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Curlin 4000 User Manual - Med-E

1. aeui 5 ACCEPT This screen allows you to change the basal rate and or the bolus parameters within the predefined prescription limits Whenever any value is changed using the titrate option the new value will appear on the prescription menu when it is reviewed If a delta time rate limitation was previously programmed the rate can be increased within those parameters up to 12 times during the delta time period Ifa 13 attempt is made an alert will display MAX CHANGES FOR PERIOD REACHED a f BASL RATE Use the numeric keys to enter the new desired rate When the correct rate has been entered press the YES ENTER key to accept the rate and move to the next field The range for this field is 0 to 50 or the highest limit allowed for the administration route selected see Figure 5 1 BOLUS Use the numeric keys to enter the new bolus dose and when correct press YES ENTER to accept and move to the next field The range for this field is 0 to 50 or the highest limit allowed for the administration route selected see Figure 5 1 BOLS INT Bolus Interval Use the numeric keys to enter the new bolus time interval and when correct press YES ENTER to accept and move to next field The range for this field is 0 to 60 BOLS hr number of boluses per hour Use the numeric keys to enter the new number of boluses per hour and when correct press YES ENTER to move to the final step in the titration menu
2. 118 Chapter Troubleshooting This sechon assists in identifying and resolving alert and alarm conditions that may oxur during the use of the Curlin Medicalpump Alerts Alarms and Error Codes Alerts Alarms and Error Codes are classes of events that are relayed to the user and logged into the history file The screen will display nen imiessages the LED status lights will blink and the audio alarm will IMPORTANT sound The backlight feature will illuminate the screen during an alert INFORMATION or alarm If the batteries have been dislodged or are so low in power that they cannot operate the pump a solid tone may occur accompanied by a blank display screen and a constant red alarm light In this event replace the batteries ALERTS Alerts report conditions that require attention from the user but may not be safety issues When an alert occurs a message is displayed on the LCD screen and the audio alarm is sounded The message displays on the screen for three seconds if it is a user initiated alert such as a wrong key press If it is an automatic alert occurring while a therapy is infusing such as low battery the message displays for twenty seconds If it is an alert that requires a user response the alert remains displayed until the user presses one of the keys specified on the screen The following is a list of the alerts in alphabetical order LCD Display ALERT AIR SENS OFF Using In Line Filter Alert Ai
3. Curlin Medical Holster with pole mount to be attached to an IV pole The back of the holster slides onto the pole mount and locks securely RY in place Figure 10 5 Pump Holster 142 Keypad Covers These accessories ate hard plastic durable keypad covers that can optionally be used with the 340 0141 340 0141 01 and 340 0141 02 lockboxes to cover the keypad The keypad covers are available in two configurations e Type I 340 0142 01 covers all the keys with the exception of the SILENCE and RUN PAUSE keys e Type II 340 0142 02 covers only the numerical and PRIME BOLUS keys Keypad Cover Type II LOCKBOX 340 0142 02 Ke pad Cover Type I 340 0142 01 Figure 10 6 Keypad Covers 143 salosse2sy 144 Chapter Cleaning Environmental Conditions and Maintenance Folloving the guidelines for care ksted below will assure the best appearance and longest ie of the Curlin Medical pump Cleaning The Curlin Medical pumps are designed to be resistant to fluid spillage from any direction but are not to be immersed in solutions Keep the pump and the pumping surfaces clean dry and free of fluid spillage at all times Do not use the pump in the shower sauna or steam bath and do not position the pump where it could accidentally be dropped into a container of fluid e g basin tub or toilet The pumping surfaces can be cleaned with a cloth dampened with any of
4. On Off Key Help Option Key AIDA 4 _ Down Arrow f Fead Yes Enter Key Prime Bolus Key Data Interface Bolus Cord Port LS Up Arrow j A Decimal Point LA Silence Key No Change Key Numeric Keys X wn Figure 1 1 Curlin Medical Ambulatory Pump Front top and left view Serial Number Label Battery Compartment Door with Caution Label Recessed release Pin for Battery Door External Power Jack Port 2 Pin Port Figure 1 2 Curlin Medical Ambulatory Pump Back bottom and right view uo1 npo3 u Disposable Administration Set Illustrations and Features EK ofp 0 co bor ni S Ca y Integral Flow Bag Spike __ Male Luer io i A Stop with Tubing Guide Lock Slide Clamp breakaway tab These drawings are NOT to scale Note An important feature of the Curlin Medical administration set is the unique design of the set based Integral Flow Stop When the set is new the Integral Flow Stop has a breakaway tab that keeps the Integral Flow Stop open and allows the tubing to be gravity primed When you are ready to load the administration set into the pump remove this tab and the Integral Flow Stop will automatically clamp the tubing The Curlin Medical Integral Flow Stop prevents inadvertent flow of medication to the patient whenever the door of the pump is opened because the
5. a REPEAT Rx To repeat the present therapy and add another IV bag or reservoir with tl same prescription press the YES ENTER key at this field If more than one therapy programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing tl YES ENTER key The pump will then display the program screens with the last programmed values of tl therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at tl remaining fields ne is ne ne ne b NEW PROGRAM To program an entirely new prescription or a different therapy press the YES ENTER key at this field and the display will return to the Select Therapy Screen The lock setting can control access to this function Note The therapy is complete therefore RESUME is not an option at this time and is not displayed 101 Adeiay U9 1U119 U 102 CHAPTER Variable Therapy This therapy is designed to allay hyenty four speaied programs of varying amounts rates and times of delivery Screen The following display screen will appear requiring you to enter information egin programming a Variable Therapy by selecting Variable f
6. 0 and press YES ENTER to move to the next field d Max BOLS Maximum Bolus Dose Use this field to set the upper limit of the Bolus or Patient Demand dose If there is no bolus dose enter 0 If a value is given for the Bolus Dose use the numeric keys to enter it on this field press the YES ENTER key to accept and move to the next field The value entered for this field must be equal to or less than maximum Bolus Dose listed in Figure 5 1 Administration Routes table e MinINT Minimum Bolus Interval Use this field to set the minimum amount of time allowed between bolus doses When the correct time is entered press the YES ENTER key to accept and move to the next field f BOLS hr Number of Boluses allowed per hour Use this field to enter the maximum bolus hr When correct press the YES ENTER key to accept and move to the next field g ACCEPT If there are any changes to be made use the up or down arrows to move to that field use the numeric keys to enter the corrected data and press YES ENTER to accept the new values Move the cursor back to the ACCEPT field and press YES ENTER The Titration Limits are now entered and the display returns to the Pre Prescription screen If the entire Titration Limit Screen is to be aborted press NO to return to the Pre Prescription screen 6 NEXT If any field is not satisfactory use the arrow keys to locate the field to be c
7. Alett Cause Resolution ALERT Rx IN PROGRESS YES to Repeat NO to Return REPEAT Rx selected while a therapy is already in progress REPEAT Rx was selected and there is a therapy currently in progress To terminate the current therapy in progress press YES Resume will no longer be available The Select Therapy menu will be displayed if only one therapy is in programmed the pre Rx menu for the therapy will be displayed When the therapy to repeat is chosen the last prescription data programmed will appear in the menu excluding Delayed Start and Load Dose if therapy was previously started When the infusion is started the entire therapy will be repeated To continue the current therapy in progress press NO The Pause menu will be displayed ALERT Rx IN PROGRESS YES New Program NO to Return NEW PROGRAM was selected while a therapy is already in progress NEW PROGRAM was selected and there is a therapy currently in progress To terminate the current therapy in progress press YES Resume will no longer be available The Select Therapy menu will be displayed if only one therapy is in programmed an alert screen informing that the Rx will be erased will be displayed When the therapy for the new program is chosen entry of a new prescription will be required To continue the current therapy in progress press NO The Pause menu will be displayed ALERT Rx Programmed YES to Erase NO to Return NEW PROGRAM was sel
8. Learning to operate the Curlin Medical pump requires a fav basic points of understanding that remain constant in every therapy It may be helpful to read through these steps first and then go back and use them to operate the Curlin Medical pump keys especially the dual function keys work will allow you to give commands to the F irst examine the key pad and the functions of the individual keys Knowing how the pump Display Z sne Screen f hs Figure 2 1 Key Pad 23 duing 6uluiea7 Keypad Function ON OFF Used to turn the pump on and off When the pump is running however the PAUSE key must be used to stop the infusion first and then the OFF key can be pressed to turn the pump off This requirement prevents the interruption of an infusion by a single accidental press of the OFF key RUN PAUSE Used to start or pause the motor of the pump which in turn starts or pauses fluid delivery When the pump is running pressing this key will pause the pump When the pump is paused pressing this key during the Run Options menu will start the pump This key is also used to terminate a pump alarm Note If the cause of the alarm is not resolved when the pump is Resumed the alarm will recur ft Up arrow Used to scroll the highlight bar or field cursor wp on the display screen Note The Up arrow will not accept a selection which must be made with a YES ENTER ot NO CHANGE key
9. Mcieared ZHIAN 21135 ELAPSED Q ILZ HHMH A uol INF G 5 ml Uol INF 3 5 ml EOLUS of 4 Clin DOSE DOME DONE REg a Cleared ELAPSED This field displays the date and time the shift total was last cleared It toggles with the amount of time elapsed since that clearing b Vol INF Amt INF Volume Amount Infused This field displays the volume ml and amount mg or mcg infused since the shift total was cleared c BOLUS Clin DOSE Clinician Dose This field displays the number of clinician doses given since the total was cleared It toggles with the number of patient activated boluses received of those requested 62 d To exit the shift total feature without clearing the totals press the YES key at the highlighted EXIT field e To clear the Shift Totals press the NO key at the EXIT field The field will change to read CLEAR press the YES key now to clear A lock level 3 will require an access code entry before allowing the user to clear the Shift Totals 4 HRLY TOT Hourly Totals To view hourly infusion totals press the NO CHANGE key to change OFF to ON and then press YES ENTER Either of the following two screens will appear Hourly Totals Screen HE WOL ml BG BA i3 HE AMT ms BG BA HE AMTmeSs BG BA 28 28 The screen displays hourly infusion delivery for each hour 00 23 of the last 24 hours of therapy in the unit selected a The highlighted field has
10. Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution If it is not necessary to preserve the therapy in progress or any other programmed therapy use the CLEAR Rx feature of the Clinician Biomed menu This feature will erase all programmed therapies in the pump The Date and Time can then be changed If the therapy is to be terminated but the prescription preserved excluding Delayed Start go to the Pause menu select REPEAT Rx and press YES at the Rx in progress alert screen The pump can then be turned off and then on to access the Date Time change option in the Clinician Biomed menu Selecting NEW PROGRAM and the name for the therapy in progress instead of REPEAT Rx may also be used but this selection will erase the prescription for the therapy ALERT DATE TIME INVALID Unable to enter invalid date or time Date or time entry is not in a valid format Recheck data entry An invalid date or time will not be accepted ALERT DELAY START TIME NOT VALID Delay Start time not valid Delay start time entered is less than one minute or greater than 24 hours from the current system time Reset Delay Start Time to fall within pump limits To obtain the current date and time of the pump turn the pump off and then on and observe the time on the Welcome screen ALERT DOOR OPEN or SET NOT PROPERLY
11. U Down arrow Used to scroll the highlight bar or field cursor down on the display screen Note The Down arrow will not accept a selection which must be made with a YES ENTER or NO CHANGE key NO CHANGE Used to respond NO to data or questions presented or to reject or to change highlighted data Note The Curlin Medical pump requires you to actively change a selection The Up arrow or Down arrow will not change a selection YES ENTER Used to respond YES ENTER to data or questions presented or to accept highlighted data when prompted to press enter key Note The Curlin Medical pump requires you to affirmatively accept a selection The Up arrow ot Down arrow will not accept a selection HELP OPTIONS Used to request a help screen when the pump is paused or is at the Infusion Complete Screen It is also used to access the options screen when the pump is running When the options screen is displayed help is again available with this key When in a help screen use the arrow keys to scroll through the help message and then press the help key again to exit help SILENCE Used as a decimal point when programming numeric data Used also to temporarily silence the alarm for one minute intervals PRIME BOLUS Used to prime fluid through the tubing to clear it of air or to administer a patient demand bolus dose of medication in PCA therapy 10 0 9 Numeric keys Used for data entry 24 LED Light In
12. YES ENTER key If the changes are not acceptable use arrow keys to cursor up to any field for corrections or abort all changes made in this menu by pressing the NO key and return to the previous screen There are two remaining selections to consider from the Run Options Screen NO to REVIEW and RUN to START Reviewing or Changing the Program To review or make any changes in the prescription programming press the NO CHANGE key at the Run Options screen and the prescription screens will reappear Changes may be inhibited by lock setting Changes to the prescription can be made before the start of the therapy however once a therapy has started no changes can be made to the Pre Prescription Screen It will appear only for review purposes Attempts to change the Pre Prescription Menu during a new program review will cause an alert screen to be displayed notifying the programmer that changes will require reprogramming of the prescription Starting the Infusion RUN When all parameters are correct and the pump has been primed properly and connected to the access site press RUN at the Run Options screen to start the therapy If a delayed start is programmed the Delay Start Count Down Screen will appear If no delay start is programmed or the delay has elapsed the pump will begin infusing and the following screen displays the status of the therapy TPN Run Screen T RATE 275 8 ml he E vol TBI 1000 ml m
13. 5 Accuracy 55 to 90 F 10 Accuracy 45 to 55 F 10 Accuracy 90 to 104 F e Relative Humidity 15 to 95 Non condensing Maintenance Yearly preventive maintenance checks are recommended and will be prompted in the Set Up menu and on the display when the date occurs This date accrues from the date of factory release and is reset when each annual maintenance check is completed Any time an error code message occurs repeatedly or any time a pump appears to be tampered with or shows any indication of not performing to standards the pump should be returned to the healthcare provider dispensing the pump At no time should unauthorized personnel open the hard case of the pump Limited Warranty Curlin Medical Inc the Manufacturer warrants to the Original Purchaser that the infusion pump the Pump not including accessories shall be free from defects in material and workmanship under normal use if used in accordance with this User s Manual for a period of one year from the actual date of sale to the Original Purchaser THERE ARE NO OTHER WARRANTIES The warranty does not cover normal wear and tear and maintenance items and specifically excludes batteries administration sets extension sets or any other accessory items or equipment used with the Pump Subject to the conditions of and upon compliance with this Limited Warranty the Manufacturer will repair or replace at its option without charge except
14. ALERT TIME LESS THAN RAMP TIME Unable to enter a TPN therapy time that is less than the ramp times Time value entered for TPN infusion is less than ramp times Recheck data entry TPN infusion time cannot be less than specified ramp times ALERT USING 2 0 ML DEFAULT PRESS YES TO OFF FOR OFF The air sensitivity currently being used by the pump is 2 0ml YES was pressed at the ACCEPT field on the Options menu and the displayed setting in Options for the AIR SENS field is OFF however the pump is using a setting of 2 0ml This occurs when YES was not pressed when the AIR SENS OFF Using In Line Filter alert screen was last displayed and the down scroll arrow was used instead of the YES key to pass the AIR SENS field on the Options menu Alert is only displayed when Options is displayed and pump is running The cursor will be on the AIR SENS field when the alert is cleared Press YES to display the AIR SENS OFF Using In Line Filter screen Press YES if an air eliminating filter is being used Press NO if no air eliminating filter is being used ALERT VALUE PREVENTS A SUBSEQUENT DOSE Value entered will prevent the ability to program any more doses The value entered for the Variable Dose Amt or Time field will cause no remaining amount or time for a subsequent Recheck data entry If this is a new program reprogramming of the therapy will be required if the error is in a previously programmed dose If the therapy is in
15. S L FRES 18 mmHG TOT VOL 181 4 mal REMAIN S00 6 ml REMAIN 5116 HH MM This screen will continue to display as long as the infusion is running Notice the information on each field 81 Ade1 4L Ndl 1 The first field displays the RATE of the infusion If the therapy is in a ramp up or down phase the rate will change accordingly to reflect the gradual increase or decrease in rate The Rate toggles with the Volume to Be Infused 2 The second field is a graphic bar representing the percentage of the completed infusion It also depicts the up or down ramping phase with gradually taller or shorter lines on the bar graph In CMS enabled pumps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units 3 The third field displays total volume infused 4 The fourth field displays the remaining time to the completion of the infusion This toggles with the remaining volume 5 In addition to the display screen accumulating information regarding the status of the infusion the green LED light blinks whenever the pump is infusing The information on the run screen will alternate between a four line display and a large font display of each individual line of information on the screen TPN Information Screens Tot Vol Remain 107 2 mL 3 13 HH MM Vol TBI Remain 1000 mL 882 3 mL Rate Line
16. When the PCA therapy is used patient bolus dosing can be programmed To facilitate ease of patient self dosing the patient can use the Bolus key or the Remote Bolus Access Cord The cord is five feet long and has a patient access button at the top of the remote cord The four pin adapter plugs into the four hole port on the left side of the pump see Figure 1 14 below This port may be covered with a plastic plug If so remove the plug to access the port To correctly connect the bolus cord align the red dot and the connector s keyed notch with the red dot and notch in the port on the left side of the pump When the cord is plugged into the pump it is locked in place by the locking sleeve To remove the cord pull back on the soft green locking sleeve and disengage the cord from the pump by pulling it straight out of the access port Because bolus dosing is applicable only in PCA therapy if the cord is left in place and the button is pushed while any other therapy is infusing an alert message will appear on the display screen stating Notin PCA No Bolus Allowed Bolus Data Port on Left oe N side of Pump Four pronged adapter plugs into access port on left side of pump as shown To remove bolus cord pull back on locking sleeve and pull cord straight out of access port Figure 1 14 Attaching and removing the remote Bolus Cord 22 Chapter Learning Pump Features
17. aborts the feature and also returns to the menu 12 CHANGE CONTRAST The contrast on the display screen can be adjusted To do so press the YES ENTER key at this field and the following screen appears CHANGE CONTRAST Level Ei ACCEFT YES NO The level can be adjusted from 0 lightest screen to 100 darkest screen The pump is set to an optimized setting when shipped from the factory To change the setting enter any number between 0 and 100 and press the YES ENTER key to see the change in the screen If this level of contrast is not satisfactory move the cursor back to the LEVEL field and enter another number and press the YES ENTER key When the contrast is satisfactory move the cursor to the ACCEPT field and press the YES ENTER key To abort the entire selection and return to the previous contrast setting press the NO CHANGE key at this field and return to the BIOMED SETUP Menu Changing Date and Time 13 CHANGE DATE AND TIME When this field is selected the screen on the left appears Change Date and Time Screen DATE AND TIME DATE AND TIME CLOCK clock iZhr TIME 17216 HH MM AMF AM DATE 23JANGS TIME 17 16 HH MM ACCEFT YES NO DATE 23 JAN S ACCEFT YES NO This screen is used to set the system Real Time Clock in the pump and will change the date and time displayed on the Welcome screen Note The time must be reset to accommodate Daylight Savings Time changes and also
18. 76 administration set was first connected to the bag see Chapter 1 Preparing Medication for Infusion However if it was not done then or if there are any remaining air bubbles to be removed the pump s PRIME function will assist in this process To prime the set by using the pump follow the directions below Note The lock setting may restrict the ability to prime using the pump 1 Press and release the PRIME key at the Run Options screen 2 The following screen appears Prime Direction Screen Disconnect Pt Release Clamps HOLO siemala key HA to EXIT 3 Disconnect the administration set from the access site using aseptic protocols IMPORTANT Priming with the set connected to the patient could result in overdose INFORMATION and may cause injury or even death to the patient 4 Release any clamps on the administration set 5 Press and hold the PRIME key Fluid will be pumped at a rate of 300 ml hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped The pump will then beep once and require repressing and holding the PRIME key again until 6 more milliliters is delivered Continue this process until all air has been purged from the IV bag and the administration set Note If the bag volume is depleted during priming a subsequent priming event cannot be initiated While the PRIME key is depressed the following screen appears PRIM
19. The range for this field is 0 1 to 999 3 DOSE RATE Rate at which each dose is to be delivered The Curlin Medical pump can deliver from 0 1 ml to 400 ml per hour Use the numeric keys to enter the prescribed rate again the units chosen in the pre infusion menu will appear here When the correct rate displays use the YES ENTER key to accept the rate and move to the next field Adejiady U9 1U119 U Note You may elect to skip the dose rate and enter the dose time first to let the pump automatically calculate the dose rate 4 DOSE Time Using the numeric keys enter the amount of time over which each dose is to be infused The range for this field is 0 01 to 99 59 HH MM When correct use the YES ENTER key to accept this field and to move on to the next Note If you have entered the dose amount and rate the pump will automatically calculate the dose time 5 DOSE Freq Dose Frequency Represents the time from the start of one dose to the start of the next e g every six hours Use the numeric keys to enter the dose frequency and when correct press the YES ENTER key to accept the cycle time and to move on to the next field The range for this field is 0 01 to 99 59 HH MM 6 KVO Rate Keep Vein Open Rate This field requires data entry using the numeric keys to set the rate at which fluid will be delivered in a Keep Open state The KVO Rate will be used between doses The pump can be set from 0 to 10
20. You have the option to continue by pressing the YES ENTER key or return to the Run Options screen by pressing the NO key Options Once the prescription is programmed there are more customizing features available for each therapy Press the OPTIONS key from the Run Options screen to access these options The OPTIONS menu can also be accessed while the pump is running Note After the infusion has started any changes made through the OPTIONS menu involving e Clin DOSE e SHFT TOT e HRLY TOT and e CLR HRLY will return you directly to the ACCEPT OPT field The following screen displays the PCA Therapy Options available When you open this menu use the up and down arrows to move the highlight bar to the desired option Lock settings may require an access code before the option can be changed Any new setting except CLEAR HOURLY screen acceptance and SHIFT TOTAL clear screen acceptance becomes effective when the Options screen is exited by pressing YES ENTER at the ACCEPT OPT field PCA Options Menu OPTIONS Lock OFF 4 Lock Maa i z 3 4 Clin DOSE OFF of SHFT TOT OFF of OM OM ON LOW 2 8 OFF 1i i 3 ON HRL ToT OFF LR HALY OFF Titr Rx OFF DH Oeclu HIGH AAIRSENS O 5 ral i AUDIO S FHR CK i ACCEPT OFT YES NO Note The pump s default settings are indicated above in the left
21. change the lock to meet the security needs of this therapy There are four choices OFF 1 2 or 3 Each level higher limits the available options To change the lock setting press the NO CHANGE key until the correct lock setting appears Then press YES ENTER key to accept the new lock selection Once the pump has been set into a locked condition any subsequent request to change the lock will require a clinician access code See Clinical Information and Access Code chapter for access code information lock setting table and available features for each lock setting 2 HRLY TOT Hourly Totals To view hourly infusion totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Hourly Totals Screen AMT ms ANTM 9 The screen displays hourly infusion delivery for each hour 00 23 of the last 24 hours of therapy in the unit selected a The highlighted field has a marker lt indicating the current hour in progress b Use the up arrow key to scroll back through the last 24 hours c Ifthe infusion was not running a series of will appear for that hour 47 Adeiay snonunuog d To exit this screen press the NO CHANGE key 3 CLR HRLY Clear Hourly Totals To clear Hourly Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Clear Hourly Totals Screen Clear Hourly
22. changes to the program unless an access code is given Also remember that no changes are allowed in the first prescription menu if an infusion is in progress c Press the OPTIONS or PRIME keys if either of these functions is desired at this time Hanging a New Container 2 REPEAT Rx To repeat the present therapy and add another IV container with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields When the program is accepted the display returns to the above Run Options Screen If the current therapy is still in progress when the REPEAT Rx function is selected the following screen will appear ALERT Rx in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If the therapy is to be terminated and a new IV container added press YES ENTER to go to the programming screen
23. confirm the program and proceed with the repeat infusion b Ifthe incomplete therapy is to be continued press NO and the Pause Menu screen will be displayed then press YES and the Run Options screen will be displayed To resume the unfinished therapy press RUN Entering a New Program NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key at this field the ability to change these parameters may be controlled by the lock setting The display will return to the Select Therapy Screen if more than one therapy mode is enabled or to the Pre Prescription Screen of the single therapy mode If the current container has not completely infused the following screen will appear ALERT Rx in progress New Program to Return a This screen is a reminder that the infusion is not complete If you want to return to the current container and finish infusing it press the NO CHANGE key to return to the Pause Menu screen b To abort the current container and enter a new program press the YES ENTER key If a prescription has previously been entered for the therapy mode you wish to program the following screen will appear ALERT Rx Programmed to Erase Rx to Return Ades9uL Wd c Ifyou want to save the current prescription press the NO CHANGE key to return to the Pause Menu screen If you wish to erase the current prescription and e
24. the upper and lower programming limits for mg and mcg Use the NO CHANGE key until the desired units appears on the display and then press the YES ENTER key to accept and move to the next field 2 CONCEN Concentration This field is active whenever mg or mcg is selected in the units field and requires data entry of the concentration of mg or mcg per ml When the correct data is entered press YES ENTER to accept and move the cursor to the next field If ml is chosen in the units field this line will not display The range for this field is 0 1 to 999 55 Ades9yuL Wd 3 ADMIN Rt Administration Route Allows a selection from three routes of administration the default setting of IV intravenous EPI epidural and SQ subcutaneous If Epidural is selected the Therapy Identifier bar in the Prescription Menu will display EPI instead of PCA Each of the routes has defined settings as illustrated in the following table Administration Routes Administration Occlusion Setting Maximum Rate During Maximum Maximum Route mmHg psi Basal Rate Bolus Bolus Dose Load Dose ml hr ml hr ml ml Intravenous 900 or 400 18 or 8 50 125 50 50 Epidural 900 or 400 18 or 8 25 90 25 25 Subcutaneous 900 or 400 18 or 8 5 60 5 5 Figure 5 1 PCA Administration Route Default Settings 4 Load Dose Loading Dose Allows the clinician to program in a pre infusion loading dose
25. 158 Chapter Clinician Information and Access Code This chapter should be removed before initial patient training and instruction on the Curlin Medical pump so the intended locked functions or secured functions of the pump cannot be accessed except by a trained dinidan Removal of this chapter will assist in patient safih W henever it is necessary for the clinician to unlock a secured lock setting the following screen will appear Clinician Access Code ENTER CODE ae INVALID CODE EXIT YES The access code for the Curlin Medical pump is given below Clinician Access Code KKK KK The clinician enters a four digit personal identification number followed by the five digit access code If the five digit code is valid the display will automatically move to the requested screen or field The four digit personal identification number appears on the screen but the access code numbers are displayed as five asterisks The personal identification number is recorded in the history file for the purpose of providing an audit trail If an invalid access code is accidentally entered a message displays Invalid Code and the clinician can reenter the correct code Note After entering the access code DO NOT press the YES ENTER key The pump will automatically recognize the correct code and give you access to the secured section Entering the clinician access code does not change the lock setting of the pump but does allow the
26. 16 57 AIR FILTER 21JAN03 16 57 RUN PAUSE KEY 217AN03 16 57 CON RUN OPTION Options Lock OFF Lock OFF Hourly Tot OFF Clear Hrly OFF Dn Occlu HIGH Air Sens OFF Audio 9 PWR CK OFF Accept OPT YES NO CON Rx Bag Vol Amt TBI Rate Time KVO Rate Done CON PRE Rx Units Delay Titrate Next REPEAT Rx 16 56 ON PUMP 16 33 OFF PUMP Hx Log Used bytes YES 217AN03 9900 9500 7400 0 1 23 45 Hie ee YES ml ml ml hr HH MM ml hr 217AN03 tml 217AN03 217AN03 Z217AN03 Patient 16 57 1693 of 61440 Figure 3 1 History Event Log 34 8 PRINT PATIENT HISTORY To print the patient history log connect the Data Interface Cable to the communication port on left side of the pump before selecting this command PRINT Pt Hx ACCEPT FOLLOW DIRECTIONS THAT ACCOMPANY THE DATA INTERFACE CABLE The pump will display When you select YES the display will read Printing Patient History Record When the printing is completed the pump display returns to the BIOMED SETUP Menu To abort the printing process press the NO CHANGE key on the pump s keypad and the display will return to the BIOMED SETUP Menu If the Patient History Log stops before all data is transferred exit and restart the Print Pt Hx command Note To utilize the print feature of the Curlin Medical pump you must have a PC running the Hyperterminal program within MS Windows and use the Curlin
27. 3 Household bleach diluted 9 1 with water 4 Commercial disinfectant When clean dry pump and other items with a soft clean dry cloth The soft carry packs are intended for single patient use They may be cleaned in the gentle cycle of a washing machine using cold water no chlorine bleach and line dried They cannot be dried in a clothes dryer The Bolus Data connector is to be used by the patient only for the connection of the bolus cord with remote switch Other accessory equipment connected to this digital interface must be certified to the respective IEC EN standards i e IEC 950 for data processing equipment and EN 60601 1 for medical equipment Furthermore all configurations shall comply with the system standard EN 60601 1 Anyone who connects additional equipment to the signal input part or signal output part configures a medical system and is therefore responsible that the system complies with the requirements of the system standard EN 60601 1 If in doubt consult the technical services department or your local Curlin Medical representative The Curlin Medical has been tested and found to comply with the European Standard EN 60601 1 2 1993 and EN 60601 2 24 1994 These limits are designed to provide reasonable protection against harmful interference in a typical medical installation e This equipment generates uses and can radiate radio frequency energy and if not installed and used in accordance with the instructions m
28. 3 seconds if there is no KVO every 20 minutes if there is a KVO to alert the user to this condition Additionally the LED lights blink to alert you to the status of the pump The green light blinks when the KVO rate is infusing if one is programmed and the red light blinks to indicate that the Infusion Complete alarm exists Stopping the Infusion To halt the infusion at Infusion Complete press the PAUSE key and then choose to either 1 Turn off the pump by pressing the OFF key or 2 Select one of the options from the Pause screen Pause Menu Screen ENTER to Select NEW PROGRAM a REPEAT Rx To repeat the present therapy and add another container with the same ptescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields b NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key when
29. 5 ml the default setting 2 0 ml and OFF Press the NO CHANGE key to change the options until the desired setting appears on the display and then press YES ENTER to select and move the cursor to the next line IMPORTANT Whenever the Air In Line Sensor is set to OFF Curlin Medical INFORMATION recommends the use of an air eliminating filter When the Air In Line Sensor is set to OFF and the RUN key is pressed at the Run Option screen the alert message below will appear on the screen It will also appear if the Air In Line is changed from the OPTIONS menu when an infusion is in progress and the AIR SENS field is accepted Air In Line Sensor Off Message Screen ALF Sensor OFF Using In Line Air Filter This message alerts you to the Air In Line Sensor being set to OFF The message will require answering yes or no to whether the administration set being used has an air eliminating filter If you press the YES key to indicate that there is an air eliminating filter in use the Air In Line sensor will be completely disabled and the pump will start the infusion If you press the NO key to indicate a filter is not in use the Air In Line sensor will be set to detect the presence of any contiguous 2 milliliter air in the line The alert message below will then briefly appear on the screen If the alert occurred at the Run Options screen the pump will start the infusion Air In
30. Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution ALARM EMPTY BATTERY Empty Battery The battery no longer has sufficient power to run the pump If the battery pack is being used both it and the C size batteries are depleted Turn the pump off Replace both of the C size batteries Recharge or replace the battery pack if applicable ALARM HIGH UP PRESSURE High positive pressure between the pump and IV reservoir The pump has detected excessive positive pressure between the pump and the IV Source Press Pause to clear alarm screen Check for excessive pressure on the IV bag and relieve it When ready to begin infusion select RESUME ALARM REPLACE SET Replace Set The pump has detected that the disposable administration set must be replaced Replace the disposable administration set prime the set if necessary and when ready to begin infusing select RESUME to continue the infusion ALARM SET NOT INSTALLED Administration Set Not Installed The administration set has not been installed or has been installed improperly Install appropriate Curlin Medical Administration set for desired therapy Use ONLY Curlin Medical Administration sets If the blue tubing guide on the administration set has been damaged in any way replace the entire
31. COMPLETE Py tee M TOTVOL 2000 8 ml KMORATE 10 0 mlhe 84 This screen displays 1 INFUSION COMPLETE 2 A graphic representation completely filled in bar graph indicating infusion complete or the smaller dot configuration shown here if a KVO RATE is programmed 3 TOT Vol Total Volume Displays the total volume infused 4 KVO Rate The preset KVO rate displays 5 Infusion Complete is considered an alarm status and the audio alarm will beep periodically every 3 seconds if there is no KVO every 20 minutes if there is a KVO to alert the user to this condition Additionally the LED lights blink to alert you to the status of the pump The green light blinks when the KVO rate is infusing if one is programmed and the red light blinks to indicate that the Infusion Complete alarm exists Stopping the Infusion To halt the infusion at Infusion Complete press the PAUSE key and then choose to either 1 Turn off the pump by pressing the OFF key or 2 Select one of the options from the Pause screen a Note Pause Menu Screen ENTER to Select MEH PROGRAM REPEAT Rx To repeat the present therapy and add another IV container with the same ptescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the ther
32. Continuous Therapy by selecting Continuous from the Select Therapy Screen The following display screen appears and requires you to enter information needed to program this therapy Prescription Menus Continuous Pre Prescription Menu Screen UNITS ML UNITE M UHITE mc DELAY OFF CONCEN ERT racer CONCEN ERE cor Titrate OFF DELAY ON DELAY OM HEXT YES Titrate OFF Titrate ON HEXT YES NEXT YES These menu items allow you to customize the program to match each individual prescription The pump s default settings are displayed in the left screen Each field is individually explained below Note Some of the lines are abbreviated to fit on the display screen the full descriptions appear below 1 UNITS Allows you to select from units of ml mg or mcg to match the patient s prescription The pump will allow a volume range of 0 1 to 400 ml hr therefore if mg or meg is selected the concentration requested in the next field will determine the upper and lower programming limits for mg and mcg Use the NO CHANGE key until the desired units appears on the display and then press the YES ENTER key to accept and move to the next field 2 CONCEN Concentration This field is active whenever mg or mcg is selected in the units field and requires data entry of the concentration of mg or mcg per ml When the correct data is entered using the numeric keys press YES ENTER to accept and move
33. INSTALLED Door Open or Administration Set is not properly installed Door Latch is not completely closed or the Administration Set is not installed according to installation instructions Recheck the door latch assembly and securely close the door If the door was closed properly re install the set according to the installation instructions ALERT DOSE AMT IS LESS THAN DOSE INFUSED Dose amount entered is less than the amount already infused for the dose New dose value entered is less than the amount already infused for the dose Recheck data entry After the dose in progress finishes the dose amount may be changed to the lower value If the above is not suitable re program the prescription LCD Display ALERT DOSE CANCELLED RESUME INFUSION THEN NEW DOSE 123 Buljooyseajqnoi Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Cancellation of a Clinician Dose is pending and can only be processed with the pump running Clinician Dose in progress is cancelled while the infusion is paused and the user attempts to enter a new Clinician Dose prior to resuming the infusion Resume the infusion and then program the desired Clinician Dose ALERT DOSE FREQ LESS THAN DOSE TIME Dose frequency time is less than
34. Ifthe incomplete therapy is to be continued press NO and the Pause Menu screen will be displayed then press YES and the Run Options screen will be displayed To resume the unfinished therapy press RUN Following the confirmation and acceptance of the prescription screens a screen will appear to confirm the dosing schedule This screen is displayed only if the previous INT infusion was terminated prior to the completion of the infusion Intermittent Dosing Schedule NEXT DOSE DUE IH GHEEN HH mm DONE YES The dosing schedule of the previous container is retained and displayed on this screen In Lock setting 0 and 1 you can change the time In lock 2 or 3 the next dose time is displayed but requires an access code before allowing a change When the next dose time is correct ptess the YES ENTER key The cursor will move to the DONE field press the YES ENTER key again and the Run Options screen will display Entering a New Program NEW PROGRAM To program an entirely new prescription or a different therapy press the YES ENTER key at this field the ability to change these parameters may be controlled by the lock setting The display will return to the Select Therapy Screen if more than one therapy mode is enabled or to the Pre Prescription Screen of the single therapy mode If the current container has not completely infused the following screen will appear ALERT R
35. Medical Data Interface Cable which is purchased separately Detailed user instructions are provided with the cable Clearing the History Log 9 CLEAR Hx LOG This feature is used to clear the patient history log from the pump When you select YES ENTER the pump displays CLEAR Hx LOG YES CLEARS Pt Hx Loge Not Data ACCEPT When you select YES the history log is cleared and the display returns to the BIOMED SETUP Menu Selecting NO aborts the feature and also returns to the menu Clearing Patient Information 10 CLEAR Rx When this command is selected prescription information for all currently programmed therapies is cleared however the patient data is retained When you select YES ENTER the pump displays CLEAR Fx YES CLEARS ALL Rx Dota ACCEPT When you select YES all prescription programs are cleared and the display returns to the BIOMED SETUP Menu Selecting NO aborts the feature and also returns to the menu 35 GBulmwei6o0lig soiseg 11 CLEAR Pt DATA Selecting this feature clears all data programmed and resets the pump to its default settings The history log is NOT cleared All disabled therapies are reenabled When you select YES ENTER at this field the following screen displays CLEAR Pt DATA YES CLEARS ALL Ft Data ACCEFT MR When you select YES all patient data clears and the display returns to the BIOMED SETUP Menu Selecting NO
36. PRESS to START to REVIEM or Sadia Note that you do not need to answer yes or no questions or enter data as previously requested This screen requires only that you press the corresponding key on the keypad to begin the requested function The following section explains each selection beginning with Prime Prime The IV bag or syringe and administration set should be inspected and be free of all air and air bubbles before they are connected to the access site Priming may have been done by gravity when the administration set was first connected to the bag see Chapter 1 Preparing Medication for Infusion However if it was not done then or if there are any remaining air bubbles to be removed the pump s PRIME function will assist in this process To prime the set by using the pump follow the directions below Note The lock setting may restrict the ability to prime using the pump 1 Press and release the PRIME key at the Run Options screen 2 The following screen appears Prime Direction Screen Disconnect Pt Release Clamps HOLO aktga ke HA to EXIT 3 Disconnect the administration set from the patient s access site using aseptic protocols 59 Ades9uL Wd IMPORTANT Priming with the set connected to the patient could result in INFORMATION overdose and may cause injury or even death to the patient 4 Release any clamps on the administration set 5 Press and hold the PRIME key
37. PRESS to START to REVIEM or aiaiga Note that you do not need to answer yes or no questions or enter data with the numeric keys as previously requested This screen requires only that you press the corresponding key on the keypad to begin the requested function The following explains each selection beginning with Prime Prime The IV bag and administration set should be inspected and be free of all air and air bubbles before they are connected to the patient s access site Priming may have been done by gravity when the administration set was first connected to the bag see Chapter 1 Preparing Medication for Infusion However if it was not done then or if there are any remaining air bubbles to be removed the pump s PRIME function will assist in this process To prime the set by using the pump follow the directions below Note The lock setting may restrict the ability to prime using the pump 1 Press and release the PRIME key at the Run Options screen 2 The following screen appears Prime Direction Screen Disconnect Pt Release Clamps HOLD adilekey Mee to EXIT 3 Disconnect the administration set from the patient s access site using aseptic protocols IMPORTANT Priming with the set connected to the patient could result in overdose INFORMATION and may cause injury or even death to the patient 45 Adeiay LL snonunuog 4 Release any clamps on the administration set 5 Press
38. Pres 275 0 mLhr 10 mmHg CMS pumps only Interrupting an Infusion The infusion can be paused at any time by pressing the PAUSE key The yellow Standby LED light blinks and the following screen displays Pause Menu Screen ENTER to Select REPEAT Fx NEW PROGRAM 82 The screen offers the user three options Resuming the Current Container 1 RESUME To resume the therapy in progress from where it left off press the YES ENTER key at this field The pump will return to the Run Options Screen and you can resume the therapy Note If you wish to hang a new container move the cursor to REPEAT Rx see following section Run Options Screen PRESS to START to REVIEW or apanga a Press the RUN key to resume the therapy b Press the NO key to go back to the programming screen to make changes in the therapy program this feature may be blocked by a security lock thus not allowing changes to the program unless an access code is given Also remember that no changes are allowed in the first prescription menu if an infusion is in progress c Press the OPTIONS or PRIME keys if either of these functions is desired at this time Hanging a New Container 2 REPEAT Rx To repeat the present therapy and add another IV container with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will lis
39. REPEAT Rx and press the YES ENTER key This action will take you to the Select Therapy Screen and allow you to choose which of the programs you now wish to repeat Note If you are choosing a therapy that is different than the last one selected Shift Totals and Hourly Totals will be cleared 38 If only one therapy is programmed and REPEAT Rx is selected the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription by pressing the YES key at the remaining fields Note REPEAT Rx does not allow any changes to the Pre Prescription Menu If changes need to be made in Pre Prescription selections units concentration etc select New Program and reenter the entire prescription The lock settings affect the use of REPEAT Rx Lock 1 allows REPEAT with changes to the prescription screen only Lock 2 allows REPEAT but does NOT allow the user to make changes in the prescription Lock 3 does not allow REPEAT See lock setting table If a therapy has not completed and the REPEAT Rx function is selected the following screen will display ALERT Rx in progress to Repeat to Return If the current infusion is to be discontinued and a new IV bag started press YES ENTER to repeat If the current infusion is to continue press NO a
40. Remote Bolus Cord Lockable Safety Shells These accessories ate hard plastic durable cases that are lockable with a key The small safety shell 340 0106 will secure the 150 ml medication bag administration set and the pump and yet allow access to the pump s keypad controls communication connectors and battery compartment door The larger organizer safety shells will secure a syringe or an IV bag up to 500 ml and are available in three colors e Clear 340 0141 for general purpose e Yellow 340 0141 01 for epidural and e Green 340 0141 02 for PCA applications All security shells can be pole mounted with the detachable pole clamp set on a stable flat surface or carried in a soft carry pack 140 Figure 10 3 Safety Shells Additional graphics below show how to install the Pole Clamp on the Lock Box a Push and slide Lock Box to remove lever to release Align and slide the Lock Box over the Pole Clamp until the Latch is looked in place Figure 10 4 Pole Clamp and Safety Shell Installation Press Latch N 141 Y S HOSSIII Pump Holster 340 0111 This accessory is a simple slide pump in case with a pole clamp mounting bracket on the back allowing the pump to securely be mounted onto a pole and yet allow the user easy access to the display keypad controls battery compartment and connectors for external power or communications
41. Report error code to factory Call Provider 315 Turn pump OFF Therapy status write violate Report error code to factory Call Provider 138 Chapter Accessories There are a number of helpful acessories for use with the Cuttin Medical pumps Some of the most common accessones are described in this chapter For a complete and updated ist refer to the Curlin Medial website mncurtnimedical com Detachable Pole Clamps The pole clamps attach to the Lockable Safety Shells or the Pump Holster and can accommodate a pole of 75 to 1 25 inch diameter There is a Standard Pole Clamp 340 0104 as well as a Lockable Pole Clamp 340 0125 available Figure 10 1 Detachable Pole Clamp 139 salosse2sy Remote Bolus Cord 340 2005 This five foot flexible cable offers a remote push button switch for the patient s use in administering bolus dosing in the PCA therapy This accessory cannot be used in any therapy except PCA and if it is left connected for any other therapy an alert message will display on the pump screen instructing the operator to remove this cable oy SES Bolus Data Port on Left gt side of Pump Remote bolus access port Four pronged adapter plugs into access port on left side of pump as Locking see shown To remove bolus cord pull back on locking sleeve and pull cord straight out of access port Figure 10 2
42. Reservoir include the overfill volume Note The volume used for priming via the pump is deducted from the Bag Volume Therefore Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion When the correct amount has been entered press the YES ENTER key to accept this field and move on to the next The range for this field is 1 to 9999 2 BASL RATE Basal Rate The Curlin Medical pump in PCA Therapy can be set for a continuous basal infusion of 0 to 50 ml per hour or the highest limit allowed for the administration route selected see Figure 5 1 Use the numeric keys to enter the prescribed rate the units chosen in the Pre Prescription Menu will appear here Note If the rate falls out of the range of the pump depending on the administration route selected a beep will sound and one of the following alert messages will appear ALERT ALERT GREATER THAN MAX LESS THAN MIM FIELO LIMIT FIELD LIMIT MAX Ax X MINEXx x This field will not be accepted with the YES ENTER key until the rate is adjusted to fall within pump s range When the rate is correct use the YES ENTER key to accept and move to the next field 3 BOLUS Bolus Dose Use the numeric keys to enter the prescribed bolus patient demand dose and when correct press the YES ENTER key to accept and move on to the next field The Bolus Dose can be set for 0 to 50 ml or the highest limit allowed for the
43. Rx Programmed to Erase Rx to Return c Ifyou want to save the current prescription press the NO CHANGE key to return to the Pause Menu screen If you wish to erase the current prescription and enter a new program press the YES ENTER key to proceed All previous prescription values will be erased 115 AdessyL ajqeue Note Selecting NEW PROGRAM will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually Infusion Complete When the infusion is complete the following screen will display Variable Infusion Complete INFUSION COMPLETE TOTVOL ZO ml KMORATE 1 0 mlhr This screen displays 1 INFUSION COMPLETE 2 A graphic representation completely filled in bar graph indicating infusion complete or the smaller dot configuration shown here if a KVO RATE is programmed 3 TOT Vol Total Volume If units are mg or mcg this field will also toggle to give the Total Infused 4 KVO Rate The preset KVO rate displays 5 Infusion Complete is considered an alarm status and the audio alarm will beep periodically every 3 seconds if there is no KVO every 20 minutes if there is a KVO to alert the user to this condition Additionally the LED lights blink to alert you to the status of the pump The green light blinks when the KVO rate is infusing if one is programmed and the red light blinks to indicate that t
44. The range for this field is 0 to 15 ACCEPT YES NO If necessary use the arrow keys to move to any field and change the data entered To abort this screen entirely press NO at this prompt Any data entered on this display will be aborted and the display will return to the options menu If the parameters entered are correct press the YES ENTER key and the new rate or rates will be accepted The display returns to the Options menu when this screen is exited New values will be in effect when the Options menu is accepted 7 DN Occlu Down Occlusion This feature allows the pump to sense an occlusion pressure in the line between the pump and the access site e g a kink in the tubing between the pump and the patient a blockage in the access site or a clamp left on the distal tubing There are two options for this field the Low setting triggers the alarm when it detects in line 64 pressures at 400 mmHg 150 8 3 psi pounds per square inch or the High setting default setting alarms when it detects in line pressures at 900 mmHg 150 18 3 psi Press NO to change the selection When the correct pressure setting appears press the YES ENTER key to accept it and move the cursor to the next field 8 AIR SENS Air In Line Sensor This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state The choices are 0 1 ml 0
45. Totals MOH ACCEPT a To clear the Hourly Totals press the YES ENTER key All Hourly Totals will be cleared and the cursor will return to the Options Menu b To maintain the Hourly Totals press the NO CHANGE key Hourly Totals will be maintained and the cursor will return to the Options Menu c A lock level 2 or 3 will require an access code entry before allowing hourly total reset 4 TitrRx Titrate Prescription If this feature was not selected in the Pre Prescription Menu it will not appear on the Options Menu Ifa Titrate prescription was programmed and if the therapy is to be titrated now select ON and then press the YES ENTER key to accept and to go to the Continuous titration menu Continuous Titration Menu TITRATE RATE EACE rol hie ACCEPT YES NO This screen allows the user to change the rate within the predefined prescription limits a RATE Using the numeric keys enter the new desired rate When the new rate has been entered press the YES ENTER key to move to the next field If the titration option is used to change the rate the new rate will then appear on the run screen and on the prescription menu whenever it is reviewed b ACCEPT YES NO Use the up down arrows to move to a field and change the data entered at this time To abort this screen entirely press NO at this prompt and the display will return to the options menu If the rate is correct press the
46. YES ENTER key and the new rate will automatically be accepted The display returns to the Options menu when this screen is exited c New values will be in effect when the Options Menu is exited 5 DN Occlu Down Occlusion This feature allows the pump to sense an occlusion pressure in the line between the pump and the access site e g a kink in the tubing between the pump and the patient a blockage in the access site a clamp left on the distal tubing There ate two options for this field the Low setting default setting triggers the alarm when it 48 detects in line pressures at 400 mmHg 150 8 3 psi pounds per square inch or the High setting alarms when it detects in line pressures at 900 mmHg 150 18 3 psi Press NO CHANGE to change the selection When the correct pressure setting appears press the YES ENTER key to accept it and move the cursor to the next field 6 AIR SENS Air In Line Sensor This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state The choices are 0 1 ml 0 5 ml the default setting 2 0 ml and OFF Press the NO CHANGE key to change the options until the desired setting appears on the display and then press YES ENTER to select and move the cursor to the next line IMPORTANT Whenever the Air In Line Sensor is set to OFF Curlin Medical INFORMATION recommends the use
47. a New Program 53 Infusion Complete sscseesees 53 Continuous Infusion Complete 53 Stopping the Infusion 00 54 Pause Menu Screen 54 PCA THERAPY seocssssensassonnsene 55 Prescription Menus scceeeeeees 55 PCA Pre Prescription Menu PCA Prescription Menu oss Run Options Screen OPTIONS oseca ve eria PCA Options Menu Clinician Dose Menu Clinician Dose Run Screen Se Shift Totals Screens ccccceeseseeeeees Hourly Totals Screen wees Clear Hourly Totals Screen i PCA Titrate S teeNennscinienensa Air In Line Sensor at 2 0ml Alert CROC sees terete E 65 Reviewing or Changing the PLO GLAM 4 0 5sicsansdssnndectontessvasesonacesen 66 Starting the Infusion PCA Run Screen PCA Information Screens 67 Interrupting an Infusion 68 Pause Menu Screen sssescsssesssessesisese 68 Entering a New Program 69 Infusion Complete csccceeee PCA Infusion Complete Stopping the Infusion 000 Pause Menu Screen ccceceeseeeeeee TPN THERAPY WITH AUTOMATIC RAMPING 73 Prescription Menus sccceeseees 73 TABLE OF CONTENTS TPN Pre Prescription Menu Screen Primeran an Be a eel eek 76 Prime Direction Screen 77 OPHONso 2 scensaaseiseces ins cossnasssensccses TPN Options Menu Hourly Totals Screen Clear Hourly Totals Screen Air In L
48. a marker lt indicating the current hour in progress b Volume or Amount will show in the first column BG Bolus Given in the second column and BA Bolus Attempted in the third column Use the up arrow key to scroll back through the last 24 hours d If the infusion was not running a series of will appear for that hour e To exit this screen press the NO CHANGE key 5 CLR HRLY Clear Hourly Totals To clear Hourly Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Clear Hourly Totals Screen Clear Hourly Totals MOH i ACCEPT To clear the Hourly Totals press the YES ENTER key All Hourly Totals will be cleared and the cursor will return to the Options menu a To maintain the Hourly Totals press the NO CHANGE key Hourly Totals will be maintained and the cursor will return to the Options menu 63 Ades9uL Wd b A lock level of 2 or 3 will require an access code entry before allowing Hourly Totals reset 6 TitrRx Titrate Prescription If this feature was not selected in the Pre Prescription Menu it will not appear on the Options menu If Titration parameters were programmed previously this field will appear and if you want to titrate now select ON and press the YES ENTER key to go to the PCA titration menu PCA Titrate Screen TITRATE SASL RATE OO njeh EOLUS 5 8 Ti EBoLS INT 18 HIH
49. and hold the PRIME key Fluid will be pumped at a rate of 300 ml hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped The pump will then beep once and require repressing and holding the PRIME key again until 6 more milliliters is delivered Continue this process until all air has been purged from the IV bag and the administration set Note If the bag volume is depleted during priming a subsequent priming event cannot be initiated While the PRIME key is depressed the following screen appears PRIMING Release ipsia key to Stop Prime Amt ml The amount used for the prime session is accumulated and displayed on the bottom field of this screen 6 When priming is complete release the PRIME key The following screen will display PRESS to Cont to EXIT Prime Amt 2 ml 7 To continue priming press the PRIME key again If priming is complete press YES ENTER to exit and return to the Run Options screen The total amount of solution used in this priming session displays on the bottom field Note The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient The bag volume should still be equal to or greater than the Amount TBI before you can proceed with the infusion If it is not an alert will appear stating AMT T
50. appears to provide information regarding the status of that particular infusion In the following chapters each display screen will be explained Identifier bar with down atrow indicator ENTER to Select Text field with highlight bar or cursor appearing on first field ty INTERMITTENT VARIABLE Figure 2 2 Sample of display screen 26 Chapter Basics of Programming The Curlin Medical pump allows the operator to customize this device to meet the specific infusion needs of each individual patent This chapter will explain the custonazing features along with the programming steps rogramming the Curlin Medical pump requires initial orientation and training but the P programming steps have been designed to be user friendly and self prompting to minimize training time Several different types of screens and fields may appear on the displays Each of the different types of screens is explained below Whenever you are required to interact with the pump a highlight bar or cursor will be present on the screen Types of Display Screens 1 An action field screen allows you to select a pump action from the menu Sample of an Action Field Screen In this sample the RESUME highlight bar is resting on REPEAT Rx the RESUME field NEW PROGRAM To select a field other than the one highlighted use the arrow keys to move the cursor up or down to the desired field When the cursor is highlighting the co
51. at any time the pump is moved into a different time zone 36 a Time Format You have the option of selecting twelve hour or twenty four hour time format Press the NO key until the correct selection appears on the field and then press the YES ENTER key to accept the selection and move the cursor to the next field b AM PM The second field allows you to select AM or PM when the twelve hour time format is selected in the previous field If the twenty four hour format was selected this field will not appear Press the NO key until the correct selection appears on the field and then press the YES ENTER key to choose the selection and move the cursor to the next field c Time Use the numeric keys to enter the correct time and then press the YES ENTER key to accept and move the cursor to the next field d Using the numeric keys enter the correct mm dd yy using two digits for each e g if the month is January enter 01 if it is a single digit date use the number preceded by a 0 and then enter the last two digits of the year code 00 01 etc When the date is correct press the YES ENTER key to accept and move to the next field e A final prompt will be given to ACCEPT YES NO If any data needs to be corrected use the arrow keys to locate the correct field press NO to change the data enter the correction s and then press YES ENTER again to accept the correction
52. charge or install incorrectly Do not mix with other battery types as alkaline manganese dioxide with carbon zinc Replace both batteries at the same time Do not store batteries loose Refer to battery manufacturer s material safety data sheet for specific product recommendations and precautions External Power Sources Battery Pack The battery pack is an external rechargeable battery pack than can be used as an additional long life portable external source of power It is rechargeable by plugging the AC Adapter into the recharging port The battery pack is connected to the pump via the two hole port located on the bottom of the pump as shown below The two pin connector plugs into the receptacle correctly by aligning the red dots on each Note Pause the pump and then turn it off before connecting the Battery Pack Note also that the connector is keyed with a notch at this red dot location to guide alignment To remove pull back on the locking sleeve to unlock and then pull gently to remove the connector from the pump s port 19 uo1 onpo1 u AC Adapter Charger This accessory Universal AC Adapter 340 2022 becomes the external power source when plugged directly into the Curlin Medical pump see Figure 1 2 for external power port location on the bottom of the pump The AC Adapter can also be used to recharge the portable battery pack by plugging the connecting cable into the recharging port on the battery pa
53. code messages and how to resolve them The audio alarm also beeps and the LEDs blink 28 whenever an alarm or error code occurs In the event of an error code user directions will be displayed on the screen most often this will require turning the pump off and back on again Using Help Help screens are available for data entry selection screens during action field screens and at the infusion complete screen To access help press the HELP key Use the arrow keys to scroll through the help message and then press the HELP key again to exit help When a help screen is displayed and there is more text to read which is not currently on the screen a small up aim or down F arrow indicator will appear to let you know you can scroll up or down to read the complete help message Starting the Pump Start the pump by pushing the blue ON key The following screen displays Welcome Screen HELC OME 27TJAN S 17iZH Rey RSH F4 Be Self Test The above Welcome screen gives the date time and a message that the pump is performing a self diagnostic test If the numbers on the date field are displayed as zeros the system clock will need to be set using the BIOMED Set Up See BIOMED SETUP section The display also lists the software revision number for this pump During this test you will hear three beeps as each of the LED indicators blink If any one of the green yellow or red LED lig
54. early down ramp process The range for this field is 0 00 to 9 00 HH MM Selecting early ramp down by selecting ON and pressing the YES ENTER key when the highlight bar is on this field brings a second screen as seen below EARLY RAMP NOM A OM Ramp oo HH tir W ACCEFT YES NO 79 Ade1 4L Ndl Note Whatever Down Ramp time was accepted in the prescription menu will appear as the DN Ramp time on this screen This time can be changed using the numeric keys or accepted as already displayed When correct press the YES ENTER key When the new time is accepted the screen returns to the Options menu The Early Down Ramp phase begins when the Options menu is exited and the pump is running 5 DN Occlu Down Occlusion This feature allows the pump to sense an occlusion pressure in the line between the pump and the access site e g a kink in the tubing between the pump and the patient a blockage in the access site or a clamp left on the distal tubing There ate two options for this field the Low setting default setting triggers the alarm when it detects in line pressures at 400 mmHg 150 8 3 psi pounds per square inch or the High setting alarms when it detects in line pressures at 900 mmHg 150 18 3 psi Press NO CHANGE to change the selection When the correct pressure setting appears press the YES ENTER key to accept it and move the cursor to the next field 6 AIR SENS Air
55. enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to move on to the next screen At the following screens the prescription information is entered to complete the programming of the therapy Variable Therapies are programmed in individual dose screens from one up to twenty four Before information about each individual dose is entered the bag volume and number of total doses per bag are entered on the initial programming screen Once the total number of doses is entered and accepted the pump will subsequently display a screen for each dose to program the specific dose amount rate and time Variable Prescription Menu1 BAG ol ERE ml EMORATE 2 10 mlhr I KEST YES 1 BAG Vol IV Bag Volume Use the numeric keys to enter the amount of fluid in the IV Bag ot Medication Reservoir include the overfill volume Note The volume used for priming via the pump or for KVO is deducted from the Bag Volume Therefore Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion When the correct amount has been entered press the YES ENTER key to accept this field and move on to the next The range for this field is 1 to 9999 2 Doses The Variable Therapy can be programmed to deliver from one to twenty four individual programs or doses Enter the total n
56. evaluated the Curlin Medical Pumps with International AC Adapter 340 2022 360 2022 and Domestic AC adapter 340 2026 360 2026 to UL 60601 1 and CSA C22 2 No 601 1 for General Standards of Safety for Medical Equipment and found the Curlin Medical Pumps to be compliant e Underwriters Laboratories has evaluated the Curlin Medical Pumps with accessory equipments Battery Pack 350 2026 and the International AC Adapters 340 2022 360 2022 and Domestic AC Adapters 340 2026 360 2026 to IEC 60601 2 24 Particular requirements for safety of infusion pumps and controllers and they were found to be compliant e Underwriters Laboratories has evaluated the Curlin Medical Pumps and the International AC Adapters 340 2022 360 2022 and Domestic AC Adapters 340 2026 360 2026 for Electromagnetic Compatibility to regulations EN 60601 1 1 2 1993 and EN 60601 2 24 1994 and they were found to be compliant The indicator shown at the left appears throughout this manual to emphasize important information in the operation of the Curlin INFORMATION Medical Pump Please read these sections carefully IMPORTANT uo1 npo1 u Warnings Cautions Notices EXPLANATION FOR SYMBOLS on the Curlin Medical Pump with the Classified UL 60601 1 and CSA C22 2 No 601 1 Label The meanings for the symbols on the pump are as follows A Attention consult ACOMPANYING DOCUMENTS mh de Type CF Equipment IPX1 Protected against dripping water kc c INFUS
57. is programmed then that KVO rate will be used in the Delay Start period 4 TITRATE Allows the programmer to set titration limits into the prescription settings of the pump If there is no titration prescription select OFF and press YES ENTER to accept The cursor will move to the next field If a titration prescription has been written press the NO key to select ON and press the YES ENTER key to accept The following screen will appear to program the titration parameters Continuous Titration Limit Screen TITRATE LIMITS Ms RATE PAO role ACCEPT YES NO a MaxRATE Maximum Rate limits Use the numeric keys to enter the upper limits of the infusion rate When the maximum titration rate is entered correctly press YES ENTER and the cursor moves to the next field The range for this field is from 0 1 to 400 ml hr b ACCEPT If there are any changes to be made use the up or down arrows to move to the desired field use the numeric keys to enter the corrected data and press YES ENTER to accept the new values Move the cursor back to the ACCEPT field and enter YES ENTER The Titration Limit is now entered and the display returns to the Pre Prescription Screen If the entire Titration Limit Screen is to be aborted press NO to return to the Pre Prescription Screen 5 NEXT If there are any changes to be made use the up or down arrow keys to locate the field to be
58. ml hour but cannot be set at a rate to exceed the therapy operating rate When the desired KVO rate has been entered press the YES ENTER key to accept and move the cursor to the next field When a KVO rate is programmed for the Intermittent Therapy the patient is not disconnected between dosing The pump automatically cycles through dosing and KVO A single beep alerts the user to the change between dosing and KVO Ifthe KVO rate is IMPORTANT INFORMATION set at 0 the pump can be off between doses The internal time clock of the pump continues to monitor the dosing cycle Note The next three fields are automatically calculated based on the information already programmed and are helpful in providing additional information for managing an intermittent therapy At each of these fields when the information is correct press the YES ENTER key to accept and move to the next field 7 DOSE BAG Displays the number of doses that can be delivered from the BAG Volume given You can change this number to a lower number of doses per bag but cannot change to a greater number When correct press the YES ENTER key to accept and move to the next field The range for this field is 1 to 200 8 REQ Vol Required Volume The volume needed for the programmed number of doses including the amount needed for KVO rates if a KVO rate is programmed The pump calculates this volume for you based on previously programmed infor
59. monitor the dosing cycle and the following time considerations apply 1 When the infusion is resumed thirty minutes or less past the scheduled Next Dose Time the dose is ready for immediate delivery and no changes will be made in the original scheduling except to shorten the next KVO time between doses to comply with the dosing cycle 2 When the infusion is resumed more than thirty minutes past the scheduled Next Dose Time the next dose will be ready for delivery when the pump is turned on All subsequent dosing will be shifted to keep the dosing cycle consistent unless the NXT DOSE Option is used to change subsequent dose times 3 Ifa dose in progress is interrupted for thirty minutes or less and the infusion is resumed the dose in progress will resume and the only adjustment made will be to shorten the next KVO time between doses If a dose in progress is interrupted for more than thirty minutes and the infusion is resumed the dose in progress will be terminated If necessary use the NXT DOSE Option to reset the next dose delivery time 4 Ifthe KVO cycle is interrupted before reaching the time for next dose no changes occur in dosing time cycles If it is necessary to change the batteries during the delivery of an intermittent dose be sure to press the PAUSE key and then turn the pump off before removing the batteries If the pump is delivering a dose and the batteries are removed without first pausi
60. of all air and air bubbles before they are connected to the access site Priming may have been done by gravity when the administration set was first connected to the bag see Chapter 1 Preparing Medication for Infusion However if it was not done then or if there are any remaining air bubbles to be removed the pump s PRIME function will assist in this process To prime the set by using the pump follow the directions below Note The lock setting may restrict the ability to prime using the pump 1 Press and release the PRIME key at the Run Options screen 2 The following screen appears Prime Direction Screen Disconnect Pt Release Clamps HOLO edge key Hae to EXIT 3 Disconnect the administration set from the access site using aseptic protocols IMPORTANT Priming with the set connected to the patient could result in overdose and may cause injury or even death to the patient INFORMATION 4 Release any clamps on the administration set 5 Press and hold the PRIME key Fluid will be pumped at a rate of 300 ml hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped The pump will then beep once and require repressing and holding the PRIME key again until 6 more milliliters is delivered Continue this process until all air has been purged from the IV bag and the administration set Note If the bag volume is depleted during priming a subsequent
61. of an air eliminating filter When the Air In Line Sensor is set to OFF and the RUN key is pressed at the Run Options screen the alert message below will appear on the screen It will also appear if the Air In Line is changed from the OPTIONS menu when an infusion is in progress and the AIR SENS field is accepted Air In Line Sensor Off Message Screen ALF Sensor OFF Using In Line Air Filter PES MO This message alerts you to the Air In Line Sensor being set to OFF The message will require answering yes or no to whether the administration set being used has an air eliminating filter If you press the YES key to indicate that there is an air eliminating filter in use the Air In Line sensor will be completely disabled and the pump will start the infusion If you press the NO key to indicate a filter is not in use the Air In Line sensor will be set to detect the presence of any contiguous 2 milliliter air in the line The alert message below will then briefly appear on the screen If the alert occurred at the Run Options screen the pump will start the infusion Air In Line Sensor Set at 2 0mi Alert Screen ALERT AIR SENSOR HAS BEEN SET T 2 0 ML Also when the Air In Line sensor is completely disabled and the infusion goes to an Infusion Complete or Empty Bag status the Air Sensor setting will automatically change to 2 0 ml 7 AUDIO Audio Volume This feature allo
62. of explosion if used in the presence of flammable anesthetic or explosive gasses CAUTIONS US federal law restricts this device to sale by or on the order of a physician or other licensed practitioner Visually inspect the pump pumping chamber and administration set before use Do not use any pump or administration set that appears to be damaged or tampered with or if there is any indication of improper function Keep the pumping surfaces clean dry and free of fluid spillage at all times This pump is fluid resistant and can withstand fluid spillage It is not however designed for total submersion as moisture buildup within the case could cause damage to the operating components Do not use the pump in the shower sauna or steam bath and do not position the pump where it could accidentally be dropped into a container of fluid e g basin tub or toilet Avoid fluid contact with the power port and data port of the pump Do not try to insert foreign objects into any of the pump connectors as such objects may damage the pump Use only Curlin Medical external power sources to power the Curlin Medical pump Using other power sources may result in circuitry or microprocessor damage When using the AC Adapter connect the plug only into a grounded AC outlet Use only non rigid non vented IV fluid containers unless an air vent adapter is in place and the container is suspended from an IV pole Do not unduly stretch the tubing of
63. of the fill volume when determining the final IV bag volume Gravity Priming Set and Filter To gravity prime the administration set twist and remove the breakaway tab from the Integral Flow Stop then spike the IV bag Squeeze the Integral Flow Stop between your thumb and forefinger to allow fluid to flow through the tubing until all air is removed from the IV bag and administration set See figures 1 5 and 1 6 Release the Integral Flow Stop to automatically clamp the tubing To correctly prime a filtered set hold the filter in a vertical position with the flow downwards allowing the filter to completely fill with fluid Close the slide clamp on the administration set before the door of the pump is opened This step along with the automatic clamping properties of the Integral Flow Stop prevents inadvertent fluid flow Use an administration set with an air eliminating filter whenever the Air In Line Sensor is disabled or set to OFF Follow CDC guidelines or Intravenous Nursing Standards of Practice Guidelines regarding the frequency of changing the administration sets Use aseptic technique and universal precautions as directed by the policies of your healthcare facility or institution Use only Curlin Medical administration sets with the Curlin Medical pump Dispose of administration sets in accordance with all applicable regulatory and institutional policies and directions 14 pore 7 _ f Figu
64. only for review purposes Attempts to change the Pre Prescription Menu during a new program review will cause an alert screen to be displayed notifying the programmer that changes will require reprogramming of the prescription Starting the Infusion RUN When all parameters are correct and the pump has been primed properly and connected to the access site press RUN at the Run Options screen to start the therapy If a delayed start is programmed the Delay Start Count Down Screen will appear If no delay start is programmed or the delay has elapsed the pump will begin infusing and the following screen displays the status of the therapy Variable Run Screen 1 This information toggles with the following 112 Variable Run Screen 2 oose 1 of 4 L FRES 18 mms TOTMVOL 99 2 mil REMAIN 2215 HH MM This screen displays as long as the infusion is running Notice the information on each field 1 The first field displays the RATE of the infusion in whichever units hour has been selected This field toggles to also display the current dose of total doses programmed The second field is a graphic bar representing the percentage completed of the current dose In CMS enabled pumps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units The third field displays Total Volume infus
65. priming event cannot be initiated While the PRIME key is depressed the following screen appears PRIMING Release iggule key to Stop Prime Amt 8 ml The amount used for the prime session is accumulated and displayed on the bottom field of this screen 6 When priming is complete release the PRIME key The following screen will display 108 PRESS to Cont to EXIT Prime Amt 2 ml 7 To continue priming press the PRIME key again If priming is complete press YES ENTER to exit and return to the Run Options screen The total amount of solution used in this priming session displays on the bottom field Note The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient The bag volume should still be equal to or greater than the Amount TBI before you can proceed with the infusion If it is not an alert will appear stating AMT TBI GREATER THAN BAG VOL You have the option to continue by pressing the YES ENTER key or return to the Run Options screen by pressing the NO key Options Once the prescription is programmed there are more customizing features available for each therapy Press the OPTIONS key from the Run Options screen to access these options The OPTIONS menu can also be accessed while the pump is running Note After t
66. progress or this is a repeat program that has not started and the error is in a previously programmed dose turn the pump off and then on Choosing to resume or repeat the therapy will display the last prescription that was completely programmed 130 ALARMS Alarms are conditions that require correction by the user and may be a safety issue but are not system errors of the pump All alarm conditions stop the infusion The only exception to this tule is at the Infusion Complete alarm which allows the KVO rate when programmed to continue infusing When an alarm occurs a message is displayed on the screen the audio alarm is sounded and the red LED light flashes The message stays on the screen until the pause key is pressed The Silence key can be pressed to disable the audio alarm for one minute intervals The cause of the alarm must be resolved or the alarm will recur when the infusion is restarted To exit an alarm screen press the PAUSE key resolve the alarm condition and then resume the therapy by selecting RESUME from the Pause Menu The following is a selected and alphabetical list of the alarms conditions that cause the alarms messages displayed on the screen and actions necessary to resolve them LCD Display ALARM AIR IN LINE Alarm Air In Line Cause Pump has detected air in the administration set during an infusion Resolution Check air settings and remove air from administration set and IV
67. push downward until it is in its closed position Then push the door latch down until it locks The over center latching mechanism assures that the door closes easily and securely Figure 1 8 Closing the pump door 13 Choosing and installing the Curlin Medical Administration Set A number of distinctively designed Curlin Medical administration sets are available to deliver each prescription accurately See Curlin Medical Product Catalog Each set is designed to meet the requirements of specific therapies therefore if a basic bag spike set or a set with a medication reservoir is needed with or without air eliminating filters etc there are several configurations from which to choose Follow the healthcare providers protocols for preparing the medication and the administration set before loading the set into the pump remembering the following basic rules 1 Examine the packaging and the administration set before use to assure the package integrity Do not use the set if the protective caps are dislodged or if the package integrity is breached as fluid path sterility cannot be guaranteed under those circumstances Notice that there is an instructional insert included in the administration set package This insert includes written and graphic instructions for proper installation of the administration set into the pump It also lists the fill volume of the administration set Allow for the amount
68. screen 1 LOCK When the lock is set to OFF the clinician has access to all of the pump functions After the pump is completely programmed change the lock to meet the security needs of this therapy There are four choices OFF 1 2 or 3 Each level higher limits the available options To change the lock setting press the NO CHANGE key until the correct lock setting appears Then press YES ENTER key to accept the new lock selection Once the pump has been set into a locked condition any subsequent request to change the lock will require a clinician access code See Clinical Information and Access Code chapter for access code information lock setting table and available features for each lock setting 2 ClinDOSE Clinician Dose Allows an additional prescribed dose to be administered by a clinician at any time except during a Load Dose or Bolus Dose The Maximum Clinician Dose is determined by the administration route see Figure 5 1 Clinician Dose Menu CLINICIAN DOSE i Clin DOSE ET ml A ACCEPT YES NO 61 Ade1 34L YV d Note Ifa lock setting of 1 2 or 3 is selected an access code will be requested If you wish to give a clinician dose at this time change OFF to ON and press YES key Enter the amount of clinician dose to be delivered Press YES to accept the clinician dose menu The Clinician Dose will begin when the options screen is accepted and the pump is running The following Run Scre
69. the following solutions and dried with a soft cloth without harming the pump Clean the pump remote bolus cord AC adapter safety shells holster and battery pack with a soft cloth dampened in any of the following Warm soapy water do not submerse Isopropyl alcohol Household bleach diluted 9 1 with water Commercial disinfectant Do NOT spray the cleaning solution directly on the pump IMPORTANT The following cleaning disinfecting methods are specifically prohibited INFORMATION e Do not use full strength bleach e Do not autoclave or use steam sterilization e Do not clean in a dishwasher e Do not use acetone lacquer thinner or any other solvents or abrasive cleansers to clean the pump With proper care the pump will retain its finish for many years of service 145 aoueusjuleW Burueajyg Transport and Storage During transport or storage the batteries should be removed the pump should be cleaned and kept in its hard shell packing case The environmental conditions should be within the range of e Anambient temperature 20 F to 140 F e A relative humidity range of 10 to 95 e Anatmospheric pressure range of 500 Hpa to 1060 Hpa All accessories should be stored in their original packing containers to ensure the longest service Operating Environment The following conditions of ambient temperature range and relative humidity are recommended for the fluid delivered accuracy of e Temperature
70. the administration set or leave the tubing in the pump for more than twenty four hours when the pump is not running Use Curlin Medical administration sets with appropriate air in line filters any time the Air In Line Sensor of the pump is disabled If any signs or symptoms of infiltration or inflammation are noted at the infusion site stop the infusion and report it to the appropriate healthcare provider Always use the slide clamp on the administration set as an additional precaution to occlude the tubing before opening the door of the pump Do not subject the pump to dropping or hitting against a hard surface If at any time the pump is dropped or hit inspect it for signs of damage If any damage is discovered report the damage to the healthcare provider for replacement of the pump NOTICES The Curlin Medical pump is not intended for the administration of blood or cellular blood products Dispose of all used administration sets in accordance with all applicable regulatory and institutional policies Teach users to check all tubing sites for proper aseptic connections and to check the administration sets for air leaks before and during the infusion uo1 npo3 u To minimize the potential hazard of air bubble formation or out gassing administer all medications at the proper temperatures and remove medications from refrigerators as specified by the healthcare provider or pharmaceutical manufacturer Follow local governing or
71. the time required to infuse the programmed dose The dose frequency value entered is less than the time required to infuse the programmed dose amount Recheck data entry Dose frequency cannot be less than required time for dose to infuse ALERT EMPTY BAG Empty Bag Occurs when the volume infused for the prescription is equal to the Bag Vol Bag Vol may have been reduced due to priming Verify that the volume remaining in the source container is sufficient to complete the current therapy If the volume is insufficient add another source container or stop the infusion ALERT EXCEEDS POSSIBLE DOSES PER HR Unable to enter of boluses hr that would be possible given the programmed bolus amount Boluses hr value exceeds the possible given the bolus amount Recheck data entered The of boluses per hour cannot exceed the time required to deliver the bolus amount programmed ALERT EXTERNAL POWER DISCONNECTED External power source disconnected External power source is disconnected during pump operation Reestablish external power source or let pump continue to operate on batteries Note The battery level should be checked after the external source is disconnected to gage if additional batteries will be required before an external power source is available again ALERT FIELD NOT ACCEPTED Field Not Accepted The field indicated by the flashing cursor has not been accepted 124 Resolution LCD Display Ale
72. therapy time limit of 288 00 HHMM 167 59 HHMM Software Versions below R37C Recheck data entry The time calculated by the pump cannot exceed the pump range ALERT CHANGES REQUIRE REPROGRAMMING YES to Continue NO to Return Changes to the data will require re entry of prescription Attempted to change the Pre Prescription Screen prior to start of infusion If a change to the programmed prescription is required press YES Note Selecting YES will clear the entire prescription and require re entry the prescription If no change is required press NO to preserve the current prescription and return back to the Pre Prescription screen ALERT CMS LEARN MODE ACTIVE KEY NOT ACCEPTED The pump is performing a CMS Create Prescription function and the key pressed is not valid for this mode While using the pump with CMS PC in order to create a prescription only certain keys are allowed to be recorded as part of the prescription Whenever a prohibited key is pressed i e RUN key this alert will occur and the key will not be recorded Do not press the key causing the alert during a CMS Create Prescription function ALERT DATE TIME CHANGE NOT ALLOWED Not allowed to change date or time Attempt made to modify system clock while a therapy delay is in progress If the therapy in progress is to be continued wait until the infusion is complete and then change the Date and Time 122 LCD Display Alett Cause
73. this field is highlighted and the display will return to the Select Therapy Screen The lock setting can control access to this function Note The therapy is complete therefore RESUME is not an option at this time and is not displayed 54 Chapter PCA Therapy PCA or Patient Controlled Anakesia is designed for therapies requiring a continuous rate of infusion patient controlled demand boluses or both egin programming a PCA Therapy by selecting PCA from the Select Therapy Screen The following display screen will appear requiring you to enter information needed to program this therapy Prescription Menus PCA Pre Prescription Menu Screen I unite A UNITE mcg UNITS ML 4 CONCEN COMCEN ADMIN Rt SG A ADMIN Rt IL LoADDose ml LOAD DOSE Titrate ON H H Titrat OFF Titrat OFF NEXT YES HEXT YES WET YES These menu items allow you to customize the program to match each individual prescription The pump s default settings are listed in the left screen Each field is individually explained below Note Some of the lines are abbreviated to fit on the display screen the full descriptions appear below 1 UNITS Allows you to select from units of mg mcg or ml depending on how the prescription is written In the PCA therapy the pump will allow rates as defined in figure 5 1 therefore if mg or mcg is selected the concentration requested in the next field will determine
74. time is not acceptable press the NO key to edit this field and enter the new TIME Remember when you change the time a new RATE will be calculated and will have to be accepted before you exit this menu When the time is correct press YES ENTER to accept and move to the next field The range for this field is 0 01 to 288 00 HH MM Note The time entered is limited by what time is remaining out of the maximum time of 288 hours The time calculated by the pump may be less than a minute however one minute is the minimum entry and display value 106 5 NEXT If there are any changes to be made use the arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to accept and move on to the next dose programming screen When the total number of doses is programmed the pump will display the Variable Summary screen The summary screen indicates the total number of doses programmed and the total time and volume required The fields on this screen cannot be modified Variable Summary Screen TOT DOSES Fe 4 TOT Time OO AA HHH REQ Yoi D A ral DONE YES 1 TOT DOSES The field displays the total number of doses programmed If correct press the YES ENTER key to accept and move to the next field 2 TOT Time The p
75. to REPEAT Rx The cursor will automatically scroll through the program No changes will be allowed in the Pre Prescription Menu during this time thus maintaining the originally programmed Delay Start time To change the Delay Start time press the NO CHANGE key when the Run Options Screen is displayed Run Options Screen PRESS ta START to REVIEM or Saila This will allow the clinician to go back to review the program and at this point a change can be made to the delay start time Note If the pump is not connected to the patient s access site at this time the patient or caregiver should be taught proper techniques to access the infusion site before the scheduled start time When the RUN key is pressed the Green and Yellow LED lights will flash to indicate that the pump will automatically start when the delay start countdown period is up During the delay start time the following screen appears T DELAYED START INFUSION STARTIN 220 HH hMM EVORATE 1 00 mlhe If the KVO rate is set to 0 the pump will beep ten minutes prior to the beginning of the therapy start time To stop the audible beep press the Silence key During the delay start period if the KVO rate is set to 0 no fluid is IMPORTANT infusing Be sure the access device is patent and has been flushed per facility policy to maintain patency during this time period Ifa INFORMATION KVO rate is programmed then that KVO rate wil
76. 1 mi hr with a positive headheight of 100 mm Hg Detail 15 5 10 wi E 5 2 0 Rate Calculation Window min 154 Curlin pump inusing at 1 mi hr w ith zero headheight hour 2 2 10 15 20 25 infusion time hrs 30 35 40 E on g 0 105 amp 01 S 0 095 oO gt 0 09 1 3 5 10 15 20 Rate Calculation Window hrs Curlin pump infusing at 1 m hr w ith zero headheight hour 70 0 11 0 105 01 2 0 095 5 0 09 0 085 0 08 1 3 5 10 15 20 Rate Calculation Window hrs Curlin Pump delivering at 1 ml per hour with zero headheight Calculated Average 0 1011 ml per hr _ 0 12 52 gt S on Cc ge ol rs E zg 0 09 Eg 45 Percent Error Percent Error Curlin Pump delivering successive shots of 1 ml at 25 ml per hr in Intermittent 3 1 1 3 N Mode Time hrs 155 Percent Error 8 6 4 2 0 2 4 Percentage Error Curlin Pump delivering successive boluses of 1 ml in PCA SQ mode Time hrs Percent Error 8 6 4 2 0 Percent Erro Curlin Pump delivering successive boluses of 1 ml in PCA IV mode 0 1 0 1 0 2 0 3 0 3 0 4 0 5 0 5 0 6 0 7 0 7 0 8 0 9 0 9 1 0 1 1 1 1 1 2 1 3 1 3 1 4 1 5 1 5 1 6 1 7 Time hrs Percent Error 60 40 20 0 20 40 60 Percent Error Curlin Pump infusing at 1 m hr with a negative headheight
77. AMT TBI GREATER THAN BAG VOL You have the option to continue by pressing the YES ENTER key or return to the Run Options screen by pressing the NO key Options Once the prescription is programmed there are more customizing features available for each therapy Press the OPTIONS key from the Run Options screen to access these options The OPTIONS menu can also be accessed while the pump is running Note After the infusion has started any changes made through the OPTIONS menu involving e HRLY TOT and e CLR HRLY will return you directly to the ACCEPT OPT field 92 The following screen displays the Intermittent Therapy Options available When you open this menu use the up and down arrows to move the highlight bar to the desired option Lock settings may require an access code before the option can be changed Any new setting except CLEAR HOURLY screen acceptance becomes effective when the Options screen is exited by pressing YES ENTER at the ACCEPT OPT field Intermittent Options Menu OPTIONS Lack OFF Lock ii HRLY TOT OFF LEHRLY OFF OM Geclu LOW HIGH MAIR SENS OS ral 2 8 OFF 4 NXTDOSE QQ HH MM AUDIO S er ey M PLR CK OFF on ACCEPT OFT YES NO Note The pump s default settings are indicated above in the left screen 1 LOCK When the lock is set to OFF the clinician has access to all of the pump functions After the pum
78. BI GREATER THAN BAG VOL You have the option to continue by pressing the YES ENTER key or return to the Run Options screen by pressing the NO key Options Once the prescription is programmed there are more customizing features available for each therapy Press the OPTIONS key from the Run Options screen to access these options The OPTIONS menu can also be accessed while the pump is running Note After the infusion has started any changes made through the OPTIONS menu involving e HRLY TOT and e CLR HRLY will return you directly to the ACCEPT OPT field 46 The following screen displays the Continuous Therapy Options available When you open this menu use the up and down arrows to move the highlight bar to the desired option Lock settings may require an access code before the option can be changed Any new setting except CLEAR HOURLY screen acceptance becomes effective when the Options screen is exited by pressing YES ENTER at the ACCEPT OPT field Continuous Options Menu OFTIONS Lock OFF Lock fied HRL ToT OFF LEHRLY OFF ROM occlu LOM HIGH AIR SENS OS 2 8 OFF i AUDIO S i 3 FHR CK OFF Of WaccErtT oft YES NO Note The pump s default settings are indicated above in the left screen 1 LOCK When the lock is set to OFF the clinician has access to all of the pump functions After the pump is completely programmed
79. CURLIN MEDICAL User s Manual for use with the 4000 Plus and 4000 CMS Ambulatory Infusion Systems mse Ss 0050 ISO 13485 MEDICAL DEVICES CURLIN MEDICAL Inc 15751 Graham Street Huntington Beach CA 92649 Phone 714 893 2200 Fax 714 894 2602 www cutlinmedical com For 24 hour Clinical or Technical Support call toll free 1 888 287 5999 888 CURL 999 Covered by U S Patents 5 575 631 5 683 233 5 791 881 5 924 852 6 164 921 6 371 732 B1 Des 408 911 Des 437 547 S Other U S and Foreign Patents Pending Copyright 2000 2004 CURLIN MEDICAL Inc All Rights Reserved Revision J Reorder Number 350 9009 TABLE OF CONTENTS Display Screen ecescsseesseeseeeees 25 INTRODUCTION 1 pa cae Delivery Modes ccscccsssseeseseees 1 BASICS OF PROGRAMMING ee eee 27 Indications for Use ccsscceeeeeees 2 Types of Display Screens 27 Special Features of the 4000 Sample of an Action Field Screen 27 Series PUMP 00 eee eeeseeeesseseeeeseeeee 2 Sample of a Selection List Field 27 Regulatory Agency Approvals 3 Sample of a Data Entry Screen 28 f P Sample of a Run Screen 28 Warnings Cautions Notices 4 Sample of User Notification Pump Illustrations and Features 8 OCLEEAaiat witli i akla wale etal le 28 Disposable Administration Set Using Help ccccccsssseeeceeeseeees 29 Illustrati
80. EAT Rx The cursor will automatically scroll through the program No changes will be allowed in the Pre Prescription Menu during this time thus maintaining the originally programmed Delay Start time To change the Delay Start time press the NO CHANGE key when the Run Options Screen is displayed Run Options Screen PRESS to START to REVIEM or aaga This will allow the clinician to go back to review the program and at this point a change can be made to the delay start time Note If the pump is not connected to the patient s access site at this time the patient or caregiver should be taught proper techniques to access the infusion site before the scheduled start time When the RUN key is pressed the Green and Yellow LED lights will flash to indicate that the pump will automatically start when the delay start countdown period is up During the delay start time the following screen appears DELAYED START INFUSION STARTIN 225 HHM KVORATE i 0 mlhe 42 If the KVO rate is set to 0 the pump will beep ten minutes prior to the beginning of the Continuous Therapy start time To stop the audible beep press the Silence key During the delay start period if the KVO rate is set to 0 no fluid is infusing Be sure the patients access device is patent and has been Enya ee flushed per facility policy to maintain patency during this time period INFORMATION If a KVO rate
81. ERT Rx in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If the therapy is to be terminated and a new IV container added press YES ENTER to go to the programming screen confirm the program and proceed with the repeat infusion b Ifthe incomplete therapy is to be continued press NO and the Pause Menu screen will be displayed then press YES and the Run Options screen will be displayed To resume the unfinished therapy press RUN Entering a New Program NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key at this field The ability to change these parameters may be controlled by the lock setting The display will return to the Select Therapy Screen if more than one therapy mode is enabled or to the Pre Prescription Screen of the single therapy mode If the current container has not completely infused the following screen will appear ALERT Rx_in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If you want to return to the current container and finish infusing it press the NO CHANGE key to return to the Pause Menu screen b To abort the current container and enter a new program press the YES ENTER key If a prescription has previously been entered for the therapy mode you wish to program the following screen will appear ALERT
82. Fluid will be pumped at a rate of 300 ml hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped The pump will then beep once and require repressing and holding the PRIME key again until 6 more milliliters is delivered Continue this process until all air has been purged from the IV bag and the administration set Note If the bag volume is depleted during priming a subsequent priming event cannot be initiated While the PRIME key is depressed the following screen appears PRIMING Release Araig key to Stop Prime Amt ml The amount used for the prime session is accumulated and displayed on the bottom field of this screen 6 When priming is complete release the PRIME key The following screen will display PRESS aes to Cont to EXIT Prime Amt 2 ml 7 To continue priming press the PRIME key again If priming is complete press YES ENTER to exit and return to the Run Option screen The total amount of solution used in this priming session displays on the bottom field Note The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient The bag volume should still be equal to or greater than the Amount TBI before you can proceed with the infusion If it is not an alert will appear stating AMT TBI GREATER THAN BAG VOL
83. HHititi W ExT YES Note One dose per screen is entered Variable Prescription Menu 3 DOSE Z oF 24 DOSE oF 24 DOSE 2 of 24 a Arnot TEI Oe ral Amt TED EAEE n Amt TEI Go nic RATE a a ral he RATE 3 a mathe RATE 2 8 megh TIME 50 HAMM TIME 100 HH MM TIME 0100 HHMI W NEXT YES 1 DOSE The dose number on the first field changes to indicate which dose is currently being programmed The total number of doses is also displayed and the pump will only prompt programming screens for the number of doses indicated on the initial programming screen 2 Amt TBI Use the numeric keys to enter the amount to be delivered in this dose The Units selected in the prescription menu will automatically appear in this field whether ml mg or mcg The amount to be infused is limited to the bag volume total and each time a dose is programmed the new amount to be infused is limited to the remaining bag volume total When the amount is correctly entered press the YES ENTER key to accept and move to the next field The range for this field is 1 to 9999 or the remaining bag volume amount 3 RATE The Curlin Medical pump can deliver from 0 1 ml to 400 ml per hour Use the numeric keys to enter the prescribed rate for this dose When this field is correct press the YES ENTER key to accept and move to the next field 4 TIME calculated by pump Displays the time required to complete this dose If the
84. ING Release aipiga key to Stop Prime Amt 0 0 ml The amount used for the prime session is accumulated and displayed on the bottom field of this screen 6 When priming is complete release the PRIME key The following screen will display PRESS to Cont to EXIT Prime Amt 2 ml 77 Adessyl Ndl 7 To continue priming press the PRIME key again If priming is complete press YES ENTER to exit and return to the Run Option screen The total amount of solution used in this priming session displays on the bottom field Note The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient The bag volume should still be equal to or greater than the Amount TBI before you can proceed with the infusion If it is not an alert will appear stating AMT TBI GREATER THAN BAG VOL You have the option to continue by pressing the YES ENTER key or return to the Run Options screen by pressing the NO key Options Once the prescription is programmed there are more customizing features available for each therapy Press the OPTIONS key from the Run Options screen to access these options The OPTIONS menu can also be accessed while the pump is running Note After the infusion has started any changes made through the OPTIONS menu involving e HRLY TOT and e CL
85. ING THE SET AND USING THE SLIDE CLAMP TO CLOSE THE TUBING a i E A AE ET EE 11 FIGURE 1 5 CURLIN MEDICAL ADMINISTRATION SET INTEGRAL FLOW STOP WITH BREAKAWAY TAB 12 FIGURE 1 6 INTENTIONALLY OPENING THE INTEGRAL FLOW STOP ccccsssssseeseeee 12 FIGURE 1 7 OPENING THE PUMP DOOR 13 FIGURE 1 8 CLOSING THE PUMP DOOR 13 FIGURE 1 9 PROPER INSTALLATION OF THE CURLIN MEDICAL ADMINISTRATION SET INTO THE PUMP oeeeeseeessersssersersrerse 15 FIGURE 1 10 TOP CUTAWAY VIEW OF THE CURLIN MEDICAL PUMP WITH CURLIN MEDICAL ADMINISTRATION SET IN PROPER INSTALLATION POSITION 16 FIGURE 1 11 CURLIN PUMP BATTERY REPLACEMENT rreo aitia 18 FIGURE 1 12 BATTERY PACK cccccssessesseeeeee 20 FIGURE 1 13 UNIVERSAL AC ADAPTER 21 FIGURE 1 14 ATTACHING AND REMOVING THE REMOTE BOLUS CORD ccccs0e 22 FIGURE 2 1 KEY PAD srssisssissssssssnisssssssiussessssosass sen 23 FIGURE 2 2 SAMPLE OF DISPLAY SCREEN 26 FIGURE 3 1 HISTORY EVENT LOG cc00 34 FIGURE 5 1 PCA ADMINISTRATION ROUTE DEFAULT SETTING Siiri iins 56 FIGURE 10 1 DETACHABLE POLE CLAMP 139 FIGURE 10 2 REMOTE BOLUS CORD 140 FIGURE 10 3 SAFETY SHELLS cccceseseseees 141 FIGURE 10 4 POLE CLAMP AND SAFETY SHELL INSTALLATION inntir ieis 141 FIGURE 10 5 PUMP HOLSTER c ccssseees 142 FIGURE 10 6 KEYPAD COVERS ccccseseseees 143 Ch
86. ION PUMP WITH RESPECT TO ELECTRIC SHOCK FIRE AND MECHANICAL HAZARDS ONLY IN ACCORDANCE WITH UL60601 1 CAN CSA C22 2 NO 601 1 70TK INTERNALLY POWERED OR FOR USE WITH AC ADAPTER 340 2022 AND 340 2026 DEFIBRILLATION PROOF TYPE CF APPLIED PARTS EQUIPMENT PROTECTED AGAINST DRIPPING WATER IPX1 EQUIPMENT NOT SUITABLE FOR USE IN THE PRESENCE OF A FLAMMABLE ANESTHETIC MIXTURE WITH AIR OR WITH OXYGEN OR NITROUS OXIDE MODE OF OPERATION CONTINUOUS WARNINGS e Prevent direct exposure to radiations Secure an essential infusion pump outside of the radiation field using extension tubing if required e Use only Curlin Medical administration sets in your Curlin Medical pump Use of nonproprietary administration sets may alter accuracy in delivery of fluids and could result in over or under infusions leading to possible patient injury or death e Do not use this pump with a pressure cuff applied to the IV bag or medication reservoir bag and do not unduly squeeze or compress the bag during a running infusion e Remove all air from the administration set and IV bag or reservoir before connecting it to a patient s access site e Do NOT prime the administration set while it is connected to the patient s access device Doing so could result in overdosing the patient and could cause injury or death e Do not attempt to open the pump s housing All service problems should be referred to an appropriate service technician e Danger Risk
87. IONS menu when an infusion is in progress and the AIR SENS field is accepted Air In Line Sensor Off Message Screen AIR Sensor OFF Using In Line Air Filter PESO This message alerts you to the Air In Line Sensor being set to OFF The message will require answering yes or no to whether the administration set being used has an air eliminating filter If you press the YES key to indicate that there is an air eliminating filter in use the Air In Line sensor will be completely disabled and the pump will start the infusion If you press the NO key to indicate a filter is not in use the Air In Line sensor will be set to detect the presence of any contiguous 2 milliliter air in the line The alert message below will then briefly appear on the screen If the alert occurred at the Run Options screen the pump will start the infusion Air In Line Sensor Set at 2 0m Alert Screen ALERT AIR SENSOR HAS BEEN SET TO 2 8 ML 111 AdessyL ajqeue Also when the Air In Line sensor is completely disabled and the infusion goes to an Infusion Complete or Empty Bag status the Air Sensor setting will automatically change to 2 0 ml 6 AUDIO Audio Volume This feature allows you to adjust the audio volume of the pump s alarm setting You can enter a number from 9 the loudest setting to 1 the quietest setting When you select a number the pump will beep at that audio level Press the N
88. If the source container contains sufficient volume to complete the remaining dose cycles dose volume KVO volume increase the Bag Vol If the volume is insufficient decrease the DOSE BAG such that the therapy can continue with the new modified prescription Note If either Bag Vol or DOSE BAG is modified and the therapy is repeated these fields will have to be verified against the source container volume and prescribed prescription and changed accordingly ALERT INVALID ENTRY Invalid Entry Data entered does not fall within the defined limits of the program Enter data that falls within the limits of the program Refer to the specific therapy section in the User s Manual 125 Buljooyseajqnoi LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution ALERT KVO RATE IS GREATER THAN INF RATE Unable to enter KVO rate that is greater than infusion rate Occurs when user enters a KVO rate that is greater than infusion rate Recheck data entry calculated infusion rate KVO rate must be less than programmed or ALERT LESS THAN MIN FIELD LIMIT MIN Unable to program a field with a value that is less than the minimum limit Value entered is less than the minimum limit for the pump or titration limit programmed Rec
89. In Line Sensor This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state The choices are 0 1 ml 0 5 ml the default setting 2 0 ml and OFF Press the NO CHANGE key to change the options until the desired setting appears on the display and then press YES ENTER to select and move the cursor to the next line IMPORTANT Whenever the Air In Line Sensor is set to OFF Curlin Medical INFORMATION recommends the use of an air eliminating filter When the Air In Line Sensor is set to OFF and the RUN key is pressed at the Run Option screen the alert message below will appear on the screen It will also appear if the Air In Line is changed from the OPTIONS menu when an infusion is in progress and the AIR SENS field is accepted Air In Line Sensor Off Message Screen AIR Sensor OFF Using In Line Air Filter PES NO This message alerts you to the Air In Line Sensor being set to OFF The message will require answering yes or no to whether the administration set being used has an air eliminating filter If you press the YES key to indicate that there is an air eliminating filter in use the Air In Line sensor will be completely disabled and the pump will start the infusion If you press the NO key to indicate a filter is not in use the Air In Line sensor will be set to detect the presence of any co
90. Integral Flow Stop automatically reacts to clamp the tubing The Integral Flow Stop can however be opened after the tab is broken away by intentionally squeezing down on the movable spring action section of the Integral Flow Stop See Figure 1 6 for an illustration of how to intentionally open the Integral Flow Stop For a complete listing of all available administration sets see the Curlin Medical Product Catalog CAUTION USE ONLY CURLIN MEDICAL ADMINISTRATION SETS WITH THIS PUMP CURLIN MEDICAL Ce e F r Male Luer Integral Flow pR Guide Medication Lock Slide Clamp Stop with Reservoir breakaway tab Figure 1 3 Samples of Curlin Medical Administration Sets 10 Preparing Medication for Infusion Changing IV Bags When using an IV bag grasp the bag spike firmly in one hand and the IV bag spike port in the other and insert the spike completely into the port using aseptic technique Holding the bag with fill ports down allows fluid to fill tubing and displace the air in the line Be sure all air has been removed from the IV bag as well Air in the line moves down through k the tubing as the fluid fills Notice the breakaway tab on the Integral Flow Stop has been removed The set can be gravity ptimed by intentionally squeezing the Integral Flow Stop and thus releasing th
91. Line Filter screen is displayed This will disable air detection as indicated under AIR SENS OFF Using In Line Filter alert explanation ALERT AMT NOT 0 OR CURRENT DOSE AMT Unable to change clinician dose while clinician dose in progress A clinician dose is in progress and a new clinician dose value is entered g gt that is not 0 or the current dose amount If the current clinician dose is to be continued change the Clin DOSE value back to the original value and accept the field and menu If the current clinician dose is to be terminated which will allow a new clinician dose to be programmed enter a value of 0 in the Clin DOSE field and accept the field and menu The next time that the Options menu is accessed a new Clin DOSE value can be entered ALERT AMT TBI GREATER THAN BAG VOLUME Value entered is greater than value in Bag Vol field Occurs when the amount the entered for the Amt TBI or Vol TBI field is greater than the value in the bag volume field Recheck the data entry ALERT AMT TBI GREATER THAN Continue NO to Return BAG VOLUME YES to Insufficient volume Occurs when bag volume is less than amount to be infused Can occur when pump s priming feature is used as bag volume is depleted by the amount used in priming To modify the Bag Volume or Amt Vol TBI press NO to return to the Run Options screen The programming screens will then be accessible by press
92. Line Sensor at 2 0mi Alert Screen ALERT ALF SENSOR HAS BEEN SET TO 2 8 ML Also when the Air In Line sensor is completely disabled and the infusion goes to an Infusion Complete or Empty Bag status the Air Sensor setting will automatically change to 2 0 ml 9 AUDIO Audio Volume This feature allows you to adjust the audio volume of the pump s alarm setting You can enter a number from 9 the loudest setting to 1 the quietest setting When you select a number the pump will beep at that audio level Press the NO key and 65 Ades9uL Wd enter a new setting 1 9 Repeat until the desired setting is reached and then press YES ENTER to select and move the cursor to the next field 10 PWR CK Power Check This feature allows you to periodically recheck the battery charge It will display the active power source of the pump whether internal batteries or external power If the active source is the batteries a graph will indicate approximately how much charge remains in the batteries To access this information select ON and press YES ENTER The Power Source Screen will display for five seconds and return to the Options Menu 11 ACCEPT OPT If the changes made in the Options Menu are acceptable press the YES ENTER key If the changes are not acceptable cursor up to any field for corrections or abort all changes made in this menu by pressing the NO key and return to the pre
93. Low Report error code to factory Call Provider 32 Turn Pump OFF Audio Main Speaker High Check replace D31 Replace PCB Call Provider 33 Low Alarm Audio Audio Auxiliary Speaker Low Connect pump to AC Battery Connect AC Adapt Turn pump OFF ON Eliminator and turn power off on to pump May require turning pump off on a few times 135 Buljooyseajqnoi Error LCD Displayed Probable Cause Corrective Action Code Message 34 Turn Pump OFF Audio Auxiliary Speaker High Report error code to factory Call Provider 35 History File History Log Erased Report error code to factory Turn pump OFF ON 36 Bad Cal Data Bad EEPROM Data CRC Report error code to factory Turn pump OFF value Call Provider 37 Turn Pump OFF Analog to Digital Converter did Report error code to factory Call Provider not Run 38 Turn Pump OFF Air In Line Circuit not Tested Report error code to factory Call Provider 39 Turn Pump OFF Bad EEPROM Data CRC 2 Report error code to factory Call Provider 40 Turn Pump OFF Bad EEPROM Data Header Report error code to factory Call Provider 41 Bad Cal Range Bad EEPROM Limit Report error code to factory Turn Pump OFF Call Provider 100 Turn pumpOFF ON Menu not found Report error code to factory Call Provider 101 Turn pumpOFF ON Mode not found Report error code to factory Call Provider 102 Turn pum
94. Move the cursor back to the ACCEPT YES field and press YES ENTER This action enters the new time and date and moves to the next field in the BIOMED SETUP Menu Pressing the NO key on this field aborts the change date and time selection and returns to the BIOMED SETUP Menu IMPORTANT If a therapy is in progress the date and time changing functions will not be Eo Rao accessible until the therapy is complete 14 When BIOMED SETUP is complete move the cursor to the DONE Field and press the YES ENTER key to return to the Program or Set Up Menu Screen Program Program BioMed Setup Menu ENTER to Select PROGRAM BIOMED SETUP To select PROGRAM use the arrow keys to move the cursor to the PROGRAM field and press the YES ENTER key If no therapy is already programmed a Select Therapy Screen appears prompting you to select a therapy If a therapy has been programmed the following screen appears 37 Bulmwei6oig soiseg Resume Repeat Rx New Program Menu ENTER to Select REPEAT Fx NEW PROGRAM There are three different ways that you can start a therapy RESUME Should be used if a therapy is interrupted The pump picks up where it left off and continues the therapy REPEAT Rx Should be used to hang a new bag and repeat the same therapy over again The infusion history displayed is reset volume infused boluses requested boluses received etc Shift Totals and Ho
95. O key and enter a new setting 1 9 Repeat until the desired setting appears on the display and then press YES ENTER to select it and move the cursor to the next field 7 PWR CK Power Check This feature allows you to periodically recheck the battery charge It will display the active power source of the pump whether batteries or external power If the active source is the batteries a graph will indicate approximately how much charge remains in the batteries To access this information select ON and press YES ENTER The Power Source Screen will display for five seconds and return to the Options Menu 8 ACCEPT OPT If the changes made in the Options Menu are acceptable press the YES ENTER key If the changes are not acceptable use arrow keys to cursor up to any field for corrections or abort all changes made in this menu by pressing the NO key and return to the previous screen There are two remaining selections to consider from the Run Options Screen NO to REVIEW and RUN to START Reviewing or Changing the Program To review or make any changes in the prescription programming press the NO CHANGE key at the Run Options screen and the prescription screens will reappear Changes may be inhibited by lock setting Changes to the prescription can be made before the start of the therapy however once a therapy has started no changes can be made to the Pre Prescription Screen It will appear
96. OLUS 1 of i REMAIN 20 5 ral This screen will continue to display as long as the infusion is running Notice the information on each field 1 The first field displays the RATE of the infusion toggled with the programmed Bolus Dose Amount This field also displays BOLUS xx mg ml mcg whenever a bolus dose is being delivered The programmed bolus amount displays and the BOLUS text flashes when the pump is delivering a bolus dose The second field is a graphic bar representing the percentage of the completed infusion In CMS enabled pumps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units The third line displays the total volume TOT Vol infused and if mg or mcg is the selected unit this field will toggle to display the total mg or mcg infused TOT INF as well The fourth line displays the number of boluses delivered and number of boluses attempted per bag volume If the patient attempts a bolus before the allowed amount of time set between boluses an alert message will display Bolus Requested and only the second number will increase Also toggling with number of boluses delivered requested is the remaining volume left in the bag In addition to the display screen information on the status of the infusion is provided by the three LED lights The green LED light blink
97. Options menu displayed when the alert occurred the run screen for the therapy will be displayed when the alert is cleared Any changes to the Options menu are discarded and will have to be re entered ALERT NO THERAPY ENABLED No Therapy Enabled Attempting to accept the Enable Therapy menu with all therapies set to OFF At least one therapy must be enabled or ON for menu to be accepted Enable the therapy or therapies that are to be active for the pump ALERT NOT ALLOWED DOSE IN PROGRESS Change is not allowed while a dose is in progress Modification to the current field is not allowed while the dose is in progress Wait until the dose in progress completes before modifying field 127 Burooys jqnoIL LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution ALERT NOT in PCA NO BOLUS ALLOWED Bolus requested when therapy is not PCA Remote Bolus button or BOLUS key is pressed when not in PCA therapy Remove the remote bolus cord from the pump if connected Refrain from pressing the BOLUS key ALERT NUMBER OF DOSES INVALID Number of doses entered exceeds maximum for therapy The number of doses per bag in Intermittent therapy exceeds the allowable maximum Recheck data ent
98. R HRLY will return you directly to the ACCEPT OPT field The following screen displays the TPN Therapy Options available When you open this menu use the up and down arrows to move the highlight bar to the desired option Lock settings may require an access code before the option can be changed Any new setting except CLEAR HOURLY screen acceptance becomes effective when the Options screen is exited by pressing YES ENTER at the ACCEPT OPT field TPN Options Menu OFTIONS Lock OFF Lock S z G HRLY ToT OFF on LRHRLY OFF on T ON Ramp OFF fay OM Occu LOM MAIR SENS O15 ral AUDIO S if FHRCK OFF ACCEPT OFT YES NO On HIGH 2 8 OFF 41 i 3g On Note The pump s default settings are indicated above in the left screen 1 LOCK When the lock is set to OFF the clinician has access to all of the pump functions After the pump is completely programmed change the lock to meet the security needs of this therapy There are four choices OFF 1 2 or 3 Each level higher limits the available options To change the lock setting press the NO CHANGE key until the correct lock setting appears Then press YES ENTER key to accept the new lock selection Once the 78 pump has been set into a locked condition any subsequent request to change the lock will require a clinician access code See Clinical Information and Access Code chapter
99. Screen ENTER CODE S999 s i a a INVALID CODE EXIT YES The clinician enters a four digit personal identification number followed by the five digit access code and if the code is valid the display will automatically move to the requested screen or field The four digit personal identification number appears on the screen but the access code numbers do not instead five asterisks appear The personal identification number is recorded in the history file for the purpose of providing an audit trail If an invalid code is accidentally entered a message displays Invalid Code and the clinician can reenter the correct code Note After entering the access code DO NOT press the YES ENTER key The pump will automatically recognize the correct code and give you access to the secured section IMPORTANT INFORMATION If an access code screen displays and the access code is not known use the down atrow to move the cursor to the EXIT field Press the YES ENTER key at this field to return to the previous screen and make another selection Also remember that the HELP key is available when the pump is paused Look first at the BIOMED SETUP menu and its special customization features BioMed Setup Bio Med Setup Menu ENTER to Select MAINT OS TANGY PROGRAMMER ID PATIENT IO Rx NUMBER INVOICE NUMBER CHANGE LOCK ENABLE THERAPY PRINT Pt Hx CLEAR Hx LOG CLEAR Fx CLEAR Pt DATA CHANGE CON
100. TRAST DATE TIME DONE The BIOMED SETUP menu lists special optional customization and performance functions of the pump 31 GBulmwei6olig soiseg You may skip any of these functions by using the down arrow to move the cursor to only the desired selection When the desired selection is highlighted press the YES ENTER key A secondary screen will be displayed When all BIOMED SETUP functions are completed move the cursor to the last field DONE YES and press the YES ENTER key to exit this menu IMPORTANT INFORMATION 1 PREVENTIVE MAINTENANCE DATE The first field displays the date the pump requires its annual routine preventive maintenance check Note You cannot change this date it is changed only when a factory technician performs the routine pump maintenance The clinician that initially programs the pump for a patient should note the maintenance date Once this date arrives a Perform Routine Maintenance message will briefly appear after the welcome screen If the Maintenance Due date will occur during the time the patient will be on service the clinician may wish to select another Curlin Medical pump for this patient This action will avoid any undue concern on the patient s part at the notice of maintenance due and eliminate the need to recall a pump in service for maintenance The pump however can continue to be used without disrupting service when this message appears but
101. UN on the Run Options screen to start the therapy If a delayed start is programmed the Delay Start Count Down Screen will appear If no delay start is programmed or the delay has elapsed the pump will begin infusing and the following screen displays the status of the therapy Intermittent Run Screen I RATE 250 8 ml he pose 1 of z L FRES 18 b TOTWOL Fr a ml B TOT VOL T5 9 MXTDOSE S542 HH MM MXT DOSE S HL This screen continues to display as long as the infusion is in progress Notice the information given in each field 1 The first field displays the RATE of the infusion in whichever units hour has been selected The dose number in progress of the total number of doses programmed toggles with the infusion rate 2 The second field is a graphic representation of the delivered amount of the dose in progress or that of the KVO cycle in progress In CMS enabled pumps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units 3 The third field toggles to give Total Volume Infused Dose Infused and if units are mg or meg the Total Amount Infused also 4 The fourth field gives the remaining time for the entire infusion all doses in this IV bag the remaining amount in mg or mcg the remaining volume and the time the next dose is due 5 In addition to the display screen accum
102. UOUS Infusion Pre Rx UNITS ml DELAY OFF Titrate OFF NEXT YES Prescription BAG VOL 100 ml VOL TBI 10 0 ml RATE 125 ml hr TIME 0 04 HH MM KVO Rate 0 0 ml hr DONE YES Start the continuous therapy running by pressing RUN button When the 10 ml infusion is over observe the amount volume infused as measured on the measurement device Passing measurement is 9 5 g to 10 50 g 9 5ml to 10 5ml When Infusion complete occurs verify that the Audio Alarm is beeping and that the Green and Red LEDs are flashing 3 CHECK ALL SAFETY SYSTEMS a Low Down Stream Occlusion Repeat the same Continuous Infusion as above Go to the Option screen and confirm that the Down Occlusion level is set to LOW Start the infusion and while the pump is running pinch off or close the down stream side of the administration set Confirm the pump goes into Down Occlusion alarm Open or clear the down stream occlusion and confirm the pump resumes infusion High Down Stream Occlusion Go to the Option screen and change the Down Occlusion level to HIGH Again pinch off or close the clamp on the down stream side of the administration set Confirm the pump goes into Down Occlusion Open or clear the down stream occlusion and confirm the pump resumes infusion Up Stream Occlusion Resume the infusion pumping then pinch off or close the up stream side of the administration set Confirm that the pump goes into an Up Occlusion alarm Open or clear
103. VIEW or araga Note that you do not need to answer yes or no questions or enter data with the numeric keys as previously requested This screen requires only that you press the corresponding key on the keypad to begin the requested function The following explains each selection beginning with Prime Prime The IV bag and administration set should be inspected and be free of all air and air bubbles before they are connected to the access site Priming may have been done by gravity when the administration set was first connected to the bag see Chapter 1 Preparing Medication for Infusion However if it was not done then or if there are any remaining air bubbles to be removed the pump s PRIME function will assist in this process To prime the set by using the pump follow the directions below Note The lock setting may restrict the ability to prime using the pump 1 Press and release the PRIME key at the Run Options screen 2 The following screen appears Prime Direction Screen Disconnect Pt Release Clamps HOLD HAtakey HA to EXIT 3 Disconnect the administration set from the access site using aseptic protocols IMPORTANT Priming with the set connected to the patient could result in overdose and may cause injury or even death to the patient INFORMATION 91 AdesayL U9 1U119 U 4 Release any clamps on the administration set 5 Press and hold the PRIME key Fluid will be p
104. able Therapy Menu ENABLE THERAPY com OFF FCA TFH INT OFF VAR OFF ACCEPT a To enable a therapy move the cursor to that therapy selection and press the YES ENTER key when the selection states ON b To disable a therapy move the cursor to that therapy selection and press the NO CHANGE key The ON status will change to OFF Press the YES key to accept the OFF or disable status c When the ON OFF status of each therapy is satisfactory move the cursor to the last field ACCEPT and press the YES ENTER key to accept To abort the enable therapy process press the NO key to exit this menu and return to the BIOMED SETUP Menu d Atleast one therapy must remain enabled before you exit this screen Note Ifa therapy that has previously been programmed is disabled the program is cleared and the default settings are reestablished Patient History Log The patient history log is a cumulative record of the approximately last 6 000 events that have occurred in the pump Example When prescription information is saved using the YES ENTER key at the DONE or ACCEPT fields a copy of the information also gets date and time stamped and is recorded in the patient history log Alarms error codes certain alerts and certain key press events also get logged when they occur The patient history log can be printed using the Curlin Medical p
105. administration route selected see Figure 5 1 Note Ifa bolus dose entered falls out of the range of the pump the above Greater than Max Field Limit or Less than Min Field Limit alert will also appear and display the limit 4 BOLS INT Bolus Interval This field allows the clinician to enter the minimum amount of time from 0 to 60 min prescribed between patient activated bolus dosing Enter the time 58 using the numeric keys and when correct press the YES ENTER key to accept and move the cursor to the next field 5 BOLS hr Number of Bolus Doses per hour Using the numeric keys enter the number 0 to 15 of boluses allowed per hour and when correct press the YES ENTER key to accept and move to the last field 6 DONE If the programming is not done use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable at the DONE prompt press the YES ENTER key to move on to the next screen Before the infusion is started it is important to consider a few remaining issues such as checking the administration set to be sure it was primed or purged of all air or perhaps the pump may need to be put into a security lock setting for additional safety IMPORTANT INFORMATION The following screen offers you four choices Run Options Screen
106. administration set See Chapter entitled Introduction Figures 1 9 and 1 10 for proper installation of administration set ALARM UNATTENDED PUMP No key presses have occurred while the pump was paused When a therapy is in progress and a pump is placed in a paused state and left unattended for more than two minutes this alarm will sound If the prime menus are left unattended for one minute this alarm will sound Press the PAUSE key to clear the alarm screen If required return to the screen displayed at the time of the alarm and complete the activity that was in progress or resume the infusion or turn the pump off 132 LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution LCD Display Alarm Cause Resolution ALARM UP OCCLUSION Negative pressure detected between the pump and IV reservoir Pump has detected excessive negative pressure in the administration set between the medication reservoir or IV bag up stream and the pump Pause the pump Check administration set from IV bag to pump for potential causes of occlusion Open the door of the pump and remove the administration set from the pumping chamber If an area of the tubing is flattened massage that area to a more rounded shape If a clamp is in place open it if tubing is kinked straighten it Replace administrat
107. ant When the TIME field is satisfactory press the YES ENTER key and move to the final field The range for this field is 0 01 to 288 00 HH MM Note The time calculated by the pump may be less than a minute however one minute is the minimum entry and display value 5 KVO Rate Keep Vein Open Rate This field requires data entry using the numeric keys to set the rate at which fluid will be delivered in a Keep Open state The pump defaults to a rate of 0 1 ml hour can be set from 0 to 10 ml hour but cannot be set at a rate to exceed the therapy operating rate When the desired KVO rate has been entered press the YES ENTER key to accept and move the cursor to the next field 44 6 DONE If any changes are to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable move the cursor to the DONE field and press the YES ENTER key to move on to the next screen Before the infusion is started it is important to consider a few IMPORTANT remaining issues such as checking the administration set to be sure it was primed or purged of all air or perhaps the pump may need to be put into a security lock setting for additional safety INFORMATION The next screen that appears when the programming is complete offers four choices Run Options Screen
108. apter Introduction The Curlin Medical Infusion Pumps have been designed with the user in mind and have the latest in frend simpple to karn technology to alloy fast and easy acess to the features of these pumps With a little introducton and training an operator will quickly be able to program and use these pumps to deliver the therapies prescribed Note Throughout this Manual the text will refer to the Curlin Medical pump All the features described here apply equally to the 4000 Plus and the 4000 CMS pumps unless specifically otherwise stated ets begin by introducing you to the Curlin Medical pump an easy to use ambulatory or pole mounted infusion device designed to meet the needs of the hospital or alternate site patient It operates accurately in any position has a low rate resolution of 2 microliters and its small compact lightweight design allows mobility for ambulatory patients The Curlin Medical pump can be carried in any of the four convenient carryall soft packs pole mounted placed into the locked safety shells or set on a suitable surface for use Delivery Modes The pump features five therapy delivery modes 1 Continuous Infusion Designed to allow a constant programmed rate of infusion 2 PCA or Patient Controlled Analgesia Designed for therapies that require a continuous rate of infusion patient controlled demand boluses or both 3 TPN with Automatic Ramping Designed to allow a level rate of
109. apy of choice and pressing the YES ENTER key The pump will then display the program screens with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key at this field and the display will return to the Select Therapy Screen The lock setting can control access to this function The therapy is complete therefore RESUME is not an option at this time and is not displayed 85 Ade1 4L Ndl 86 Chapter Intermittent Therapy Intermittent Therapy is designed to deliver progrananed intervals and rates of speated amounts of infusates and to optionally deliver small amounts of the infusate behveen doses to keep the ass site patent egin programming an Intermittent Therapy by selecting Intermittent from the Select Therapy Screen The following display screen will appear requiring you to enter information needed to program this therapy Prescription Menus Intermittent Pre Prescription Menu Screen UNITS fe UNITS mg UNITS meg DELAY OFF COMCEN 3 0 moa ml COoMCcEN a HEST YES DELAY OFF DELAY OFF NEXT YES HEXT YES These menu items a
110. ay Start time To change the Delay Start time press the NO CHANGE key when the Run Options Screen is displayed Run Options Screen PRESS to START to REVIEM or aaga This will allow the clinician to go back to review the program and at this point a change can be made to the delay start time Note If the pump is not connected to the patient s access site at this time the patient or caregiver should be taught proper techniques to access the infusion site before the scheduled start time When the RUN key is pressed the Green and Yellow LED lights will flash to indicate that the pump will automatically start when the delay start count down period is up During the delay start time the following screen appears DELAYED START INFUSION STARTIN 12 215 HH MM BEVORATE i 0 lhe If the KVO rate is set to 0 the pump will beep ten minutes prior to the beginning of the Continuous Therapy start time To stop the audible beep press the Silence key 104 During the delay start period if the KVO rate is set to 0 no fluid is IMPORTANT infusing Be sure the access device is patent and has been flushed per facility policy to maintain patency during this time period If a KVO rate is programmed then that KVO rate will be used in the Delay Start period INFORMATION 4 NEXT If there are any changes to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to
111. ay cause harmful interference to other devices in the vicinity However there is no guarantee that interference will not occur in a particular installation If this equipment does cause harmful interference to other devices which can be determined by turning the equipment off and on the user is encouraged to try to correct the interference by one of more of the following measures 1 Reorient or relocate the receiving device 2 Increase the separation between the equipment 3 Connect the equipment into an outlet on a circuit different from that to which the other device s are connected 4 Consult the manufacturer or field service technician for help Note For information regarding the clinician access code read the chapter entitled Clinician Information and Access Code When entered correctly the access code allows a user to change the lock settings of the pump and thereby change the settings of the pump Because the chapter entitled Clinician Information and Access IMPORTANT Code contains access code information the entite chapter should be INFORMATION removed before initial patient teaching and should not be left in the manual while in the patient setting Doing so could jeopardize the security levels intended only for clinician use and access uo1 onpo1 u Pump Illustrations and Features Pump Door LED Status Display Screen Pump Door Indicator Instruction Label Door Latch Run Pause Key
112. bag or reservoir per protocol Disconnect from patient s access site before using prime function LCD Display ALARM DOOR OPEN or SET NOT PROPERLY INSTALLED Alarm Door is opened or administration set is not properly installed while the pump is running Cause Door is opened or administration set is not properly installed while the pump is running Resolution Check the door latch assembly and securely close the door If the door was closed properly re install the set according to the installation instructions See Figure 1 8 for instructions on closing door LCD Display ALARM DOWN OCCLUSION Alarm Occlusion between pump and patient access site Cause Pump has detected excessive pressure in the administration set between the pump and the patient s access site Resolution Check administration set from pump to patient access site for potential causes of occlusion If tubing is kinked straighten it If filter is blocked replace administration set If patient access is obstructed check it according to protocol Consider changing the down occlusion pressure setting from Low to High If the occlusion is cleared without the need to open the pump door the pump automatically resumes its operation Note If the door of the pump is opened to clear the occlusion e g replacing the set you must press the pause key select Resume and then press the RUN key to restart the infusion 131 Buljooyseajqnoi LCD Display
113. ccommodate pump AC Adapter and up to four liter IV bag 1 Some syringes are not qualified for use Please call Curlin Medical for details 2 e Retained memory features that allow the pump to easily resume a therapy exactly from where it left off when it is interrupted before completion or to repeat a therapy using the same programmed prescription e Compact lockable safety shells that provide additional security when needed and that are designed to be free standing pole mounted or placed in the convenient soft carry case e Backlit illumination for display screen Backlight remains on continuously if AC Adapter is in use e Pump will not permit the user to enter any programming value that is outside of its predetermined range e Integral Up as well as Down Occlusion alarms to notify user if an occlusion is present on either side of the pumping chamber e Integral High Upstream pressure alarm to notify user of excessive upstream pressure e Integral Air In Line alarm to notify user of presence of air in the tubing e Adjustable Down Occlusion settings of High and Low to customize the pump s down pressure requirements e Patient side downstream Line Pressure displayed on CMS enabled pumps Regulatory Agency Approvals SLZA C INFUSION PUMP WITH RESPECT TO ELECTRIC SHOCK FIRE AND MECHANICAL HAZARDS ONLY IN ACCORDANCE WITH UL60601 1 CAN CSA C22 2 NO 601 1 70TK e Underwriters Laboratories has
114. changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to move on to the next screen At the following screen the prescription information is entered to complete the programming of the pump for a Continuous Therapy Note that the Screen Identifier at the left side of the display gives the abbreviation CON for Continuous Therapy and has a down arrow configuration which indicates that there are more than four fields of text or lines of information to be considered 43 Adeiay LL snonunuog Continuous Prescription Menu BAG Jol GE rol BAG Vol GE rl BAG Vol OAE ml AmtTEI 8 ml AmtTEI mg AmtTEI 3 8 meg RATE 8 9 mlshe RATE 8 9 mathe RATE D 0 megh TIME GQ HHMH TIME Q 0D HHM TIME OO HHiMH KMORATE 1 0 mle DONE YES 1 BAG Vol IV Bag Volume Use the numeric keys to enter the amount of fluid in the IV Bag ot Medication Reservoir include the overfill volume Note The volume used for priming via the pump or for KVO is deducted from the Bag Volume Therefore Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion When the correct amount has been entered press the YES ENTER key to accept this field and move on to the next The range for this field is 1 to 9999 2 Amt TBI Amount To Be I
115. ck see Figure 1 12 The two pin connector on the end of the cable plugs into the receptacles correctly by aligning the red dots on each Note Pause the pump and then turn it off before connecting the AC Adapter Note also that the connector is keyed with a notch at this red dot location to guide alignment To remove pull back on the locking sleeve to unlock and then pull gently to remove the connector from the battery pack or pump s port Illustration of the bottom of the Curlin Medical Pump on Recharging Port f K 4i Align the red dots and the notches Then plug the two pin connector into the two hole receptacle located on the bottom of the Curlin Medical pump To charge the Battery Pack Plug the AC Adapter into a grounded wall outlet and then plug the AC Adapter into the recharging port of the Battery Pack see above On initial use the Battery Pack should be charged for a full 24 hours subsequent recharge takes approximately 12 hours overnight Figure 1 12 Battery Pack 20 Locking Sleeve Two Pin Adapter plugs into port on bottom of the pump for AC power or can be used to recharge the battery pack by plugging into the recharging port on the battery pack see Figure 1 12 Note the connector notched keying and red dot alignment To remove pull back on the locking sleeve Figure 1 13 Universal AC Adapter 21 uo1 onpo1 u Attaching and Removing the Bolus Cord
116. clinician to perform the locked out function 159 uonewoyzuj UBIDIUTD Lock Setting Table The following table illustrates which features are controlled under which lock settings Pump Operation Active Lock Lock Lock Lock Therapy OFF 1 2 3 Change Lock Settings A All settings with correct access code Turn Pump Off On Pause Run Therapy Access Help Options Resume Therapy Repeat Therapy Change Audio Level C Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes gt i Ala fad oad oa aot hange Rx screen information hange Rx screen at No to Review ccess New Program hange Air in Line Settin hange Down Pressure hange KVO Rate Delay Start Change Units New Program Utilize Titration Option Yes Program Titration Limits Yes Change Administration Route New Program Yes Program Loading Dose Yes Program Clinician Dose Access Early Down Ramp Change Next Dose Time Whenever a lock setting is placed in the pump it is retained unless changed by using either the BIOMED SETUP function or the OPTIONS function to change the setting If a locked out function is requested such as PRIME in lock setting 3 a screen will appear requesting the entry of the access code When the correct code is entered the locked out function can be performed by the clinician Note The l
117. container and enter a new program press the YES ENTER key If a prescription has previously been entered for the therapy mode you wish to program the following screen will appear ALERT Rx Programmed to Erase Rx to Return If you want to save the current prescription press the NO CHANGE key to return to the Pause Menu screen If you wish to erase the current prescription and enter a new program press the YES ENTER key to proceed All previous prescription values will be erased Selecting NEW PROGRAM will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually Infusion Complete When the infusion is complete the audio alarm will beep and the following screen will display Note To temporarily silence the alarm press the Silence key Continuous Infusion Complete IMFUSION COMPLETE TOTWOL 20 8 ml KVORATE 1 00 mlhe 53 Adeiay LL snonunuog This screen displays 1 INFUSION COMPLETE 2 A graphic representation completely filled in bar graph indicating infusion complete or the smaller dot configuration shown here if a KVO RATE is programmed 3 TOT Vol Total Volume If units are mg or mcg this field will also toggle to give the Total Infused 4 KVO Rate The preset KVO rate displays 5 Infusion Complete is considered an alarm status and the audio alarm will beep periodically every
118. d surface of the pump head indicates the direction and location for the Integral Flow Stop CAUTION Hold the Flow Stop by the small handle DO NOT press down on the top of the Integral Flow Stop when inserting it into the receptacle This action could inadvertently open the Integral Flow Stop and allow fluid to flow through the tubing 4 Press the tubing into the air detector slot gently with index finger Figure 1 10 Top cutaway view of the Curlin Medical pump with Curlin Medical Administration set in proper installation position Up Stream Occlusion Alarm Feature The Curlin Medical pump has an Up Stream Occlusion alarm feature e g it detects low up stream pressure This feature notifies you if an occlusion is present between the IV container and the pump If this alarm occurs the display will read ALARM UP OCCLUSION the alarm will sound the red LED light will blink and the infusion will stop This situation requires that you press the Pause key examine the administration set from the IV container to the pump for potential causes of the occlusion If a clamp is in place open or remove it if the administration set is kinked straighten it If indicated close the slide clamp on the administration set and open the door of the pump to verify that the set is correctly placed Close the pump s door and reopen the slide clamp When ready to begin infusing select RESUME and then press
119. d setting appears on the display and then press YES ENTER to select and move the cursor to the next line IMPORTANT Whenever the Air In Line Sensor is set to OFF Curlin Medical INFORMATION recommends the use of an air eliminating filter When the Air In Line Sensor is set to OFF and the RUN key is pressed at the Run Option screen the alert message below will appear on the screen It will also appear if the Air In Line is changed from the OPTIONS menu when an infusion is in progress and the AIR SENS field is accepted Air In Line Sensor Off Message Screen ALF Sensor OFF Using In Line Air Filter PESO 94 This message alerts you to the Air In Line Sensor being set to OFF The message will require answering yes or no to whether the administration set being used has an air eliminating filter If you press the YES key to indicate that there is an air eliminating filter in use the Air In Line sensor will be completely disabled and the pump will start the infusion If you press the NO key to indicate a filter is not in use the Air In Line sensor will be set to detect the presence of any contiguous 2 milliliter air in the line The alert message below will then briefly appear on the screen If the alert occurred at the Run Options screen the pump will start the infusion Air In Line Sensor Set at 2 0mlI Alert Screen ALERT ALF SENSOR HAS BEEN SET TO 2 8 ML Also
120. der CONDITIONS OF WARRANTY The warranty is void if the pump has been 1 repaired by someone other than the Manufacturer or its authorized agent 2 altered so that its stability or reliability is affected 3 misused or 4 damaged by negligence or accident Misuse includes but not limited to use not in compliance with the User s Manual or use with non approved accessories The pump is a sealed unit and the fact that the seal has been broken will be considered conclusive evidence that the Pump has been altered or misused Removal or damage to the Pump s serial number will invalidate this warranty LIMITATIONS AND EXCLUSIONS Repair or replacement of the pump or any component part thereof is the EXCLUSIVE remedy offered by the Manufacturer The following and limitations shall apply a No agent representative or employee of the Manufacturer has authority to bind the Manufacturer to any representation or warranty expressed or implied b THERE IS NO WARRANTY OF MERCHANTABILITY OR FITNESS OR USE OF THE PUMP FOR ANY PARTICULAR PURPOSE c The pump can only be used under the supervision of medical personnel whose skill and judgment determine the suitability of the Pump for any particular medical treatment d All recommendations information and descriptive literature supplied by the Manufacturer or its agents are believed to be accurate and reliable but do not constitute warranties The Manufacturer disclaims responsibility for t
121. dicators This three light feature gives the user feed back on the current status of the pump 1 Green indicates a RUNNING status of the pump and blinks approximately once every three seconds when a therapy is in progress Yellow indicates a STANDBY status of the pump and blinks while the pump is paused 3 Red indicates a STOPPED or ALARM status of the pump and blinks whenever an alarm status exists 4 Green and Red indicates an Infusion Complete Alarm status with KVO or a Down Occlusion Alarm with automatic restart 5 Yellow and Green indicates a Standby status with automatic start This occurs during any delay start with a 0 KVO programmed or in PCA during a 0 basal rate and bolus only programmed Audio Indicator An audible alarm or beep is used to alert you to a change in the status of the pump or a situation requiring user action or notification A message will appear on the display screen describing the situation The rate number of beeps and volume further specify status This pump offers nine different volume levels from which to select for the audio feature however the beep cannot be totally disabled The audio beep can be silenced for one minute intervals by pressing the SILENCE key except during an Error Code at which time the alarm continues and the pump must be turned off The chapter of this manual entitled Troubleshooting includes tables with the alerts alarms and er
122. dinances and recycling plans regarding disposal or recycling of device components When the C size batteries are to be discarded do not incinerate them Dispose of all used administration sets in accordance with all applicable regulatory and institutional policies and directions Adhere to any warnings precautions or recommendations stated by drug manufacturers regarding the use of infusion pumps and disposable administration sets in the administration of their specific products Administer all drugs selected for epidural administration in accordance with the indications included in the manufacturet s package insert accompanying the drugs Note that the administration of medications into the epidural space is limited to delivery via specially designed indwelling catheters inserted by a qualified physician Any patients receiving epidural infusions should be managed and monitored by medical professionals familiar with epidural administrations and their clinical management Curlin Medical offers administration sets specifically designed for epidural infusions with 0 22 micron filters no injection ports and yellow striping to clearly identify the set for epidural use Any administration set being used for epidural infusions should be clearly labeled as such Clean the pump remote bolus cord AC adapter and battery pack with a soft clean cloth dampened in any of the following 1 Warm soapy water do not submerse 2 Isopropyl alcohol
123. e clamping action See Figures 1 5 amp 1 6 OPEN CLOSED In these illustrations the slide clamps are shown in their open and closed states Figure 1 4 Spiking the fluid container gravity priming the set and using the slide clamp to close the tubing 11 uo1 onpo1 u Twist and remove breakaway tab from Integral Flow Stop Figure 1 5 Curlin Medical Administration set Integral Flow Stop with breakaway tab Squeeze Integral Flow Stop between thumb and forefinger 4 as shown to allow fluid to flow through tubing after the breakaway tab has been removed Figure 1 6 Intentionally Opening the Integral Flow Stop 12 Opening and Closing the Pump Door The pump door located on the top of the Curlin Medical pump has a sturdy over center latching mechanism which assists in securely closing the door Review the following illustrations gt Door Latch g Lift to open uo1 onpo1 u Latch Hook Latch Pins To open the pump door 1 Pull the door latch up releasing the latch hooks from the latch pins 2 Grasp the door latch and pull upwards and to the right to open the entire door mechanism Full range access is now available for installing the Curlin Medical Administration set See figures 1 9 and 1 10 Push down a To close the pump door properly move the entire door assembly to the left and
124. e to Provider factory 179 Bolus Cord Stuck Remote Bolus Switch If Bolus Switch was pressed Unplug Cord release it Replace Bolus Turn pump OFF ON assembly Otherwise report error code to factory 180 Turn pump OFF ON Invalid Key Report error code to factory Call Provider 200 Turn pump OFF ON Invalid system state Report error code to factory Call Provider 201 Turn pump OFF ON Bad power up test number Report error code to factory Call Provider 202 Turn pump OFF ON Bad power up state Report error code to factory Call Provider 203 Turn pump OFF ON Bad A to D Max address Report error code to factory Call Provider 137 Buljooyseajqnoi Error LCD Displayed Probable Cause Corrective Action Code Message 204 Turn pump OFF ON Bad run state Report error code to factory Call Provider 205 Turn pump OFF ON Bad pump status Report error code to factory Call Provider 206 Turn pump OFF ON Bad volume type Report error code to factory Call Provider 207 Turn pump OFF ON Bad rate type Report error code to factory Call Provider 208 Turn pump OFF ON Bad motor test number Report error code to factory Call Provider 209 Turn pump OFF ON Bad hist type Report error code to factory Call Provider 210 Turn pump OFF ON Bad EEPROM Data ID Report error code to factory Call Provider 211 Turn pump OFF ON Bad run time CRC state R
125. e to the delay start time Note If the pump is not connected to the patient s access site at this time the patient or caregiver should be taught proper techniques to access the infusion site before the scheduled start time When the RUN key is pressed the Green and Yellow LED lights will flash to indicate that the pump will automatically start when the delay start countdown period is up During the delay start time the following screen appears DELAYED START INFUSION ay STARTIN LZ 15 HH MM EM ORATE 1 00 ml he If the KVO rate is set to 0 the pump will beep ten minutes prior to the beginning of the therapy start time To stop the audible beep press the Silence key During the delay start period if the KVO rate is set to 0 no fluid is IMPORTANT infusing Be sure the access device is patent and has been flushed INFORMATION per facility policy to maintain patency during this time period Ifa KVO rate is programmed then that KVO rate will be used in the Delay Start period 4 NEXT If there are any changes to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to move on to the next screen At the following screen the prescription information is entered to comple
126. ected for a therapy that has an existing prescription NEW PROGRAM was selected for a therapy that has an existing prescription To erase the prescription for the selected therapy press YES The pre Rx menu will be displayed and entry of a new prescription will be required To preserve the prescription for the selected therapy press NO The Pause menu will be displayed ALERT SET NOT INSTALLED Set Not Installed Administration set is not properly installed Install the appropriate Curlin Medical administration set for the desired therapy Use ONLY Curlin Medical administration sets See Chapter 1 figures 1 9 and 1 10 of the User s Manual for proper installation of the administration set 129 Buljooysajqnoi LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution ALERT SYSTEM CLOCK NOT SET System Clock Not Set The clock for the pump is not set Use the BIOMED SETUP menu Date and Time option to set the date and time ALERT THERAPY TIME INVALID Invalid therapy time calculated While programming or modifying an Intermittent therapy the combination of dose duration and dose frequency result in a prescription with a duration greater than 288 00 HH MM Recheck data entry The changes to the field must comply with the total time limit
127. ed for entire therapy and toggles with the amount infused of the dose in progress and Total Infused if units are in mg or mcg The fourth field displays the remaining time to the completion of the total infusion and toggles with total remaining volume to be infused and total remaining amounts if units are in mg or mcg In addition to the display screen giving information regarding the status of the infusion the green LED light blinks whenever the pump is infusing The information on the run screen will alternate between a four line display and a large font display of each individual line of information on the screen Variable Information Screens Dose Rate lof 4 400 0 mL hr Dose Inf 152 3 mL Remain 849 7 mL p 113 AdessyL ajqeue Interrupting an Infusion The infusion can be paused at any time by pressing the PAUSE key The yellow Standby LED light blinks and the following screen displays Pause Menu Screen ENTER to Select REPEAT Fx NEW PROGRAM The screen offers the user three options Resuming the Current Container 1 RESUME To resume the therapy in progress from where it left off press the YES ENTER key at this field The pump will return to the Run Options Screen and you can resume the therapy Note If you wish to hang a new container move the cursor to REPEAT Rx see following section Run Options Screen PRESS to START to REVIEW or araia a Pres
128. ed it can be left blank and skipped using the down arrow to scroll to the next field When the INVOICE NUMBER is satisfactory press the YES ENTER key at the ACCEPT YES NO field and the number will be stored in the pump history log 6 CHANGE LOCK This selection allows the clinician to change the lock setting of the pump This feature is also available under the OPTIONS menu of each therapy There are four choices in this field OFF 1 2 or 3 When the lock is set to OFF the clinician has access 32 to all pump functions Each level higher limits the options available to the patient or caregiver see each lock option screen in the individual therapy sections and or the lock level table in the chapter entitled C nician Information and Access Code If the desired lock does not appear on the display press the NO CHANGE key until the correct lock does appear Then press the YES ENTER key to accept and move the cursor to the next field ENABLE THERAPY This field is used to customize the Curlin Medical pump to the specific therapy ordered for the patient When you select this function by pressing the YES ENTER key the menu below appears listing all five of the possible therapies The pump s default setting is to enable all therapies You can choose however to enable or disable any of the therapies listed Once a therapy is disabled no further prompts will appear in programming for that therapy En
129. ed by the lock setting The display will return to the Select Therapy Screen if more than one therapy mode is enabled or to the Pre Prescription Screen of the single therapy mode If the current container has not completely infused the following screen will appear a b ALERT Rx in progress New Program to Return This screen is a reminder that the infusion is not complete If you want to return to the current container and finish infusing it press the NO CHANGE key to return to the Pause Menu screen To abort the current container and enter a new program press the YES ENTER key If a prescription has previously been entered for the therapy mode you wish to program the following screen will appear ALERT Rx Programmed to Erase Rx to Return If you want to save the current prescription press the NO CHANGE key to return to the Pause Menu screen If you wish to erase the current prescription and enter a new program press the YES ENTER key to proceed All previous prescription values will be erased Note Selecting NEW PROGRAM will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually Infusion Complete When the infusion is complete the audio alarm will beep and the following screen will display Note To temporarily silence the alarm press the Silence key TPN Infusion Complete INFUSION
130. een DELAY lee HEXT YES This menu item allows you to customize the program to match each individual prescription The pump s default setting is displayed in the left screen Each field is individually explained below 1 DELAY Delay Start This field allows you to delay the start of the infusion from one minute up to twenty four hours If the infusion is NOT to be delayed select OFF and press the YES ENTER to enter The cursor will move to the next field If the infusion IS to be delayed until a later time select ON and press YES ENTER to accept The following screen will appear TPN Delay Start Setting T DELAY START DELAY START TIME SXEPSTSM HH mm 1 Abi P r EE DATE mmddyy TIME 00 HH hMM ACCEPT YES NO DATE mmddyy WW accErT BRT 73 Ade1 4L Ndl The time format 12 hr AM PM or 24 hr Military selected in the BIOMED SETUP Menu will apply in this table and if Military was selected the AM PM field will not appear here If the entire delay start screen is to be aborted press the NO key at the ACCEPT field When the start time and date are entered and the data is accepted after the YES ENTER key is pressed the infusion is set to start at the programmed time The display then returns to the next field in the Pre Prescription Menu After the entire prescription program is accepted if the pump is turned OFF and back ON press YES at PROGRAM and YES
131. el infusion Enter the down ramp 75 Ade1 4L Ndl time period using the numeric keys and when correct press the YES ENTER key to accept and move the cursor to the next field Since this field is optional 0 may be entered and accepted The range for this field is 0 00 to 9 00 HH MM 6 TotTime Total Time This field displays the entire time period over which the infusion will be delivered including up and down ramp times When the pump is given the Volume To Be Infused the RATE at which to infuse and the up and down ramp times it will automatically calculate the Total Time and display it here Or you may choose to program the Total Volume To Be Infused Total Time and ramp times and let the pump calculate the level rate of infusion If so the cursor will go back to the Inf RATE field display the rate and require the operator to accept it by pressing the YES ENTER key If the time is not acceptable enter the new TIME with the numeric keys When the TIME field is satisfactory press the YES ENTER key and move to the final field The range for this field is 0 01 to 288 00 HH MM Note The time calculated by the pump may be less than a minute however one minute is the minimum entry and display value 7 KVO Rate Keep Vein Open Rate This field requires data entry using the numeric keys to set the rate at which fluid will be delivered in a Keep Open state The pump defaults to a rate of 0 1 ml h
132. ember that no changes are allowed in the first prescription menu if an infusion is in progress c Press the OPTIONS or PRIME keys if either of these functions is desired at this time Hanging a New Container REPEAT Rx To repeat the present therapy and add another IV bag or reservoir with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields When the program is accepted the display returns to the above Run Options Screen If the current therapy is still in progress when the REPEAT Rx function is selected the following screen will appear ALERT Rx in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If the therapy is to be terminated and a new IV container added press YES ENTER to go to the programming screen confirm the program and proceed with the repeat infusion b
133. en will appear until it is completed Clinician Dose Run Screen CLINICIAN DOSE L FRES 18 mmH i ol IMF 1 4 DOSEINF L H ml REMAIN 3 6 REMAIN DIL HH MM The graphic bar now depicts the clinician dose in progress and when this dose is complete reverts back to reflecting the container in progress In CMS enabled pumps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units The Volume Infused will toggle with Dose Infused if mg or mcg are the selected unit Remaining dose time will toggle with remaining dose volume to infuse When the clinician dose is complete the pump will beep return to the IMPORTANT previous running rate and resume the PCA therapy The lockout INFORMATION time for bolus dosing will restart at the end of the clinician dose to prevent a bolus from being delivered too quickly after a clinician dose Once the clinician dose is given the clinician dose field returns to its default of 0 and any subsequent clinician doses will need to be reentered 3 SHFT TOT Ghift Totals This feature allows the clinician to track the infusion for a selected period of time such as an 8 or 12 hour shift To access Shift Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screens will appear alternately Shift Totals Screens
134. enter the actual volume of infusion to be delivered excluding any KVO amounts When the amount is correctly entered use the YES ENTER key to accept this field and to move to the next If VOL TBI entered is greater than Bag Volume the pump will beep once An alert message of AMT TBI GREATER THAN BAG VOL will appear to remind you to recheck and change the number before the YES ENTER key will accept the value and move to the next field The range for this field is 1 to 9999 3 Inf RATE Infusion Rate or rate of the level infusion The Curlin Medical pump can deliver from 0 1 ml to 400 ml per hour Use the numeric keys to enter the prescribed rate When this field is correct use the YES ENTER key to accept the rate and move to the next field You may choose to let the pump calculate the rate by skipping this field and entering the up ramp time down ramp and total time 4 UP Ramp This optional feature allows the beginning of the infusion to be gradually tapered up to the level infusion rate over a specified period of time Enter the up ramp time period using the numeric keys and when correct press the YES ENTER key to accept this field and move to the next Since this field is optional 0 may be entered and accepted The range for this field is 0 00 to 9 00 HH MM 5 DN Ramp Down Ramp This optional feature allows the infusion to be gradually tapered down over a specified period of time at the end of the lev
135. eport error code to factory Call Provider 212 Turn pump OFF Bad EEPROM Write Report error code to factory Call Provider 213 Turn pump OFF Bad total volume Report error code to factory Call Provider 214 Turn pump OFF Bad total time Report error code to factory Call Provider 300 Turn pump OFF Stack Overflow Report error code to factory Call Provider 301 Turn pump OFF Bad Flash Report error code to factory Call Provider 302 Turn pump OFF Bad Run Time Flash Report error code to factory Call Provider 303 Turn pump OFF Bad Ram Report error code to factory Call Provider 304 Turn pump OFF Bad output data Report error code to factory Call Provider 305 Turn pump OFF Bad active data Report error code to factory Call Provider 306 Turn pump OFF Bad overflow count Report error code to factory Call Provider 307 Turn pump OFF Therapy data CRC failure Report error code to factory Call Provider 308 Watch Dog Bad Watch Dog Test Report error code to factory Call Provider 309 Turn pump OFF Stopped Motor Motion Count Report error code to factory Call Provider 310 Turn pump OFF Stopped Motor Motion Volt Report error code to factory Call Provider 311 Turn pump OFF Bad Active Flags Report error code to factory Call Provider 312 Turn pump OFF Bad Active Flags 2 Report error code to factory Call Provider 313 Turn pump OFF Negative Motor Motion Report error code to factory Call Provider 314 Turn pump OFF Therapy params write violate
136. ey The delay start will change to ON Now when you press the YES ENTER to accept the following screen will appear 87 Adeiay U9 1U119 U Intermittent Delay Start Setting I DELAY START I DELAY START i TIME GET HH N Abd Prd EE DATE mmddyy T TIME 1000 HHtik ACCEPT YESZNO DATE MMdd yy H Accert YES NO The time format 12 hr AM PM or 24 hr Military selected in the BIOMED SETUP Menu will apply in this table and if Military was selected the AM PM field will not appear here If the entire delay start screen is to be aborted press the NO key at the ACCEPT field When the start time and date are entered and the data is accepted after the YES ENTER key is pressed the infusion is set to start at the programmed time The display then returns to the next field in the Pre Prescription Menu After the entire prescription program is accepted if the pump is turned OFF and back ON press YES at PROGRAM and YES to REPEAT Rx The cursor will automatically scroll through the program No changes will be allowed in the Pre Prescription Menu during this time thus maintaining the originally programmed Delay Start time To change the Delay Start time press the NO CHANGE key when the Run Options Screen is displayed Run Options Screen PRESS to START to REVIEW or aie ye This will allow the clinician to go back to review the program and at this point a change can be mad
137. feature allows the pump to sense an occlusion pressure in the line between the pump and the access site e g a kink in the tubing between the pump and the patient a blockage in the access site a clamp left on the distal tubing There are two options for this field the Low setting default setting triggers the alarm when it detects in line pressures at 400 mmHg 150 8 3 psi pounds per square inch or the High setting alarms when it detects in line pressures at 900 mmHg 150 18 3 psi Press NO CHANGE to change the selection When the correct pressure setting appears press the YES ENTER key to accept it and move the cursor to the next field 5 AIR SENS Air In Line Sensor This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state The choices are 0 1 ml 0 5 ml the default setting and OFF Press the NO CHANGE key to change the options until the desired setting appears on the display and then press YES ENTER to select and move the cursor to the next line IMPORTANT Whenever the Air In Line Sensor is set to OFF Curlin Medical INFORMATION recommends the use of an air eliminating filter When the Air In Line Sensor is set to OFF and the RUN key is pressed at the Run Options screen the alert message below will appear on the screen It will also appear if the Air In Line is changed from the OPT
138. for access code information lock setting table and available features for each lock setting HRLY TOT Hourly Totals To view hourly infusion totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Hourly Totals Screen a The screen displays hourly infusion delivery for each hour 00 23 of the last 24 hours of therapy in the unit selected a The highlighted field has a marker lt indicating the current hour in progress b Use the up arrow key to scroll back through the last 24 hours If the infusion was not running a series of will appear for that hour d To exit this screen press the NO CHANGE key CLR HRLY Clear Hourly Totals To clear Hourly Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Clear Hourly Totals Screen T Clear Hourly Totals NOW ACCEPT MEE a To clear the Hourly Totals press the YES ENTER key All Hourly Totals will be cleared and the cursor will return to the Options menu b To maintain the Hourly Totals press the NO CHANGE key Hourly Totals will be maintained and the cursor will return to the Options menu c A lock level of 2 or 3 will require an access code entry before allowing Hourly Totals reset DN Ramp Early Down Ramp During a TPN infusion it may be necessary or desirable to stop the level rate of infusion and begin an
139. for a minimal charge for postage and handling any Pump not including accessories which is defective if a claim is made during such one year period The following conditions procedures and limitations apply to the Manufacturer s obligation under this warranty 146 PARTIES COVERED BY THIS WARRANTY This warranty extends only to the Original Purchaser of the Pump This warranty does not extend to subsequent purchasers The Original Purchaser may be a patient medical personnel or a medical facility that purchases the Pump for treatment of patients The Original Purchaser should retain the invoice or sales receipt as proof as to the actual date of purchase WARRANTY PERFORMANCE PROCEDURE Notice of the claimed defect must be made in writing or by telephone to the Manufacturer as follows Customer Service Department Curlin Medical Inc 15751 Graham Street Huntington Beach CA 92649 714 893 2200 Notice to the Manufacturer must include date of purchase model and serial number and a description of the claimed defect in sufficient detail to allow the Manufacturer to determine and facilitate any repairs that may be necessary AUTHORIZATION MUST BE OBTAINED PRIOR TO RETURNING THE PUMP and confirmed with issuance of an RMA Return Materials Authorization number When authorized the Pump must be properly and carefully packaged and returned to the Manufacturer postage prepaid Any loss or damage during shipment is at the risk of the sen
140. ge Center the tubing in the middle of the pumping fingers covering the yellow dot 6 Holding the yellow Integral Flow Stop by the handle see Figure 1 9 insert it on an angle into the receptacle on the left side of the pump in the direction of the yellow arrow CAUTION Do not press down on the top of the Integral Flow Stop when inserting it into the receptacle This action could inadvertently open the Integral Flow Stop and allow fluid to flow through the tubing Open the slide clamp on the administration set Push the tubing slightly into the black Air Detector slot Fully close the door of the pump and latch it securely 0 If the set is not primed prime the set according to prime section in the relevant therapy chapter 11 Attach the primed set to the patient s venous access device per agency protocols 12 Dispose of used administration sets in accordance with all applicable regulatory and institutional policies and directions BONE on eo oN 15 uo onpo1 u Air Detector Slot Flow Stop handle 1 Insert blue Tubing Guide on right side of pump with tubing in front of the door The Blue arrow on the background surface of the pump head indicates direction and location for the blue Tubing Guide 2 Important Center the tubing horizontally over the pumping fingers covering the yellow dot 3 Insert yellow Integral Flow Stop on the left side of the pump The yellow arrow on the backgroun
141. hanged enter the changes press the YES ENTER key to accept the new values and then go back to the NEXT field When all fields are satisfied with correct settings press the YES ENTER key to exit this screen and move on to the next PCA Programming Menu At the following screen the patient s prescription information is entered to complete the programming of the pump for a PCA Therapy Remember that there may be additional limits to rates and doses based on limits for the route of administration selected See Figure 5 1 Note that the screen Identifier gives the abbreviation PCA for Patient Controlled Analgesic Therapy or EPI if Epidural route is selected and has a down arrow configuration which indicates that there are more than four fields of text or information to be considered 57 Ades9ul Wd PCA Prescription Menu BAG Vol SEE rol BAG Vol EAE ml BAG Vol GE ml SEASLRATES oml he eASLRATE malhk easLRATE megh EOLUS 0 8 ral EOLUS mg EOLUS 3 8 mcg EQLS INT MIH E L INT MIH EgLS INT MIM SAH EOL She DONE YES Note The PCA therapy can be programmed for Basal Rate continuous infusion only for Bolus patient demand dose only or for both At least one of these settings must be entered though before this menu can be accepted at the DONE prompt 1 BAG Vol IV Bag Volume Using the numeric keys enter the amount of fluid in the IV Bag ot Medication
142. he Infusion Complete alarm exists Stopping the Infusion To halt the infusion at Infusion Complete press the PAUSE key and then choose to either 1 Turn off the pump by pressing the OFF key or 2 Select one of the options from the Pause screen Pause Menu Screen ENTER to Select NEW PROGRAM 3 REPEAT Rx To repeat the present therapy and add another IV bag with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key 116 The pump will then display the program screens with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields 4 NEW PROGRAM To program an entirely new prescription or a different therapy press the YES ENTER key at this field and the display will return to the Select Therapy Screen The ability to change these parameters may be controlled by the lock setting Note The therapy is complete therefore RESUME is not an option at this time and is not displayed 117 AdessyL ajqeue
143. he infusion has started any changes made through the OPTIONS menu involving e HRLY TOT and e CLR HRLY will return you directly to the ACCEPT OPT field The following screen displays the Variable Therapy Options available When you open this menu use the up and down arrows to move the highlight bar to the desired option Lock settings may require an access code before the option can be changed Any new setting except CLEAR HOURLY screen acceptance becomes effective when the Options screen is exited by pressing YES ENTER at the ACCEPT OPT field Variable Options Menu OPTIONS Lack OFF Lock iil HRL ToT OFF LRHRLY OFF HOM occlu LOW HIGH MAIR SENS S Z 0 OFF i AUDIO S rs 2 FHR CK OFF on WaAccEFT ofT YES NO Note The pump s default settings are indicated above in the left screen 109 AdessyL ajqeue 1 LOCK When the lock is set to OFF the clinician has access to all of the pump functions After the pump is completely programmed change the lock to meet the security needs of this therapy There are four choices OFF 1 2 or 3 Each level higher limits the available options To change the lock setting press the NO CHANGE key until the correct lock setting appears Then press YES ENTER key to accept the new lock selection Once the pump has been set into a locked condition any subsequent request to change the lock will requ
144. he suitability of the pump for any particular medical treatment or for any medical complications resulting from the use of the Pump The Manufacturer shall not be responsible for any incidental damages or consequential damages to property loss of profits or loss of use caused by any defect or malfunction of the pump This warranty gives the Original Purchaser specific legal rights and the Original Purchaser may have other legal rights which may vary from state to state 147 aoueusjuleW Burueajyg Procedure for Checking Pumps Between Patients Purpose This Pump Test Procedure is for use by Technicians to inspect test and prepare a pump for use by a new patient It checks volumetric delivery accuracy and all pump safety systems Also initialization is performed for various parameters This procedure is intended to be used by Technicians familiar with operation of the Curlin Medical Infusion Pump Note This procedure does not replace the recommended Annual Preventive Maintenance The pump should receive preventive maintenance by a qualified technician annually Required Equipment The following equipment is required for this procedure e ANEW Administration Set old or used sets are not suitable for the volumetric delivery and pressure measurements tests e Volumetric measurement device i e calibrated weight scale burette or syringe e Beaker with clean fresh water or I V container Note Ifthe administration set co
145. heck data entry A value entered cannot be less than the field s minimum limit ALERT LOW C BATTERIES or LOW EXTERNAL BATTERY Battery source power is low The batteries that are powering the pump have reached levels that may prevent the continued operation of the pump beyond 1 hour actual time is rate dependent Alert applies to both C size and rechargeable battery pack PAUSE the therapy in progress turn the pump OFF and then replace the batteries See chapter 1 of the User s Manual for instructions on battery change Replace or recharge the battery pack if applicable ALERT MAX CHANGES FOR PERIOD REACHED The maximum number of changes for the current delta time window has been reached The maximum number of pump rate changes for the current delta time window has been reached This occurs when the rate has been changed more than 12 times during any delta time window Allow more time to elapse before attempting to change the rate or reprogram the therapy with titration limits and prescription basal and bolus ranges that will reduce the number of times that the rate will have to be adjusted ALERT MODIFICATION NOT ALLOWED Modification Not Allowed The selection cannot be modified at this time or the programmed lock setting does not permit modifications to this selection Review the User s Manual for program restrictions or if lock level restricted change lock setting to access area you wish to modif
146. herapy cssccccssesseessreeeecesseeseeeens 38 Keypad Function ccccccsseeeseees 24 How to go to New Program 39 LED Light Indicators 006 25 i Selecting a Therapy s sesssssesssessese 39 Audio Indicator ccceeseeseeeeeeeees 25 Select Therapy Screen vcs 39 TABLE OF CONTENTS Entering or Changing Data ICIS csccacsadesdiicateasddetecessessctecvecedeae 40 CONTINUOUS THERAPY 41 Prescription Menus ccseecceees 41 Continuous Pre Prescription Meny Scr tiz tak intaa cintitinetens 41 Continuous Delay Start Setting 42 Run Options Screen 42 Continuous Titration Limit Sereemm ainan e a aaae 43 Continuous Prescription Menu 44 Run Options Screen 45 PENG eierstok E EREDAR EENE 45 Prime Direction Screen 45 OptOns oehoe niere 46 Continuous Options Menu 47 Hourly Totals Screen 47 Clear Hourly Totals Screen 48 Continuous Titration Menu 48 Air In Line Sensor Off Message SCHEER rran aE ER ca een cements 49 Air In Line Sensor Set at 2 0ml Alert Screen asia ciniasiainaidacsh 49 Reviewing or Changing the PLrOQTAM e oiiire irssi 50 Starting the Infusion 0008 50 Continuous Run Screen 50 Continuous Information Screens 51 Interrupting an Infusion Pause Menu Screen Resuming the Current Container 52 Run Options Screen 52 Hanging a New Containet 52 Entering
147. hts fails to light or to blink return the pump for service If the self test fails the alarm will sound and a new screen will appear stating ERROR CODE or SYSTEM ERR See Troubleshooting chapter for a list of error notices and how to resolve them The error notice will include a numeric code At any error notice the only user option is to turn the pump OFF If at any time there is indication of pump damage error code or messages requiting the pump to be turned off call the healthcare Eee ee agency or facility as directed to report the condition IMPORTANT Note If an error notice appears turn the pump off and back on again If the pump passes its start up diagnostics tests you can safely resume the therapy If the error notice recurs however turn the pump off and notify the healthcare agency responsible for monitoring the pump Some error notices may reset the pump back to it s default settings and therefore will require reprogramming 29 GBulmwei6olig soiseg When the Curlin Medical pump successfully passes it s self test a brief message of System OR appears and the display moves to the next screen Power Status Screen POWER SOURCE INTERNAL POWER This screen displays the active power source of the pump whether internal batteries or external power If the active source is the C size batteries a bar graph will indicate the amount of power remaining in the batteries Thi
148. ienced a Check Sum Error At the completion of an upload of a CMS script the Check Sum signature from the CMS system did not match the signature calculated by the pump A second attempt to upload the script should be made If the second attempt fails then a new script should be created for the desired prescription See CMS User s Manual 134 ERROR CODES If a pump goes into an error code a numeric code will appear on the display screen If this has occurred turn the pump off and back on If the error code message does not reappear continue using the pump If the pump passes its start up diagnostic tests resume the therapy If an error code recurs turn the pump off replace it and report the error code to the healthcare provider Error LCD Displayed Probable Cause Corrective Action Code Message 10 Turn pump OFF ON or Replace Motor Control Loss Replace batteries Battery or Call Provider Connect AC Adaptor Turn power off on and resume 11 Turn pump Off On Keyboard Buffer Full Report error code to factory 12 Air Sensor Air In Line test circuit failure Report error code to factory Turn pump Off ON or Call provider 13 Pressure Sens DN Bad Down Strain Beam Replace set and Resume Check Admin Set turn pump Off On 14 Pressure Sens UP Check Admin Bad Up Strain Beam Replace set and Resume Set Turn pump Off On 15 Turn pump Off On or Ca
149. if it is prescribed If a loading dose is not ordered select the default setting of 0 by pressing YES ENTER If it is ordered enter the dose in this field and press the YES ENTER key to accept and move to the next field The maximum load dose is determined by the administration route refer to Figure 5 1 above The amount of drug infused during the loading dose depends on IMPORTANT the units chosen which may be in ml s mg or mcg A loading dose INFORMATION of 5 mg will infuse 50 ml if the concentration is 0 1 mg ml Note The units will correspond to the choice previously selected The loading dose will be delivered at the fixed bolus delivery rate when the RUN key is pressed to start the PCA infusion The amount of the loading dose is included in the displayed amount infused and is logged into the history file The bolus lockout time is set from the end of the loading dose Because the loading dose is only used on initial start up of an infusion it will revert to a value of 0 whenever the REPEAT Rx function is selected To terminate a loading dose in progress but save the rest of the prescription pause the pump and select REPEAT Rx When the NE OR MAT LON RUN key is pressed the prescription will restart without the loading dose IMPORTANT 5 Titrate Allows the clinician to program titration limits into the prescription settings of the pump If there i
150. in 10ml hr lt 20 seconds lt 45 seconds 50ml hr lt 5 seconds lt 15 seconds 125 ml hr lt 3 seconds lt 5 seconds Programmable Time HH MM Continuous 00 01 to 288 00 HH MM TPN 00 01 to 288 00 HH MM Intermittent 00 01 to 288 00 HH MM Variable 00 01 to 288 00 HH MM PCA No time limit Bolus Volumes Microbore tubing with occlusion at Low Pressure lt 0 1 ml distal Luer High Pressure lt 0 1 ml Percent Error Curlin Pump infusing at 25 ml hr w ith a negative headheight of 100 mm Hg 2 1 0 1 2 3 4 4 5 6 7 8 Percent Eror Rate caluclation Window min Percent Error Curlin Pump infusing at 25 ml hr with a positive headheight of 100 mm Hg 10 8 6 4 2 0 Percent Error 2 5 11 19 31 Rate Calculation Window min 153 suoljeolpioads jeauyooL Percent Error Curlin Pump infusing at 25 mi hr w ith zero Headheight 5 3 5 5 3 0 W 2 5 c 3 2 0 1 5 1 0 0 0 5 1 1 5 2 2 5 3 3 5 4 4 5 Time hrs Percent Error Curlin Pump infusing at 1 mi hr w ith zero headheight hour 2 detail 10 5 a 5 E S 5 0 5 Rate Calculation Window min Percent Error Curlin Pump infusing at 1 m hr with a positive headheight of 100 mm Hg 60 _ 40 6 5 20 5 0 S 20 a 40 60 Rate Calculation Window min Percent Error Curlin Pump infusing at
151. ine Sensor Off Message SELES OPEET E headend ca haces 80 Air In Line Sensor Set at 2 0ml Alert Screeners 80 Reviewing or Changing the Program sssecceeeseeees Starting the Infusion TPN Run Screen TPN Information Screens 82 Interrupting an Infusion 82 Pause Menu Screet ccceeeseeeeees 82 Resuming the Current Container 83 Prat si csecseiescease dese cab caicensdaosed cesses 91 Prime Direction Screen oo 91 OPTIONS sceeseesecseeeeeeesseeeeeeentees 92 Intermittent Options Menu 93 Hourly Totals Screen Clear Hourly Totals Screen Air In Line Sensor Off Message SCreehrntateelne telat ae dante leis 94 Air In Line Sensor Set at 2 0ml Alert Screen ascadisciacinnticcinsaies 95 Reviewing or Changing the PLOQTAM ccessecesseceesssceseneeesenseees 96 Starting the Infusion 006 96 Intermittent Run Screen 96 Intermittent Information Screens 97 Interrupting an Infusion 97 Pause Menu Screen ocenenia 97 Run Options Screen 98 Hanging a New Container 98 Intermittent Dosing Schedule 99 Entering a New Program 99 Timing Rules when Interrupting Run Options Screen sss 83 Intermittent Therapies 100 Hanging a New Containet 83 Infusion Complete cceee 100 Bitenne anew Btoptatiiamocs 84 Intermittent Infusion Complete 100 S ing the I
152. infusion of parenteral nutritional products with the option of tapering at the beginning end or both beginning and end of the infusion This mode also has an early ramp down feature 4 Intermittent Delivery Designed to deliver programmed intervals and rates of specified amounts of infusates and to optionally deliver small amounts of the infusate between doses to keep the patient s access site patent 5 Variable Program Designed to allow varying amounts rates and times of delivery of infusions up to twenty four specified programs uo1 npo3 u Indications for Use The Curlin Medical pump can be used for intravenous epidural or subcutaneous therapies It can be used to deliver medications from the specially designed Curlin Medical medication reservoir syringes or from IV bags A physician or a certified licensed healthcare practitioner must oversee any therapy Patients and caregivers using the Curlin Medical pump should be instructed in its use by a qualified clinician and demonstrate an adequate level of proficiency in the use of the pump Special Features of the 4000 Series Pump e Shift Totals in PCA e Hourly Totals in all therapies e Automatic quick repeat function e Large font display e Small accurate ambulatory volumetric infusion pump that provides reliable and safe delivery of infusion therapies e Cost effective safe and easy to load disposable Curlin Medical administration sets featuring a unique sp
153. infusion will stop and the display screen will be blank Turn the pump off reconnect the power source turn the pump on and resume the therapy All programmed information is retained When replacing batteries pause any infusion in progress by pressing the PAUSE key and then turn the pump off Replace the batteries and when the pump is turned back on select RESUME to continue the therapy from the point at which it was interrupted 17 uo1 npo3 u Curlin Pump Battery Replacement The battery door compartment is located on the back of the pump To open the door depress the recessed release pin Use a small coin such as a penny to depress the pin Do not use a screwdriver or other sharp objects to open battery compartment door Slide the battery door down and remove it from the pump Using the small coin penny pry up and out on the top edge of the battery to cause the battery to pop out Use the same technique on the second battery Do not use a screwdriver or other sharp objects to pry batteries out of the pump Install two new C size batteries by depressing the coil spring with bottom end of the battery and sliding the top of the battery into place Please note Both positive poles are at the top of the battery compartment To depress the coil spring insert the battery at a slight angle Slide the battery door compartment back to its closed position until the recessed
154. ing NO to Review on the Run Options screen 120 LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution Note Access to the programming screens is lock level restrictive If the actual amount in the source bag container is sufficient to complete the programmed infusion press YES to start the infusion Note If the infusion is continued without sufficient volume air in line or up occlusion alarms may occur later in the infusion ALERT AMT TBI LESS THAN AMT INFUSED Unable to change amount to be infused to an amount less than what has already infused Occurs when user tries to change the Vol TBI Amt TBI field in the prescription menu to an amount lower that the amount which has already infused Recheck the data entry If alert recurs resume the infusion and observe the Vol Inf Amt Inf field on the run menu The value for data entry must be greater than the value displayed on the run menu ALERT BOLUS DOSE IS NON ZERO Unable to enter a bolus interval or of boluses hour of 0 Bolus interval or of boluses hour value entered is zero and bolus dose value is non zero When a bolus value is entered there must also be a value greater than 0 entered for bolus interval and of boluses hout Recheck data entered for the
155. ion set back in the pump When ready to begin infusing select RESUME If the alarm continues use a new administration set or if the IV bag is almost empty replace it CMS NOT ENABLED Pump is not CMS capable A CMS system had attempted to communicate with this pump which was not CMS capable This pump is not capable of CMS communication and should not be used for any CMS function COMM TIMEOUT Communication Timeout occurred during Pump CMS communication The communication link between the pump and the P C running CMS was broken i e the cable between them was unplugged during a CMS upload to the pump Check the cable connection between the pump and the PDA or P C INFUSION COMPLETE Infusion Complete Programmed Amount to be Infused is depleted to 0 If the therapy is to be repeated press PAUSE add another IV bag or reservoir and select the REPEAT Rx function If the therapy will not be repeated press PAUSE key and turn the pump off by pressing the OFP key UPLOAD CHAR ERR While uploading a prescription to the pump a character was misinterpreted Faulty communications link between the pump and the P C running CMS Replace the communication cable between the pump and the PDA or PC If other programs are running on the PC that might with the operation of CMS PC close those programs 133 Buljooyseajqnoi LCD Display Alarm Cause Resolution UPLOAD CkSum ERR CMS Upload exper
156. ire a clinician access code See Clinical Information and Access Code chapter for access code information lock setting table and available features for each lock setting HRLY TOT Hourly Totals To view hourly infusion totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Hourly Totals Screen The screen displays hourly infusion delivery for each hour 00 23 of the last 24 hours of therapy in the unit selected a The highlighted field has a marker lt indicating the current hour in progress b Use the up arrow key to scroll back through the last 24 hours If the infusion was not running a series of will appear for that hour d To exit this screen press the NO CHANGE key CLR HRLY Clear Hourly Totals To clear Hourly Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Clear Hourly Totals Screen Clear Hourly Totals NOW ACCEPT a To clear the Hourly Totals press the YES ENTER key All Hourly Totals will be cleared and the cursor will return to the Options menu b To maintain the Hourly Totals press the NO CHANGE key Hourly Totals will be maintained and the cursor will return to the Options menu c A lock level of 2 or 3 will require an access code entry before allowing Hourly Totals reset 110 4 DN Occlu Down Occlusion This
157. l be used in the Delay Start period 2 NEXT If there are any changes to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to move on to the next screen 74 At the following screen the prescription information is entered to complete the programming of the pump TPN Prescription Screen BAG Vol GER ml fy ol TEI GB ral INF RATE ral he UF Ramp AAA HH MM ON Ramp Oo a TOT Time Be MEMORATE 1 DONE YES Note that the screen identifier gives the abbreviation TPN for Total Parenteral Nutrition and has a down arrow configuration which indicates that there are more than four fields of text or information to be considered 1 BAG Vol IV Bag Volume Use the numeric keys to enter the amount of fluid in the IV Bag ot Medication Reservoir include the overfill volume Note The volume used for priming via the pump or for KVO is deducted from the Bag Volume Therefore Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion When the correct amount has been entered press the YES ENTER key to accept this field and move on to the next The range for this field is 1 to 9999 2 VOL TBI Volume To Be Infused Use the numeric keys to
158. l hr Nominal 85 hours at arate of 2 ml hr Internal Memory Battery 5 years life Display Graphic LCD 4 text fields 16 characters per field Flow Rates 0 1 to 400 ml hr KVO Rates 0 to 10 ml hr Can be set at 0 in Continuous TPN Variable and Intermittent Therapies Volume Accuracy 5 for volume delivery gt 1 ml under the following conditions e Temperature 55 to 90 F e Back pressure to 300 mmHg 5 8 PSI 10 for volume delivery gt 1 ml under the following conditions e Temperature 45 to 55 F e Temperature 90 to 104 F e Back pressure to 750 mmHg 14 5 PSI The maximum volume that may be infused under Single Fault Conditions is 0 8 ml Recommended administration set usage not to exceed 72 hours follow standards of practice for set changes Administration Sets Proprietary Curlin Medical non DEHP PVC administration sets available in different configurations Fill Volume for Administration Sets Nonfiltered microbore sets 4 ml See individual administration set label for specific fill volume Up Occlusion Detection Time Rate Time to Alarm Microbore tubing with occlusion 0 1 ml hr lt 20 minutes below spike 1 ml hr lt 4 minutes 10 ml hr lt 20 seconds 50 ml hr lt 10 seconds 152 ITEM SPECIFICATION Down Occlusion Detection Time Rate Low Pressure High Pressure Microbore tubing with occlusion at 0 1 ml hr lt 45 min lt 1 hr 30 min distal Luer 1 ml hr lt 5 min lt 7 m
159. ll Bad Encoder Report error code to factory Provider 16 Turn pump Off On or call Bad Analog to Digital Report error code to factory Provider Conversion 17 Turn pump OFF Call Provider Bad Clock Report error code to factory 18 Call Provider Bad Air In Line comparator Report error code to factory register reading from FPGA 19 Turn Pump OFF Call Provider Bad Door Sensor Report error code to factory 20 Empty Lithium Battery Empty Lithium Battery Report error code to factory Call Provider 21 Turn pump Off Bad Tristate Pin Report error code to factory Call Provider 22 Turn Pump OFF Bad Test Pin Report error code to factory Call Provider 23 Turn Pump OFF Bad Reverence Voltage Report error code to factory Call Provider 24 Turn Pump OFF Bad Motor Supply Report error code to factory Call Provider 25 Stalled Pump Broken Motor Shaft Turn power off on and resume Turn pump OFF ON Call Provider 26 Turn Pump OFF Bad Motor Inhibit Report error code to factory Call Provider 27 Turn Pump OFF Bad Motor Supply Enable Report error code to factory Call Provider 28 Turn Pump OFF Bad Motor Logic Enable Report error code to factory Call Provider 29 Low Alarm Batt Low Auxiliary Battery Connect pump to AC Battery Connect AC Adapt Eliminator and turn power off on to Turn pump OFF ON pump May require turning pump off on a few times 30 Turn Pump OFF Bad Auxiliary Battery Report error code to factory Call Provider 31 Turn Pump OFF Audio Main Speaker
160. llow you to customize the program to match each individual prescription The pump s default settings are displayed in the left screen Each field is individually explained below Note Some of the lines are abbreviated to fit on the display screen the full descriptions appear below 1 UNITS Allows you to select from units of ml mg or mcg to match the prescription The pump will allow a volume range of 0 1 to 400 ml hr therefore if mg or mcg is selected the concentration requested in the next field will determine the upper and lower programming limits for mg and mcg Use the NO CHANGE key until the desired units appears on the display and then press the YES ENTER key to accept and move to the next field 2 CONCEN Concentration This field is active whenever mg or mcg is selected in the units field and requires data entry of the concentration of mg or mcg per ml When the correct data is entered press YES ENTER to accept and move the cursor to the next field If ml is chosen in the units field this line will not display The range for this field is 0 1 to 999 3 DELAY This field allows you to delay the start of the infusion from one minute up to twenty four hours If the infusion is NOT to be delayed accept the default setting of OFF by pressing the YES ENTER key and the cursor will move to the next field If the infusion IS to be delayed until a later time press the NO CHANGE k
161. mation and you cannot change the data in this field Use the down arrow or the YES ENTER key to move to the next field The range for this field is 1 to 9999 9 TOT Time Total time Time required to deliver the number of doses programmed The pump calculates this time based on previously programmed information and you cannot change data in this field Use the down arrow or the YES ENTER key to move to the next field The range for this field is 0 01 to 288 00 HH MM Note A DOSE is always followed by a KVO period Therefore after the last dose the KVO will run until the dose frequency time has expired 10 DONE If there are any changes to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press YES ENTER to accept the new data Remember that if a field is changed subsequent fields will need reconfirmation to verify accuracy If all the fields are acceptable move the cursor to the DONE field and press the YES ENTER key to move on to the next screen Before the infusion is started it is important to consider a few IMPORTANT remaining issues such as checking the administration set to be sure it was primed or purged of all air or perhaps the pump may need to be put into a security lock setting for additional safety INFORMATION The following screen offers four choices Run Options Screen PRESS to START to RE
162. mps the graphic bar will toggle with Line Pressure L Press which displays the current patient side downstream pressure in the administration set in millimeter of mercury mmHg units 3 The third line displays the total volume infused and if mg or mcg is the selected unit this field will toggle to display the total mg or mcg infused as well 4 The last line displays the remaining time to the completion of the infusion toggled with the remaining amount to be infused 5 In addition to the display screen giving information regarding the status of the infusion the green LED light blinks whenever the pump is infusing The information on the run screen will alternate between a four line display and a large font display of each line of information on the screen Continuous Information Screens Amt TBI Remain 500 0 mL 1 14 HH MM Tot Vol Rate 44 5 mL 400 0 mL hr Line Pres 10 mmHg Adeiay snonunuog CMS pumps only Interrupting an Infusion The infusion can be paused at any time by pressing the PAUSE key The yellow Standby LED light blinks and the following screen displays Pause Menu Screen ENTER to Select REPEAT Fx MEH PROGRAM 51 The screen offers you three options Resuming the Current Container 1 RESUME To resume the therapy in progress from where it left off press the YES ENTER key at this field The pump will return to the Run Options Screen and you can res
163. nd you will be prompted to resume the therapy How to go to New Program NEW PROGRAM If the cursor is moved to this field and the YES ENTER key is pressed the display changes to allow you to select which therapy you wish to program Selecting a Therapy Select Therapy Screen ENTER to Select PCA TPH INTERMITTENT VARIABLE This screen displays only those therapies enabled from the BIOMED SETUP Menu Move the cursor to the appropriate therapy and select it by pressing the YES ENTER key If only one therapy is enabled this screen will not display and the pump will automatically move to the first screen for specific therapy programming 39 Bulmwei6o0lig soiseg Entering or Changing Data Fields When prescription data fields appear use the numeric keys to enter specific patient prescription information and when correct press the YES ENTER key to accept Ifa field on the menu is not accepted by the program a context sensitive Alert prompt will appear and the cursor returns you back to the fields that require the change to help you resolve the problem The following screen is the general alert prompt ALERT INVALID ENTRY Each individual therapy will now be considered separately in this manual and will have its own chapter heading 40 Chapter Continuous Therapy Continuous Therapy is designed to allay a constant programmed rate of infusion egin programming a
164. nfused Use the numeric keys to enter the actual amount of infusion to be delivered excluding any KVO amounts The Units selected in the prescription menu will automatically appear in this field whether ml mg or mcg When the amount is correctly entered use the YES ENTER key to accept this field and to move to the next If the Amt TBI entered is greater than Bag Volume the pump will beep once A message of AMT TBI GREATER THAN BAG VOL will appear to remind you to recheck and change the number before the YES ENTER key will accept the value and move to the next field The range for this field is 1 to 9999 3 RATE The Curlin Medical pump can deliver from 0 1 ml to 400 ml per hour Use the numeric keys to enter the prescribed rate If the time of the infusion is entered first the pump will automatically calculate the rate When this field is correct use the YES ENTER key to accept the rate and move to the next field 4 TIME Displays the time required to complete the infusion When the pump is given the Amount To Be Infused and the RATE at which to infuse it will automatically calculate the Time and display it here If the time is not acceptable press the NO key to edit this field and enter the new TIME with the numeric keys Remember by changing the time of the infusion a new RATE will be calculated and will have to be accepted before exiting this menu The Amount To Be Infused will remain const
165. nfusion 06 101 Infusion Complete cscceeee 84 e SA 101 TPN Infusion Complete BAe pe ag corte eee en gm ee ee Stopping the Infusion 00 85 VARIABLE THERAPY 103 Pause Menu Screen 85 Prescription Menus s0c0000 103 INTERMITTENT pore Pre Prescription Menu oe THERAPY 3 s cccsescasassseisscceesnccten 87 Variable Delay Start Setting 104 Prescription Menus seseeeeeeee 87 Run Options Screen 104 Intermittent Pre Prescription Variable Prescription Menu 105 Menu Serec cecinere 87 Variable Prescription Menu 2 106 Intermittent Delay Start Setting 88 Variable Prescription Menu 3 106 Run Options Screen 88 Variable Summary Screen 107 Intermittent Prescription Menu 89 Run Options Screen 107 Run Options Screen 91 TABLE OF CONTENTS OPTIONS cceescsessseesseeeeeeesneeees Variable Options Menu Hourly Totals Screen Clear Hourly Totals Screen 110 Air In Line Sensor Off Message erect aama na naa 111 Air In Line Sensor Set at 2 0ml Alert SCreensssccccestininianianciace 111 Reviewing or Changing the Program ccsssscsecsesceeeceesnsseeeeeesees 112 Starting the Infusion 006 Variable Run Screen 1 Variable Run Screen 2 Variable Information Screens 113 Interrupting an Infusion Pause Menu Sct een Resuming the Current Container 114 R
166. ng the pump the dose in progress will be aborted IMPORTANT INFORMATION Infusion Complete When the infusion is complete all doses of this IV bag are administered and the last KVO cycle is complete the following screen displays Intermittent Infusion Complete I IMFUSIOM COMPLETE H j TOT YOL 2000 8 rml KMORATE mlihr 100 This screen displays 1 INFUSION COMPLETE 2 A graphic representation completely filled in bar graph indicating infusion complete or the smaller dot configuration shown here if a KVO RATE is programmed 3 TOT Vol Total Volume If units are mg or mcg this field will also toggle to give the Total Infused 4 KVO Rate The preset KVO rate displays Infusion Complete is considered an alarm status and the audio alarm will beep periodically every 3 seconds if there is no KVO every 20 minutes if there is a KVO to alert the user to this condition Additionally the LED lights blink to alert you to the status of the pump The green light blinks when the KVO rate is infusing if one is programmed and the red light blinks to indicate that the Infusion Complete alarm exists Stopping the Infusion To halt the infusion at Infusion Complete press the PAUSE key and then choose to either 1 Turn off the pump by pressing the OFF key or 2 Select one of the options from the Pause screen Pause Menu Screen ENTER to Select MEH PROGRAM
167. ns to the above Run Options Screen If the current therapy is still in progress when the REPEAT Rx function is selected the following screen will appear ALERT Rx in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If the therapy is to be terminated and a new IV container added press YES ENTER to go to the programming screen confirm the program and proceed with the repeat infusion 52 b If the incomplete therapy is to be continued press NO and the Pause Menu screen will be displayed then press YES and the Run Options screen will be displayed To resume the unfinished therapy press RUN Entering a New Program 3 NEW PROGRAM To program an entirely new prescription or a different therapy press the YES ENTER key at this field the ability to change these parameters may be controlled by the lock setting The display will return to the Select Therapy Screen if more than one therapy mode is enabled or to the Pre Prescription Screen of the single therapy mode If the current container has not completely infused the following screen will appear a Note ALERT Rx in progress Hew Program to Return This screen is a reminder that the infusion is not complete If you want to return to the current container and finish infusing it press the NO CHANGE key to return to the Pause Menu screen To abort the current
168. ntains a filter sterile saline or sterile water should be used Maintenance Between Patients This procedure does not replace the recommended preventive maintenance The pump should receive preventive maintenance by a qualified technician annually 1 CLEAN AND INSPECT PUMP FOR DAMAGE a Clean the pump with a soft cloth dampened with a designated antiseptic disinfectant solution or a solution of household bleach diluted 9 1 with water Be sure to clean all surfaces including the pumping chamber b Inspect pump for damage Check all case surfaces for cracks Open the pumping chamber door Examine the finger seal to confirm that no cuts or tears exist Confirm that the door is well aligned by closing it with no unreasonable interference Verify that the Power and Bolus Data connectors are securely mounted on the case no loose nuts Verify that all labels are legible and in good condition Check that Keypad is securely attached to case and that no corners are pealing up Verify that the Battery Door is in place and that the Battery Contacts in the Battery Compartment are not deformed 2 VOLUMETRIC DELIVERY TEST a Install a new primed Administration Set in the pump and latch the door b Connect the up stream side of administration set to a un pressurized water soutce c Connect the down stream side of administration set to a volumettic measurement device i e a calibrated scale or burette 148 d 8 Program the following CONTIN
169. nter a new program press the YES ENTER key to proceed All previous prescription values will be erased Note Selecting NEW PROGRAM will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually Infusion Complete When the infusion is complete the audio alarm will beep and the following screen will display Note To temporarily silence the alarm press the Silence key PCA Infusion Complete INFUSION COMPLETE A TOT VOL 28 8 ml BOLUS of 4 This screen displays 1 INFUSION COMPLETE 2 A completely filled in bar graph indicating infusion complete 3 TOT Vol Total Volume If units are mg or mcg this field will also toggle to give the Total Infused 4 Infusion Complete is considered an alarm status and the audio alarm will beep periodically every 3 seconds to alert the user to this condition Additionally the red LED light blinks to indicate that the Infusion Complete alarm exists Stopping the Infusion At Infusion Complete press the PAUSE key and then choose to either 1 Turn off the pump by pressing the OFF key or 2 Select one of the options from the Pause screen Pause Menu Screen ENTER to Select NEW PROGRAM a REPEAT Rx To repeat the present therapy and add another IV container with the same prescription press the YES ENTER key at this field If more than one therapy is pr
170. ntiguous 2 milliliter air in the line The alert message below will then briefly appear on the screen If the alert occurred at the Run Options screen the pump will start the infusion Air In Line Sensor Set at 2 0m Alert Screen ALERT AIR SENSOR HAS BEEN SET TO 2 8 ML Also when the Air In Line sensor is completely disabled and the infusion goes to an Infusion Complete or Empty Bag status the Air Sensor setting will automatically change to 2 0 ml 7 AUDIO Audio Volume This feature allows you to adjust the audio volume of the pump s alarm setting You can enter a number from 9 the loudest setting to 1 the quietest setting When you select a number the pump will beep at that audio level Press the NO key and enter a new setting 1 9 Repeat until the desired setting is reached and then press YES ENTER to select it and move the cursor to the next field 8 PWR CK Power Check This feature allows you to periodically recheck the battery charge It will display the active power source of the pump whether internal batteries or external power If the active source is the batteries a graph will indicate approximately how much charge remains in the batteries To access this information select ON and press YES ENTER The Power Source Screen will display for five seconds and return to the Options Menu 9 ACCEPT OPT If the changes made in the Options Menu are acceptable press the
171. o default or the last programmed value 4 Run screens display information to the operator about the progress of the specific infusion while the pump is running Sample of a Run Screen RATE HOG ml h TOTWOL 91 6 ml REMAIN SSS H ml The standard run screen displays the Mode Identifier the rate of pumping a graphical bar that indicates the progress of the infusion the volume already infused and the time remaining for the infusion No action is required on a run screen therefore no highlight bar appears In some therapies a field may toggle to give the operator more information i e the REMAIN field may change from HH MM time remaining to to tell you how much volume is remaining as well The information on the run screen will alternate between a four line display and a large font display of each line of information on the screen 5 User Notification Screens are messages displayed to the user for information Sample of User Notification Screen PRESS to START to REVIEM or aaga Words representing keys are displayed in reverse video shown in this manual as bold text The action requested by a notification screen is either to press a specified key or to resolve an alert alarm or error code For all events such as alerts alarms or error codes specific notification screens will also be displayed See chapter entitled Troubleshooting for specific alert alarm and error
172. ock setting remains the same but the pump recognizes the access code and authorizes the function to be performed without the need to change the lock setting 160
173. of 100 mm Hg Rate Calculation Window min Percent Error 10 5 0 5 10 Percent Error Curlin Pump infusing at 1 m hr with a negative headheight of 100 mm Hg Detail Rate Calculation Window min 156 Percent Error Curlin Pump infusing at 1 m hr zero headheight hour 2 60 _ 40 6 20 5 0 S 20 40 60 Rate Calculation Window min Percent Error Curlin Pump infusing at 1 mi hr w ith zero headheight hour 70 0 6 04 2 02 5 0 0 2 0 4 0 6 Rate Calculation Window min Curlin Infusion pump delivering in TPN mode at 25 mi hr with 1 hour ramp up and 1 hour ramp down g g c Q oO 2 Time hrs Percent Error Curlin Pump infusing at 1 mi hr no headhight hour 70 detail 0 1 5 0 05 wo 5 0 2 0 05 Rate Calculation Window 157 Flow Rate 1 hour calculation window Curlin Pump delivering at 1 ml per hour with zero headheight detail Calculated Average 0 1011 ml per hr 0 12 0 115 0 11 0 105 0 1 0 095 0 09 10 10 5 11 11 5 12 12 5 13 13 5 14 14 5 15 infusion time hrs infusion error Curlin pump infusing at 1 mi hr w ith zero headheight hour 2 7 2 3 8 Rate Calculation Window hrs Infusion error Curlin pump infusing at 1 mi hr w ith zero headheight hour 70 10 5 0 5 10 15 Rate Calculation Window hrs
174. ogrammed a Select Therapy Screen will list all preprogrammed therapies Select 70 Note which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screens with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key when this field is highlighted and the display will return to the Select Therapy Screen The lock setting can control access to this function The therapy is complete therefore RESUME is not an option at this time and is not displayed 71 Ades9ul Wd 72 Chapter TPN Therapy with Automatic Ramping This therapy is designed to alloy a kvel rate of infusion of parenteral nutritional products with the option of tapering at the beginning end or both of the infusion It also has an eariy ramp dovn feature egin programming a TPN Therapy by selecting TPN from the Select Therapy Screen The following display screen will appear requiring you to enter information needed to program this therapy Prescription Menus TPN Pre Prescription Menu Scr
175. ons and Features 10 Starting the Pump 29 Preparing Medication for Welcome Screen eeeecesseececeeseeees 29 Infusion Changing IV Bags 11 Power Status Screens ognini 30 i Preventive Maintenance Screen 30 Opening and Closing the Pump Select Program or Bio Med Setup DOOF ssssossnsesonesncnnsscesrssennstesseesensnszees 3 DICH CIN cee e E 30 Choosing and installing the Access Code 31 Curlin Medical Administration Clinician Access Code Screen 31 Setena ins i eas 14 i o BioMed Setup ssesssssssesessesssesssecesses Gravity Priming Set and Filter 14 Bio Med Setup Menu Steps in Installing Administration Enable Therapy Menu Set into Curlin Medical Pumps 15 Patient History Log Up Stream Occlusion Alarm History Event Log 34 Featuren noan 16 Clearing the History Log 35 Installing the Batteries and Using Clearing Patient Information 35 External Powet scccccsssseesceeeees 17 Changing Date and Time 36 External Power Soutces 000 19 Change Date and Time Screen 36 Battery Pack ssssvessrsssvessonssessorsssees 19 Program eessssssssesseersseesssessssersseessse 37 AC Adapter Charget ssssesereeere 20 Program BioMed Setup Menu 37 Attaching and Removing the a ia Ny 38 Bolus Cord 6 iitsiec een 22 ieee by cage ane Resuming a therapy ccccsseseeees 38 LEARNING PUMP ee Pa PERATURES cestacunainuisincn 23 Repeating a Pre Ptogtammed T
176. our can be set from 0 to 10 ml hour but cannot be set at a rate to exceed the therapy operating rate When the desired KVO rate has been entered press the YES ENTER key to accept and move the cursor to the next field 8 DONE If there are any changes to be made use the up or down arrow keys to locate the field to be changed enter the corrected information and press YES ENTER to accept the new data If all the fields are acceptable at the DONE prompt press YES ENTER to move to the next screen Before the infusion is started it is important to consider a few IMPORTANT remaining issues such as checking the administration set to be sure it was primed or purged of all air or perhaps the pump may need to INFORMATION be put into a security lock setting for additional safety The next screen that appears when the programming is complete offers four choices Run Options Screen PRESS to START to REVIEW or gedit Note that you do not need to answer yes or no questions or enter data with the numeric keys as previously requested This screen requires you to press the corresponding key on the keypad to begin the requested function The following section explains each selection beginning with Prime Prime The IV bag and administration set should be inspected and be free of all air and air bubbles before they are connected to the access site Priming may have been done by gravity when the
177. ows you to delay the start of the infusion from one minute up to twenty four hours If the infusion is NOT to be delayed select OFF and press YES ENTER to enter The cursor will move to the next field If the infusion IS to be delayed until a later time press the NO CHANGE key The delay start will change to 103 AdessyL ajqeue ON Now when you press the YES ENTER to accept the following screen will appear Variable Delay Start Setting DELAY START DELAY START TIME ETS HH ef AiP h lol DATE mMM dd yy TIME 2 HH ACCEPT YES NO i DATE mM dd y4 W Accert YES NO The time format 12 hr AM PM or 24 hr Military selected in the BIOMED SETUP Menu will apply in this table and if Military was selected the AM PM field will not appear here If the entire delay start screen is to be aborted press the NO key at the ACCEPT field When the start time and date are entered and the data is accepted after the YES ENTER key is pressed the infusion is set to start at the programmed time The display then returns to the next field in the Pre Prescription Menu After the entire prescription program is accepted if the pump is turned OFF and back ON press YES at PROGRAM and YES to REPEAT Rx The cursor will automatically scroll through the program No changes will be allowed in the Pre Prescription Menu during this time thus maintaining the originally programmed Del
178. p is completely programmed change the lock to meet the security needs of this therapy There are four choices OFF 1 2 or 3 Each level higher limits the available options To change the lock setting press the NO CHANGE key until the correct lock setting appears Then press YES ENTER key to accept the new lock selection Once the pump has been set into a locked condition any subsequent request to change the lock will require a clinician access code See Clinical Information and Access Code chapter for access code information lock setting table and available features for each lock setting HRLY TOT Hourly Totals To view hourly infusion totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Hourly Totals Screen The screen displays hourly infusion delivery for each hour 00 23 of the last 24 hours of therapy in the unit selected a The highlighted field has a marker lt indicating the current hour in progress b Use the up arrow key to scroll back through the last 24 hours If the infusion was not running a series of will appear for that hour d To exit this screen press the NO CHANGE key 93 Adejiady U9 1U119 U 3 CLR HRLY Clear Hourly Totals To clear Hourly Totals press the NO CHANGE key to change OFF to ON and then press YES ENTER The following screen will appear Clear Hourly Totals Screen I Clear Ho
179. pOFF ON Item not found Report error code to factory Call Provider 103 Turn pumpOFF ON Field not found Report error code to factory Call Provider 104 Turn pumpOFF ON Data mismatch Report error code to factory Call Provider 105 Turn pumpOFF ON No menu pointer Report error code to factory Call Provider 106 Turn pumpOFF ON Count out of range Report error code to factory Call Provider 107 Turn pumpOFF ON Display task queue overflow Report error code to factory Call Provider 108 Turn pumpOFF ON Divide by zero Report error code to factory Call Provider 109 Turn pumpOFF ON Concentration zero value Report error code to factory Call Provider 110 Turn pumpOFF ON Invalid occurrence Report error code to factory Call Provider 111 Turn pumpOFF ON Multiple param struct access Report error code to factory Call Provider 112 Turn pumpOFF ON Multiple status struct access Report error code to factory Call Provider 140 Turn pumpOFF ON Infusion volume out of range Report error code to factory Call Provider 141 Turn pumpOFF ON Infusion rate out of range Report error code to factory Call Provider 142 Turn pumpOFF ON Infusion time out of range Report error code to factory Call Provider 143 Turn pumpOFF ON Volume conversion error Report error code to factory Call Provider 144 Turn pumpOFF ON Rate conversion error Report error code to factory Call Provider 145 Turn pumpOFF ON Time conversion error Report error code to factory Call Provide
180. pin locks into place To check battery levels while CAUTION If batteries are removed from the bottom the pump is running end first damage to the springs in the bottom of the e Press the Help Options keys battery case can occur Damaged springs can create a e Scroll down to PWR Ck situation in which the battery overheats If the battery or Press No to change to ON the pump becomes excessively warm to the touch do o Piress Vers view batterz level not attempt to remove the batteries Set the pump aside and contact your home infusion pharmacy Press Yes to Accept OPT to exit Options menu It is recommended to use Duracell Procell batteries in Curlin Pumps Figure 1 11 Curlin Pump Battery Replacement 1 Duracell and Procell are registered trademarks of Proctor amp Gamble 18 al IMPORTANT INFORMATION Whenever an external source is powering the pump it is still important to always install the two C size batteries In the event of a power failure or accidental power cord disconnection the batteries will power the pump without interrupting the therapy in progress If the batteries are in place when the power cord is disconnected the display will say External Power Disconnected the alert beep will sound the batteries will take over powering the pump and the therapy will continue infusing Handling and Storage Store at room temperature Avoid mechanical or electrical abuse Do not short
181. prescription ALERT BOLUS DOSE NOT ALLOWED A bolus dose is not allowed Bolus key or button pressed when no bolus dose is programmed If bolus doses are part of the prescription modify the Rx titration program to allow bolus doses ALERT BOLUS REQUESTED Not time for bolus Bolus button or key is pressed before the programmed time interval between bolus doses have elapsed Advise patient of time limits between bolus doses per agency protocols ALERT CALCULATED AMT OUT OF RANGE Invalid calculated amount for infusion The calculated amount for the infusion based on the values entered for Rate and Time exceeds either the pump limit or the value entered for bag volume Recheck data entry for Rx 121 Buljooyseajqnoi LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution ALERT CALCULATED RATE OUT OF RANGE Invalid calculated rate of infusion The calculated rate for the infusion based on the values entered for Volume Amount and Time exceeds either the minimum or maximum rate limit of the pump or the maximum rate programmed in titration limits Recheck data entry for Rx ALERT CALCULATED TIME OUT OF RANGE Invalid calculated time The calculated time for the therapy based on the values entered for Volume Amount and Rate exceeds the
182. r 146 Turn pumpOFF ON Bad PCA dose ratio Report error code to factory Call Provider 160 Stuck PERIOD Key Stuck Period Silence Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 161 Stuck ON OFF Key Stuck On Off Key If key was pressed release it Turn pump OFF ON or Call Provider Otherwise report error code to factory 136 Error LCD Displayed Probable Cause Corrective Action Code Message 162 Stuck 0 Key Stuck 0 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 163 Stuck 1 Key Stuck 1 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 164 Stuck 2 Key Stuck 2 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 165 Stuck 3 Key Stuck 3 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 166 Stuck 4 Key Stuck 4 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 167 Stuck 5 Key Stuck 5 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 168 Stuck 6 Key Stuck 6 Key If key was pressed release it Turn pump OFF ON o
183. r Call Otherwise report error code to Provider factory 169 Stuck 7 Key Stuck 7 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 170 Stuck 8 Key Stuck 8 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 171 Stuck 9 Key Stuck 9 Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 172 Stuck UP Key Stuck Up Arrow Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 173 Stuck NO Key Stuck No Change Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 174 Stuck YES Key Stuck Yes Enter Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 175 Stuck DOWN Key Stuck Down Arrow Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 176 Stuck RUN Key Stuck Run Pause Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 177 Stuck HELP Key Stuck Help Options Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error code to Provider factory 178 Stuck PRIME Key Stuck Prime Bolus Key If key was pressed release it Turn pump OFF ON or Call Otherwise report error cod
184. r In Line Sensor Disabled Cause The Air In Line Sensor has been disabled and either the RUN key has been pressed to run an infusion or the AIR SENS setting has been set to OFF on the Options menu while the pump is running Resolution If an air eliminating filter is being used press YES The infusion will start resume and the Air In Line sensitivity will be disabled until the empty bag alert occurs or infusion complete is reached No AIR IN LINE alarms will occur while the air sensitivity is disabled 119 Huljooysajqnoi LCD Display Alett Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution LCD Display Alert Cause Resolution If no air eliminating filter is being used press NO The infusion will start resume and the Air In Line sensitivity will be set to 2 ml for the remainder of the infusion Note If the screen is not acknowledged with a YES or NO key press the Air In Line sensitivity will be set to 2 ml when the screen is cleared i e alarm occurs while screen is displayed ALERT AIR SENSOR HAS BEEN SET TO 2 0 ML Air in line sensitivity will be set to 2 0ml NO was pressed at the AIR SENS OFF Using In Line Filter alert screen The air in line sensitivity will be set to trigger an AIR IN LINE alarm if 2 0ml of air is detected If an air eliminating filter is being used press YES when the AIR SENS OFF Using In
185. re 1 9 shows the y Administration Set Curlin Medical pump A _ Tubing with a cut away of the Air Detector t Guide Blue display screen allowing you to visualize the receptacles for the small blue Tubing Guide on the right side of the pump and the larger yellow Integral Flow Stop 4 Tubing Guide on the left side of the Receptacle pump The arrows in corresponding colors ate visible on the background surface of l the pump head and aN indicate the proper direction for placing these locators into their 7 receptacles Also note that the breakaway tab ed Sh Eb Note The has been removed from 3 yo Ke Administration the Integral Flow J Set tubing 18 Stop allowing the f always placed in administration set to be front of the door placed into the pump hinge correctly Note Open the slide clamp before closing the pump door Pumping Fingers r NN N A a Flow Stop Receptacle L Figure 1 9 Proper installation of the Curlin Medical Administration set into the pump Steps in Installing Administration Set into Curlin Medical Pumps Fully open the door of the pump Close the slide clamp on the administration set Activate the Integral Flow Stop by twisting and removing the breakaway tab Insert the blue tubing guide into the receptacle on right side of pump in the direction of the blue arrow positioning the tubing in front of the door hin
186. ring activated self clamping set based Integral Flow Stop device that automatically clamps the tubing when the door of the pump is opened and prevents inadvertent fluid flow e User friendly easy to teach programming that shortens staff inservice time and patient teaching time e Helpful help screens and display messages e Three tamper resistant lock settings to assist in maintaining patient compliance and safety e Patient and therapy specific programming features via the Curlin Medical BIOMED SETUP and Options Menus e Selection by user from three units of delivery milliliters ml milligrams mg and micrograms meg e Titration features in both PCA and Continuous therapies e Retention of programmed infusion settings until cleared by the clinician thus eliminating the need to reprogram before each use e Mandatory requirement of two independent key press actions before a running pump can be turned off thus minimizing the accidental interruption of a therapy in progress e Powered by two readily available cost effective C size alkaline batteries e Attractive yet robust design that is impact resistant and water resistant e Audio alarms that can be adjusted from 1 very quiet to 9 loudest to meet specific patient and clinical setting needs but that cannot be totally disabled e Four sizes of convenient carry packs to assist the ambulatory patient in maintaining independence of lifestyle Backpack will a
187. rint package and by selecting the Print Pt Hx option Selecting the Clear Hx Log option will erase the patient history log When the history log is full it will overwrite on a first in first out basis 33 GBulmwe s6olig soiseg Note The patient history log should be printed before clearing occurs if a hard copy record is required The history log when printed lists the most recent event first Clearing the history log does not affect the saved patient information When printed the patient history log includes a heading at its beginning and a footer at its end The heading includes the pump serial number the patient history log title and revision number information of the software and hardware of the pump The footer contains information about how much of the history log has been used The information is printed with the most recent event first and organized for easy transfer to a spreadsheet for sorting and reporting A partial sample of a history log is given below History Event Log 101293 10AuG00 SERIAL NUMBER MANUFACTURE DATE MAINTENANCE DUE DATE HISTORY EVENT LOG 227AN03 15 38 m1 Vin mmH BY 227AN03 15 18 ml Vin mmH BY 227ANO3 14 58 ml Vin mmH BV 167AN04 9070 6 2 2 8 0 76 8937 3 2 2 10 0 76 10 0 76 8803 9 2 2 WA AAAS VY 21JAN03 16 58 ml Vin mmH BV 2 1 3 1 0 0 78 21JAN03 16 57 ml Vex mmH BV 0 0 6 7 0 0 78 217AN03 16 57 START PUMP 70 0 ml 21JAN03 16 57 START THERAPY 21JAN03
188. rom the Select Therapy B needed to program this therapy Prescription Menus Variable Pre Prescription Menu Screen UNITS ie UNITS ma UNITS Meg DELAY OFF COMCEN ma ml CONCEN HEXT YES DELAY OFF DELAY OFF NEXT YES NEXT YES These menu items allow you to customize the program to match each individual prescription The pump s default settings are displayed in the left screen Each field is individually explained on following pages Note Some of the lines are abbreviated to fit on the display screen the full descriptions appear below 1 UNITS Allows you to select from units of ml mg or mcg to match the prescription The pump will allow a volume range of 0 1 to 400 ml hr therefore if mg or mcg is selected the concentration requested in the next field will determine the upper and lower programming limits for mg and mcg Use the NO CHANGE key until the desired units appears on the display and then press the YES ENTER key to accept and move to the next field 2 CONCEN Concentration This field is active whenever mg or mcg is selected in the units field and requires data entry of the concentration of mg or mcg per ml When the correct data is entered using the numeric keys press YES ENTER to accept and move the cursor to the next field If ml is chosen in the units field this line will not display The range for this field is 0 1 to 999 3 DELAY Start This field all
189. ror codes the conditions causing them the message displayed on the screen and the actions required for resolution If an alert or alarm occurs please refer to these tables Display Screen The display screen provides a maximum of four lines of text or fields at any one time for feedback regarding the pump status and data entry It notifies the user with prompts or messages when necessary The screen has backlighting that remains e onif connected to an AC outlet e lit for 15 seconds if using batteries or during any key press sequences e on with alert alarm messages When no keys are pressed for fifteen seconds the light goes off to conserve battery power Backlighting is resumed with any key press In most displays a Therapy Identifier Bar appears at the far left of the screen indicating which therapy is running or which programming screen is being considered This identifier also has another function and that is to alert you when more text exists either above the top line or below the bottom line on the display screen The identifier bar will have an arrow configuration either pointing up or down or both whenever there is more text or it will appear as a squared off block if no further text exists 25 duing uue The screen also has a cursor or highlight bar to tell you which field is being considered Use the up and down arrow keys to move the cursor When the pump is running a specially designed running screen
190. rrect field and you press the YES ENTER key the pump accepts the selection and executes that action In the example above the pump would proceed with steps to resume the therapy 2 A Selection List field allows you to select from a predetermined list of values Sample of a Selection List Field is UNITS mL ling meg The above example allows you to select which unit to use in programming e g Units ml mg or mcg Only one selection is displayed at a time When the cursor blinks it is indicating that no selection has yet been accepted The selection displayed on the screen changes each time you press the NO CHANGE key Pressing the YES ENTER key accepts the selection displayed and moves the cursor to the next field 27 GBulmwei6o0ig soiseg 3 Data entry screens are used to specify prescription parameters Sample of a Data Entry Screen BAG ol PEHEN ml AmtTeI 8 mi RATE mlshe TIME QIO HHihiti In the above example the cursor rests on a field requiring numeric data entry for specific prescription information e g the volume in the IV bag The operator enters the correct information using the numeric keys and decimal point key When the correct data is displayed and the YES ENTER key is pressed the pump accepts the selection if it is a valid entry value and moves the cursor down to the next field If the down arrow key is used to move to the next field the value reverts back t
191. ry The number of doses requested must be less than or equal to the maximum for the therapy ALERT PERFORM ROUTINE MAINTENANCE Maintenance Date displayed only if date has arrived when pump is turned on Current Date is beyond the Maintenance Date Return pump for routine maintenance ALERT RAMP INVALID FOR AMT RATE Ramp time entered is invalid for amt rate already programmed Ramp value entered for TPN is unacceptable given the desired rate and amount programmed Recheck all data entered for prescription If programming a new TPN therapy NEW PROGRAM selected and the ramp time is a requirement enter the ramp time s and total time first followed by the next governing parameter rate or volume to be infused ALERT RATE EXCEEDS DELTA RATE DELTA TIME Rate entered exceeds the delta time limits The rate entered falls outside of the allowable range for the delta rate delta time limits programmed Recheck data entry or wait more time elapses then attempt to change the rate Rate selected cannot exceed the range placed on titration ALERT RUNNING PAUSE PUMP BEFORE OFF Pause Infusion before turning off The OFF key was pressed while the pump was infusing or a running screen displayed Press PAUSE key before pressing OFF key to stop an infusion 128 LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display
192. s graph is only an approximation of the charge left and is not intended to give a specific representation of battery life The display will again automatically move to the next screen Preventive Maintenance Screen ALERT PERFORM ROUTINE MAINTENANCE The above alert screen will appear after the Welcome Screen only when the Maintenance Due date has arrived and will continue to appear until the date has been reset during the actual maintenance performance The pump may continue to be used after the maintenance due date but should be returned for its routine maintenance at the earliest opportunity Select Program or Bio Med Setup Screen ENTER to Select PROGRAM BIOMED SETUP This screen is the first requiring you to act It gives two selections from which to choose PROGRAM or BIOMED SETUP Using the up or down arrows move the cursor to the desired field and then press the ENTER key Selecting PROGRAM allows you to proceed with choosing features and entering data required for the pump to deliver a prescribed therapy Selecting BIOMED SETUP allows the pump to be programmed and customized by the clinician to perform a number of special functions including setting the system clock See BIOMED SETUP Accessing BIOMED SETUP requires you to enter a clinician access code Refer to the chapter entitled C nician Information and Access Code of this manual 30 Access Code Clinician Access Code
193. s no titration prescription select OFF and press YES ENTER to accept and move the cursor to the next field If a titration prescription has been written select ON press the YES ENTER key to accept and the following screen will appear to program the titration parameters PCA Titrate Limits Screen ATITRATE_LIMITS 4 McRATE EAEE mlh 4 ARATE D ml A TIME iOO HHMH MaxBoLs A A ml 4 Min INT HIH EOLS he ACCEPT HSER 56 a MxRATE Maximum Rate limits Use the numeric keys to enter the upper limits of the infusion rate When the correct maximum titration rate is entered press YES ENTER and the cursor will move to the next field The minimum rate is 0 and the maximum rate must be equal to or less than maximum Basal Rate listed in Figure 5 1 Administration Routes table b ARate Delta Rate Some prescriptions include incremental levels or dea limitations e g Do not raise the rate more than 1 ml in 12 hours If the prescription has these components use the ARate field and the A Time field to enter those limits Example Enter the incremental titration amount level of 1 ml on this field and press YES ENTER to move to the next field c ATime Delta Time Enter the incremental or delta time limit Example Enter 12 00 hours If there are no incremental or delta level components to the prescription leave these fields ARate and ATime set at their default settings of
194. s the RUN key to resume the therapy b Press the NO key to go back to the programming screen to make changes in the therapy program this feature may be blocked by a security lock thus not allowing changes to the program unless an access code is given Also remember that no changes are allowed in the first prescription menu if an infusion is in progress c Press the OPTIONS or PRIME keys if either of these functions is desired at this time Hanging a New Container 2 REPEAT Rx To repeat the present therapy and add another IV bag or reservoir with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can 114 stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields When the program is accepted the display returns to the above Run Options Screen If the current therapy is still in progress when the REPEAT Rx function is selected the following screen will appear AL
195. s whenever the pump is infusing If the Basal rate is set at 0 the yellow LED light will blink along with the green light until the bolus is actually being delivered While the bolus is infusing only the green light will blink The information on the run screen will alternate between a four line display and a large font display of each individual line of information on the screen PCA Information Screens Bolus Bolus Dose 1of 1 5 0 mL Tot Vol Rate 10 4 mL 20 0 mL hr Remain Line Pres 90 1mL 10 mmHg CMS pumps only 67 Ades9uL Wd Interrupting an Infusion The infusion can be paused at any time by pressing the PAUSE key The yellow Standby LED light blinks and the following screen displays Pause Menu Screen ENTER to Select REPEAT Fx NEW PROGRAM The screen offers the user three options Resuming the Current Container 1 RESUME To resume the therapy in progress from where it left off press the YES ENTER key at this field The pump will return to the Run Options Screen and you can resume the therapy Note If you wish to hang a new container move the cursor to REPEAT Rx see following section Run Options Screen PRESS to START to REVIEM or aaga a Press the RUN key to resume the therapy b Press the NO key to go back to the programming screen to make changes in the therapy program this feature may be blocked by a security lock thus not allowing
196. should be returned for service as quickly as possible 2 PROGRAMMER ID This feature gives the programmer the option to use the numeric keypad to enter his or her assigned ID number up to ten digits If this option is not to be used it can be left blank and skipped using the down arrow to scroll to the next field When the PROGRAMMER ID number is satisfactory press the YES ENTER key at the ACCEPT YES NO field and the number will be stored in the pump history log 3 PATIENT ID This feature gives the programmer the option to use the numeric keypad to enter a patient ID number up to ten digits If this option is not to be used it can be left blank and skipped using the down arrow to scroll to the next field When the PATIENT ID number is satisfactory press the YES ENTER key at the ACCEPT YES NO field and the number will be stored in the pump history log 4 Rx NUMBER This feature gives the programmer the option to use the numeric keypad to enter a prescription number up to ten digits If this option is not to be used it can be left blank and skipped using the down arrow to scroll to the next field When the Rx NUMBER is satisfactory press the YES ENTER key at the ACCEPT YES NO field and the number will be stored in the pump history log 5 INVOICE NUMBER This feature gives the programmer the option to use the numeric keypad to enter an invoice number up to ten digits If this option is not to be us
197. stationary e g at night The pump has a low battery alert that beeps periodically with a message appearing to tell you when the power is low in the C size batteries and or the battery pack This alert gives you a window of time to be sure you have back up power e g extra batteries AC adapter or a recharged battery pack At a continuous infusion rate of 25 ml per hour you can expect at least a 30 minute warning before your pump can no longer operate due to empty batteries At higher infusion rates your advance warning will be less The user should be taught that whenever the low battery alert appears to pause the therapy turn the pump off and to replace both C size batteries Then turn the pump back on select resume to continue the therapy When the empty battery alarm occurs the pump will go into an alarm state and the infusion will stop If this occurs turn the pump off replace both of the C size batteries turn the pump on and go to the Resume function to continue the therapy All programming information is retained If the C size batteries are empty and you want to connect the AC adapter to power the pump turn the pump off first plug in the AC adapter and then turn the pump back on Note If you ate operating the pump solely on the battery pack or the AC Adapter no C size batteries installed and the power source is disconnected from the pump the alarm will sound the
198. t program the correct date and time from the Biomed Clinician menu Enter the Biomed Clinician Menu using the Clinician Code Set the Lock Level to OFF in the CHANGE LOCK menu Clear the Pt DATA from the pump Observe the Pump Maintenance Date top of the Biomed Clinician Menu to insure adequate time for the next use by patient Sign date and return the Check List to your record file Pumps that pass can be used for new patients Pumps that fail are to be returned for service 150 Chapter Technical Specifications The following specifications apply to the Curlin Medical Ambulatory Infusion Pump ITEM SPECIFICATION Pumping Mechanism Pump Size Height Width Depth Weight Curvilinear peristaltic finger action 5 inches 4 inches 2 5 inches 17 5 ounces Case Material Operating Environment Operating Temperature Operating Relative Humidity Storage Environment Storage Temperature Range Storage Relative Humidity Power Requirements UL rated flame retardant non toxic high impact plastic 5 Accuracy 55 to 90 F 10 Accuracy 45 to 55 F 10 Accuracy 90 to 104 F 15 to 95 non condensing 20 to 140 F 5 to 95 non condensing 2 C size Single Use Batteries AC Power 151 suoljeolpioeds jeaiuyosoL ITEM SPECIFICATION Operating Time with Full Charge Nominal 10 hours at a rate of 400 ml hr Batteries Nominal 30 hours at a rate of 125 m
199. t all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields When the program is accepted the display returns to the above Run Options Screen If the current therapy is still in progress when the REPEAT Rx function is selected the following screen will appear ALERT Rx in progress to Repeat to Return a This screen is a reminder that the infusion is not complete If the therapy is to be terminated and a new IV container added press YES ENTER to go to the programming screen confirm the program and proceed with the repeat infusion 83 Ade1 4L Ndl b If the incomplete therapy is to be continued press NO and the Pause Menu screen will be displayed then press YES and the Run Options screen will be displayed To resume the unfinished therapy press RUN Entering a New Program NEW PROGRAM To program an entirely new prescription or different therapy press the YES ENTER key at this field the ability to change these parameters may be controll
200. te the programming of the pump Note that the screen Identifier gives you the abbreviation INT for Intermittent Therapy and has a down arrow configuration which indicates that there are more than four fields of text or information to be considered Intermittent Prescription Menu BAG ol GEE ml BAG ol GEE ml BAG ol GEE ml Pa AMITIDOSE GB ral AHT DOSE D A m AMTIDOSE O20 meg DOSERATE omlthe oosERATE mothe DosERATES megh DOSE Time OG DOSE Time GEAR HH MM pose Time 0 ESA HAM DOSEFreg DEDO HHtik I MEMORATE Ge L ral he SOOSEEAG O REG Yoi a ral ay TOTTime GG HH DONE YES 1 BAG Vol IV Bag Volume Using the numeric keys to enter the amount of fluid in the IV Bag or Medication Reservoir include the overfill volume Note The volume used for priming via the pump or for KVO is deducted from the Bag Volume Therefore Bag Volume should be equal to or greater than the Amount To Be Infused to start the infusion When the correct amount has been entered press the YES ENTER key to accept this field and move on to the next The range for this field is 1 to 9999 2 AMT DOSE Amount per Dose Using the numeric keys enter the actual amount per dose to be delivered The Units selected in the prescription menu will automatically appear in this field whether ml mg or mcg When the amount is correctly entered use the YES ENTER key to accept this field and to move to the next
201. the RUN key The pump also detects excessive up stream pressure pressure on the IV bag The display will read ALARM HIGH UP PRESSURE the alarm will sound the red LED light will blink and the infusion will stop If this situation occurs relieve the source of excessive pressure on the IV bag and when ready to begin infusing select RESUME and then press the RUN key Note The up stream occlusion detection is disabled during priming 16 Installing the Batteries and Using External Power The Curlin Medical pump can be powered solely with the use of two C size alkaline batteries installed into the pump as shown in Figure 1 11 C size batteries are readily available at most retail facilities that carry alkaline batteries A second alternative for power is the portable rechargeable Battery Pack shown in Figure 1 12 The third alternative for power is to use the AC Adapter shown in Figure 1 13 allowing the pump to be connected to any approved three prong electrical wall outlet The C size batteries will last approximately 30 hours at a rate of 125 ml hour and over 85 hours at rates of 2 ml hr or less Factors that influence battery life are the number of times the screen is illuminated with a key press the viscosity of the fluid being delivered the age and temperature at which the batteries have been stored To extend the life of the batteries patients can use the AC adapter whenever they are
202. the cursor to the next field If ml is chosen in the units field this line will not display The range for this field is 0 1 to 999 3 DELAY Start This field allows you to delay the start of the infusion from one minute up to twenty four hours If the infusion is NOT to be delayed accept the OFF setting by pressing the YES ENTER key The cursor will move to the next field If the infusion IS to 41 Adeiay LL snonunuog be delayed until a later time press the NO CHANGE key The delay start will change from OFF to ON Press the YES ENTER to accept and the following screen will appear Continuous Delay Start Setting DELAY START DELAY START TIME ESTE HH bt Abd Fh EE DATE mmddyy TIME 100 HHH ACCEPT YES ZNO DATE mmddyy W accert YES NO The time format 12 hr AM PM or 24 hr Military selected in the BIOMED SETUP Menu will apply in this table and if Military was selected the AM PM field will not appear here If the entire delay start screen is to be aborted press the NO key at the ACCEPT field When the start time and date are entered and the data is accepted after the YES ENTER key is pressed the infusion is set to start at the programmed time The display then returns to the next field in the Pre Prescription Menu After the entire prescription program is accepted if the pump is turned OFF and back ON press YES at PROGRAM and YES to REP
203. the prescription screens will reappear Changes may be inhibited by lock setting Changes to the prescription can be made before the start of the therapy however once a therapy has started no changes can be made to the Pre Prescription Screen It will appear only for review purposes Attempts to change the Pre Prescription Menu during a new program review will cause an alert screen to be displayed notifying the programmer that changes will require reprogramming of the prescription Starting the Infusion RUN When all parameters are correct and the pump has been primed properly and connected to the access site press RUN at the Run Options screen to start the therapy If a delayed start is programmed the Delay Start Count Down Screen will appear If no delay start is programmed or the delay has elapsed the pump will begin infusing and the following screen will display the status of the therapy Continuous Run Screen RATE HGG ml he AmtTEI SOD ral L FRES 18 ran TOTVOL 65 2 ml TOTVOL 66 8 ml REMAIN 456 5 ral REMAIN LEH HH MM This screen displays as long as the infusion is running Notice the information on each field 1 The first line displays the rate of the infusion in whichever units hour has been selected This information toggles with the programmed Amount To Be Infused 2 The second line displays a graphic bar representing the percentage of the completed infusion 50 In CMS enabled pu
204. the up stream occlusion press Pause then Resume the infusion Door Sensor With infusion in progress open the door latch and observe ALARM DOOR OPEN OR SET NOT INSTALLED Air In Line Sensor Reinstall the administration set properly and resume the infusion From the Options menu set the AIL SENS AIR IN LINE sensitivity to 0 1ml With the pump running introduce an Air Bolus of approximately 0 5ml into the fluid path at the input side of the pump Once approximately 0 1ml of air has past the AIL detector an ALARM AIR IN LINE will occur Pause and Prime the air bolus past the AIL sensor then resume the infusion Auxiliary Alarm With the pump running observe the Vol INF volume infused on the run screen and disconnect the pump from all power sources unplug the AC 149 aoueusjuleW Burueajyg Adapter eliminator and remove one C Cell battery Observe that the Auxiliary Alarm System is activated with the Red LED and Beeper on constant not intermittently beeping With the battery still out of the pump press the ON OFF button to turn off the auxiliary alarm Replace the battery in the battery compartment and turn on the pump Resume the therapy and confirm that the infusion continues where it stopped due to Auxiliary Alarm occurrence 4 SET BIOMED CLINICIAN MENU ITEMS a Turn the pump Off and back On While pump is performing Self Tests confirm that the pump is set to the correct Date and Time If date and time are not correc
205. tt Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution Recheck the field and accept it by pressing the YES ENTER key ALERT GREATER THAN MAX FIELD LIMIT MAX __ Unable to program a field with a value that exceeds the maximum limit Value entered is greater than the allowable limit Recheck data entry A value entered cannot exceed the field limit ALERT GREATER THAN WHAT BOLS INT ALLOWS Unable to enter a of boluses hr that exceeds the possible number allowed given the bolus interval Boluses hr value exceeds the possible number given the bolus interval BOLS INT programmed Recheck data entry The of boluses hr cannot be set for higher than the number allowed using the given bolus interval ALERT INFUSION NOT IN PROGRESS Infusion not in progress Modification attempted to Next Dose or Early Down Ramp field without an infusion in progress Wait until infusion is in progress before modifying or modify original Rx programmed ALERT INSUFFICIENT VOLUME MAX DOSES Bag Volume value is insufficient to deliver the remaining Occurs whenever the prescription is changed so that Bag Volume is now less than Amount Required for the entire therapy based on volume already infused plus volume required to deliver the remaining doses Recheck data entry
206. tteries To access this information use the NO CHANGE key to change from the default setting of OFF to ON and press YES ENTER The Power Source Screen will display for five seconds and return to the Options Menu ACCEPT If the changes made in the Options Menu are acceptable press the YES ENTER key If the changes are not acceptable use the arrow keys to cursor up to any field for corrections or abort all changes made in this menu by pressing the NO key and return to the previous screen There are two remaining selections to consider from the Run Options Screen NO to REVIEW and RUN to START 95 Adeiay U9 1U119 U Reviewing or Changing the Program To review or make any changes in the prescription programming press the NO CHANGE key at the Run Options screen and the prescription screens will reappear Changes may be inhibited by lock setting Changes to the prescription can be made before the start of the therapy however once a therapy has started no changes can be made to the Pre Prescription Screen It will appear only for review purposes Attempts to change the Pre Prescription Menu during a new program review will cause an alert screen to be displayed notifying the programmer that changes will require reprogramming of the prescription Starting the Infusion RUN When all parameters are correct and the pump has been primed properly and connected to the access site press R
207. ulating information regarding the status of the infusion the green LED light blinks whenever the pump is infusing The information on the run screen will alternate between a four line display and a large font display of each individual line of information on the screen Intermittent Information Screens Tot Vol Remain 30 6 mL 23 53 HH MM Dose Dose Inf lof 4 37 5 mL Remain 970 8 mL Rate Line Pres 250 0 mL hr 10 mmHg CMS pumps only Interrupting an Infusion The infusion can be paused at any time by pressing the PAUSE key The yellow Standby LED light blinks and the following screen displays Pause Menu Screen ENTER to Select REPEAT Fx NEW PROGRAM The screen offers the user three options Resuming the Current Container 1 RESUME To resume the therapy in progress from where it left off press the YES ENTER key at this field The pump will return to the Run Options Screen and you can resume the therapy Note If you wish to hang a new container move the cursor to REPEAT Rx see following section 97 AdesayL U9 1U119 U Run Options Screen PRESS to START to REVIEW or araga a Press the RUN key to resume the therapy b Press the NO key to go back to the programming screen to make changes in the therapy program this feature may be blocked by a security lock thus not allowing changes to the program unless an access code is given Also rem
208. umber of doses to be delivered from the previously entered bag volume This number dictates the number of dose programming screens that will subsequently display When the correct number of doses has been entered press the YES ENTER key to accept this field and move on to the next 3 KVO RATE This field requires data entry using the numeric keys to set the rate at which fluid will be delivered in a Keep Open state The pump defaults to a rate of 0 1 ml hour can be set from 0 to 10 ml hour All dose rates ml hr must be greater than the KVO rate When the desired KVO rate has been entered press the YES ENTER key to accept and move the cursor to the next field 4 NEXT If there are any changes to be made use the up or down arrow keys to locate the field to be changed use the numeric keys to enter the corrected information and press 105 AdessyL ajqeue YES ENTER to accept the new data If all the fields are acceptable move the cursor to the NEXT field and press the YES ENTER key to move on to the next screen At the following screens the dose information is entered to complete the programming of the pump for a Variable Therapy Each variable dose will have its own prescription screen Variable Prescription Menu 2 DOSE 1 of 24 DOSE OF 24 DOSE OF 24 a Amt TEL CMC n Amt TEI a ee Amt TEI eo ee RATE 8 0 mlhe RATE D a mathe RATE a a megh TIME 0 00 HH TIME 0100 HMM TIME 2
209. ume the therapy Note If you wish to hang a new container move the cursor to REPEAT Rx see following section Run Options Screen PRESS to START to REVIEW or Saila a Press the RUN key to resume the therapy b Press the NO key to go back to the programming screen to make changes in the therapy program this feature may be blocked by a security lock thus not allowing changes to the program unless an access code is given Also remember that no changes are allowed in the first prescription menu if an infusion is in progress c Press the OPTIONS or PRIME keys if either of these functions is desired at this time Hanging a New Container 2 REPEAT Rx To repeat the present therapy and add another IV container with the same prescription press the YES ENTER key at this field If more than one therapy is programmed a Select Therapy Screen will list all preprogrammed therapies Select which therapy to repeat by moving the cursor to the therapy of choice and pressing the YES ENTER key The pump will then display the program screen with the last programmed values of the therapy and the cursor will automatically advance through the prescription menus You can stop the auto advance function by pressing any key except ON OFF and then complete the confirmation of the prescription manually by pressing the YES key at the remaining fields When the program is accepted the display retur
210. ump calculates the total time required to deliver the total number of doses Press the YES ENTER key to accept and move to the next field 3 REQ VOL Required Volume The pump calculates the total volume required to deliver the doses Press the YES ENTER key to accept and move to the next field 4 DONE If any of the information is NOT acceptable press the YES key and then the NO key at the Run Options screen The display will return to the Pre Prescription and Prescription screens to allow changes to be made When all fields are acceptable move the cursor to the DONE field and press the YES ENTER key to move on to the next screen Before the infusion is started it is important to consider a few EO LA remaining issues such as checking the administration set to be sure INFORMATION it was primed or purged of all air or perhaps the pump may need to be put into a security lock setting for additional safety The following screen offers four choices Run Options Screen PRESS to START to REVIEW or aila Note that you do not need to answer yes or no questions or enter data with the numeric keys as previously requested This screen requires only that you press the corresponding key on the keypad to begin the requested function The following explains each selection beginning with Prime 107 AdessyL ajqeue Prime The IV bag and administration set should be inspected and be free
211. umped at a rate of 300 ml hr through the administration set as long as the PRIME key is pressed or until 6 ml is pumped The pump will then beep once and require repressing and holding the PRIME key again until 6 more milliliters is delivered Continue this process until all air has been purged from the IV bag and the administration set Note If the bag volume is depleted during priming a subsequent priming event cannot be initiated While the PRIME key is depressed the following screen appears PRIMING Release Artiga key to Stop Prime Amt 0 0 ml The amount used for the prime session is accumulated and displayed on the bottom field of this screen 6 When priming is complete release the PRIME key The following screen will display PRESS to Cont to EXIT Prime Amt 2 ml 7 To continue priming press the PRIME key again To continue priming press the PRIME key again If priming is complete press YES ENTER to exit and return to the Run Options screen The total amount of solution used in this priming session displays on the bottom field Note The amount of fluid used in the priming process will be deducted from the Bag Volume Total but will NOT be counted in the amount infused because this amount is not to be delivered to the patient The bag volume should still be equal to or greater than the Amount TBI before you can proceed with the infusion If it is not an alert will appear stating
212. un Options Screen 114 Hanging a New Container 114 Entering a New Program 115 Infusion Complete cccceeeees 116 Variable Infusion Complete 116 Stopping the Infusion 008 116 Pause Menu Screen 116 TROUBLESHOOTING 119 Alerts Alarms and Error Codes 119 ACCESSORIEG sceccseeees 139 Detachable Pole Clamp 139 Remote Bolus Cord 340 2005 140 Lockable Safety Shells 140 Pump Holster 340 0111 142 Keypad Covet sscsscessesesreeseees 143 CLEANING ENVIRONMENTAL CONDITIONS AND MAINTENANCE 145 Cheating a ieiicdicceccsesssssedsesnastbgvecebaee 145 Transport and Stotage 0000 146 Operating Environment 146 Maintenance ccscessscseeseeeeseees 146 Limited Warranty scceeseeeees 146 Procedure for Checking Pumps Between Patients sccceeeseees 148 TECHNICAL SPECIFICATIONG 06 151 CLINICIAN INFORMATION AND ACCESS CODE ceceeeeees 159 Clinician Access Code 159 Lock Setting Table IV TABLE OF FIGURES FIGURE 1 1 CURLIN MEDICAL AMBULATORY PUMP FRONT TOP AND LEFT VIEW 8 FIGURE 1 2 CURLIN MEDICAL AMBULATORY PUMP BACK BOTTOM AND RIGHT FIGURE 1 3 SAMPLES OF CURLIN MEDICAL ADMINISTRATION SETS cscsssessseseeeeee 10 FIGURE 1 4 SPIKING THE FLUID CONTAINER GRAVITY PRIM
213. urly m Totals NOW T ACCEPT a To clear the Hourly Totals press the YES ENTER key All Hourly Totals will be cleared and the cursor will return to the Options menu b To maintain the Hourly Totals press the NO CHANGE key Hourly Totals will be maintained and the cursor will return to the Options menu c A lock level of 2 or 3 will require an access code entry before allowing Hourly Totals reset 4 DN Occlu Down Occlusion This feature allows the pump to sense an occlusion pressure in the line between the pump and the access site e g a kink in the tubing between the pump and the patient a blockage in the access site or a clamp left on the distal tubing There are two options for this field the Low setting default setting triggers the alarm when it detects in line pressures at 400 mmHg 150 8 3 psi pounds per square inch or the High setting alarms when it detects in line pressures at 900 mmHg 150 18 3 psi Press NO CHANGE to change the selection When the correct pressure setting appears press the YES ENTER key to accept it and move the cursor to the next field 5 AIR SENS Air In Line Sensor This feature allows you to select the amount of air the pump will detect in the administration set tubing before it goes into an alarm state The choices are 0 1 ml 0 5 ml the default setting 2 0 ml and OFF Press the NO CHANGE key to change the options until the desire
214. urly Totals continue to accrue NEW PROGRAM Should be used to program a totally new Rx All the therapy parameters in the pump are set to factory default and must be re entered by the clinician The judicious choice of the option can help speed up programming This screen gives you all three options Resuming a therapy 1 RESUME TIf a therapy is interrupted and the pump is turned off or paused before completion of the infusion you may select RESUME by moving the cursor to this field and pressing the YES ENTER key A notification screen displays and a prompt is given to run the pump At this time you can continue to infuse the prescription from the exact point at which it was interrupted Note Patients should be taught proper time frames or limitations for leaving their IV bags or medication reservoirs hanging during an interrupted state and if indicated to change to a new bag according to the healthcare providers policies and drug manufacturer s instructions Repeating a Pre Programmed Therapy 2 REPEAT Rx Use this feature if an infusion is complete and you wish to repeat the same prescription over again or if a therapy is programmed and the pump is turned off before the infusion is started Select this field by moving the cursor to REPEAT Rx and press the YES ENTER key If the pump has been programmed for more than one therapy and you wish to select a therapy at this time move the cursor to
215. vious screen There are two remaining selections to consider from the Run Options Screen NO to REVIEW and RUN to START Reviewing or Changing the Program To review or make any changes in the prescription programming press the NO CHANGE key at the Run Options screen and the prescription screens will reappear Changes may be inhibited by lock setting Changes to the prescription can be made before the start of the therapy however once a therapy has started no changes can be made to the Pre Prescription Screen It will appear only for review purposes Attempts to change the Pre Prescription Menu during a new program review will cause an alert screen to be displayed notifying the programmer that changes will require reprogramming of the prescription Starting the Infusion RUN When the programming is complete and the pump has been primed properly and connected to the access site press the RUN key at the Run Option screen to start the therapy The pump will begin infusing and except when a LOAD DOSE or CLIN DOSE is programmed the following screen will display data on the status of the therapy The amount of drug infused during the loading dose depends on the units chosen which may be in ml s mg or mcg A INFORMATION loading dose of 5 mg will infuse 50 ml if the concentration is 0 1 mg ml IMPORTANT PCA Run Screen Beorsooce S 0 ml E 20 8 mlhe I L PRES 10 mm A TOT VOL 3 6 ral A TOT VOL 9 5 B
216. when the Air In Line sensor is completely disabled and the infusion goes to an Infusion Complete or Empty Bag status the Air Sensor setting will automatically change to 2 0 ml NXT DOSE Next Dose Allows the time of the next dose to be changed The current time remaining until the next dose is displayed Use the numeric keys to change the time for the start of the next dose If correct press the YES ENTER key to accept and move to the next field The range for this field is 0 00 to 24 00 HH MM Note If there is a dose currently in progress and the NXT DOSE feature is used the current 7 dose will be terminated and the cycle will continue at the KVO rate until the time for the new next dose AUDIO Audio Volume This feature allows you to adjust the audio volume of the pump s alarm setting You can enter a number from 9 the loudest setting to 1 the quietest setting When you select a number the pump will beep at that audio level Press the NO CHANGE key and enter a new setting 1 9 Repeat until the desired setting is reached and then press YES ENTER to select it and move the cursor to the next field PWR CK Power Check This feature allows the user to recheck the battery charge The display gives the active power source of the pump whether internal batteries or external power If the active source is the batteries a bar graph will indicate approximately how much charge remains in the ba
217. ws you to adjust the audio volume of the pump s alarm setting You can enter a number from 9 the loudest setting to 1 the quietest setting 49 Adeiay LL snonunuog When you select a number the pump will beep at that audio level Press the NO key and enter a new setting 1 9 Repeat until the desired setting is reached and then press YES ENTER to select it and move the cursor to the next field 8 PWR CK Power Check This feature allows you to periodically recheck the battery charge It will display the active power source of the pump whether internal batteries or external power If the active source is the batteries a graph will indicate approximately how much charge remains in the batteries To access this information select ON and press YES ENTER The Power Source Screen will display for five seconds and return to the Options Menu 9 ACCEPT OPT If the changes made in the Options Menu are acceptable press the YES ENTER key If the changes are not acceptable use arrow keys to cursor up to any field for corrections or abort all changes made in this menu by pressing the NO key and return to the previous screen There are two remaining selections to consider from the Run Options Screen NO to REVIEW and RUN to START Reviewing or Changing the Program To review or make any changes in the prescription programming press the NO CHANGE key at the Run Options screen and
218. x in progress Hew Program to Return a This screen is a reminder that the infusion is not complete If you want to return to the current container and finish infusing it press the NO CHANGE key to return to the Pause Menu screen b To abort the current container and enter a new program press the YES ENTER key If a prescription has previously been entered for the therapy mode you wish to program the following screen will appear ALERT Rx Programmed to Erase Rx to Return c Ifyou want to save the current prescription press the NO CHANGE key to return to the Pause Menu screen If you wish to erase the current prescription and enter a new program press the YES ENTER key to proceed All previous prescription values will be erased Note Selecting NEW PROGRAM will also reset the OPTIONS selected to their default settings except for the LOCK and AUDIO settings which must be changed manually Adejiady U9 1U119 U Timing Rules when Interrupting Intermittent Therapies IMPORTANT Remember this therapy is time dependent and the following rules NRO CMON apply for interruptions in the therapy For the Intermittent Therapy the pump automatically cycles through dosing and KVO A single beep alerts the user to the change in the cycle If the KVO rate is set at 0 the pump can be off between those doses When the pump is idle or OFF the internal time clock of the pump continues to
219. y 126 LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution LCD Display Alett Cause Resolution ALERT NEW DOSE IS LESS THAN CURRENT DOSE Unable to program a lower number of doses than number of doses already infused While the Variable or Intermittent therapy is in progress a lower number of doses to be delivered is entered than the number already infused Wait until current therapy in progress is complete or PAUSE pump and using the REPEAT Rx function modify the number of doses Note Selecting to repeat the therapy in progress will terminate the current therapy ALERT NO BOLUS DOSE DEFINED Unable to enter bolus interval or of bolus hr because no bolus value has been programmed Entry of a value other than zero for the Bolus Interval or Bolus per hour field when no bolus value has been programmed Enter bolus value before entering bolus interval or of boluses ht ALERT NO KEYPAD ACTIVITY No Keypad Activity The pump has been displaying a non running screen for two minutes without any keys being pressed The alert will recur every 2 minutes as long as there are no key presses Complete the activity for the displayed menu The pump may also be turned off however all programming that was not complete will be discarded If the pump was running and the

Curlin 4000 User Manual - Med-E

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