIME PATIENT LINE key to power prime the patient line The gravity flow prevention valve prevents gravity prime mode from priming the patient line Note If additional power primes are needed to prime the patient line repeat Steps 9 and 10 until primed Press the ESCAPE key When the Cassette Test Screen displays enter YES to byp
31. MING 93074001 Figure 3 3 Syringe Connected to the Cassette Omni Flow 4000 Plus IV Medication Management System 3 11 430 06371 A04 Rev 4 94 Section 3 SETUP 3 6 CONNECTING A SYRINGE AND SYRINGE ADAPTOR TO THE CASSETTE A syringe adaptor serves to vent the syringe making it less susceptible to plunger stopper resistance When programming the 4000 Plus and using the syringe adaptor it is recommended that the Syringe option be set to NO To attach a syringe and syringe adaptor to the cassette proceed as follows 1 2 3 4 5 Prepare the syringe using aseptic technique Attach the adapter to the syringe see Figure 3 4 Connecting Syringe and Syringe Adaptor to Cassette Attach an Omni Flow compatible stop cock or a syringe support elbow to the adaptor see Figure 3 4 Prime the adaptor and stop cock syringe support elbow Remove the luer lock protection for the cassette line to be used Connect primed stop cock or syringe support elbow to the cassette THE LINE IS NOW READY FOR PROGRAMMING SYRINGE ADAPTOR Benn STOP COCK Figure 3 4 Connecting Syringe and Syringe Adaptor to Cassette 430 0637 1 A04 Rev 4 94 3 12 System Operating Manual 3 7 REMOVING THE CASSETTE FROM THE DEVICE 3 7 REMOVING THE CASSETTE FROM THE DEVICE WARNING REMOVING CASSETTE FROM DEVICE WITHOUT CLOSING LINE CLAMPS MAY RESULT IN UNRESTRICTED FLOW All CLAMPS MUST BE CLOSED TO PREVENT FLOW TO PATIENT _ AND OR MIX
32. O THE CASSETTE REPLACE CASSETTE IF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM A CASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE DEVICE IF FLUID SPILL ACCUMULATION IS A PROBABLE CAUSE OF MALFUNCTION REPLACE DEVICE AFTER A FLUID SPILL REMOVE 4000 PLUS AS SOON AS POSSIBLE TO PERMIT CLEANING CONNECT UNIT TO AC CURRENT CYCLE POWER TURN POWER OFF TURN POWER ON RESUME PREVIOUS PROGRAMMING AND RESTART INFUSION ON AC CURRENT IF DAMAGE IS SUSPECTED TO THE BATTERY PACK REPLACE DEVICE REPLACE BATTERY PACK IF BATTERIES DISCHARGE FREQUENTLY REPLACE DEVICE REPLACE DEVICE OPERATE THE CASSETTE LOCKING LEVER SEVERAL TIMES THEN REPEAT CASSETTE TEST IF FAILURE PERSISTS REPLACE CASSETTE IF SECOND CASSETTE FAILS TEST REPLACE DEVICE REPLACE DEVICE REPLACE DEVICE System Operating Manual PAE Section 8 CLEANING AND DISINFECTING CAUTIONS To avoid mechanical or electronic damage do not immerse the device in any fluids or cleaning solutions Do not operate devices that contain residue from solution spills Sticky or gummy residue can interfere with the free movement of the valve stems and or the pressure sensing mechanism If the device cannot be completely clean
33. OML HR VOL OML WT OKG OMCG KG MIN OMG IN OML ENTER The cursor is in the ML HR field Use the NEXT key to move the cursor to the VOL field and enter the container volume Note If no entry is made in the VOL field the volume entered in the ML field becomes the default container volume Use the NEXT key to move the cursor to the WT field and enter the appropriate global body weight if one does not already exist Note If programming in MCG MIN is desired enter a body weight of one 1 Use the NEXT key to move the cursor to the MCG KG MIN field and enter the desired rate Use the NEXT key to move the cursor to the MG field and enter the medication dose Use the NEXT key to move the cursor to the ML field Enter the diluent volume Note The calculated delivery rate in ML HR appears in the ML HR Rate field To start the infusion press the ENTER key The following screen is displayed A INF B ON C OFF D OFF TOTAL 12 30PM 35 0 16 9 0 0 51 9 ML HR In this example the base screen shows Line A has been programmed as a maintenance at 35 mL hr Line B runs at 16 9 mL hr in a continuous mode of operation and continues until stopped The mL hr rate for Line B is the calculated result of the MCG KG MIN program The base screen only displays delivery rates in mL hr Repeat Steps 1 through 7 for each line to operate in a continuous mode of operation 430 0637 1 004 Rev 4 93 4 4 System Operating Manual
34. ON IS A PROBABLE CAUSE OF MALFUNCTION REPLACE DEVICE AFTER A FLUID SPILL REMOVE DEVICE AS SOON AS POSSIBLE TO PERMIT CLEANING USE ONLY ABBOTT OMNI FLOW SECONDARY SETS 430 0637 1 004 Rev 4 93 Section 7 TROUBLESHOOTING SYMPTOM FAILURE TO DETECT OCCLUSION OCCLUDED LINE IS OBSERVED AND THE OCCLUSION ALARM HAS NOT BEEN ACTIVATED BATTERY PACK IS DEPLETED WHEN OPERATING ON BATTERY THE SCREEN GOES BLANK WITH OR WITHOUT AN ALARM NO OPERATION ON AC OR BATTERY CASSETTE TEST FAILS KEYPAD FAILS TO RESPOND 430 0637 1 004 Rev 4 93 PROBABLE CAUSE CORRECTIVE ACTION OCCLUSION ALARM DELAYED BECAUSE LOWER DELIVERY RATE REQUIRES A LONGER TIME TO REACH THE OCCLUSION ALARM POINT OCCLUSION SETTING IS SET HIGHER THAN USER EXPECTED CASSETTE OR 4000 PLUS IS DAMAGED THE DEVICE CASSETTE PRESSURE TRANSDUCER IS NOT MEASURING THE TRUE PRESSURE IN THE CASSETTE OR A VALVE IS LEAKING FLUID SPILL ACCUMULATIONS CAUSE VALVES TO FUNCTION IMPROPERLY THE BATTERY PACK HAS BEEN USED PAST ITS LIMIT BATTERY PACK IS DEFECTIVE AND CANNOT BE RECHARGED BATTERY CHARGER CIRCUIT IS DEFECTIVE 4000 PLUS HAS BEEN EXPOSED TO EXCESSIVE VOLTAGE FUSE IS OPEN POWER BOARD IS DAMAGED CASSETTE VALVE DIAPHRAGM IS NOT FUNCTIONING PROPERLY 4000 PLUS IS DAMAGED AND CASSETTE INTERFACE IS INADEQUATE KEYPAD IS DAMAGED RESET RATE OR RESET OCCLUSION SETTING RESET OCCLUSION PRESSURE TO LOWER SETTING IF DAMAGE IS SUSPECTED T
35. OSE OML OVER 0 00 HRS MIN RATE OML HR Q 0X 1 ENTER 2 Input the volume of EACH dose infused B gt EACH DOSE 50 0ML OVER 0 00 HRS MIN RATE OML HR Q 0X 1 ENTER 3 Press the NEXT key Input the total time EACH dose is to be infused B gt EACH DOSE 50 0ML OVER 0 20 HRS MIN RATE 150ML HR Q 0X 1 ENTER Note Rate has been automatically calculated Note If the line rate chosen exceeds the combined maximum rate of the device an alert message appears on the display Refer to Section 12 Specifications for delivery rate range specifications STARTING LINE WOULD CAUSE MAXIMUM RATE TO BE EXCEEDED REPROGRAM ENTER If this is a single dose proceed to Step 6 4 Press the NEXT key Input the dosing frequency Q the number of hours between doses B gt EACH DOSE 50 0ML OVER 0 20 HRS MIN RATE 150ML HR 0 6 X 0 ENTER 5 Press the NEXT key Input the total number of doses to be delivered X B gt EACH DOSE 50 0ML OVER 0 20 HRS MIN RATE 150ML HR Q 6 X 4 ENTER Note A maximum of 24 hours of intermittent infusions can be programmed for a line i e the total of the dosing frequency times the number of doses cannot exceed 24 6 Press the ENTER key B gt CALLBACK Y N NO SYRINGE Y N NO DILUTION Y N NO ENTER The Callback Y N Syringe Y N and Dilution Y N queries as shown in the above screen default to NO If MO is correct proceed to Step 7 430 0637 1
36. Press the YES NO key to change NO to YES Press the ENTER key The base screen is displayed A OFF B OFF C OFF D OFF TOTAL 12 30PM 0 0 0 0 0 ML HR Refer to Section 5 4 Special Functions for detailed instructions on using SPECIAL FUNCTION 1 to set date time and display format When date and time are correct cycle the device power by toggling the ON CHARGE switch to CHARGE then ON Cycling the power returns the device to the Self Test screen followed by the Restore Previous Programming screen Repeat Steps 1 and 2 as follows 1 Select NO to Restore Previous Programming Y N Previous programming is removed from the device 2 Press the ENTER key The Insert Cassette and Lock In Place screen is displayed Confirm the correct date and time are displayed on the screen 3 Proceed to Section 3 2 Priming Procedures Primary Administration Set Note Do not bypass the cassette test 3 1 3 RESPONSE TO LOW BATTERY CONDITION If a low battery condition is detected by the device self test the Current Time screen is displayed CURRENT TIME 11 35 PM 24 HR TIME Y N NO DATE DD MM YY 30 MAR 92 ENTER 1 Confirm the correct date and time are displayed on the Current Time screen 2 If the date and time are incorrect use the NEXT key and LAST key to position the cursor as appropriate Overwrite the old data with the new data Note Refer to Section 5 4 Special Functions for more detailed information on setting date
37. RDELIVERY AMOUNT OF SOLUTION IN IV CONTAINER IS LESS THAN INDICATED BY IV FLOW SHEET AND LINE STATUS SCREEN TOTAL DELIVERY IS MORE THAN PROGRAMMED ACCORDING TO IV FLOW SHEET OR LINE STATUS SCREEN SUSPECTED UNDERDELIVERY AMOUNT OF SOLUTION IN IV CONTAINER IS GREATER THAN INDICATED BY IV FLOW SHEET AND LINE STATUS SCREEN TOTAL DELIVERY IS LESS THAN PROGRAMMED ACCORDING TO IV FLOW SHEET OR LINE STATUS SCREEN 430 0637 1 004 Rev 4 93 PROBABLE CAUSE OPERATOR PROGRAMMING ERROR SUSPECTED OVERDELIVERY EXCESSIVE AIR IN LINE WHICH CAUSES EXCESSIVE DELIVERY TO THE COLLECTION BAG SUSPECTED UNDERDELIVERY INCOMPATIBLE ADMINISTRATION SET USED IV FLOW SHEET WAS CLEARED DELIVERY EXCEEDS 9 999 ML CAUSING NUMBER ROLLOVER CASSETTE INLET PORTS ARE DAMAGED AND ARE LEAKING WHICH CAUSE EXTERNAL LEAKAGE FLUID SPILL ACCUMULATIONS CAUSE VALVES TO FUNCTION IMPROPERLY CASSETTE OR 4000 PLUS IS DAMAGED AND THE VALVES ARE NOT FULLY OPERATIONAL CASSETTE LOCKING LEVER IS UNLOCKED WITHOUT FIRST CLOSING OFF ALL TUBING CLAMPS FOR EACH LINE CASSETTE LOCKING LEVER IS DAMAGED IMPROPERLY FILLED IV FLUID CONTAINER CORRECTIVE ACTION REVIEW THE PROGRAM SETTINGS AS ENTERED AND CORRECT ANY ERRORS CHECK TO ENSURE THAT LUER CONNECTIONS ARE SECURE USE COMPATIBLE ADMINISTRATION SET CYCLE POWER TURN POWER OFF TURN POWER ON RESUME PREVIOUS PROGRAMMING AND RESTART INFUSION IF THE RESTART DOES NOT CLEAR THE PROBLEM
38. REMOVE 4000 PLUS FOR SERVICING IF DAMAGE IS SUSPECTED TO THE CASSETTE REPLACE CASSETTE IF FLUID SPILL ACCUMULATION IS A PROBABLE CAUSE OF MALFUNCTION REPLACE DEVICE AFTER AFLUID SPILL REMOVE DEVICE AS SOON AS POSSIBLE TO PERMIT CLEANING iF CASSETTE OR 4000 PLUS RELIABILITY IS SUSPECT STOP DELIVERY AND PERFORM A CASSETTE TEST IF CASSETTE PASSES TEST RESTART THE 4000 PLUS AND ESTABLISH CORRECT FLOW MONITOR ALL LINES FOR PROPER OPERATION IF CASSETTE FAILS TEST REPEAT TEST IF CASSETTE FAILS AGAIN REPLACE CASSETTE SHOULD 4000 PLUS FAIL TO PERFORM CORRECTLY REPLACE DEVICE CLOSE TUBING CLAMPS ON ALL LINES BEFORE UNLOCKING CASSETTE LOCKING LEVER GRAVITY DELIVERY AND OR MIXING RESULTS IF MORE THAN ONE LINE IS OPEN REPLACE DEVICE REPROGRAM INFUSION AND OR RESTART RESULTING IN INCORRECT STARTING VOLUME A NEW CONTAINER System Operating Manual FLUID BACKUP FLUID IS BACKING UP ONE OR MORE OF THE LINES THE DRIP CHAMBER IS FILLING EXCESSIVE PURGING COLLECTION BAG IS FILLING TOO QUICKLY Omni Flow 4000 Plus IV Medication Management System PROBABLE CAUSE CASSETTE LOCKING LEVER AND ALL TUBING CLAMPS ARE NOT CLOSED CASSETTE OR 4000 PLUS IS DAMAGED AND DEVICE CASSETTE VALVE INTERFACE IS NOT CLOSING DURING DEVICE DELIVERY STROKE FLUID SPILL ACCUMULATIONS CAUSE VALVES TO FUNCTION IMPROPERLY EXCESSIVE AIR IN LINE WHICH CAUSES EXCESSIVE DELIVERY TO THE COLLECTION BAG CASSETTE OR 4000 PLUS IS
39. RTS e 5 13 5 8 1 ACCESSING HISTORY REPORTS WITHOUT A PRINTER 5 13 5 8 2 ACCESSING HISTORY REPORTS WITH A PRINTER 5 14 5 8 2 1 DEVICE STATUSREPORT o 5 14 5 8 2 2 IV HISTORY REPORT 5 14 Section 6 ALARM CONDITIONS AND DISPLAYS 6 6 2 ee tee ee eo o 6 1 6 1 FLUID DELIVERY ALARMS 2 ee eet ee ee ee et 6 2 6 2 PUMPING ALARMS 002 ee ee et te es 6 3 6 3 WARNING ALARMS 2 0 2 ee eee eee ee ee ee ee ee 6 3 Section 7 TROUBLESHOOTING 2 0c a ee ee 7 1 7 1 TROUBLESHOOTING GUIDE eee ee ee te es 7 1 Section 8 CLEANING AND DISINFECTING e 8 1 430 0637 1 B04 Rev 7 95 iv System Operating Manual Contents Section 9 WARNINGS CAUTIONS AND PRECAUTIONS eee tr 9 1 9 1 WARNINGS eo de a a E A AR SOARES 9 1 99 CAUTIONS Ly 4 Abe A DA AA OREA SE A 9 2 9 3 PRECAUTIONS 2 oa see do A Se RA A A A 9 3 Section 10 SERVICE AND PERFORMANCE INFORMATION o 10 1 Section 11 4000 PLUS SETS ua EE a OE EE REA 1l 1 11 1 IV ADMINISTRATION SETS ee eee ts ll 1 11 2 ACCESSORY SETS 6 0 e ERAS ARA AAA NA 11 2 Section 12 SPECIFICATIONS e 4S 6 24 6 SES owe ER A A AR AA See eS AAA 12 1 Section 13 KEYPAD DESCRIPTION oa et tt 13 1 Section 14 WARRANTY ox hoch Sea ir ts ea OE IRA OR A 14 1 Copyright 1996 Abbott Laboratories All Rights Reserved This document and the subject ma
40. Sets or changes the current time and date 1 Programs a flush either after or 2 before any intermittent line infusion Cancels all subsequent flushes 3 Stops all lines at once 4 Selects or cancels Callback 5 430 0637 1 004 Rev 4 93 5 4 System Operating Manuat 5 4 SPECIAL FUNCTIONS Selects or changes preset values of KVO 6 rate maximum occlusion pressure units of temperature enables Callback and allows reset of these values to manufacturer s settings Selects the print format mode 7 definition Selects preprogram function 8 Clears IV Flow Sheet 9 Prints IV Flow Sheet AM PM Displays purge totals for all lines IV FLOW SHEET Reset IV History CLEAR ENTRY All lines must be OFF to select this function 5 4 1 DESCRIPTION OF SPECIAL FUNCTIONS The following subsections describe each special function and procedures for their use SPECIAL FUNCTION 0 Records external events The 4000 Plus documents certain external events by entering them into the battery backed up memory with a date time stamp then printing them with the IV History Report The event fields accept any values entered within the allowable spaces and print out the same The YES NO key can be used to review the events available or the number of the desired event may be entered PROC 1 BLOOD SAMPLE DRAW CHEMISTRY 20 MAR 92 3 29 PM YES NO ENTER Events are as follows Blood Sample Chemistry Blood Sample Hem
41. The base screen only displays delivery rates in mL hr 4 2 2 3 CHANGING AN ALTERNATE UNIT OF MEASURE INFUSION TO ML HR INFUSION To change an alternate unit of measure infusion to mL hr proceed as follows 1 Press the CONTINUOL S INFUSION key for the line used For example when using line B the following screen is displayed B gt RATE 16 9ML HR VOL 250ML WT 75 0KG 3 OOMCG KG MIN 200MG IN 250ML ENTER Since the line was previously programmed in alternate units of measure the cursor will appear in the MCG KG MIN field Use the LAST key to move the cursor to the WT field Press CLEAR ENTRY to clear the body weight Omni Flow 4000 Plus IV Medication Management System 4 5 430 06371 004 Rev 4 93 Section 4 PROGRAMMING 4 Use the LAST key to move the cursor to the VOL field Enter the volume to be delivered 5 Use the LAST key to move the cursor to the ML HR field and enter the desired rate Note If the line rate chosen exceeds the combined maximum rate of the device a message appears on the display screen Refer to Section 12 Specifications Delivery Rate Range for specifications 6 Press the ENTER key to start the infusion 4 2 3 CHANGING THE GLOBAL BODY WEIGHT The global body weight is established when the first weight and concentration are entered on a continuous line Entries in both fields are required to program in MCG The patient weight must be consistent on all lines with the exceptio
42. Throughout this manual three types of alert messages are used warnings cautions and notes as described below Pay attention to all alert messages WARNING A WARNING CONTAINS SPECIAL SAFETY EMPHASIS AND MUST BE OBSERVED AT ALL TIMES FAILURE TO OBSERVE A WARNING IS POTENTIALLY LIFE THREATENING CAUTION A CAUTION usually appears in front of a procedure or statement It contains information that could prevent irreversible damage or hardware failure Neglecting to pay attention to a CAUTION could result in serious injury Note A Note highlights information that helps explain a concept or procedure 1 4 INSTRUMENT INSTALLATION PROCEDURES In order to fully utilize 4000 Plus capabilities it is important to become thoroughly familiar with the System Operating Manual prior to use WARNING PRODUCT DAMAGE MAY OCCUR UNLESS PROPER CARE IS EXERCISED DURING THE UNPACKING AND INSTALLATION PROCESS THE BATTERY PACK MAY NOT BE FULLY CHARGED UPON RECEIPT DO NOT PLACE THE DEVICE IN SERVICE IF IT FAILS THE SELF TEST Note Instrument installation should be performed by qualified personnel only 1 4 1 UNPACKING INSTRUCTIONS Each shipping carton should contain the following items Q Omni Flow 4000 Plus IV Medication Management System with attached power cord Q Omni Flow 4000 Plus System Operating Manual Carefully remove the device from the shipping carton The carton should be retained in the event the device needs to be shipped
43. ass the cassette test and return to the base screen When the base screen displays press Line A PRIME PATIENT LINE to power prime the patient line Press the ENTER key when the patient line is fully primed The device preforms a cassette test Determine if the venipuncture device is indwelling If the venipuncture device is not indwelling prepare and insert the venipuncture device in the patient per hospital procedure Attach the primed patient line to the venipuncture device THE LINE IS NOW READY FOR PROGRAMMING 3 4 PRIMING PROCEDURES SECONDARY ADMINISTRATION SET To prime the 4000 Plus with a secondary administration set proceed as follows 1 Select the desired Omni Flow Secondary Set Remove set from package close clamp CAUTION Use only Abbott Omni Flow Secondary Sets Refer to the administration package insert for complete instructions Prepare IV container close all clamps remove spike protector insert spike through outlet hole in container and squeeze drip chamber to adjust fluid level until approximately half full Hang container Confirm fluid level is correct Remove distal cap from secondary set Remove the luer lock protector for the cassette line to be used Connect secondary set to cassette Note An alternative method is to open the clamp and clear all air from the set by gravity prime prior to connecting the secondary set to the cassctte 430 06371 A04 Rev 4 94 3 10 System Operatin
44. atology Blood Sample Other Urine Sample Oral Medication Administration Y Site Injection Patient Temperature value can be entered Pulse value can be entered Respiration value can be entered CVP value can be entered 11 Blood Pressure Reading value can be entered Omni Flow 4000 Plus IV Medication Management System 5 430 0637 1 004 Rev 4 93 MONA AWN o e Section 5 ADDITIONAL OPERATING FEATURES Record an event by entering a value date and time of actual event if different from current date and time then press the ENTER key The device returns to the Procedure O screen to allow selection of another event Press the ESCAPE key to return to the base screen SPECIAL FUNCTION 1 Sets or changes date and time The device maintains date and time values when powered down The time format may be based on 12 hour AM PM or 24 hour military time as the default Note The time and date can only be changed when ALL lines are OFF To change the date and time values proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 1 CURRENT TIME 12 00 PM 24HR TIME Y N NO DATE DD MMM YY 21 FEB 92 ENTER 2 Input the new time using the numeric keys CURRENT TIME 10 00 PM 24HR TIME Y N NO DATE DD MMM YY 21 FEB 92 ENTER 3 To change the display to AM PM designation press the NEXT key to move the cursor then press the AM PM key CURRENT TIME 10 00 AM 24HR TIME Y N NO DAT
45. cation and luer lock adaptor 40524 Colorgard Midlength Secondary IV Set 40 inches purple striped tubing for line identification and luer lock adaptor 11137 Nonvented Soluset 150 x 15 40 inches with male luer lock adaptor 11140 Low absorption proximal nitroglycerin set vented 40 inches with male luer lock adaptor 11141 Nonvented Y type blood set with high capacity bucket type nylon blood filter 40 inches with male luer lock adaptor 11181 Mid length secondary set with in line IVEX 22 micron filter 40 inches with male luer lock adaptor When infusing highly viscous solutions i e 25 Dextrose through micro bore sets at normal delivery rates an occlusion pressure of twelve 12 psi should be set for the device A maximum backpressure of approximately 1 5 psi approximately 75 mmHg is allowed Exceeding these parameters may result in occlusion alarms 11 2 LIST NO DESCRIPTION 1736 Low absorption distal nitroglycerin extension set 60 inches with male luer lock adaptor 40500 Collection bag Sterile nonpyrogenic fluid path Single use only Do not resterilize 40055 Colorgard three way stopcock Omni Flow compatible for use with syringes or mid length secondary sets 11607 Gravity flow prevention valve for use with the Omni Flow medication management systems Restricts gravity flow 11441 Vented syringe adapter Note This list may be updated without notice contact the Customer Service Department for current
46. ch line at the time the printed status report is requested The Device Status Report includes the following information Q Line status A B C and D ON OFF PGM INF DLY Q Dilution and flush data Q Current infusion regimen details O Time and volume remaining in dose To obtain a Device Status Report proceed as follows 1 Press SPECIAL FUNCTION followed by numeric key 7 IV HISTORY Y N NO DEV STATUS Y N YES PRINT MODE DEFINITION ENTER 2 Select NO for IV History Y N Device Status Y N automatically changes to YES 3 Press ENTER The 4000 Plus returns to the base screen A OFF B OFF C OFF D OFF TOTAL 12 30PM 0 0 0 0 0 ML HR 4 Confirm that the printer is connected to the 4000 Plus has paper supply is turned on and is ready to print 5 Press the PRINT key and the date and time is displayed for this print Press ENTER and printing begins immediately Note If printer is not ready or is not properly connected three beeps sound This function requires AC power 5 8 2 2 IV HISTORY REPORT The IV History Report retains a minimum of 48 hours of the most recent historical data Any portion of or all the data may be printed out at any time When the historical data buffer is full the oldest information is deleted first The IV History Report includes the following information 430 0637 1 B04 Rev 7 95 5 14 System Operating Manual 5 8 ACCESSING HISTORY REPORTS O Line mode changes off on intermitt
47. d WARNING HOLD DELAYS OR RESCHEDULES INFUSIONS ESCAPE OR PRESS ENTER Note To cancel the hold operation press the ESCAPE key and the base screen returns to the display 2 Press the ENTER key to continue the hold operation The following screen is displayed HOLD LINES _ USE STATUS KEYS OR TO HOLD ALL LINES PRESS ENTER To specify the lines to be put on hold proceed as follows 1 Press the LINE STATUS key and NEXT key for each line to be put on hold 2 Press the ENTER key The lines selected if currently infusing are placed on hold The HLD message appears on the base screen for all lines currently infusing To ensure that lines which have intermittent infusions with dilution will not be affected Line A may only be placed on hold using the Hold All Lines option Note To place all lines on hold press the ENTER key without specifying individual lines All lines currently infusing are placed on hold The HLD message appears on the base screen A line programmed for future intermittent infusions is displayed as PGM on the base screen If placed on hold its programmed start time and the start time for subsequent intermittent infusions is delayed Start time is rescheduled to a time which is equivalent to the original start time plus the length of time the line was on hold A DLY delayed status message appears on the base screen Lines placed on hold which were currently infusing continuous or
48. d when the device operates in these environments Shield the device from X ray by a lead apron If exposure to RF X ray or MRI emissions does occur cycle the power by turning the device off then back on to allow the self test to repeat Return the device for service if there is any concern about reliability of operation The 4000 Plus is not to be used in a hyperbaric chamber A solution must be placed on Line A for the device to function properly It is recommended that a neutral solution be placed on Line A To cancel the dilution of a particular line press the STOP key and reprogram the line being diluted by changing the YES to NO Recheck the number of doses remaining in the container and the start time of the next dose Nonhazardous low level electrical potentials are commonly observed when fluids are administered using infusion devices These potentials are well within accepted safety standards but may create artifacts on voltage sensing equipment such as ECG EMG and EEG machines These artifacts vary at a rate that is associated with the infusion rate If the monitoring machine is not operating correctly or has loose or defective connections to its sensing electrodes these artifacts may be accentuated so as to simulate actual physiological signals To determine if the abnormality in the monitoring equipment is caused by the infusion device instead of some other source in the environment set the infusion device so that it is tempo
49. e device without closing the clamps The gravity flow prevention valve does not prevent mixing of drug lines Close all clamps before removing cassette The gravity flow prevention valve requires pressure to open 1 5 to 5 0 psi The device occlusion pressure setting may require adjustment to prevent nuisance occlusion alarms Note These instructions offer an alternative priming procedure to those found on the package insert of the administration set These instructions apply to the 4000 Plus only To prime the 4000 Plus with a primary administration set containing the gravity flow prevention valve proceed as follows 1 Remove the primary set from package close the upper clamp for Line A and confirm that all luer lock connections on the cassette are secure CAUTION Use only Abbott Omni Fiow Primary Sets on the device Refer to the administration package insert for complete instructions 2 Prepare IV container close all clamps remove spike protector insert spike through outlet hole in container and squeeze drip chamber to adjust fluid level until approximately half full Hang the container 3 Confirm fluid level is correct Grasp cassette so that the collection bag and patient line are at the top and the luer lock connectors are pointing to the right 4 Confirm that the ON CHARGE switch is ON and the cassette lever is in the unlocked position Insert cassette into holster located along the right side of device see Figure 3 1
50. ed return it for service Certain cleaning and sanitizing compounds may slowly degrade components made from some plastic materials Using abrasive cleaners or cleaning solutions not recommended by Abbott Laboratories may result in product damage Do not use compounds containing combinations of isopropyl alcohol and dimethyl benzyl ammonium chloride Never use sharp objects such as fingernails paper clips or needles to clean any part of the device Do not sterilize by heat steam ethylene oxide ETO or radiation To avoid device damage cleaning solutions should be used only as directed in Table 8 1 Cleaning Solutions The disinfecting properties of cleaning solutions vary consult the manufacturer for specific information It is important to ensure that the cassette channel and all plungers on the right side of the device are free of any material buildup or sticky substance This area should be checked and cleaned frequently Do not use acetone alcohol or abrasive cleaners on the device Clean the device with a soft lint free cloth or swab dampened with soap and water or a general nonstaining chemical disinfectant Refer to hospital housekeeping central service or infection control for further information Note Not all cleaning solutions are sanitizers Check product labeling Table 8 1 Cleaning Solutions Cleaning Solution Manutacturer Preparation Vesphene Ii se Manu klonz Formula c Super Edisonite
51. eld Primary Macro bore Device Set convertible piercing pin approximately 118 inches in length collection bag roller clamp two prepierced reseal Y injection sites 11599 LifeShield Primary Micro bore Device Set convertible piercing pin approximately 110 inches in total length with 60 inches of micro bore tubing from cassette to patient collection bag roller clamp two prepierced reseal Y injection sites 11606 Primary Micro bore Device Set with gravity flow prevention valve convertible piercing pin approximately 110 inches in total length with 60 inches of Micro bore tubing from cassette to patient collection bag roller clamp one Y injection site and luer lock adaptor 11681 LifeShield Omni Flow Primary 1 V Pump Set with capped luer activated valve port at lower y injection site Convertible piercing pin approximately 110 inches in total length Sixty inches of Micro bore tubing approx 2 ml priming capacity from cassette to patient collection bag and roller clamp Omni Flow 4000 Plus IV Medication Management System 11 1 430 06371 A04 Rev 4 94 Section 11 4000 PLUS SETS 11139 Secondary Set convertible piercing pin approximately 40 inches in total length clamp luer lock adaptor 40521 Colorgard Midlength Secondary IV Set 40 inches orange striped tubing for line identification and luer lock adaptor 40522 Colorgard Midlength Secondary IV Set 40 inches green striped tubing for line identifi
52. em operating manual which is included with the printer The following DIP switch configuration is for the Seiko DPU 411 printer The printer operating manual should detail the printer DIP switch locations To set up the Seiko DPU 411 printer for use with the 4000 Plus proceed as follows 1 Set the printer DIP switch configuration as shown in the following display DIPO1 OFF 123 4 5 6 7 8 DIPO1 Note DIPO1 switches set input data format number of columns and characters 430 0637 1 004 Rev 4 93 1 4 System Operating Manual Note DIPO2 switches are set for serial input 1 4 INSTRUMENT INSTALLATION PROCEDURES 2 Connect the printer cable to the serial port labeled RS 232 on the printer 3 Connect the other end of the printer cable to the nine pin serial port labeled RS 232 on the rear of the 4000 Plus See Figure 1 1 4000 Plus Rear View 4 Connect the AC power plug to the printer and the AC adapter to an AC outlet Note If necessary the Seiko DPU 411 printer can be operated on battery power 5 Turn the printer switch to the ON position The LED power on light is on and the printer LED reads OFF LINE Press the printer ON LINE switch and confirm the ON LINE LED is on POLE CLAMP KNOB SERIAL RS 232 DB 9 COMMUNICATION PORT COLLECTION BAG HANGER RS 232 DB 25 SOME MODELS NOTE CONNECTOR NOT ACTIVE Omni Flow 4000 Plus IV Medication Management System Figure 1 1 4000 Plus Rear View
53. ent infusion hold dilute delay flush KVO Q Non infusion event documentation blood hematology blood chemistry vital signs etc A Date time stamp for all events To obtain an IV History Report proceed as follows 1 Press SPECIAL FUNCTIONII7 IV HISTORY Y N NO DEV STATUS Y N YES PRINT MODE DEFINITION ENTER 2 With the cursor at IV History Y N select YES and press ENTER Note By answering YES to IV History Y N Device Status Y N automatically changes to NO 3 Press the PRINT key and the following screen is displayed IV HISTORY FM 20 FEB 91 10 00AM 117 EVENTS TO 23 FEB 91 11 00PM ENTER 4 Using the NEXT and LAST keys move the cursor to the data fields to specify the range of events to print The YES NO key is used to select the month The data keypad is then used to enter from and or specific date and time or number of events to print It is only necessary to enter data into two of the three category fields to receive a report Press ENTER to display the following screen SERIAL PORT Y N YES DISPLAY Y N NO IV HISTORY DESTINATION ENTER 5 To view the IV History on the display screen select NO to Serial Port Y N YES to Display Y N and press the ENTER key The first two lines of the most recent IV History event are displayed on the screen Note See Table 5 1 Scanning IV History for detailed scanning instructions 6 Toprint the IV History Report select YES to Serial Port Y N NO to Dis
54. entry is made in the Volume field the volume entered in the ML field becomes the default container volume Note The calculated delivery rate in ML HR appears in the ML HR Rate field To start the infusion press the ENTER key The following screen is displayed A INF B ON C OFF D OFF TOTAL 12 30PM 35 0 16 9 0 0 51 9 ML HR In this example the base screen shows Line A has been programmed as a maintenance at 35 mL hr Line B runs at 16 9 mL hr in a continuous mode of operation and continues until stopped The mL hr rate for Line B is the calculated result of the MCG KG MIN program The base screen only displays delivery rates in mL hr Omni Flow 4000 Plus IV Medication Management System 4 3 430 0637 1 004 Rev 4 93 Section 4 PROGRAMMING 4 2 2 ALTERNATE UNITS OF MEASURE MCG KG MIN INFUSIONS The following sections detail the required steps to program an alternate unit of measure infusion and the steps to change a unit of measure infusion Note The 4000 Plus will not accept MCG KG MIN programming unless all data fields are specified non zero rate MCG KG MIN dose amount MG diluent volume ML and body weight WT 4 2 2 1 PROGRAMMING A NEW ALTERNATE UNIT OF MEASURE INFUSION To program a new alternate unit of measure MCG KG MIN infusion proceed as follows 1 al Press the CONTINUOUS INFUSION key for the line used For example when using line B the following screen is displayed B gt RATE
55. er use of the device as outlined in this manual Precautions to be observed in operation of the 4000 Plus follow a a Do not attempt to disassemble or repair the device Refer all service to qualified and trained service personnel Aservice code may be displayed if the device is turned on with a cassette locked in the cassette holster If the service code appears remove the cassette and cycle the power Toggle the ON CHARGE switch to CHARGE then ON to clear the service code Turn cassette locking lever slowly to prevent sudden release of spring mechanism Itis recommended that the cassette test safety feature be routinely performed at each cassette insertion For normal operation the device must be connected to a hospital grade AC outlet If quality of AC power source is in doubt use battery power To prevent flow interruption it is necessary to plug the device into AC power immediately upon low battery alarm If the battery pack has become fully discharged cycle the power Toggle the ON CHARGE switch to CHARGE then ON and reset the time with the SPECIAL FUNCTION 1 keys The internal self check of the real time clock may have been missed while the battery pack was depleted After programming the device ensure that pumping has begun by verifying flow into the drip chamber on each fill stroke When infusing two or more medications the user should confirm drug compatibility and program the device accordingly When admini
56. es are ON OFF or programmed to start in the future PGM the current infusion rates of each line and the cumulative infusion rate at that time A OFF B OFF C 0FF D OFF TOTAL 12 30PM 0 0 0 0 O ML HR Omni Flow 4000 Plus IV Medication Management System 2 1 430 0637 1 004 Rev 4 93 Section 2 EQUIPMENT DESCRIPTION The base screen is the device status screen During programming or operation an intermittent beeping tone alerts the user that the device is not in the base screen The beeping toneis a reminder to the user that a programming sequence is not complete This reminder tone ceases upon return to the base screen The base screen utilizes the following indicators to assist in determining the pumping status of each individual line ON Indicates the line is currently running in the continuous mode of operation INF Indicates the line is infusing an intermittent dose to the patient Also appears if Line A is running in the maintenance mode of operation DIL Indicates that Line A is diluting a drug on another line FLS Indicates that Line A is flushing the cassette and patient line after or before an intermittent infusion PGM Indicates that an intermittent line is programmed to deliver a dose of medication sometime in the future AND OR if line A is running in maintenance mode while another line is delivering an intermittent dose HLD Indicates that line operation is suspended either due to an alarm condition or the user plac
57. es for lines are delayed for as long as the power is down Upon power up and restoring previous programming the user should review the programmed information before pressing the RESUME key to begin programmed infusions Note To reduce the likelihood of restoring corrupted line programming after Service Code conditions occur the Restore Previous Programming option is not available after the occurrence of certain Service Code alarms In this case the following screen is displayed after turning power on INSERT CASSETTE AND LOCK IN PLACE 4 JUN 92 PRESS ENTER 11 05 AM 3 1 2 INITIATE NEW PROGRAMMING To initiate new programming at the Restore Previous Programming screen proceed as follows 1 Select NO to Restore Previous Programming Y N Previous programming is removed from the device 2 Press the ENTER key The Insert Cassette and Lock In Place screen is displayed INSERT CASSETTE AND LOCK IN PLACE 20 MAR 92 PRESS ENTER 11 30 AM Confirm the correct date and time are displayed on the Insert Cassette and Lock In Place screen If the date and time are correct press the ENTER key Proceed to Section 3 2 Priming Procedures Primary Administration Set 430 0637 1 A04 Rev 4 94 3 2 System Operating Manual 3 1 SETUP PROCEDURES If the date and time are incorrect on the Insert Cassette and Lock In Place screen press the ESCAPE key The Bypass Cassette Test screen is displayed BYPASS CASSETTE TEST NO PRESS ENTER
58. f a line is suspended on hold The LED indicators located on the left side of the front panel indicate their status as follows Q AC POWER illuminated green when the device is operating on AC power 1 BATTERY illuminated yellow when the device is operating on battery power Q ALARM illuminated red when the device is in an alarm condition See Figure 13 1 4000 Plus Front View for location of the LED indicators 2 6 NOTATION AREAS The white area next to the alphabetical line designations A B C D on the front panel are for making notations about the medication or the programming on that line A non permanent felt tip pen or pencil should be used for these notations This area can be cleaned with an alcohol swab or a soft eraser Omni Flow 4000 Plus IV Medication Management System 2 3 430 0637 1 004 Rev 4 93 Section 2 EQUIPMENT DESCRIPTION 237 PRINTER A printer optional can be attached to the 4000 Plus and used to print history report information See Figure 2 1 Seiko DPU 411 Printer Optional For more information on using the printer refer to Section 5 8 2 Accessing History Reports with a Printer OFF LINE PAPER END 9216H002 Figure 2 1 Seiko DPU 411 Printer Optional Note The Seiko DPU 411 printer illustrated in Figure 2 1 is one of several printers which can be used with the 4000 Plus 430 0637 1 004 Rev 4 93 2 4 System Operating Manual a Section 3 SETUP The following secti
59. f it is determined that the device memory has been reset to default values due to an extreme low battery condition or power interruption the Preset Values screen is displayed SPECIAL FUNCTION 7 Selects print mode To select print mode proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 7 The following screen is displayed IV HISTORY Y N NO DEV STATUS Y N YES PRINT MODE DEFINITION ENTER 2 Use the YES NO key in the IV History field to change the response in the Device Status field and specify which printed report is desired Use of the NEXT and LAST keys is not required and has no effect The mode selection is preserved in memory and retained when the device is powered ON 3 Press the ENTER key to enter the selections Note See Section 5 8 2 Accessing History Reports with a Printer for a detailed description of the Device Status and IV History Report print modes SPECIAL FUNCTION 8 Selects preprogram function This function can only be selected when all lines are OFF To select a preprogram function proceed as follows 1 Press the SPECIAL FUNCTION key followed by numeric key 8 PREPROGRAM FUNCTION SELECTION Y N NO RESUME TO START INFUSIONS ENTER Omni Flow 4000 Plus IV Medication Management System 5 9 430 06371 A04 Rev 4 94 Section 5 ADDITIONAL OPERATING FEATURES Note This screen shows the current status of the preprogram function If enabled the screen
60. g Manual 3 5 CONNECTING A SYRINGE TO THE CASSETTE 5 Prime the line by pressing the appropriate PRIME CASSETTE key until no air bubbles are visible in the connection site or cassette THE LINE IS NOW READY FOR PROGRAMMING To prime the 4000 Plus with a secondary administration set while other lines are running proceed as follows 1 Put all lines on hold 2 Connect and prime secondary set as described above 3 Press the RESUME key then the ENTER key CAUTION Priming directs air and fluid out through the cassette and into the collection bag Fluid originally in the cassette may be displaced into the collection bag by the priming sequence 3 5 CONNECTING A SYRINGE TO THE CASSETTE Note For syringe infusions only use 20 cc to 60 cc size syringes To connect a syringe to the cassette proceed as follows 1 Remove luer lock protector for the cassette line to be used Connect an Omni Flow compatible stop cock or syringe support elbow into the cassette 2 Connect the syringe to the stop cock or elbow with the syringe in a vertical position see Figure 3 3 Syringe Connected to the Cassette Open fluid pathway from syringe to the cassette 3 Ifair bubbles are visible in the connection sight or cassette prime the line by pressing the appropriate PRIME CASSETTE key Note Syringes may not prime easily with gravity flow Some force may be required on the plunger during cassette prime THE LINE IS NOW READY FOR PROGRAM
61. ging the battery pack replacing the device or cassette or other procedures described in this manual As discussed in previous sections the 4000 Plus is designed to sound an audible alarm and display an appropriate message should system checks identify a problem The audible alarm and message display alerts the healthcare professional of operational problems and permits timely intervention to place the device back into operation quickly without undue risk to the patient Section 6 summarizes various alarm conditions and recommended corrective actions Section 7 is a troubleshooting guide for failures which may occur but do not necessarily result in an alarm condition Note Alarm events are added to the IV History which retains a minimum of 48 hours of the most recent historical data To aid in alarm analysis the IV History can be reviewed or printed see Section 5 8 Accessing History Reports Should an alarm sound proceed as follows 1 Press MUTE to temporarily silence the audible alarm for a maximum of two minutes The red alarm light remains ON After two minutes the audible alarm is reactivated Note In the Callback mode or if a faulty cassette alarm occurs press the MUTE key a second time to completely cancel the alarm 2 Observe the display and determine the cause of the alarm It is possible to have multiple alarm conditions occur Each alarm type is prioritized as to severity and chronology The current alarm visual d
62. gramming continuous infusions over these lines CAUTION When restarting an intermittent line that has been stopped the start time and dosing information for the next dose must be reset Note If two or more intermittent infusions are scheduled to start at exactly the same time the device infuses them in alphabetical order Line B then C then D Only one intermittent infusion can be infusing at a time The schedule of doses rolls and begins from the time the first dose is given Note Near the end of an intermittent infusion with dilution delivery of the diluent may be completed before delivery of medication is completed or vice versa depending on the diluent medication ratio When this occurs the rate for the completed line will be displayed as zero until the full dosage dilution programmed is delivered If an intermittent line is scheduled to start during the infusion delivery time frame of another intermittent line its scheduled start and dose schedule is delayed until the current intermittent infusion has completed This feature maintains the proper interval between scheduled intermittent doses Note To program an automatic flush before or after any intermittent infusions refer to the SPECIAL FUNCTION 2 description in Section 5 4 Special Functions for further information Note If a flush is programmed to occur after an intermittent infusion and the intermittent line is placed on hold while the intermittent infusion i
63. he collection bag PRIME PATIENT LINE KEY Press and hold this key to clear the patient line of all air The patient line can be primed only when ALL lines are OFF CONTINUOUS INFUSION KEY Press this key on Lines A B C or D to program a continuous infusion on any line INTERMITTENT INFUSION KEY Press this key on Lines B C or D to program an intermittent infusion of a medication STOP KEY Press this key on Lines A B C or D then press the ENTER key to stop the operation of any of the lines LINE STATUS KEY Press this key on Lines A B C or D to obtain the current programming information for each line The information remains visible on the display screen until the ENTER or ESCAPE key is pressed LINE INDICATOR LIGHTS On continuously when a line is programmed to start flashing when a line is operating off when a line is off NOTATION AREAS These areas may be used to make notations concerning the medication and or programming on each line Clean with an alcohol swab or a soft eraser Use a nonpermanent felt tip pen or pencil MAINTENANCE INFUSION KEY Press this key on Line A only to program a maintenance infusion on Line A Line A stops when an intermittent infusion starts and restarts automatically when the intermittent line stops Section 13 KEYPAD DESCRIPTION 15 YES NO KEY Press this key to answer any of the programming questions on intermittent infusions or special functi
64. ilution programmed on Lines B C or D is puton hold and a maintenance infusion was previously prgrammed on Line A the dilution is put on hold and the maintenance programming on Line A continues To set up line A proceed as follows 1 Press the MAINTENANCE INFUSION key for Line A A gt MAINTENANCE RATE 5 OML HR TOTAL VOLUME O ML ENTER 2 Set a rate using the numeric keys then press the NEXT key Note If the line rate chosen exceeds the combined maximum rate of the device a message appears on the display screen Refer to Section 12 Specifications for rate range specifications 3 Set a Total Volume to be infused using the numeric keys then press the ENTER key to start the line A gt MAINTENANCE RATE 5 OML HR TOTAL VOLUME 250ML CENTER The base screen is displayed A INF B OFF C OFF D OFF TOTAL 12 30 PM 5 0 0 0 0 5 0 ML HR Note Maintenance or continuous rate on Line A can only be changed when Line A is not in the flushing or diluting mode If Line A is flushing or diluting the display only allows the entry of a new source container volume Omni Flow 4000 Plus IV Medication Management System 4 1 430 0637 1 004 Rev 4 93 Section 4 PROGRAMMING 4 2 CONTINUOUS INFUSIONS The 4000 Plus infuses up to four medications at the same time in the continuous mode and offers the user two methods of programming ML HR and MCG KG MIN Note To change either the rate in MCG or mL hr or total volume on any line
65. ing it on hold DLY Indicates a programmed intermittent infusion PGM is being delayed due to a preceding intermittent infusion being on hold HLD or due to a flush OFF Indicates the line has been stopped and is OFF 2 4 PROGRAMMING INPUT INDICATOR CURSOR A flashing programming input indicator cursor automatically appears on the display screen at the first information entry point The cursor must be moved to the next entry point on the screen Press the NEXT key to move the cursor forward To move to a previous entry point press the LAST key to move the cursor backwards To clear any entry where the cursor is flashing press the CLEAR ENTRY key Note Several programming screens do not allow an advance to the next screen if all the necessary programming information has not been entered on that screen i e if a rate is entered but nota total volume on a continuous infusion the screen cannot be advanced In these cases the cursor automatically moves to the entry point which is missing the required programming information 430 0637 1 004 Rev 4 93 2 2 System Operating Manual 2 5 LED STATUS INDICATORS 2 5 LED STATUS INDICATORS The front panel LED indicators located next to the alphabetical line designations A B C D indicate their status as follows Q Off when the line is off Q Flashing when the line is infusing medication A On steadily when the line is programmed to start at a future time or the infusion o
66. intermittent are displayed as HLD on hold on the base screen These lines also have subsequent intermittent infusions if any rescheduled to a time which is equivalent to the original start time plus the length of time the line was on hold 430 06371 A04 Rev 4 94 5 2 System Operating Manual 5 3 LINE STATUS FUNCTION 5 2 2 RESUME INFUSIONS AFTER HOLD To resume infusions after a hold proceed as follows l Press the RESUME key 2 Press the ENTER key If the device is in hold for more than two minutes it will alarm and the following Warning screen is displayed WARNING MUTE HOLD TIME EXCEEDED PRESS MUTE OR RESUME Resume infusions as detailed in Steps 1 and 2 or press the MUTE key to silence the alarm for two additional minutes 5 3 LINE STATUS FUNCTION At any time during the medication infusion the programming status on each line can be obtained by pressing the appropriate LINE STATUS keys Note The line status screens can be accessed only when the base screen appears on the display To go from one line status screen to another press the LINE STATUS key desired Press the ENTER key or the ESCAPE key to return to the base screen Sample status screens for various operating conditions follow A gt MAINTENANCE RATE 50 0ML HR VOL REM 85 0ML TIME REM 1HR 42MIN Line A operating in a maintenance mode A gt FLUSHING AFTER B TOTAL FLUSH 5 0ML FLUSH REM 5 0ML TIME REM OHR 1MIN Line A opera
67. ion regarding priming secondary administration sets from the device 3 2 2 PRIMING THE CASSETTE The cassette is primed from lines B C and D by gravity flow as follows 1 Press and hold the PRIME CASSETTE key on lines B C or D until solution enters the collection bag HOLD DOWN CASSETTE KEY ON lt B gt TO PRIME INTO COLLECTION BAG PRESS ENTER 2 Press the ENTER key when priming is complete 430 0637 1 004 Rev 4 93 3 6 System Operating Manual 3 2 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET 3 2 3 PATIENT LINE PRIMING MODES The patient distal line may be primed either by power prime or by gravity prime WARNING DO NOT CONNECT LINE TO PATIENT WHILE PRIMING PATIENT LINE Note Priming the patient line can only occur when ALL lines are OFF 3 2 3 1 PATIENT LINE POWER PRIME When the Prime Patient Line screen is displayed and the PRIME PATIENT LINE key is pressed then released the pumping action of the system pulls fluid from Line A into the cassette At each device stroke the system measures cassette pressure when cassette pressure is above threshold it is fully primed After reaching the pressure threshold the patient line is opened and an additional 13 strokes are pumped corresponding to 3 mL of fluid This volume is sufficient to prime the entire microbore 60 inch patient line Note When using power prime confirm the patient line is fully cleared of all air before connecting to patient Add
68. isplay is overwritten but not lost if a subsequent higher priority alarm occurs The preceding alarm is placed on the alarm stack based on priority and time of occurrence The first press of the MUTE key silences the audible alarm subsequently pressing the MUTE key returns the user to the base screen Omni Flow 4000 Plus IV Medication Management System 6 1 430 06371 B04 Rev 7 95 Section 6 ALARM CONDITIONS AND DISPLAYS 3 Correct the identified problem and press the RESUME key followed by the ENTER key to resume all infusions Using the resume function stacked alarms are displayed by priority Higher priority alarms are displayed first If multiple alarms of the same priority exist such as multiple Upstream Occlusions the alarms are displayed in reverse chronological order the most recent alarm displayed first Each stacked alarm displayed is accompanied by an audible alarm tone of two seconds duration This tone is used to call attention to the alarm condition but does not require pressing the MUTE key to silence the audible tone Note When multiple alarms occur the alarms are presented in order of severity and chronology Three distinct alarm severity classifications exist These classifications are listed in the following tables in order of priority 6 1 FLUID DELIVERY ALARMS A fluid delivery alarm causes ALL lines to be put on hold HLD The following table details conditions which may cause fluid delivery alarms
69. itional gravity priming may be required to fully clear air from the line Note In the event of an occlusion alarm use the appropriate aseptic techniques to remove the filter cap at the distal end of the patient line 3 2 3 2 PATIENT LINE GRAVITY PRIME When the PRIME PATIENT LINE key is pressed and held the system reverts to gravity prime Gravity pulls fluid into the cassette until the PRIME PATIENT LINE key is released 3 2 4 PRIMING THE PATIENT LINE To prime the patient line from lines B C or D proceed as follows 1 Press and hold the PRIME PATIENT LINE key until all air is cleared from the patient line HOLD DOWN PATIENT LINE KEY ON lt B gt TO PRIME PATIENT LINE PRESS ENTER 2 When priming is complete press the ENTER key Note When using the gravity flow prevention valve set see Section 3 3 Priming Procedures Primary Administration Set With Gravity Flow Prevention Valve Omni Flow 4000 Plus IV Medication Management System 3 7 430 0637 1 004 Rev 4 93 Section 3 SETUP 3 2 5 CASSETTE TEST The device performs a cassette test for approximately 36 seconds CAUTION It is extremely important to always perform the cassette test when inserting a new cassette CASSETTE TEST IN PROGRESS ABBOTT 4000 PLUS When the cassette test is completed one of two screens is displayed Possible Faulty Cassette screen or Select Infusion Type screen 3 2 5 1 CASSETTE TEST FAILED If the cassette fails the ca
70. joooooooaooao Additional capabilities of the 4000 Plus include A Programmable in Mcg Kg Min on all channels A RS 232 communication for printers Q Date time stamp optional of blood chemistry hematology vital signs and other medication administration Q Detailed documentation through the following printed reports on demand Device Status Report Line status A B C and D ON OFF PGM HLD INF DLY Dilution and flush data Current infusion regimen details Time and volume remaining in dose IV Flow Sheet Omni Flow 4000 Plus IV Medication Management System 1 1 430 0637 1 004 Rev 4 93 Section 1 INTRODUCTION DOCO0ODODODOO 1 2 IV History Report Line mode changes off on intermittent infusion hold dilute delay flush KVO programmed Records details of infusion as programmed actual delivered regimen changed Records non infusion event documentation blood hematology blood chemistry vital signs All events date time stamped Programming and memory retention following power OFF Selective hold for each medication line Advanced programming to preprogram all lines and place lines on hold until needed Automatic power prime of Line A for minimum solution waste Prioritized alarms stacked and presented sequentially for resolution Additional alarms full collection bag transfer to battery external communications fault User selected power up defaults Time 12 hour AM PM or 24 hour military format KVO
71. ld by pressing the ENTER key again Any combination of Lines B C and D may be put on hold by pressing LINE STATUS keys An alarm sounds after two minutes when lines are on hold 28 RESUME KEY Press this key to review pending alarms then press the ENTER key to resume device operation following an alarm condition Press the RESUME key then press the ENTER key to resume device operation after a HOLD condition 430 06371 004 Rev 4 93 13 2 System Operating Manual NE IV flow N sheet special function 3 wie O Ole all am yes battery pm no alarm escape cear last next S cassette D unlocked E cassette locked CD COGI G8 2 R DIOOD FLOW 4000 PLUS ENE 7 0972 EAS contin VRED rime uous infusion cdssette inter mittent infusion line status line status contin rime cdssette infusion inter mittent infusion contin prime uous infusion cassette prime inter patient mittent tine infusion contin prime uous infusion cassette ine 13 2 9216 001 Figure 13 1 4000 Plus Front View Omni Flow 4000 Plus IV Medication Management System 13 3 430 0637 1 004 Rev 4 93
72. livery rate Use the NEXT key to move the cursor to the VOL field Enter the volume to be delivered Note If the line rate chosen exceeds the combined maximum rate of the device a message appears on the display screen Refer to Section 12 Specifications Delivery Rate Range for specifications 3 Press the ENTER key to start the infusion 430 0637 1 004 Rev 4 93 4 2 System Operating Manual 4 2 CONTINUOUS INFUSIONS 4 2 1 2 CHANGING AN ML HR INFUSION TO AN ALTERNATE UNIT OF MEASURE INFUSION To change an existing mL hr infusion to an alternate unit of measure infusion proceed as follows 1 Press the CONTINUOUS INFUSION key for the line used For example when using line B the following screen is displayed B gt RATE 15 0ML HR VOL 250ML WT OKG OMCG KG MIN OMG IN OML ENTER Since the line has previously been programmed in mL hr the cursor will appear in the ML HR field Use the NEXT key to enter the appropriate global body weight if one does not already exist Note If programming in MCG MIN is desired enter a body weight of one 1 Use the NEXT key to move the cursor to the MCG KG MIN field and enter the MCG KG MIN rate Use the NEXT key to move the cursor to the MG field and enter the medication dose Use the NEXT key to move the cursor to the ML field Enter the diluent volume B gt RATE 16 9ML HR VOL 250ML WT 75 0KG 3 OOMCG KG MIN 200MG IN 250ML ENTER Note If no
73. n of 1 kg to program in MCG MIN If another weight is entered the following screen is displayed GLOBAL BODY WEIGHT CANNOT BE CHANGED WHILE LINES ARE INFUSING ESCAPE Global body weight can be changed only while lines are stopped or while no other line is running in MCG KG MIN When a new body weight is entered the following screen is displayed BODY WT CHANGED FROM __KG TO__KG ENTER TO ACCEPT ESCAPE TO REVISE Pressing ENTER starts the line and establishes a new global body weight The ESCAPE key causes the line programming screen to appear with the cursor in the global body weight field When subsequent lines programmed in MCG are restarted the new global body weight appears and the mL hr rate is adjusted based on the MCG KG MIN field and new weight To accept the new global body weight and adjusted delivery rate for lines programmed in MCG press the CONTINUOUS INFUSION key for the respective line and then confirm the new setting by pressing the ENTER key If a line was previously programmed with a weight of 1 kg its body weight is retained when the global body weight is changed If the global body weight is changed to 1 kg or 1 kg is changed to global body weight the MCG KG MIN and Concentration fields are erased as the cursor is moved from the WT field The previous mL hr value remains unchanged To change from MCG programming to mL hr programming enter a zero in the body weight field When ENTER is pressed o
74. nger located on the bottom right corner of the device see Figure 1 1 4000 Plus Rear Vieu CASSETTE HOLDER SS COLLECTION BAG 9307 A002 Figure 3 1 Inserting the Cassette CASSETTE UNLOCKED Co CASSETTE LOCKED Iiii 9216H004 Figure 3 2 Locking the Cassette in Place Omni Flow 4000 Plus IV Medication Management System 3 5 430 0637 1 004 Rev 4 93 Section 3 SETUP 3 2 1 CASSETTE PRIMING MODES The 4000 Plus has two priming modes cassette power prime and cassette gravity prime Line A can be primed using either mode When priming the cassette the fluid goes into the collection bag HOLD DOWN CASSETTE KEY ON lt A gt TO PRIME INTO COLLECTION BAG PRESS ENTER 3 2 1 1 CASSETTE POWER PRIME LINE A When the prime cassette screen is displayed and the PRIME CASSETTE key is pressed and released the pumping action of the system pulls fluid from Line Ainto the cassette At each device stroke the system measures cassette pressure when cassette pressure is above threshold it is fully primed A device stroke limit of 25 is set in the event there is a cassette leak 3 2 1 2 GRAVITY PRIME When the prime cassette screen is displayed and the PRIME CASSETTE key is pressed and held the system reverts to gravity prime Gravity pulls fluid into the cassette until the PRIME CASSETTE key is released Note See Section 3 3 Priming Procedures Secondary Administration Sets for informat
75. not automatically clear the total the total must be cleared separately 4 Press the ENTER key Note Resetting the IV Flow Sheet in this manner does not affect the programming information and or performance of the device 5 Alternately to clear all lines and the cumulative total simultaneously press the SPECIAL FUNCTION 9 and ENTER keys This special function feature automatically encodes the IV Flow Sheet information into the IV History and then clears all values to zero 6 After turning the device ON select NO to the RESTORE PREVIOUS PROGRAMMING query and the IV Flow Sheet information is cleared Note To use this feature it is important to confirm the IV Flow Sheet log has been reset to zero for all values at the beginning of any period being monitored Omni Flow 4000 Plus IV Medication Management System 5 13 430 06371 B04 Rev 7 95 Section 5 ADDITIONAL OPERATING FEATURES 5 8 2 ACCESSING HISTORY REPORTS WITH A PRINTER The 4000 Plus can provide printed reports of infusion status and infusion history as well as certain time date stamped external events There are two standard reports for local or remote printing Device Status Report and IV History Report See Section 1 4 4 Printer Setup for detailed information on printer setup Confirm that the printer is connected to the 4000 Plus and turned on 5 8 2 1 DEVICE STATUS REPORT The device status is a snapshot of the current status and the programmed events on ea
76. ons 16 NEXT KEY Press this key to move the cursor to the next information entry point on a screen 17 ENTER KEY Press this key to enter programming information or to advance to another screen 18 LAST KEY Press this key to move the cursor back to the last information entry point on a screen 19 AM PM KEY Press this key when changing the AM PM time designation 20 CLEAR ENTRY KEY Press this key to clear information at the current cursor location 21 ESCAPE KEY Press this key to return to the base screen or to return to the programming screen after certain message screens Use the key to restart any time a particular programming sequence is unclear 22 CASSETTE LOCKING LEVER Move the cassette locking lever clockwise to lock the cassette in place To unlock the cassette lift up the cassette locking lever and turn counterclockwise 23 MUTE KEY Press this key to mute the audible alarm for a two minute period or to cancel the Callback or Faulty Cassette Alarms 24 ALARM LIGHT This light illuminates when the device is in an alarm mode 25 BATTERY LIGHT This light illuminates when the device is disconnected from AC power or when there is an AC power failure 26 AC POWER LIGHT This light illuminates when the device is connected to AC power 27 HOLD KEY Use this key to put currently operating lines on hold Press the HOLD key then press the ENTER key All lines including A may be put on ho
77. ons detail setup and priming procedures for the 4000 Plus See Section 13 Keypad Description Figure 13 1 4000 Plus Front View and Section 1 Introduction Figure 1 1 4000 Plus Rear View for overview illustrations of the device Note Prior to placing the 4000 Plus in service fully recharge the battery by connecting the device to AC power for at least 24 hours 3 1 SETUP PROCEDURES n A WARNING ARRANGE TUBING CORDS AND CABLES TO MINIMIZE THE RISK OF PATIENT STRANGULATION OR ENTANGLEMENT CAUTION When programming the device the confirmatory response beep should be clearly audible If the confirmatory beep is inaudible adjust the ALARM VOLUME knob located on the back of the device If after adjustment the beep is still inaudible contact Abbott Laboratories Technical Support Operations To set up the 4000 Plus proceed as follows 1 Use the pole clamp to attach the device to an IV pole 2 Connect the power cord to a properly grounded 110 120 volt AC outlet 3 Toggle the ON CHARGE switch to the ON position Note A service code may be displayed if the device is turned on with a cassette locked in the cassette holster If the service code appears remove the cassette and cycle the power to the device power the device off then on by toggling the ON CHARGE switch to CHARGE then ON The service code is cleared 4 Confirm that the green AC POWER indicator is illuminated and that all other LED indicator lights are off
78. play Y N and press the ENTER key Note The display screen backlight flashes to distinguish it from the status screen Press the ESCAPE key to return to the base screen Table 5 1 Scanning IV History Key NEXT gt Scroll up display display next line of IV History Report lt LAST Scroll down display display previous line of IV History Report AM PM Skip to start of next newer event or start of current event YES NO Skip to start of next older event Omni Flow 4000 Plus IV Medication Management System 5 15 430 06371 B04 Rev 7 95 EA Section 6 ALARM CONDITIONS AND DISPLAYS Certain alarms may switch fluid delivery to KVO In these situations fluid and or drug therapies are interrupted The clinical consequences vary depending upon the particulars of the infusion s and the patient s clinical condition Clinicians need to be cognizant of such particulars during alarm situations CAUTION For those patients who are likely to be adversely affected by unintended operations and failures including interrupted medication or fluid delivery from the device close supervision and provision for immediate corrective action should be provided CAUTION Should excessive alarms occur remove the device from service Under most alarm conditions the device stops operation and generates an alarm for corrective action Corrective actions may include recycling the power reprogramming the device rechar
79. r as the cursor is moved from the weight field it erases the MCG KG MIN field and Concentration field values The global body weight appears upon re entry into this screen The previous mL hr value remains until changed 430 0637 1 004 Rev 4 93 4 6 System Operating Manua 4 2 CONTINUOUS INFUSIONS 4 2 4 CONCURRENT FLOW Variation in patient response may occur when delivering certain short half life drugs if the difference of the delivery rates between the lines is large Drugs with a short half life approximately six minutes or less when given intravenously include the following Dobutamine QA Nitroglycerine QU Dopamine A Nitroprusside QA Epinephrine A Norepinephrine Esmolol Q Oxytocin Q Isoproterenol Q Procainamide A Lidocaine A Trimethaphan Note This list is not intended to be all inclusive of drugs with a short half life critical drugs Clinicians should be familiar with the pharmacodynamics of any critical drug before administration The following delivery rate guidelines represent a worst case scenario of a nitroprusside infusion in combination with one or more drugs This example represents an unlikely extreme since it considers a 20 second half life for nitroprusside which is widely regarded as the drug with the shortest half life in humans reference the British Journal of Anesthesiology These guidelines for nitroprusside would avoid variations in patient response in such an extreme case Q If nitroprusside wi
80. rarily not delivering fluid Disappearance of the abnormality indicates that it was probably caused by electronic noise generated by the infusion device Proper setup and maintenance of the monitoring equipment should eliminate the artifact Refer to the appropriate monitoring system documentation for setup and maintenance instructions 430 0637 1 B04 Rev 7 95 9 4 System Operating Manual Section 10 SERVICE AND PERFORMANCE INFORMATION If the 4000 Plus fails to respond to the operating or troubleshooting procedures listed in this manual and the cause cannot be determined discontinue use of the device CAUTION Do not attempt to disassemble device or perform repairs Service and product performance information may be obtained by contacting Through January 5 1997 Abbott Laboratories Technical Support Operations 980 Linda Vista Avenue Mountain View California 94043 Effective January 6 1997 Abbott Laboratories Technical Support Operations 775 Jarvis Drive Morgan Hill California 95037 Product inquiries may be telephoned to the following number 1 800 241 4002 Contact the Abbott Laboratories Technical Service Center to obtain authorization to return the device for repair A Returned Goods Authorization must be obtained prior to the return of any 4000 Plus Carefully package the device preferably in the original packing and ship it prepaid to the Abbott Laboratories Technical Service Center with the Returned Goods A
81. ry O m If device appears to be damaged do not operate return damaged devices for service When programming the device a confirmatory response beep should be clearly audible If the confirmatory beep is inaudible adjust the ALARM VOLUME knob located on the back of the device If after adjustment the beep is still inaudible contact Abbott Laboratories Technical Support Operations Use only Abbott Omni Flow Primary Sets on the device Refer to the administration package insert for complete instructions Use only Abbott Omni Flow Secondary Sets on the device Refer to the administration package insert for complete instructions The gravity flow prevention valve protects the patient from free flow if the cassette is removed from the device without closing the clamps The gravity flow prevention valve does not prevent the mixing of drug lines Close all clamps before removing the cassette The gravity flow prevention valve requires pressure to open 1 5 5p 5 0 psi The device occlusion pressure setting may require adjustment to prevent nuisance occlusion alarms Turn the cassette locking lever slowly to lock cassette in place It is extremely important to always perform the cassette test when inserting a new cassette After programming the device ensure that pumping has begun by verifying flow into the drip chamber on each appropriate fill stroke for each line in use When restarting an intermittent line that has been stopped the star
82. s running and then stopped using the STOP key for that line or SPECIAL FUNCTION 4 the flush will not start The flush will occur if the line is active when stopped using the STOP key for that line Note Flushes increase the interval between intermittents by the amount of time allocated for the flush WARNINGS WHEN ADMINISTERING CRITICAL MEDICATIONS MONITOR DEVICE PERFORMANCE FREQUENTLY THE USE OF THE CALLBACK FEATURE IS RECOMMENDED FOR INTERMITTENT INFUSIONS DILUTIONS AND FLUSHES CALLBACK ALLOWS CONFIRMATION OF SUCCESSFUL COMPLETION OF THE INTENDED THERAPY NEAR THE END OF AN INTERMITTENT INFUSION WITH DILUTION A SMALL AMOUNT OF MEDICATION MAY BE DELIVERED WITHOUT BEING DILUTED THE DILUTION FROM LINE A MAY COMPLETE BEFORE THE MEDICATION MEDICATION THAT COULD POTENTIALLY CAUSE PATIENT HARM IF DELIVERED UNDILUTED E G POTASSIUM CHLORIDE SHOULD BE DILUTED APPROPRIATELY BEFORE ADMINISTRATION 430 06371 B04 Rev 7 95 4 10 System Operating Manual e Section 5 ADDITIONAL OPERATING FEATURES Section 5 details emptying the collection bag battery operation and additional operating features of the 4000 Plus including the following Q Stopping the device lines A Hold and resume Q Line status Q Special functions Q Automatic air detection and elimination Q Accessing history reports 5 1 TO STOP ANY OF THE LINES To stop any of the device lines proceed as follows 1 Press the STOP key for the line
83. ssette test the device alarms and the Possible Faulty Cassette screen is displayed POSSIBLE FAULTY CASSETTE REPRIME OR REPLACE CASSETTE MUTE If the cassette fails the cassette test proceed as follows 1 Silence the alarm by pressing the MUTE key To clear the alarm press the MUTE key again Check for air bubbles and reprime if necessary 2 Prime the cassette as described in Section 3 2 2 Prime the patient line as described in Section 3 2 4 3 Ifit fails the cassette test again replace cassette Prime new cassette as described in Section 3 2 2 Prime the patient line as described in Section 3 2 4 If two cassettes fail in a row send the device to clinical engineering 430 0637 1 004 Rev 4 93 3 8 System Operating Manual 3 3 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET WITH GRAVITY FLOW PREVENTION VALVE 3 2 5 2 CASSETTE TEST SATISFACTORY If the cassette test is satisfactorily completed the following screen is displayed SELECT INFUSION TYPE PRESS CONTINUOUS OR INTERMITTENT To prepare for connecting IV containers or syringes to the remaining three lines press the ESCAPE key The base screen is displayed THE DEVICE IS NOW READY FOR CONNECTING IV CONTAINERS OR SYRINGES TO THE REMAINING THREE LINES 3 3 PRIMING PROCEDURES PRIMARY ADMINISTRATION SET WITH GRAVITY FLOW PREVENTION VALVE CAUTIONS The gravity flow prevention valve protects the patient from free flow if the cassette is removed from th
84. stering critical medications monitor device performance frequently The use of the Callback feature is recommended for intermittent infusions dilutions and flushes Callback allows confirmation of successful completion of the intended therapy Omuni Flow 4000 Plus V Medication Management System 9 3 430 06371 B04 Rev 7 95 Section 9 WARNINGS CAUTIONS AND PRECAUTIONS a D 0 Certain undiluted drugs are chemically reactive and may adversely affect plastics These drugs should be diluted according to manufacturer s instructions prior to infusion Unrestricted fluid flow occurs if the cassette locking lever is unlocked while the clamps to the IV fluid containers are open Before unlocking cassette locking lever all clamps must be closed to prevent flow to patient and or mixing of drugs For continual protection against risk of fire replace fuse with a 250 VAC 0 6 A SB unit Do not sterilize autoclave or immerse this device in any manner The 4000 Plus is an electronic device with many components Efforts have been made to ensure the quality and long life of these components however any component is subject to possible failure which may cause the 4000 Plus to malfunction and alarm Backup systems to provide intravenous therapy should be available in the event of a device malfunction or failure The 4000 Plus contains electrical components that may be affected by exposure to RF X ray or MRI emissions Caution should be exercise
85. t time and dosing information for the next dose must be reset When infusing short half life drugs at a low flow rate automatic air elimination interrupts the delivery of medication to the patient This medication interruption is dependent upon the infusion rate and may cause a change in patient parameters If Line A is stopped while it is flushing only the current flush is stopped Reprogram subsequent intermittent doses Any continuous infusion already programmed on Line A will restart any maintenance infusion already programmed on Line A will restart after all currently infusing intermittents have completed If the LOW BATTERY alarm sounds connect the device to AC power immediately Do not operate a device with an insufficiently charged or depleted battery pack If the device should be disconnected or if power fails an insufficiently charged battery pack may not maintain device operation Connect the device to AC power whenever practicable to assure maximum battery capacity during patient transport or ambulation For those patients who are likely to be adversely affected by unintended operations and failures including interrupted medication or fluid delivery from the device close supervision and provision for immediate corrective action should be provided Should excessive alarms continue to occur the device should be removed for service To avoid mechanical or electronic damage do not immerse the device in any fluids or cleaning sol
86. th a 20 second half life is to be infused at a rate of less than 10 0 mL hr the combined infusion rate of drugs on the other three lines should be no greater than five times the critical drug nitroprusside rate Q If nitroprusside with a 20 second half life is to be infused at a rate of 10 0 to 20 0 mL hr the combined infusion rate of drugs on the other three lines should be no greater than 10 times the critical drug nitroprusside rate Q If nitroprusside with a 20 second half life is to be infused at a rate of 20 0 mL hr or greater the combined infusion rate of drugs on the other three lines can be programmed at any desired rate This information is presented to inform clinicians of a rare situation that could be misinterpreted if they are unfamiliar with this phenomenon CAUTION When infusing short half life drugs at a low flow rate automatic air elimination interrupts the delivery of medication to the patient This medication interruption is dependent upon the infusion rate and may cause a change in patient parameters Omni Flow 4000 Plus IV Medication Management System 4 7 430 0637 1 004 Rev 4 93 Section 4 PROGRAMMING 4 3 INTERMITTENT INFUSIONS The 4000 Plus can infuse as many as three intermittent medications These medications can only be infused on Lines B C and D To set up lines B C and D as intermittent infusions proceed as follows 1 Press the INTERMITTENT INFUSION key on the line used B gt EACH D
87. ting in flush mode Rate 300 mL hr A gt DILUTING LINE C TOTAL DILUTION 50 0ML DIL REM 25 0ML TIME REM OHR 30MIN Line A operating in dilution mode A gt CONTINUOUS RATE 100ML HR VOL REM 496ML TIME REM 4HR 58MIN Line A operating in continuous mode Omni Flow 4000 Plus IV Medication Management System 3 430 0637 1 004 Rev 4 93 Section 5 ADDITIONAL OPERATING FEATURES A gt STOPPED VOLUME REMAINING 200ML Line A in a stopped or off condition C gt CONTINUOUS RATE 100ML HR VOL REM 496ML TIME REM 4HR 58MIN Continuous line infusing at 100 mL hr B gt DOSE REM 35 0ML TIME REM 0HR 18MIN CB EACH DOSE 50 0ML Q 6 X 4 DIL 0ML Intermittent line currently infusing dose in progress a 50 mL dose with Callback C gt DOSE 50 0ML OVER OHR 30MIN DIL OML NEXT DOSE 3 00 PM Q 6 DOSES REM 3 CB Intermittent line programmed to start in the future with Callback D gt OFF Lines not started 5 4 SPECIAL FUNCTIONS The 4000 Plus incorporates a number of special functions which can only be accessed from the base screen Press the ESCAPE key at any time to return the display to the base screen To access a special function press the SPECIAL FUNCTION key followed by the appropriate special function number use keypad numeric keys Press the SPECIAL FUNCTION key and the following screen is displayed TO SELECT SPECIAL FUNCTION PRESS APPROPRIATE NUMBER 0 9 DESCRIPTION FUNCTION KEY External event recording 0
88. to be stopped either currently operational or programmed to start in the future and the following screen is displayed TO STOP LINE lt A gt PRESS ENTER 2 Press the ENTER key The line turns OFF Note To restart a stopped line with the same drugs fluid and delivery instructions press the appropriate INTERMITTENT INFUSION or CONTINUOUS INFUSION key for that line Recheck rate total volume and programming instructions then press the ENTER key CAUTION If Line A is stopped while it is flushing only the current flush is stopped Reprogram subsequent intermittent doses Any continuous infusion al eady programmed on Line A will restart any maintenance infusion already programmed will restart after all currently infusing intermittents have completed Omni Flow 4000 Plus iV Medication Management System 5 1 430 06371 A04 Rev 4 94 Section 5 ADDITIONAL OPERATING FEATURES 5 2 HOLD AND RESUME FUNCTIONS The HOLD key is used to place one or more operating lines on hold The HOLD key function delays continuous and intermittent infusions in progress and reschedules subsequent future intermittent infusions All previous intermittent line programming is unaffected Hold may be used while taking pressure readings changing containers or performing other tests 5 2 1 HOLD INDIVIDUAL LINES OR ALL LINES To place individual lines or all lines on hold proceed as follows 1 Press the HOLD key A Warning screen is displaye
89. tter disclosed herein are proprietary information Abbott Laboratories retains all the exclusive rights of dissemination reproduction manufacture and sale Any party using this document accepts it in confidence and agrees not to duplicate it in whole or in part nor disclose it to others without the written consent of Abbott Laboratories Omni Flow 4000 Plus IV Medication Management System v 430 06371 C04 Rev 8 96 as Section 1 INTRODUCTION The Omni Flow 4000 Plus IV Medication Management System incorporates all the features of the Omni Flow 4000 with added data communications capability and new data entry screens which incorporate automatic calculation plus programming from alternate units of measure entry 1 1 FEATURES OF THE IV MEDICATION MANAGEMENT SYSTEM Incorporating microprocessor electronic design and safety features the 4000 Plus represents a major advance in instrumentation for the delivery and management of intravenous therapy The 4000 Plus includes the following capabilities of the Omni Flow 4000 D Four channel medication delivery through a single patient line Programmable Multi dose containers Programmable automatic in line dilution Programmable automatic flushing between incompatible medications Any combination of both continuous and intermittent infusions Real time clock Infuses from combinations of bags bottles and syringes Automatic air detection and elimination Needleless connections gc
90. uthorization RGA clearly identified Abbott Laboratories cannot assume any responsibility for loss or damage to returned instruments while they are in transit or for the unauthorized return of any instruments Note Pre authorization must be received prior to the return of any 4000 Plus Omni Flow 4000 Plus IV Medication Management System 10 1 430 06371 C04 Rev 8 96 Ee Section 11 4000 PLUS SETS Use only Omni Flow Primary Sets with the 4000 Plus Primary Omni Flow Sets can be used as a gravity administration set with the device Sets are sterile and for single use only 11 1 IV ADMINISTRATION SETS The following table lists the intravenous administration sets for use with the 4000 Plus LIST NO DESCRIPTION 11167 Primary Macro bore Device Set convertible piercing pin 122 inches in total length with 72 inches of tubing from cassette to patient collection bag roller clamp one Y injection site and luer lock adaptor 11168 Primary Micro bore Device Set convertible piercing pin approximately 80 inches in total length with 30 inches of micro bore tubing from cassette to patient collection bag roller clamp one Y injection site and luer lock adaptor 11169 Primary Micro bore Device Set convertible piercing pin approximately 110 inches in total length with 60 inches of micro bore tubing from cassette to patient collection bag roller clamp one Y injection site and luer lock adaptor 11440 LifeShi
91. ution rate The device calculates the other value automatically based on the dose time previously entered Move cursor if necessary by pressing the NEXT key 7 To begin infusing immediately press the ENTER key B gt START AT 12 30 HR TIME NOW 12 30 HR ENTER Line B has begun to infuse its dose A OFF B INF C OFF D OFF TOTAL 12 30PM 0 150 0 0 150 ML KR Note To cancel the dilution ofa particular line STOP and reprogram the line being diluted by changing YES to NO Recheck the number of doses remaining in the container and the start time of the next dose 8 Alternately to delay the start of the line up to 23 hours input a start time using the keypad numeric keys Correct AM PM if necessary by pressing the NEXT key once then the AM PM key B gt START AT 4 00 PM TIME NOW 12 30 PM CENTER Line B now shows that it is programmed to start but does not start infusing its first dose until the time set Press ENTER to return to the base screen Omni Flow 4000 Plus IV Medication Management System 4 9 430 06371 A04 Rev 4 94 Section 4 PROGRAMMING Note The line must be OFF to re enter the intermittent programming screen and make a change for a particular line If it is currently infusing or programmed to start in the future the line must be stopped before re entering the programming screen Note Lines which are currently programmed for intermittent or maintenance infusions must first be stopped before pro
92. utions Do not operate devices that contain residue from solution spills Sticky or gummy residue can interfere with the free movement of the valve stems and or the pressure sensing mechanism If it cannot be completely cleaned return the device for service 430 0637 1 B04 Rev 7 95 9 2 System Operating Manual 9 3 9 3 PRECAUTIONS Certain cleaningand sanitizing compounds may slowly degrade components made from some plastic materials Using abrasive cleaners or cleaning solutions not recommended by Abbott Laboratories may result in product damage Do notuse compounds containing combinations of isopropy alcohol and dimethyl benzyl ammonium chloride Never use sharp objects such as fingernails paper clips or needles to clean any part of the device Do not sterilize by heat steam ethylene oxide ETO or radiation To avoid device damage cleaning solutions should be used as directed in Table 8 1 Cleaning Solutions The disinfecting properties of cleaning solutions vary consult the manufacturer for specific information Do not attempt to disassemble device or perform repairs Federal USA law restricts this device to sale by or on the order of a physician or other licensed practitioner Use of radio frequency emitting devices such as cellular telephones and 2 way radios in close proximity of this device may affect its operation PRECAUTIONS Before operating the 4000 Plus the user should become thoroughly familiar with the prop
93. y PRINT IV FLOW SHEET CENTER 2 To print the IV Flow Sheet press the ENTER key SPECIAL FUNCTION IV FLOW SHEET Displays purge totals for all lines To display purge totals for all lines proceed as follows 1 Press the SPECIAL FUNCTION key followed by the IV FLOW SHEET key 2 Press ENTER to return to the base screen 430 0637 1 A04 Rev 4 94 5 10 System Operating Manual 5 5 AUTOMATIC AIR DETECTION AND ELIMINATION SPECIAL FUNCTION CLEAR ENTRY Resets IV History for new patient To reset IV History for a new patient proceed as follows 1 Press the SPECIAL FUNCTION key followed by the CLEAR ENTRY key 2 Use the YES NO key to select YES All prior IV History information is cleared This function prevents patient IV histories being combined CLEAR IV HISTORY Y N NO PRESS ENTER 5 5 AUTOMATIC AIR DETECTION AND ELIMINATION The 4000 Plus air elimination system automatically detects and eliminates small air bubbles that might appear in the cassette during operation Upon sensing air in the cassette approximately 120 microliters the device automatically clears the air into the collection bag portion of the Omni Flow Primary Set by flushing the cassette with fluid from Line A This process causes a temporary interruption of medication delivered to the patient The device attempts to clear the air twice Should there be more air present than can be cleared automatically the device alerts the user with

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