CURLIN MEDICAL 2000 Plus, 2000 CMS User Guide

CURLIN MEDICAL

(

)

User’s Manual

for use with the

2000 Plus and 2000 CMS

Ambulatory Infusion Systems

CURLIN MEDICAL, LLC

15751 Graham Street

Huntington Beach, CA 92649

Phone [phone] • Fax [phone]

www.curlinmedical.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 © 2000/2002 CURLIN MEDICAL, LLC All Rights Reserved

0050

Revision E

Use with Software Rev. 40 for Curlin Medical 2000 Series Pumps

Reorder Number 340-9009

TABLE OF CONTENTS

INTRODUCTION .................... 1

Delivery Modes ................................ 1

Indications for Use ..........................2

Special Features of the 2000

Series Pump ...................................2

Regulatory Agency Approvals .........3

Warnings, Cautions, Notices...........4

Pump Illustrations and Features .....8

Disposable Administration Set

Illustrations and Features.............. 10

Preparing Medication for

Infusion/Changing IV Bags...........11

Opening and Closing the Pump

Door ............................................... 13

Choosing and installing the
Curlin Medical Administration

Set................................................... 14

Gravity Priming Set and Filter....... 14

Steps in Installing Administration

Set into Curlin Medical Pumps...... 15

Up Stream Occlusion Alarm

Feature ........................................... 16

Installing the Batteries and Using

External Power............................... 17

External Power Sources................. 19

Battery Pack................................... 19

AC Adapters ................................... 20

Attaching and Removing the

Bolus Cord ..................................... 21

LEARNING PUMP

FEATURES.............................. 23

Keypad Function............................ 24

LED Light Indicators ....................25

Audio Indicator.............................. 25

Display Screen ............................... 25

BASICS OF

PROGRAMMING ................... 27

Types of Display Screens .............. 27

Sample of an Action Field Screen...27

Sample of a Selection List Field ......27

Sample of a Data Entry Screen .......28

Sample of a Run Screen....................28

Sample of User Notification

Screen..................................................28

Using “Help” ................................ 29

Starting the Pump.......................... 29

Welcome Screen ................................29

Power Status Screen..........................30

Preventive Maintenance Screen.......30

Select Program or Bio-Med Setup

Screen..................................................30

Access Code....................................31

Clinician Access Code Screen..........31

BioMed Setup .................................31

Bio Med Setup Menu ........................31

Enable Therapy Menu ......................33

Patient History Log....................... 33

History Event Log.............................34

Clearing the History Log............... 35

Clearing Patient Information ........ 35

Changing Date and Time.............. 36

Change Date and Time Screen........36

Program ......................................... 37

Program/BioMed Setup Menu........37

Resume/Repeat Rx/New

Program Menu ...................................38

Resuming a therapy....................... 38

Repeating a Pre-Programmed

Therapy.......................................... 38

How to go to “New Program” ...... 39

Selecting a Therapy ....................... 39

Select Therapy Screen.......................39

I

TABLE OF CONTENTS

Entering or Changing Data

Fields.............................................. 40

CONTINUOUS THERAPY ... 41

Prescription Menus........................ 41

Continuous Pre-Prescription

Menu Screen...................................... 41

Continuous Delay Start Setting ...... 42

Run Options Screen......................... 42

Continuous Titration Limit

Screen ................................................. 43

Continuous Prescription Menu ...... 44

Run Options Screen......................... 45

Prime.............................................. 45

Prime Direction Screen.................... 45

Options .......................................... 46

Continuous Options Menu ............. 47

Continuous Titration Menu ............ 47

Air-In-Line Sensor Off Message

Screen ................................................. 48

Air-In-Line Sensor Set at 2.0ml

Alert Screen ....................................... 49

Reviewing or Changing the

Program ......................................... 49

Starting the Infusion ...................... 49

Continuous Run Screen................... 50

Continuous Information Screens ... 50

PCA Pre-Prescription Menu

Screen..................................................55

Administration Routes......................56

PCA Titrate Limits Screen ...............56

PCA Prescription Menu ...................58

Run Options Screen..........................59

Prime ............................................. 59

Prime Direction Screen ....................59

Options .......................................... 60

PCA Options Menu ..........................61

Clinician Dose Menu ........................61

Clinician Dose Run Screen ..............62

PCA Titrate Screen............................62

Air-In-Line Sensor Off Message

Screen..................................................63

Air-In-Line Sensor at 2.0ml Alert

Screen..................................................64

Reviewing or Changing the

Program ......................................... 64

Starting the Infusion...................... 65

PCA Run Screen................................65

PCA Information Screens................66

Interrupting an Infusion................ 66

Pause Menu Screen ...........................66

Resuming the Current Container.. 66

Run Options Screen..........................66

Interrupting an Infusion ................ 51

Pause Menu Screen........................... 51

Resuming the Current Container .. 51

Run Options Screen......................... 51

Hanging a New Container ............ 51

Entering a New Program............... 52

Infusion Complete ......................... 53

Continuous Infusion Complete...... 53

Stopping the Infusion .................... 53

Pause Menu Screen........................... 53

PCA THERAPY....................... 55

Prescription Menus........................ 55

Hanging a New Container ............ 67

Entering a New Program .............. 67

Infusion Complete......................... 68

PCA Infusion Complete...................68

Stopping the Infusion.................... 68

Pause Menu Screen ...........................69

TPN THERAPY WITH

AUTOMATIC RAMPING....... 71

Prescription Menus ........................71

TPN Pre-Prescription Menu

Screen..................................................71

TPN Delay Start Setting...................71

Run Options Screen..........................72

TPN Prescription Screen..................73

II

TABLE OF CONTENTS

Run Options Screen......................... 74

Prime.............................................. 74

Prime Direction Screen.................... 75

Options .......................................... 76

TPN Options Menu......................... 76

Air-In-Line Sensor Off Message

Screen ................................................. 77

Air-In-Line Sensor Set at 2.0ml

Alert Screen ....................................... 78

Reviewing or Changing the

Program ......................................... 78

Starting the Infusion ...................... 79

TPN Run Screen............................... 79

TPN Information Screens............... 80

Interrupting an Infusion ................80

Pause Menu Screen........................... 80

Resuming the Current Container ..80

Run Options Screen......................... 80

Hanging a New Container ............ 81

Entering a New Program............... 81

Infusion Complete ......................... 82

TPN Infusion Complete.................. 82

Stopping the Infusion .................... 83

Pause Menu Screen........................... 83

INTERMITTENT

THERAPY ............................... 85

Prescription Menus........................ 85

Intermittent Pre-Prescription

Menu Screen...................................... 85

Intermittent Delay Start Setting ..... 86

Run Options Screen......................... 86

Intermittent Prescription Menu...... 87

Run Options Screen......................... 89

Air-In-Line Sensor Set at 2.0ml

Alert Screen ........................................92

Reviewing or Changing the

Program ......................................... 93

Starting the Infusion...................... 93

Intermittent Run Screen...................93

Intermittent Information Screens ...94

Interrupting an Infusion................ 94

Pause Menu Screen ...........................95

Resuming the Current Container.. 95

Run Options Screen..........................95

Hanging a New Container ............ 95

Intermittent Dosing Schedule..........96

Entering a New Program .............. 96

Timing Rules when Interrupting

Intermittent Therapies .................. 97

Infusion Complete......................... 98

Intermittent Infusion Complete......98

Stopping the Infusion.................... 98

Pause Menu Screen ...........................98

VARIABLE THERAPY.......... 101

Prescription Menus ...................... 101

Variable Pre-Prescription Menu

Screen................................................101

Variable Delay Start Setting ...........102

Run Options Screen........................102

Variable Prescription Menu1 .........103

Variable Prescription Menu 2........104

Variable Prescription Menu 3........104

Variable Summary Screen...............105

Run Options Screen........................105

Prime ............................................106

Prime Direction Screen ..................106

Prime.............................................. 89

Prime Direction Screen.................... 89

Options .......................................... 90

Intermittent Options Menu............. 91

Air-In-Line Sensor Off Message

Screen ................................................. 92

Options .........................................107

Variable Options Menu ..................107

Air-In-Line Sensor Off Message

Screen................................................108

Air-In-Line Sensor Set at 2.0ml

Alert Screen ......................................109

III

TABLE OF CONTENTS

Reviewing or Changing the

Program ........................................109

Starting the Infusion .....................109

Variable Run Screen 1.................... 110

Variable Run Screen 2.................... 110

Variable Information Screens ....... 111

Interrupting an Infusion ............... 111

Pause Menu Screen......................... 111

Resuming the Current Container .111

Run Options Screen....................... 112

Hanging a New Container ...........112

Entering a New Program..............112

Infusion Complete ........................113

Variable Infusion Complete ......... 113

Stopping the Infusion ...................114

Pause Menu Screen......................... 114

TROUBLESHOOTING ........ 115

Alerts, Alarms, and Error Codes... 115

Operating Environment ............... 146

Maintenance .................................146

Limited Warranty .........................147

Procedure for Checking Pumps

Between Patients ..........................149

TECHNICAL

SPECIFICATIONS.................153

CLINICIAN
INFORMATION AND

ACCESS CODE ......................157

Clinician Access Code.....................157

Lock Setting Table ....................... 158

ACCESSORIES.......................137

AC Adapters/Chargers .................137

Battery Pack (340-2006) ................138

Soft Carry Packs............................139

Detachable Pole Clamps...............141

Remote Bolus Cord (340-2005) .....141

Lockable Safety Shells ..................142

Pump Holster (340-0111)...............142

Data Interface Cable (340-2011)....144

Palm Adapter Cable (350-2006) ....144

CLEANING,
ENVIRONMENTAL
CONDITIONS, AND

MAINTENANCE...................145

Cleaning ........................................145

Transport and Storage ..................146

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

VIEW.................................................................. 9

FIGURE 1.3 SAMPLES OF CURLIN MEDICAL

ADMINISTRATION SETS.............................10

FIGURE 10.2 BATTERY PACK ............................. 138

FIGURE 10.3 SMALL FANNY PACK.................... 139

FIGURE 10.4 LARGE FANNY PACK ................... 139

FIGURE 10.5 SOFT SHOULDER PACK .............. 140

FIGURE 10.6 SOFT BACK PACK ......................... 140

FIGURE 1.4 SPIKING THE FLUID CONTAINER,

GRAVITY PRIMING THE SET AND USING
THE SLIDE CLAMP TO CLOSE THE

TUBING. ..........................................................11

FIGURE 1.5 CURLIN MEDICAL

ADMINISTRATION SET “INTEGRAL

FLOW-STOP” WITH BREAKAWAY TAB ....12

FIGURE 1.6 INTENTIONALLY OPENING THE

“INTEGRAL FLOW-STOP”...........................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 ..................................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 INSTALLING BATTERIES INTO

THE CURLIN MEDICAL AMBULATORY

PUMP................................................................18

FIGURE 10.7 DETACHABLE POLE CLAMP ......141

FIGURE 10.8 REMOTE BOLUS CORD................141

FIGURE 10.9 SAFETY SHELLS............................ 142

FIGURE 10.10 PUMP “HOLSTER” ...................... 142

FIGURE 10.11 POLE CLAMP AND SAFETY

SHELL INSTALLATION............................. 143

FIGURE 10.12 DATA INTERFACE CABLE ........ 144

FIGURE 1.12 BATTERY PACK................................19

FIGURE 1.13 AC ADAPTERS...................................20

FIGURE 1.14 ATTACHING AND REMOVING

THE REMOTE BOLUS CORD......................21

FIGURE 2.1 KEY PAD ..............................................23

FIGURE 2.2 SAMPLE OF DISPLAY SCREEN ......26

FIGURE 5.1 PCA ADMINISTRATION ROUTE

DEFAULT SETTINGS....................................56

FIGURE 10.1 AC ADAPTERS/CHARGERS .........137

V

Chapter

Introduction

The

Curlin Medical

simple-to-learn technology to allow fast and easy access to the features of these pumps. With a little introduction 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 2000 Plus and the 2000 CMS pumps, unless
specifically otherwise stated.

Infusion Pumps have been designed with the user in mind and have the latest in friendly,

Introduction

et’s 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

L

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 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.

for ambulatory patients.

5 Variable Program—Designed to allow varying amounts, rates, and times of delivery of

infusions up to twenty-four specified programs.

1 1

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, syringes1 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 2000 Series Pump

• Automatic “quick-repeat” function

• Large font display

• Small, accurate, ambulatory, volumetric infusion pump that provides reliable and safe delivery

of infusion therapies.

• Cost effective, safe and easy-to-load disposable Curlin Medical administration sets featuring

a unique, spring-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.

• User-friendly, easy-to-teach programming that shortens staff inservice time and patient

teaching time.

• “Helpful” help screens and display messages.

• Three tamper-resistant lock settings to assist in maintaining patient compliance and safety.

• Patient and therapy specific programming features via the Curlin Medical BIOMED

SETUP and Options Menus.

• Selection by user from three units of delivery, milliliters (ml), milligrams (mg), and micrograms

(mcg).

• Titration features in both PCA and Continuous therapies.

• Retention of programmed infusion settings until cleared by the clinician, thus eliminating the

need to reprogram before each use.

• 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.

• Powered by two readily available, cost-effective “C” size alkaline batteries.

• Attractive yet robust design that is impact resistant and water resistant.

• 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.

• Four sizes of convenient carry packs to assist the ambulatory patient in maintaining

independence of lifestyle. Backpack will accommodate pump, AC Adapter, and up to four­liter IV bag.

• Retained memory features that allow the pump to easily resume a therapy exactly from where

1

Some syringes are not qualified for use. Please call Curlin Medical for details

2 2

it left off when it is interrupted before completion or to repeat a therapy using the same
programmed prescription.

• 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.

• Backlit illumination for display screen. Backlight remains on continuously if AC Adapter is in

use.

• Pump will not permit the user to enter any programming value that is outside of its

predetermined range.

• Integral Up as well as Down Occlusion alarms to notify user if an occlusion is present on

either side of the pumping chamber.

• Integral High Upstream pressure alarm to notify user of excessive upstream pressure.

• Integral Air-In-Line alarm to notify user of presence of air in the tubing.

• Adjustable Down Occlusion settings of “High” and “Low” to customize the pump’s down

pressure requirements.

• Patient side (downstream) “Line Pressure” displayed on CMS-enabled pumps.

Introduction

Regulatory Agency Approvals

INFUSION PUMP
WITH RESPECT TO ELECTRIC SHOCK, FIRE
AND MECHANICAL HAZARDS ONLY
IN ACCORDANCE WITH UL2601-1/CAN/CSA C22.2 NO. 601.1

70TK

• Underwriters Laboratories has evaluated the Curlin Medical Pump with International AC

Adapter (340-2022) to UL 2601-1 and CSA C22.2 No. 601-1 for General Standards of Safety
for Medical Equipment and found the Curlin Medical Pump to be compliant.

• Underwriters Laboratories has evaluated the Curlin Medical Pump with accessory

equipment, which is the Battery Pack (340-2006) and the AC Adapter (340-2004), to UL 544
and CSA C22.2 No. 125 Standards for Safety for Medical Equipment and they were found to
be compliant.

• TÜV PRODUCT SERVICE has evaluated the Curlin Medical Pump and the AC Adapter

(340-2004) for Electromagnetic Compatibility, to regulations EN 60601-1-1-2/1993 and EN
60601-2-24/1994 and both were found to be compliant.

IMPORTANT

INFORMATION

The indicator shown at the left appears throughout this manual to
emphasize important information in the operation of the Curlin
Medical Pump. Please read these sections carefully.

3 3

Warnings, Cautions, Notices

EXPLANATION FOR SYMBOLS on the Curlin Medical Pump with the Classified UL
2601-1 and CSA C22.2 No. 601-1 Label.

The meanings for the symbols on the pump are as follows:

Attention, consult ACCOMPANYING DOCUMENTS.

♥ Type CF Equipment

IPX1 Protected against dripping water.

INFUSION PUMP
WITH RESPECT TO ELECTRIC SHOCK, FIRE
AND MECHANICAL HAZARDS ONLY
IN ACCORDANCE WITH UL2601-1/CAN/CSA C22.2 NO. 601.1
70TK

INTERNALLY POWERED OR FOR USE WITH AC ADAPTER 340-2022
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

EXPLANATION FOR SYMBOLS on the Curlin Medical Pump and Battery Pack label
for listing to UL 544 and CSA C22.2 No. 125.

The meaning for the symbols on the pump and battery pack label are as follows:

Attention, consult ACCOMPANYING DOCUMENTS

CAUTION: Refer servicing to qualified personnel

Risk Class 2 (Type BF Equipment)
DANGER – Risk of EXPLOSION if used in the presence of FLAMMABLE
ANESTHETIC
Use with Battery Pack Model No. 340-2006 or AC Adapter Model No. 340-2004 6.9 v DC
500mA

4 4

WARNINGS

• 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.

• 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.

• Remove all air from the administration set and IV bag or reservoir before connecting it to

a patient’s access site.

• 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.

• Do not attempt to open the pump’s housing. All service problems should be referred to

an appropriate service technician.

• Danger: Risk of explosion if used in the presence of flammable anesthetic or explosive

gasses.

Introduction

CAUTIONS

• U.S. 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 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.

5 5

• 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.

• 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 ordinances 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 manufacturer’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
3 Household bleach, diluted 9:1 with water
4 Commercial disinfectant
When clean, dry pump and other items with a soft, clean, dry cloth.

6 6

• 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.

• This equipment generates, uses, and can radiate radio frequency energy and, if not

installed and used in accordance with the instructions, may 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:

Introduction

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

INFORMATION

Code” contains access code information, the entire chapter should be
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.

7 7

Pump Illustrations and Features

Data Interface/

Bolus Cord Port

Figure 1.1 Curlin Medical Ambulatory Pump—Front, top and left view

8 8

Introduction

Figure 1.2 Curlin Medical Ambulatory Pump—Back, bottom, and right view

9 9

Disposable Administration Set Illustrations and Features

Integral

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
“Integral Flow-Stop” automatically reacts to clamp the tubing. The “Integral Flow­Stop” 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

Integral

Figure 1.3 Samples of Curlin Medical Administration Sets

10 10

W

p

A

Preparing Medication for Infusion/Changing IV Bags

hen using an IV bag, grasp the bag
spike firmly in one hand and the IV bag
spike­spike completely into the port using
aseptic technique.

ort in the other, and insert the

Introduction

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.

ir in the line moves down through

the tubing as the fluid fills.

Notice the breakaway tab on the
“Integral Flow-Stop” has been
removed. The set can be gravity
primed by intentionally squeezing

OPEN

In these illustrations,
the slide clamps are
shown in their open and
closed states.

CLOSED

the “Integral Flow-Stop” and thus
releasing the clamping action. ( See
Figures 1.5 & 1.6 )

Figure 1.4 Spiking the fluid container, gravity priming the set and using the slide clamp to

close the tubing.

11 11

T

wist 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
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 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:

Door Latch

(Lift to open)

2

1

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).

Introduction

Push down

Figure 1.7 Opening the pump door

To close the pump door properly,
move the entire door assembly to the
left and 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 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 provider’s 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.

2 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 of the fill volume when determining the final IV bag volume.

Important Notification

A lack of compliance with proper positioning of the tubing could result in infusion inaccuracies.

Please center the tubing in the pumping area when installing the administration set.

Gravity Priming Set and Filter

1 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 Flow­Stop” 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.

2 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.

3 Use an administration set with an air-eliminating filter whenever the Air-In-Line Sensor is

disabled or set to “OFF.”

4 Follow CDC guidelines or Intravenous Nursing Standards of Practice Guidelines regarding

the frequency of changing the administration sets.

5 Use aseptic technique and universal precautions as directed by the policies of your healthcare

facility or institution.

6 Use only Curlin Medical administration sets with the Curlin Medical pump.

7 Dispose of administration sets in accordance with all applicable regulatory and institutional

policies and directions.

14 14

y

y

p

A

(

)

ir Detector

Note: Open the

slide clamp before

closing the pump

door

(Yellow)

Blue

Figure 1.9 shows the
Curlin Medical pump
with a cut-away of the
display screen allowing

ou to visualize the

receptacles for the

blue

small
Guide” on the right
side of the pump and
the larger
“Integral Flow-Stop”
on the left side of the

ump. The arrows, in
corresponding colors,
are visible on the
background surface of
the pump head and
indicate the proper
direction for placing
these locators into their
receptacles. Also, note
that the breakaway tab
has been removed from
the “Integral Flow­Stop”, allowing the
administration set to be
placed into the pump
correctly.

“Tubing

ellow

Introduction

Figure 1.9 Proper installation of the Curlin Medical Administration set into the pump

Steps in Installing Administration Set into Curlin Medical Pumps

1 Fully open the door of the pump.
2 Close the slide-clamp on the administration set.
3 Activate the Integral Flow-Stop by twisting and removing the breakaway tab.
4 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 hinge.
5 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.

7 Open the slide-clamp on the administration set
8 Push the tubing slightly into the black Air Detector slot.
9 Fully close the door of the pump and latch it securely.
10 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.

15 15

i

p

T

“Flow-Stop”

handle

Air Detector
Slot

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

ndicates 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 background
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

ress down on the top of the
“Integral Flow-Stop” when
inserting it into the receptacle.

his 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 up­stream 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 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 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 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.) If you are infusing at high rates, you will have approximately one hour of
warning; if you are infusing at low rates (below 10 ml/hr), you will have a significantly longer time
interval before the batteries are completely empty.

Introduction

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 are 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 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 17

The battery compartment door is located
on the back of the Curlin Medical pump.
To open the door, depress the recessed
release pin (it may be helpful to use a
small coin to depress the pin), slide the
battery door down, and remove it.
Replace the old batteries with two new
“C” size alkaline batteries. Install them
by depressing the coil spring with the
bottom of the battery and sliding the top
in place. Note: both positive poles are at
the top as shown in Figure 1.11. Always
replace both batteries. Slide the battery
compartment door back to its closed
position until the recessed pin locks into
place.

PLEASE NOTE:
Follow local governing ordinances and
recycling plans regarding disposal or
recycling of device components. When
the “C” size batteries are discarded do
not incinerate them.

Two “C size”

alkaline

batteries

Coil Springs

Battery

Compartment

Door

Recessed Release

Pin

Figure 1.11 Installing batteries into the Curlin Medical Ambulatory pump

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.

18 18

External Power Sources

Battery Pack

The battery pack is an external, rechargeable, lead acid 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.

Recharging port of

battery pack

Illustration of the bottom of

the Curlin Medical ambulatory

pump

Align the red dots
and the notches.
Then plug the two­pin connector into
the two-hole
receptacle located
on the bottom of
the Curlin Medical
Ambulatory pump.

Introduction

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, to
recharge takes approximately 12 hours (overnight).

Figure 1.12 Battery Pack

19 19

T

AC Adapters

There are two AC Adapters:

• The US Domestic AC Adapter has a three-prong plug to be plugged into a standard

three-prong, grounded wall receptacle and a six-foot cable which plugs into the power
outlet on the bottom of the pump.

• The Universal AC Adapter available for international use.

This accessory 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 pack (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.

US Domestic AC Adapter

Locking Sleeve

Universal AC Adapter

Locking Sleeve

wo-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 AC Adapters

20 20

T

Attaching and Removing the Bolus Cord

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: “Not in PCA No Bolus Allowed.”

Bolus/Data
Port on Left
side of Pump

Introduction

Remote bolus

access port

Locking Sleeve

Four-pronged adapter

plugs into access port on

left side of pump as

shown.

o 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

21 21

22 22

3

5

986

4

2

Learning Pump Features

Chapter

Learning to operate the

Curlin Medical

pump requires a few 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

irst, examine the key pad and the functions of the individual keys. Knowing how the
keys, especially the dual function keys, work will allow you to give commands to the

F

pump.

pump.

Display

Screen

LED

Indicators

1

7

7

Learning Pump

10

Figure 2.1 Key Pad

23 23

Keypad Function

1 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.

2 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.

3 ⇑ Up arrow: Used to scroll the highlight bar or field cursor up on the display screen.

Note: The Up arrow will not accept a selection which must be made with a YES/ENTER

or NO/CHANGE key.

4 ⇓ 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.

5 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.

6 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 or Down arrow will not accept a selection.

7 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.

8 ./SILENCE: Used as a decimal point when programming numeric data. Used also to

temporarily silence the alarm (for one-minute intervals).

9 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 24

LED Light Indicators

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.
2 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 error 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.

Learning Pump

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:

• on if connected to an AC outlet;

• lit for 15 seconds if using batteries or during any key press sequences,

• 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 25

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” 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 arrow indicator

Text field with highlight
bar or cursor appearing on
first field.

Figure 2.2 Sample of display screen

26 26

the

ESUME

d.

Basics of Programming

The

Curlin Medical

individual patient. This chapter will explain the customizing features along with the programming steps.

rogramming the Curlin Medical pump requires initial orientation and training, but the
programming steps have been designed to be user friendly and self-prompting to

P

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.

pump allows the operator to customize this device to meet the specific infusion needs of each

Chapter

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
highlight bar is resting on

“R

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 correct 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

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.

” fiel

Basics Programming

27 27

3 “Data entry screens” are used to specify prescription parameters.

Sample of a Data Entry Screen

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 to 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

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 ml 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

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 code

28 28

messages and how to resolve them). The audio alarm also beeps and the LEDs blink

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 (

▲) or down (▼) 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

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 lights fails to light or to blink, return the pump for service. If the self­test 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.

IMPORTANT

INFORMATION

If, at any time, there is indication of pump damage, error code, or
messages requiring the pump to be turned off, call the healthcare
agency or facility as directed to report the condition.

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.

Basics Programming

29 29

When the Curlin Medical pump successfully passes it’s self-test, a brief message of “System
OK” appears, and the display moves to the next screen:

Power Status Screen

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. This 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

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

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, Clinician Information and Access Code, of this manual.)

30 30

Access Code

Clinician Access Code Screen

The clinician enters the five-digit access code; and, if the code is valid, the display will
automatically move to the requested screen or field. The access code numbers do not appear on
the screen; instead five asterisks appear. 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.

If an access code screen displays and the access code is not known,

IMPORTANT

INFORMATION

use the down arrow 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:

Basics Programming

BioMed Setup

Bio Med Setup Menu

The BIOMED SETUP menu lists special optional customization and performance functions of
the pump:

31 31

You may skip any of these functions by using the down arrow to move

IMPORTANT

INFORMATION

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.

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
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 used, 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 Clinician 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.

7 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

disable

any of the therapies listed. Once a therapy is disabled, no further prompts will appear

enable

or

in programming for that therapy.

Enable Therapy Menu

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. At least one therapy must remain enabled before you exit this screen.

Note: If a 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 print package and by selecting the “Print

Basics Programming

33

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.

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

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.

(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 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:

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:

Basics Programming

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

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:

When you select “YES,” all patient data clears and the display returns to the BIOMED
SETUP Menu. Selecting “NO” 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:

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

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 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.
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.

Basics Programming

IMPORTANT

INFORMATION

If a therapy is in progress, the date and time changing functions will not be
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

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

Resume/Repeat Rx/New Program Menu

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).

• 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—If 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 provider’s 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 “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.

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

38

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:

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,” and you will be prompted to resume the
therapy.

How to go to “New Program”

3. 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

Basics Programming

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

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. If a 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:

Each individual therapy will now be considered separately in this manual and will have
its own chapter heading.

40

Continuous Therapy

Continuous Therapy is designed to allow a constant programmed rate of infusion.

egin programming a Continuous Therapy by selecting “Continuous” from the “Select
Therapy Screen”. The following display screen appears and requires you to enter

B

information needed to program this therapy:

Prescription Menus

Continuous Pre-Prescription Menu Screen

Chapter

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
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 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

Continuous Therapy

41

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

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

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:

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

IMPORTANT

INFORMATION

infusing. Be sure the patient’s 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.

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

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 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.

Continuous Therapy

43

Continuous Prescription Menu

1 BAG Vol (IV Bag Volume): Use 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 TBI (Amount To Be Infused): 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 0.1 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 constant.) 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

INFORMATION

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.

The next screen that appears when the programming is complete offers four choices:

Run Options Screen

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

3 Disconnect the administration set from the patient’s access site using aseptic protocols.

IMPORTANT

INFORMATION

Priming with the set connected to the patient could result in overdose
and may cause injury or even death to the patient.

Continuous Therapy

45

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:

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:

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.

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 becomes effective
when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.

Continuous Options Menu

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
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 TitrRx (Titrate Prescription): If this feature was not selected in the Pre-Prescription Menu, it

will not appear on the Options Menu. If a 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

This screen allows the user to change the rate within the predefined prescription limits.

Continuous Therapy

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.

47

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 “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.

3 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
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.

4 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

INFORMATION

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.

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 air­eliminating 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.

Whenever the Air-In-Line Sensor is set to OFF, Curlin Medical
recommends the use of an air-eliminating filter.

Air-In-Line Sensor Off Message Screen

48

Air-In-Line Sensor Set at 2.0ml Alert Screen

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.

5 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.

6 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.

7 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 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 Therapy

49

Continuous Run Screen

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.

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 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

50

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

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 resume the therapy.

Note: If you wish to hang a new container, move the cursor to REPEAT Rx (see following

section).

Run Options Screen

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.

Continuous Therapy

51

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:

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. 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. 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:

c. 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.

52

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.

Continuous Infusion Complete

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 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

Continuous Therapy

a. REPEAT Rx: To repeat the present therapy and add another container with the same

prescription, press the “YES/ENTER” key at this field. If more than one therapy is

53

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 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 Analgesia 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

B

program this therapy.

PCA Therapy

Prescription Menus

PCA Pre-Prescription Menu Screen

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
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

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

Route

Occlusion Setting

mmHg (psi)

Maximum

Basal Rate

(ml/hr)

Rate During

Bolus

(ml/hr)

Maximum

Bolus Dose

(ml)

Maximum

Load Dose

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 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).

(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

IMPORTANT

INFORMATION

prescription, pause the pump and select “REPEAT Rx.” When the
“RUN” key is pressed, the prescription will restart without the
loading dose.

5 Titrate: Allows the clinician to program titration limits into the prescription settings of the

pump. If there is 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

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. ∆Rate (Delta Rate): Some prescriptions include incremental levels or delta limitations (e.g.,

“Do not raise the rate more than 1 ml in 12 hours”). If the prescription has these
components, use the ∆Rate field and the ∆ 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. ∆Time (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 (∆Rate and ∆Time) set at their default settings of “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.

PCA Therapy

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 changed,

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

PCA Prescription Menu

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

or Medication 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:

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
administration route selected (see Figure 5.1).

Note: If a 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

IMPORTANT

INFORMATION

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.

The following screen offers you four choices:

Run Options Screen

PCA Therapy

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

3 Disconnect the administration set from the patient’s access site using aseptic protocols.

59

IMPORTANT

INFORMATION

Priming with the set connected to the patient could result in 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. 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:

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:

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.

60

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 becomes effective
when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.

PCA Options Menu

PCA Therapy

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
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

Note: If a 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 Screen will appear until it is completed:

61

Clinician Dose Run Screen

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

INFORMATION

previous running rate, and resume the PCA therapy. The lockout
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 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

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. If a 13th attempt is made an alert will display: “MAX
CHANGES FOR PERIOD REACHED”.

a. 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).

62

b. 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)

c. 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.

d. #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. The range for this field is 0 to 15.

e. 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.

f. New values will be in effect when the Options menu is accepted.

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 triggers the alarm when it detects in-line
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.

PCA Therapy

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 desired setting appears on the display, and then press
“YES/ENTER” to select and move the cursor to the next line.

IMPORTANT

INFORMATION

Whenever the Air-In-Line Sensor is set to OFF, Curlin Medical
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

63

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 air­eliminating 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 at 2.0ml Alert Screen

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 “NO” key and
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.

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 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.

8 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 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

64

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:

PCA Run Screen

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.

PCA Therapy

2 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.

3 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.

4 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.

5 In addition to the display screen, information on the status of the infusion is provided by the

three LED lights. The green LED light blinks 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.

65

PCA Information Screens

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

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

a. Press the “RUN” key to resume the therapy.

66

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.

PCA Therapy

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:

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. 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 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:

67

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:

c. 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.

PCA Infusion Complete

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

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2 Select one of the options from the “Pause” screen:

Pause Menu Screen

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
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 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.

PCA Therapy

b. 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.)

Note: The therapy is complete; therefore, RESUME is not an option at this time and is not

displayed.

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70

TPN Therapy with Automatic

Ramping

Chapter

This therapy is designed to allow a level 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 early ramp-down 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

B

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

program this therapy.

Prescription Menus

TPN Pre-Prescription Menu Screen

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 Therapy

TPN Delay Start Setting

The time format (12 hr AM/PM or 24 hr Military) selected in the BIOMED SETUP Menu

71

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

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:

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.

, no fluid is

IMPORTANT

INFORMATION

During the delay start period, if the KVO rate is set to 0
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.

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.

72

At the following screen, the prescription information is entered to complete the programming of
the pump:

TPN Prescription Screen

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

or Medication Reservoir (include the overfill volume).

TPN Therapy

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 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 0.1 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 level infusion. Enter the down ramp

73

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/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.

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

INFORMATION

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.

The next screen that appears when the programming is complete offers four choices:

Run Options Screen

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

74

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

3 Disconnect the administration set from the access site using aseptic protocols

IMPORTANT

INFORMATION

Priming with the set connected to the patient could result in overdose
and may cause injury or even death to the patient.

4 Release any clamps on the administration set.

TPN Therapy

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:

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:

75

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.

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 becomes effective
when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.

TPN Options Menu

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
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).

76

2 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 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:

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.

3 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.

TPN Therapy

4 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

INFORMATION

Whenever the Air-In-Line Sensor is set to OFF, Curlin Medical
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

77

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 air­eliminating 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 2.0ml Alert Screen

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.

5 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.

6 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.

7 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

78

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

TPN Therapy

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. 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.

79

TPN Information Screens

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

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

a. Press the “RUN” key to resume the therapy.

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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.

TPN Therapy

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:

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. 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 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:

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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:

c. 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

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.

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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

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
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.

TPN Therapy

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.

b. 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.)

Note: The therapy is complete; therefore, RESUME is not an option at this time and is not

displayed.

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Chapter

Intermittent Therapy

Intermittent Therapy is 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 access 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

B

information needed to program this therapy.

Prescription Menus

Intermittent Pre-Prescription Menu Screen

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 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.

Intermittent Therapy

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” key. The delay start
will change to “ON.” Now, when you press the “YES/ENTER” to accept, the following

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screen will appear:

Intermittent Delay Start Setting

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

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:

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.

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During the delay start period, if the KVO rate is set to 0, no fluid is

IMPORTANT

INFORMATION

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.

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 complete 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

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. The range for this field is

0.1 to 999.

Intermittent Therapy

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.

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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 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

IMPORTANT

INFORMATION

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. If the KVO rate is
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 information, 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.

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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

INFORMATION

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.

The following screen offers four choices:

Run Options Screen

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

Intermittent Therapy

3 Disconnect the administration set from the access site using aseptic protocols.

IMPORTANT

INFORMATION

Priming with the set connected to the patient could result in overdose
and may cause injury or even death to the patient.

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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:

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:

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, “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.

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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 becomes effective
when the “Options” screen is exited by pressing “YES/ENTER” at the “ACCEPT OPT?” field.

Intermittent Options Menu

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
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 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.

3 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.

Intermittent Therapy

IMPORTANT

INFORMATION

Whenever the Air-In-Line Sensor is set to OFF, Curlin Medical
recommends the use of an air-eliminating filter.

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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

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 air­eliminating 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 2.0ml Alert Screen

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.

4 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

dose will be terminated and the cycle will continue at the KVO rate until the time for the
new next dose.

5 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.

6 PWR CK? (Power Check): This feature allows the user to recheck the battery charge. The

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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 batteries. 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.

7 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.

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.

Intermittent Therapy

Starting the Infusion

RUN: When all parameters are correct and the pump has been primed properly and connected
to the access site, press “RUN” 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

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

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(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

mcg, 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 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.

Intermittent Information Screens

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:

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