Performance Verification Procedure TEMP•PLUS® II Thermometer
Contents
1. CHX indicates the chapter number in the Technical Service Manual TSM 1000PB00048 E G CH8 Refer to TSM Chapter 8 DFU Refer to the relevant DFU PVP 100 Issue 6 Page I TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved T CareFusion Performance Verification Procedure IVAC PCAM Syringe Pump Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Fit V2R8 or above software to any pump fitted with CH3 UPDATES previous software Any Mki Control Boards will require replacement Bond the syringe clamp assembly on pumps manufactured prior to March 1999 with serial numbers CH6 5001 00083 to 5001 02910 Self Test Check all functions in self test 123 Check and adjust time and date as required 251 Alarms functionality check COVER OPENED PLUNGER LOCATION SYRINGE LOCATION HANDSET REMOVED DRIVE DISENGAGED NEAR END OF SYRINGE SYRINGE EMPTY Ensure pump works on battery and AC mains INFUSING Fv Linear speed test PCA MODE METHOD Fluid delivery set to STAT PCA dose2. Hospital Name Reference Software Version Inspection 1 Physical inspection and clean Lubricate pincher cavity as required Updates Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Fit Strain Relief and Flexi Cable CH6 Self Test 4 Check all functions in self test Dry set pressure verification self test 12 Use a dry set Applied pressure 0 mmHg Displayed pressure 20 to 10 mmHg Applied pressure 400 mmHg Displayed pressure 367 to 423 mmHg Vacuum retention verification self test 27 With door closed and set installed displayed pressure lt 250 mmHg for 30 seconds Infusing Alarms functionality check LOAD SET DOOR AIL FLOW SENSOR VTBI KVO TIME OUT UPSTREAM OCCLUSION BOTTLE CLAMP DOWNSTREAM PRESSURE EXCEEDED SET OUT Ensure pump works on battery and AC mains Check operation with and without a Flow Sensor Verification APO test 10 psi with door open and closed Rate accuracy test Set pump infusing at 800 ml h for 180 seconds 0 5 seconds Delivery 38 to 42 ml ml Tests 1 Downstream pressure exceeded test Pressure set to 500 mmHg Pump occludes between 11 and 14 psi psi Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Test in accordance w
3. Low flo alarm Controller mode level to be 12 to 12 inches inches Channel A Channel B a ao cies Channel C Inches Channel D inches Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Test in accordance with the Electronically O standard EN 60601 1 and Print out oO PASS FAIL test equipment operation Other O manual Electrical Safety Tests Verification Performed OO O By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 146575 E G CH5 Refer to TSM Chapter 5 PVP 100 Issue 6 Page H TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved T CareFusion IVAC P1000 Syringe Pump IVAC P2000 Syringe Pump IVAC P3000 Syringe Pump Performance Verification Procedure Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Mandatory when serviced UPDATE Fitted Not fitted REF v Not Applicable v Rate change anomaly upgrade required for seri
4. Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean 3 Check all functions in PVP Work Flow Enter access code 212 and go to PVP Work Flow e Software Versions e Date Time e Serial Number e Door Frame e Safety Clamp e Sear e Audio Test e Chequerboard Self Test eee e Keypad e Nurse Call e RS232 Loop Back e Pumping Efficiency Test e Downstream Occlusion Pressure Test Time taken 2 minutes or less minutes seconds 2 Occlusion alarm 500 100 mmHg L5 mmHg e Alarms Functionality e Volumetric Accuracy Test Calibration Delivery 20 ml 0 6 ml 3 ml Setup Set rate to zero or lowest value possible clear Volume Infused and VTBI Class I Type CF Test results are stored Electrical Test in accordance with the Electronically O standard EN 60601 1 and test Print out Oo PASS FAIL Safety Tests f equipment operation manual Other Oo Verification Performed By EE ee Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SM00013 E G CH2 Refer to TSM Chapter 2 PVP 100 Issue 6 Page P TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries
5. Volume delivered should be 2 of expected VTBI Note weight of water to be 0 998 Expected ml Delivered ml Class II Type CF Test results are stored Place the AD Ambulatory Syringe Electronically o Electrical Safety Driver into the charging station Print out o Tests Test in accordance with the standard Other o PAS y AL EN 60601 1 and test equipment operation manual Verification Performed By Sign Print Date CHX TSM indicates the chapter number in the Technical Service Manual TSM ZI 4 TM 002 CHX TIM indicates the chapter number in the Technicians Interface Manual TSM ZI 4 TM 004 E G CH3 TSM Refer to TSM Chapter 3 PVP 100 Issue 5 Page R TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2010 CareFusion Corporation or one of its subsidiaries All rights reserved
6. Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored r Test in accordance with the Electronically O Flectrical Safety standard EN 60601 1 and test Print out o PASS FAIL equipment operation manual Other O Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manuals TSMs 143617 PC1T amp 143624 PC2T E G CH5 Refer to TSM Chapter 5 PVP 100 Issue 6 Page F TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Gemini PC 2TX Infusion Pump Performance Verification Procedure Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Updates Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Update MAC device if not micro switches TSB301 Update software to 1 86 SB432 Check all functions in maintenance mode Check and adjust time and date as required MAINTENANCE 5 Pump test pressu
7. All rights reserved T CareFusion Performance Verification Procedure Alaris Gateway Workstation Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean OPERATION 1 Power up Check Ensure that the speaker and Keypad LEDs are functioning correctly Check Beacon operation if fitted Pump Removal Loading Checks Battery Test SETUP Set the correct Date and Time Class I no applied parts Test results are stored Electrical Test in accordance with the Electronically O Safety Tests 2 standard EN 60601 1 and test Print out mi PASS FAIL y equipment operation manual Other O Verification Performed eee By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SMO0015 E G CH2 Refer to TSM Chapter 3 PVP 100 Issue 6 Page Q TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved Distributed by E CareFusion AD Ambulatory Syringe Driver Performance Verification Procedure Driver Cradle Power Supply Model Serial Number s Driver Cradle Power Supply Service Order Inventory Number s H
8. software version V5R1F or above TSM Set Confirm time and date access code 42 Set service date access code 1 Check all functions in Self Test access code 3 During standard infusion check the following KVO Operation Flow stop mechanism test Alarms Functionality Check Door AIL OCC AIR Upstream Occlusion OCC AIR Power fail Time Out Downstream Occlusion HI PRESS Ensure pump works on battery and AC mains Rate Accuracy Verification Test Automatic test in Code 5 ml Rate set to 125ml h VTBI set to 20ml Volume infused 19 7 to 21 7ml Pressure Tests Automatic test in Code 12 test 8 mmHg Pump set to alarm at 500mmdHg Pressure 350 to 650mmHg Set Rate to Zero or lowest value possible Clear Volume infused and VTBI Clear Error Alarm Battery logs As required Electrical Safety Test Test results are stored Class I Type CF Electronically Oo Test in accordance with the standard EN 60601 1 and Print out m PASS FAIL test equipment operation manual Other o Verification Performed By EEE 8 Sign Print Date For additional information refer to 1000SM00006 Alaris GW Volumetric Pump Technical Service Manual TSM PVP 100 Issue 6 Page M TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 Ca
9. 008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved T CareFusion Performance Verification Procedure Gemini PC 4 Infusion Pump Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Updates Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Update MAC device if not micro switches TSB301 Update software to 1 93 SB469 Replace resistors on Controller Boards SB420 Check all functions in maintenance mode Check and adjust time and date as required MAINTENANCE pump test pressure to reach 17 psi at 125 ml h for all channels Check voltages System battery 13 68 and 14 87 volts Nicad unloaded 4 91 and 5 97 volts Nicad loaded 4 73 and 5 65 volts Alarms functionality check FLOW STOP OPEN CLOSE DOOR CHECK IV SET AIR IN LINE CLOSE DOOR OCCLUDED PATIENT SIDE OCCLUSION FLUID SIDE Ensure pump works on battery and AC mains INFUSING gt Rate accuracy test Set pump to 125 ml h VTBI 5 ml ml min secs 4 75 to 5 25 ml in 2 mins 23 secs to 2 mins 29 secs SA T Channel A __ mo_min__ secs Channel B SE ml min BOCES Channel C ml min ____ secs Channel D Occluded patient side test Pump mode pressure to be 8 to 12 psi psi Channel A Ceu Channel B PSl Channel C DS Channel D psi VERIFICATION TESTS 1
10. 3 8 kof keg Tests 3 OR Dedicated CC alarm level 200 mmHg drive occlusion at 2 4 kgf to 3 8 kof Line pressure readings CC Alarm set to 50mmHg pump alarms 40mmHg to 60mmHg mmHg Alarm set to 750mmHg pump alarms 710mmHg to 790mmHg mmHg Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Electrical Test in accordance with the Electronically o standard EN 60601 1 and test Print out m PASS FAIL Safety Tests A equipment operation manual Other o Verification Performed By es Sign Print Date chX indicates the chapter number in the Technical Service Manual TSM 1000SMOO0001 E G CH3 Refer to TSM Chapter 3 PVP 100 Issue 6 Page L TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure Alaris GW Volumetric Pump Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Physical Inspection and Clean Update Fitted Not fitted Recommended When Serviced Updates Ref v Not Applicable v Grease the pumping mechanism with Molykote PG54 TSM Upgrade to
11. Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved T CareFusion Performance Verification Procedure IVAC P7000 Syringe Pump P7001 IVAC P6000 Syringe Pump P6001 IVAC TIVA Syringe Pump P6002 IVAC TCI amp TIVA Syringe Pump P6003 Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Mandatory when serviced UPDATE Fitted Not fitted REF v Not Applicable v Update P7000 with V3R2 software TSM ch3 Update TIVA and TCI amp TIVA with V3R2 software TSM ch3 Inspect and fit display spacers on pumps manufactured prior TSM ch6 to July 1999 with serial numbers below 6001 00001 to 6001 UPDATES 13816 6002 00001 to 6002 11388 6003 00001 to 6003 01126 7001 00001 to 7001 13717 Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Update P6000 with V3R2 software TSM ch3 Bond the syringe clamp assembly on pumps manufactured prior TSM ch6 to July 1999 with serial numbers 6001 00100 to 6001 00972 6002 00100 to 6002 00259 7001 00106 to 7001 04432 SERVICE Check set serial number and set service date optional 376 LOGS Self Test Check all functions in
12. C CareFusion Performance Verification Procedure TEMPePLUS II Thermometer 2080 Model Serial Number Service Order Inventory Number Hospital Name Reference Inspection Physical inspection and clean OPERATION Check battery operation and replace if required Updates Recommended when serviced N A OPERATION 2 During operation check the following Start up check Backlight operation Pulse timer operation Return to base alarm Monitor mode test Verification using decade box Reading should be 0 1 deg C or 0 2 deg F deg C deg F degC or deg F Channel 1 26 8 80 2 36 7 98 0 37 0 98 6 a 38 9 102 0 ee 42 1 107 8 Broken probe Channel 2 26 8 80 2 36 7 98 0 37 0 98 6 38 9 102 0 42 1 107 8 Broken probe Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 140497A E G CH3 Refer to TSM Chapter 3 PVP 100 Issue 6 Page A TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved T CareFusion IVAC 570 Variable Pressure Volumetric Pump Performance Verification Procedure Model Serial Number Service Order Inventory Number
13. Inspection Physical inspection and clean Mandatory when serviced UPDATE Fitted Not fitted REF v Not Applicable v Fit crowbar assembly to PC2T pumps 143050 Verify that the polarity for Q9 watchdog is correctly SB441 Updates orientated PC2T Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Ground harness to be fitted to all PC1T and PC2T pumps TSB254 Update MAC device if not micro switches TSB301 MAINTENANCE gt Check all functions in maintenance mode Pump test pressure to reach 17 psi at 125 ml h both channels CH7 Check serial port test A STRAIN and B STRAIN PC2T are both 00 00 with door open System battery voltages should be PC1T 290 PC2T 300 V NICAD 2 71 to 2 98 Press 1 V NICAD TST 2 61 to 2 90 INFUSING 1 Alarms functionality check FLOW STOP OPEN CLOSE DOOR CHECK IV SET AIR IN LINE CLOSE DOOR OCCLUDED PATIENT SIDE OCCLUSION FLUID SIDE Ensure pump works on battery and AC mains VERIFICATION TESTS Rate accuracy test Set pump to 125 ml h VTBI 5 ml 4 75 to 5 25 ml in 2 mins 23 secs to 2 mins 29 secs Channel A ml min secs Channel B PC2T ml min secs Occluded patient side test Pump mode pressure to be 8 to 12 psi Channel A psi Channel B PC2T psi Low flo alarm Controller mode level to be 12 to 12 inches Channel A inches Channel B PC2T inches
14. al OTB73 numbers below 1001 21923 2001 28019 3001 25485 Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Updates Motor grounding modification required for serial SB35 numbers below 1001 26146 2001 37643 3001 31881 Fit 4RL software to any P1001 P2001 amp P3001 pump 0TB146 fitted with previous software Bond the syringe clamp assembly on pumps with serial OTB66 numbers below 1001 10121 to 1001 21263 2001 10088 to 2001 24574 3001 10095 to 3001 24731 Flexible circuit upgrade required for pumps with serial OTB121 numbers 1001 10121 to 1001 13894 2001 10088 to 2001 14660 3001 10095 to 3001 13565 Self Test Check all functions in self test 123 Alarms functionality check INFUSING Fv DEC NEOI KVO EOI SYR Ensure pump works on battery and AC mains Linear speed test Pump set to 99 9 ml h syringe type BD Plastipak 50 for a distance of 15 mm mins secs Verification 4 min 51 secs to 4 min 57 secs Tests Occlusion test Pump set to 99 9 ml h syringe type BD Plastipak 50 occlusion alarm level L 4 kgf 3 1 kgf to 3 9 kgf Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class II Type CF Test results are stored Electrical Test in accordance with the Electronically o Safety Tests standard EN 60601 1 and Print out o PASS FAIL y test equipment operation Other O manual Verification Performed By Sign Print Date
15. cal Service Manual TSM 1000SM00012 E G CH3 Refer to TSM Chapter 3 DFU Refer to the relevant DFU PVP 100 Issue 6 Page K TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure Alaris Guardrails Syringe Pump GS GH CC TIVA PK Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean ERROR LOG 1 376 Check set serial number set service date optional Self Test 123 Check all functions in self test Check date and time is correct set as required 251 ch2 Syringe size detection test e 12 mm spacer 11 5 to 12 5 e 32 mm spacer 31 5 to 32 5 Alarms functionality check Drive Disengaged Check Syringe AC power fail Pressure Disc out CC Near End of INFUSING Infusion Plunger Location End of Infusion Ensure pump works on battery and AC mains Linear speed test Pump set to 200 ml h syringe type BD Plastipak 50 for a mins secs distance of 15 mm 2 min 27 01 secs to 2 mins 30 59 secs Occlusion test Pump set to 100 ml h syringe type BD Plastipak 50 alarm level Verification L 3 2 4 kgf to
16. dicates the chapter number in the Technical Service Manual TSM 139981A E G CH4 Refer to TSM Chapter 4 PVP 100 Issue 6 Page D TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure Alaris SE Pump Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Updates Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Check mechanism springs SB428A DIAGNOSTICS 6 Set date time and PM due as required Check voltages Battery status 10V 18V ADREF 3 964 4 240 VBACKUP 4 85 5 15 Vcc 4 632 5 469 Check sensors Motor Flag Latch AIL ECD Check displays and switches Perform pressure calibration Alarms functionality check SET OUT AIL LATCH OPEN UPSTREAM OCCLUSION 400 ml h within 60 seconds DOWNSTREAM OCCLUSION INFUSING Ensure pump works on battery and AC mains Mechanism leak test 15 psi e5 Rate accuracy calibration Set pump to 400 ml h for a VTBI of 40 ml in variable pressure mode 80 VCS ml Volume infused should b
17. e 1 of value shown of 80 VCS calibration set value Channel A ml VERIFICATION Channel B dual channel ml TESTS Downstream pressure exceeded test Set pump to 125 ml h in variable pressure pressure alarm set to 300 mmHg Pump occludes between 200 and 400 mmHg Channel A mmHg Channel B dual channel mmHg Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Test in accordance with the Electronically o Electrical Safety standard EN 60601 1 and Print out o Tests test equipment operation Other O ee eee manual Verification Performed By ey a Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 10010812 00 E G CH6 Refer to TSM Chapter 6 PVP 100 Issue 6 Page E TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure Gemini PC 1 Single Channel Infusion Pump Titration and Gemini PC 2 Dual Channel Infusion Pump Titration Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version
18. ies 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Alaris Tri Site Thermometer Performance Verification Procedure Model Serial Number Service Order Inventory Number Hospital Name Reference Inspection Physical inspection and clean OPERATION Check battery operation and replace if required Updates Recommended when serviced N A During operation check the following OPERATION ea alae Pulse timer operation Display test Verification using probe simulator TE 1811 Reading should be 0 1 deg C or 0 2 deg F deg C deg F degC or degF Jack 1 26 8 80 2 Red side 36 7 98 0 37 0 98 6 a 38 9 102 0 Seyi gal 42 1 107 8 Broken probe Jack 2 26 8 80 2 Blue side 36 7 98 0 37 0 98 6 38 9 102 0 42 1 107 8 Broken probe Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 10014776 E G CH3 Refer to TSM Chapter 3 PVP 100 Issue 6 Page O TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure Alaris GP Guardrails Volumetric Pump
19. ith the Electronically E Electrical standard EN 60601 1 and test Print out o Safety Tests equipment operation manual Other Oo PASS FAIL Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SM00018 E G CH4 Refer to TSM Chapter 4 PVP 100 Issue 6 Page B TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion Performance Verification Procedure IVAC 597 Volumetric Pump and IVAC 598 Volumetric Pump Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean CH2 Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Non FSO pumps Update software to v10 03 or greater TSM Updates 136814 CH2 FSO pumps Update software to v1 10 143053 TSM CH2 Full length door label 141565 English TSM CH5 INSPECTION Check cam follower gap with pin gauge CH2 Self Test 2 Check all functions in self test Check pressure calibration values re calibrate as required self tests 30 and 24 PO 0 psi 1 2 P8 8 psi 1 2 During standard infu
20. ospital Name Reference Software Version Inspection 7S Physical inspection and clean Inspect Driver Power Pack Charging Cradle and cover s supplied for scratches cracks damage and missing location tabs Inspect driver for damage to tamper resist covers Self Tests Power up confirm 6 beeps Check serial number and software version on the LCD screen ensure serial number matches the label on rear of the driver MAINTENANCE CH2 TSM CH10 TIM Syringe Driver Technicians Interface Access Service page of the Calibration menu Note battery operating usage If 20 000 hours or more replace battery amp reset use log Hours Set UP Enter set up mode and check Date amp Time adjust if required INFUSING Check operation of the Case Open Time Out NEOI EOI amp Occlusion alarms Check operation of the Bolus Cover Latch and Key Lock functions Verification Tests Occlusion Verification Low Occlusion Set timed delivery to 10 minutes 10ml syringe After 2 minutes close the tap Ensure occlusion occurs between 100 to 500 mmHg mmHg High Occlusion Set timed delivery to 10 minutes 10ml syringe After 2 minutes close the tap Ensure occlusion occurs between 400 to 800 mmHg mmHg Rate Accuracy Verification Load a 10ml syringe connect to burette and purge the line Set a timed delivery to 5 minutes and note VTBI Measure the volume delivered in the burette
21. re to reach 17 psi at 125 ml h both channels Check voltages System battery 6 0 and 7 6 volts Nicad unloaded 4 91 and 5 97 volts Nicad loaded 4 73 and 5 65 volts Alarms functionality check iz FLOW STOP OPEN CLOSE DOOR CHECK IV SET AIR IN LINE CLOSE DOOR INFUSING OCCLUDED PATIENT SIDE OCCLUSION FLUID SIDE Ensure pump works on battery and AC mains Rate accuracy test Set pump to 125 ml h VTBI 5 ml 4 75 to 5 25 ml in 2 mins 23 secs to 2 mins 29 secs Channel A ml min secs Channel B ml min secs Occluded patient side test VERIFICATION Pump mode pressure to be 8 to 12 psi CH5 TESIS Channel A psi Channel B psi Low flo alarm Controller mode level to be 12 to 12 inches Channel A inches Channel B inches Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Electrical Safet Test in accordance with the Electronically O Sale Y standard EN 60601 1 and Print out o PASS FAIL test equipment operation Other O manual Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 143648 E G CH5 Refer to TSM Chapter 5 PVP 100 Issue 6 Page G TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2
22. reFusion Corporation or one of its subsidiaries All rights reserved T CareFusion Performance Verification Procedure Alaris DS Docking System Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Loctite 4 tile screws in place required for serial numbers TSM below the following Configuration Serial Number 4x0 800810000 4x2 800812000 UPDATES 4x3 800814000 4x4 800816000 6x0 800818000 6x2 800820000 6x3 800822000 6x 4 800824000 8x0 800826000 8x2 800828000 8x3 800830000 8x4 800832000 OPERATION Check mains operation to each tie Connect supply connections tester 1000JG00237 ensure all 3 neons are illuminated Class I Type B Test results are stored Electrical Test in accordance with the Electronically oO Safety Tests 2 standard EN 60601 1 and test Print out o PASS FAIL y equipment operation manual Other O Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SM00019 E G CH3 Refer to TSM Chapter 3 PVP 100 Issue 6 Page N TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiar
23. rmance Verification Procedure Model Serial Number Service Order Inventory Number Hospital Name Reference Software Version Inspection Physical inspection and clean Updates Recommended when serviced UPDATE Fitted Not fitted REF v Not Applicable v Replace capacitors C3 to C7 C21 or C22 should be SB405 replaced with 220 microF for serial numbers below 3351885 Replace drive module assembly on pumps with motor SB471 date code 448 Retrieve and check the event error logs MAINTENANCE 4 Check date of backup battery and replace if 5 years old CALIBRATION gt Calibrate the pump using the FMS software INFUSING 14 Manually test the watchdog alarm TIME AND DATE Check time and date Alarms functionality check INFUSING 4 Patient side occluded Fluid side occluded AIL KVO Ensure pump works on battery and AC mains Rate accuracy test Pump set to 800 ml h for 3 minutes cree as Channel A 38 to 42 ml ml TEST Channel B 38 to 42 ml ml Channel C 38 to 42 ml ml Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class II Type CF Test results are stored Test in accordance with the Electronically o Electrical Safety standard EN 60601 1 and Print out o Tests test equipment operation Other O ee eee manual Verification Performed By Sign Print Date CHX in
24. self test 123 Check and adjust time and date as required 251 INFUSING Alarms functionality check Drive Disengaged VTBI done Syringe Location Plunger Location AC power fail Set Removed P7000 Near End of Syringe Syringe Empty KVO Ensure pump works on battery and AC mains Linear speed test Pump set to 100 ml h syringe type BD Plastipak 50 for a distance mins Secs of 15 mm 4 mins 52 secs to 4 mins 58 secs Occlusion test Pump set to 100 ml h syringe type BD Plastipak 50 ar BOREIA Semi Dedicated Occlusion alarm level L 3 2 2kgf to 3kgf g hep ertaa OR Dedicated P7000 alarm level 220mmHg 3 1kgf to 3 9kgf ests Line pressure test P7000 mmHg Alarm set to 50mmHg pump alarms 27mmHg to 73mmHg Alarm set to 500mmHg pump alarms 455mmHg to 545mmHg mmHg TCI function test Fit TCI syringe Diprivan 1 Set TCI mode age 40 wt 70 kg TCI target 4 0 ug ml Elapsed time to reach mins secs 4 0 pg ml 24 1 sec Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class II Type CF P7000 Test results are stored f P6000 TIVA Electronically O Electrical i Safety Class I Type CF TCI amp TIVA Print out o PASS FAIL Tests Test in accordance with the Other o standard EN 60601 1 and test equipment operation manual Verification Performed By Sign Print Date CHx indicates the chapter number in the Techni
25. sion check the following Start up sequence VTBI and rate retention KVO operation Infusing Flow Sensor option if FSO model Alarms functionality check CH2 Door P1 FLO P2 hold P3 AIL P5 RELOAD AIR P5 P6 RELOAD P6 OCCL P7 KVO Time Out Ensure pump works on battery and AC mains Rate accuracy test Automatic test in self test 13 eee Pump set to 300 ml h for 300 seconds volume infused ml Verification 23 75 to 26 25 ml Tests Occlusion tests Pump Infusing 200mI h OCCL is between 5 5 to 11 psi nominal 6 to 8 psi psi Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class I Type CF Test results are stored Test in accordance with the Electronically oO Electrical standard EN 60601 1 and Print out o Safety Tests test equipment operation Other O PASS FAIL manual Verification Performed By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SM00016 E G CH2 Refer to TSM Chapter 2 PVP 100 Issue 6 Page C TEMP PLUS IVAC MedSystem III Alaris Gemini PC 1 Gemini PC 2 Gemini PC 2TX Gemini PC 4 PCAM and Guardrails are registered trademarks of the CareFusion Corporation or one of its subsidiaries 2008 2012 CareFusion Corporation or one of its subsidiaries All rights reserved C CareFusion MedSystem III Infusion Pump 2866 Perfo
26. to 20 mg Press handset to start infusion Pump set to syringe type BD Plastipak 50 for a distance of 15 mm 4 mins 50 secs to 4 mins 58 secs mins secs OR CONTINUOUS MODE METHOD Pump set to continuous rate of 20 ml h syringe type BD Plastipak 50 for a distance of 10 mm 16 mins 21 secs 10 secs Occlusion test Verification PCA MODE METHOD Fluid delivery set to STAT PCA dose Tests 1 to 20 mg Press handset to start infusion Pump set to syringe type BD Plastipak 50 occlusion alarm level L 4 3 1 kgf to 3 9 kgf kof OR CONTINUOUS MODE METHOD Pump set to continuous rate of 20 ml h syringe type BD Plastipak 50 occlusion alarm level L 4 3 1 kgf to 3 9 kgf Battery test Run pump on battery power at the rate of 2ml h in CONTINUOUS mode for a minimum of 4 hours 2 8Ah battery or 6 hours 3 4 Ah battery Setup Set rate to zero or lowest value possible Clear Volume Infused and VTBI Clear Error Alarm Battery logs as required Class II Type CF Test results are stored Electrical Test in accordance with the Electronically Oo standard EN 60601 1 and Print out Oo PASS FAIL Safety Tests test equipment operation Other o manual Verification Performed nM By Sign Print Date CHX indicates the chapter number in the Technical Service Manual TSM 1000SM00017 E G CH3 Refer to TSM Chapter 3 DFU Refer to the relevant DFU PVP 100 Issue 6 Page J TEMP PLUS IVAC MedSystem III
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