Hospira GemStar 13086 User manual [gb]

Front Cover.fm Page i Thursday, February 3, 2005 4:58 PM

430-00897-A02, C (Rev. 04/2007)

430-00897-002.book Page i Friday, October 22, 2004 2:38 PM

Hospira GemStar® Infusion Pump

System Operating Manual

Hospira GemStar Pump

For use with the

List 13000-04-07/08
List 13100-04-07/08

PLEASE

Read this entire manual before

using the Hospira GemStar Pump

This manual is designed for use by healthcare professionals, caregivers, and patients.
The Hospira Technical Support Operations hotline is available 24 hours a day (in the
USA) to provide consultation and technical assistance regarding the Hospira GemStar
Pump.

In the USA: Hospira Technical Support Operations

1-800-241-4002

Outside the USA: Contact your local Hospira

sales office

To order additional copies of this manual

(List 13981) call Hospira Customer Care:

1-877-9HOSPIRA

(1-877-946-7747)

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) i

Title.fm Page ii Wednesday, March 9, 2005 3:30 PM

Change History

Part Number Description of Change Pages Changed

430-00897-001
(Rev. 9/02)

430-00897-A01
(Rev. 12/03)

430-00897-002
(Rev. 10/04)

430-00897-A02
(Rev. 02/05)

Original Issue N/A

Updated Cover
Updated Change History
Updated Battery Pack Information

Second Release Inclusive

Updated Cover
Updated Change History
Aligned Note and Tip icons

Corrected typographical error in
note

Reformatted dashed line with
scissors icon

Front and Back
ii
19

Front and Back
ii
21, 61, 69, 88, 97, 100–102,

106–107, 111, 122, 125, 144,
149, 178, 190

178

121–126

Added UL/CSA information
Updated CSA information

171
Back

Note: Change page manuals assembled by Hospira include a change page identifier



in the part number on the cover page and on the bottom of each changed page. This
change page manual is identified as 430-00897-A02.

ii Hospira GemStar Manual 430-00897-A02 (Rev. 02/05)

Contents.fm Page iii Friday, November 12, 2004 8:28 AM

1. Introduction 1

GemStar Pump Layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

GemStar Pump Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Therapies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

GemStar Pump Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Menu System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Operating Modes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Indications for Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Contraindications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2. Basic Operation 17

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Selecting a Power Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Connecting to the GemStar Docking Station. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Powering On the Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Accessing the Programming Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Programming the Pump. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Starting a New Container . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

GemStar Pump Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Loading the Cassette. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Releasing the Cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Priming a GemStar Pump Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Contents

3. Total Parenteral Nutrition (TPN) 47

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

TPN Programming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Changing a TPN Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

TPN Auto Taper Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

TPN Programming Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) iii

Contents.fm Page iv Thursday, November 11, 2004 7:43 AM

Contents

4. Pain Management 53

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Pain Management Programming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

Bolus Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

Loading Dose Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Changing a Pain Management Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Pain Management Programming Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

5. Intermittent 61

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Intermittent Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Intermittent Delivery Interruptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Changing an Intermittent Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Intermittent Programming Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

6. Continuous 69

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Continuous Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

Rate Titration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Piggybacking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Changing a Continuous Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

Continuous Programming Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

7. Weight Dosed 77

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

Weight Dosed Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Auto KVO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Rate Titration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

VTBI Titration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Changing a Weight Dosed Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Weight Dosed Programming Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

iv Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Contents.fm Page v Thursday, November 11, 2004 7:43 AM

8. mL/hr Only 83

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

mL/hr Only Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Auto KVO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

Rate Titration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

VTBI Titration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Piggybacking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Changing a mL/hr Only Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

mL/hr Only Programming Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

9. Variable Time 91

Therapy Features and Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Variable Time Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Variable Time Delivery Interruptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Changing a Variable Time Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

Variable Time Programming Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Contents

10. Options Menu 97

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Tips for Using the Options Menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Review Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

Histories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

Keypad Lock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104

Change Pump Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

Set Clock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

Print. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

Speed Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

Next Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Connecting to the Data Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

Transferring Data Using a Computer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

11. Clinician Instructions 121

Clinician Locking Sequence Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Program and Deliver a Clinician Activated Loading Dose. . . . . . . . . . . . . . . . . . 124

Shift Totals and History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) v

Contents.fm Page vi Wednesday, November 10, 2004 12:05 PM

Contents

12. Troubleshooting 127

Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135

Other Display Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

13. Maintenance 139

Pump Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Cleaning and Disinfecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

14. Operation Test 143

Equipment Required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

Test Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

Performing the Operation Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

Printing Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

Operation Test Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

15. Optional System Components 153

Connecting the Bolus Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

Using the GemStar Lockboxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

Using the Hospira Carrying Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

Using the GemStar Docking Station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

16. Pump Sets 167

17. GemStar Pump Specifications 171

Occlusion Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

18. Warranty/Technical Assistance 189

Index 191

IEC Symbols inside back cover

vi Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

430-00897-002.book Page 1 Friday, October 22, 2004 2:38 PM

The GemStar® Pump is a small and lightweight, single-channel infusion device
designed for use in the home, in the hospital, or anywhere electronic infusion is
required. The GemStar Pump can be powered by AC mains adaptor, rechargeable
battery pack, docking station, or two disposable AA alkaline or lithium batteries.
When powered by batteries, the GemStar Pump is ideal for ambulatory patients.

The following conventions are used throughout this manual:

Convention Use Example

Chapter 1

Introduction





[ALL CAPS] Pump keys Press [YES/ENTER] to continue.

ALL CAPS

WARNING: A WARNING message contains special safety

CAUTION: A CAUTION contains information that could prevent

Note: A NOTE contains information or examples to help explain instructions.

Tip: A TIP contains information that makes the pump easier to use.

Note: Examples are provided only to help explain a pump function and may not
be clinically relevant. Graphics are for illustrative purposes only and may not
reflect the actual product.

Display messages The pump displays:

ENTER TO CONFIRM.

information and must be observed at all times. Failure
to observe a warning message could be life
threatening.

irreversible product damage or hardware failure. Failure to
observe a caution could result in serious patient or user injury.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 1

Introduction.fm Page 2 Thursday, November 11, 2004 3:04 PM

1. Introduction

GemStar Pump Layout

Shown approximate size

2 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Introduction.fm Page 3 Thursday, November 11, 2004 3:04 PM

DISPLAY

1

2

• Displays the pump’s status.

• Silences an alarm.

3 • Stops infusion.

4 • Starts infusion.

1. Introduction

5

• Lights continuously when the pump is powered by AC mains.

• Flashes when the pump is powered by external batteries (e.g., battery pack).

Power
Indicator

• Not lit when using disposable AA batteries.

6 • Powers the pump on or off. To power-off the pump, press and hold until the

display clears.

7 • Returns to previous steps during programming.

• Exits Help, Change, and Options menus.

8

• Displays the following menu items from the

STOP or RUN mode*:

New Container Change Program (or Titrate VTBI)
New Program Piggybacking

• Resets a numeric value to zero.

9

• Displays the following Options Menu items from the

STOP or RUN mode*:

1 Review Program 5 Set Clock
2 Histories 6 Print
3 Keypad Lock 7 Speed Protocol
4 Pump Settings 8 Next Dose

10 • Scrolls through display messages.

• Toggles between AM and PM in time-based entries.

• UP arrow enters a decimal point in numeric entries.

• DOWN arrow toggles between units of measure when entering concentrations.

11 • Responds “YES” to display questions.

• Accepts entries and goes to the next step.

12 • Responds “NO” to display questions.

13 • Displays information during programming steps and alarm conditions.

• Displays Shift Totals, except during programming steps and alarm conditions.

14

• Clears an

AIR-IN-LINE alarm.

• Primes a Gemstar Pump Set.

15 [0] - [9] • Selects menu items and enters numeric values. If two numbers appear before a

menu item (e.g., 02), press both number keys to select that item.

* Not all menu items are available with all modes.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 3

Introduction.fm Page 4 Thursday, November 11, 2004 3:04 PM

1. Introduction

GemStar Pump Components

Bolus Button Press this button to start a

1

bolus delivery if available in
the current program.

Pole Clamp Track Use to connect to an

2

optional pole clamp.

Cassette Release

3

Button

Power Connector Use to connect the AC

4

Data Port

5

Connector

Bolus Connector Use to connect a bolus cord.

6

Tubing Channel Place the pump set tubing in

7

Cassette Pocket Load the cassette into this

8

I.V. Tubing Guide Use to hold the I.V. tubing.

9

Battery Pack

10

Connector

Battery Compartment Install two fresh, disposable

11

Push down on this button to
release the cassette.

mains adaptor.

Use to connect the GemStar
serial cable.

this channel.

pocket.

Use to connect the GemStar
Rechargeable Battery Pack.

AA batteries in this
compartment.

Top View

Bottom/Side View

4 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

L

Introduction.fm Page 5 Thursday, November 11, 2004 3:04 PM

Therapies

Seven types of therapy are available for infusion of medications and fluids. The
following table lists possible applications and available features of each therapy.

1. Introduction

Therapy Possible

Applications

TPN Total Parenteral

Nutrition fluid
delivery

Pain
Management

Infusion of
analgesics or
anesthetics for
patient­controlled pain
management (PCA)

Intermittent Interval-based

therapies such as
antibiotics

Continuous Infusion of mg, mcg,

or mL/hr with a
selectable KVO
(Keep Vein Open)
option

Weight Dosed Critical care,

pediatrics

mL/hr Only Simple rate

programming

Variable Time Chronotherapy

• = Available

O

E

V

K

A

R

O

T

T

I

U

T

R

A

G

T

-

N

S

Y

I

U

G

E

K

G

T

C

I

A

A

P

B

A

L

O

O

L

B

P

G

N

I

D

E

P

S

A

O

T

D

E

U

T

A

R

N

R

E

I

W

T

B

O

I

T

D

T

V

/

••

••

•• •

•• •

••• •

••

A

N

O

I

T

O

P

V

O

K

•



Note: Not all therapies are available in all pump configurations.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 5

Introduction.fm Page 6 Thursday, November 11, 2004 3:04 PM

1. Introduction

GemStar Pump Features

Feature Description Reference Page

• Adjustable
Settings

• Alerts and
Alarms

•Audible
Keypad
Response

• Keypad Lock

•New
Container

• Piggybacking

•Power-on
Self-test

• Operation
Te st

• Program
History

• Speed
Protocols

Adjusts the distal occlusion pressure limits,
air sensor sensitivity, real-time clock, and
audible alarm volume.

Signals audible and visual alarms when
attention is required.

Sounds a single beep when any key is
pressed. If an invalid key is pressed, the
pump sounds a flutter tone.

Restricts access to various options. Four
lock levels are available.

Repeats the current program without
reprogramming the pump.

Allows delivery from a secondary container
during a Continuous or mL/hr Only
program.

Performs a self-test each time the pump is
powered on.

Performs user-assisted tests to verify the
pump is operating properly.

Maintains a history event log, with a date
and time stamp of each event for each
program. Review the history on the display,
or download it to a printer or computer.

Stores up to nine frequently used programs
in the pump’s memory for quick access.

Chapter 10 Options
Menu

Chapter 12
Troubleshooting

Chapter 1 Introduction,

GemStar Pump Layout

Chapter 10 Options
Menu and Chapter 11
Clinician Instructions

Chapter 2 Basic
Operation

Chapter 6 Continuous
and Chapter 8 mL/hr
Only

Chapter 2 Basic
Operation

Chapter 14 Operation
Te st

Chapter 10 Options
Menu

Chapter 10 Options
Menu

6 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Introduction.fm Page 7 Thursday, November 11, 2004 3:04 PM

Menu System

The GemStar Pump uses a menu system that provides step-by-step instructions
through all of the pump’s functions. Refer to the following table for a list of functions
in each menu.

Use the keypad to select menu items, respond to display messages, and enter numeric
values. For example, press [
Menu.

2] to select PAIN MANAGEMENT from the Programming

1. Introduction





Note: Menu items may vary depending on the pump’s configuration.

Tip: A menu item does not have to be on the display to be selected. For example,
when the Programming Menu first displays, only the first four therapies are shown.
Instead of pressing the down arrow to see the other menu items, press [
directly to Variable Time Programming.

7] to go

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 7

Introduction.fm Page 8 Thursday, November 11, 2004 3:04 PM

1. Introduction

To displ a y
this menu:

Programming
Menu

Do this: Menu Items Available

1 Press to display

the Change menu.

2 Select

NEW PROGRAM.

1 TPN
2 PAIN MANAGEMENT
3 INTERMITTENT
4 CONTINUOUS
5 WEIGHT DOSED

mL/HR ONLY

6
7 VARIABLE TIME

Note: If a program is not currently stored in
pump memory at power-on, the Program­ming Menu automatically displays after the
self-test.

Change Menu Press . 1 NEW CONTAINER

2 NEW PROGRAM

3 CHANGE PROGRAM

4 PIGGYBACKING

Note: If the current therapy is Weight Dosed
or mL/hr Only and the pump is in
mode:

3 TITRATE VTBI

will replace

3 CHANGE PROGRAM

on the menu display.

RUN

Note: Piggybacking is available only in
mL/hr Only and Continuous therapies.

Options Menu Press . 1 REVIEW PROGRAM

8 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

2 HISTORIES

3 KEYPAD LOCK

4 PUMP SETTINGS

5 SET CLOCK

6 PRINT

7 SPEED PROTOCOL

8 NEXT DOSE

Introduction.fm Page 9 Thursday, November 11, 2004 3:04 PM

For more information on: Refer to the following pages:

Programming Menu Chapter 2 Basic Operation, page 17.

Change Menu For menu item [1], refer to Starting a New Container

Options Menu Chapter 10 Options Menu, page 97.

Operating Modes

The GemStar Pump has four operating modes:

Mode Description

1. Introduction

in Chapter 2 Basic Operation, on page 29. For
menu items [2], [3], and [4], refer to the appropriate
therapy chapter.

Help Mode The pump enters the

programming or an alarm condition. The
additional information about the current condition.

Programming Mode The pump enters the

powered on or when is pressed.

Run Mode After is pressed, the pump enters the

when not infusing.

Stop Mode When programming is complete, the pump enters the

mode until is pressed.

When the programmed therapy is complete, and during certain
alarm conditions, the pump automatically enters the

Press to enter the
CHECK CASSETTE alarm.

HELP mode when is pressed during

HELP mode displays

PROGRAMMING mode after the pump is

RUN mode, even

STOP mode.

STOP mode at any time, except during a

STOP

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 9

Introduction.fm Page 10 Thursday, November 11, 2004 3:04 PM

1. Introduction

Indications for Use

Physicians or certified, licensed healthcare professionals should always oversee
infusions. Healthcare professionals should always supervise pump users and instruct
users in pump operation and troubleshooting. Instruction should include how to
prevent intravenous (I.V.) related complications, including how to prevent accidental
infusion of air.

The pump is suitable for intravenous, arterial, subcutaneous, short-term epidural
infusion and parenteral administration of general I.V. fluids, medications, nutritional
fluids, and blood/blood products. The epidural route is recommended to provide
anesthesia or administer analgesia for periods up to 96 hours.

Note: Epidural administration of anesthetics is recommended in the continuous



mode only. Epidural administration of analgesics may be delivered by continuous,
bolus, or continuous with bolus.



For epidural use, the administration of drugs is restricted to those anesthetic and
analgesic drugs approved for continuous epidural administration: e.g., Chloroprocaine
Hydrochloride USP, Lidocaine Hydrochloride USP, and Morphine Sulfate Injection
USP (Preservative Free).

WARNING: Delayed respiratory depression following continuous

epidural administration of preservative-free morphine
sulfate has been reported.

For epidural administration, the following is recommended:

 Nylon or Teflon
 Pump sets without Y-sites
 Stickers for the tubing indicating ongoing administration

Note: Facilities practicing epidural anesthesia/analgesia must be staffed and
equipped to manage cardio-pulmonary resuscitation (CPR). Supplies should
include oxygen, naloxone, and other appropriate resuscitative drugs and
equipment. Monitor patients continuously (e.g., oximetry) during epidural
administration. Frequently observe patient for side effects (for up to 24 hours)
following completion of drug administration by the epidural route.

®

catheter

10 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Introduction.fm Page 11 Thursday, November 11, 2004 3:04 PM

Contraindications for Use

Persons who do not have the mental and physical capability or the emotional stability
to properly use the GemStar Pump should not be operate this pump.

DO NOT use the following with the GemStar Pump System:

 Drugs not compatible with silicone rubber or PVC plastic

 Drugs not stable under infusion conditions

Warnings and Cautions

Pay attention to the following warnings and cautions when operating the GemStar
Pump. These warnings and cautions are repeated in the manual when relevant to the
procedure being discussed. Pay attention to all alert messages.

General Warnings and Cautions

 Federal (USA) law restricts this device to sale by or on the order of a physician or

other licensed practitioner.

 Manual references to specific values are approximate only, unless indicated

otherwise. Air-in-line sensitivity values are approximate only.

 When a Proximal Occlusion alarm activates, DO NOT power-off the pump.

 Closely supervise patients who are likely to be adversely affected by unintended

operations and failures, including interrupted medication or fluid infusion. Ensure
provisions for immediate corrective action are available.

1. Introduction

Regarding Drugs Used, Pump Sets, and Containers

 USE ONLY GemStar Pump Sets with the GemStar Pump. Use of unauthorized

sets may result in injury to the patient or damage to the pump.

 NEVER use drugs that are incompatible with silicone rubber or PVC plastic.

 To reduce the loss of potency for drugs known to be absorbed by PVC plastic and

silicone, begin infusion as soon as practical after priming the pump set. Use of
high flow rates during infusion will minimize drug absorption.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 11

Introduction.fm Page 12 Thursday, November 11, 2004 3:04 PM

1. Introduction

 DO NOT use medications that are unstable under infusion conditions.

 ALWAYS use connections with Luer Lock™ fittings.

 To prevent contamination, use aseptic technique with all fluid-path connections.

Remove the protective coverings as assembly progresses.

 ALWAYS place the flow stop in the closed position when the set is not in the

pump.

 Make sure the cassette is properly installed. When properly installed, all four

cassette latches are visibly holding the cassette securely in the cassette pocket.

 Ensure the tubing is behind the tubing guide (at the distal end).

 Arrange tubing, cords, and cables to minimize the risk of patient strangulation or

entanglement.

 NEVER use vented fluid containers (e.g., glass or rigid plastic) unless suspended

from a pole. When using a vented drip set, ALWAYS use an air-eliminating filter
OR set the air sensitivity to either ON or 2 mL.

 Stop infusion if signs or symptoms of infiltration occur.

 GemStar Pump Sets contain an anti-siphon valve to reduce the potential for

gravity flow at a typical 36-inch head height.

 Failure to use the anti-siphon valve may result in unrestricted flow.

 ALWAYS close the slide clamps before removing the cassette from the pump.

 When using the pump for secondary delivery (piggybacking), ensure the fluids

being infused are chemically and physically compatible.

 When infusing short-half-life drugs (i.e. those dosed with units of mcg/kg/min) at

very low rates (0.8 mL/hr or less) the rate may be too slow for that drug. Consider
using a lower drug concentration with these drugs so a pump rate above 0.8 mL/hr
can be used.

 When using pre-filled vials, the system may underdeliver at low flow rates.

12 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Introduction.fm Page 13 Thursday, November 11, 2004 3:04 PM

Regarding Air-In-Line and Infusion

 To reduce the risk of infusing air, use an air-eliminating filter when the air

sensitivity is set to OFF.

 ALWAYS prime the pump set to remove all air from the cassette, tubing, and

injection site prior to connecting to the patient.

 ALWAYS disconnect the pump set from the patient prior to priming or purging.

Regarding Pump Operation

 If the pump does not perform as stated in this manual, remove the pump from

service IMMEDIATELY.

 If the pump does not display the self-test or if beeps do not sound at power-on,

check all power connections and install two fresh, disposable AA batteries. If the
problem continues, contact Hospira Technical Support Operations before using
the pump.

 Ensure a cassette is installed in the pump before connecting to a printer or

computer. If the pump is connected to a patient: BEFORE connecting the pump
to a computer or printer, press [
cassette. Leave the pump set connected to the patient. Install another cassette in
the pump before connecting to a printer or computer.

 Disconnect the pump from the patient BEFORE performing the Operation Test.

 ALWAYS connect to a grounded AC mains power source when using AC mains

power. If the quality of the grounding source is in doubt, operate the pump only
with batteries.

 USE ONLY the AC mains adaptors specifically labeled for use with the GemStar

Pump.

 USE ONLY the AC mains adaptor specifically labeled for use with the GemStar

Pump to charge the battery pack.

 The GemStar AC Mains Adaptor is for use with the GemStar Pump or GemStar

Rechargeable Battery Pack only. DO NOT
with other products.

 During charging, the battery pack is warm. If the battery pack becomes hot to the

touch, IMMEDIATELY unplug the AC mains adaptor and contact Hospira
Technical Support Operations.

1. Introduction

STOP], close the slide clamp, and eject the

use the GemStar AC mains adaptor

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 13

Introduction.fm Page 14 Thursday, November 11, 2004 3:04 PM

1. Introduction

 When removing the cord from the bottom of the pump, firmly grasp the connector

and pull straight out. DO NOT twist or bend the cord or connector.

 To ensure proper pump operation, ALWAYS replace BOTH disposable batteries

with fresh, disposable AA batteries when a change is required.

 ALWAYS fully close the battery door when using disposable batteries.

 DO NOT use rechargeable batteries in the battery compartment.

 Ensure two fresh, disposable AA batteries are installed for backup power when

using other power sources (e.g, docking station, battery pack). The pump will
continue to operate on backup power if the external power source fails.

 ALWAYS avoid sources of high-intensity electromagnetic radiation (e.g., radio

transmitters, MRI scanners, microwave ovens, X-ray machines, and CAT
scanners).

 Use of radio-frequency emitting devices, such as cellular telephones, 2-way

radios, and Electrical Surgical Devices (ESU), in close proximity to this device
may affect its operation.

 Possible explosion hazard exists if the pump is used in the presence of flammable

anesthetics. NEVER use the pump in the presence of flammable or explosive
vapors.

 Non-hazardous, low-level electrical potentials are commonly observed when

fluids are administered using infusion devices. These potentials are well within
accepted safety standards, but may create artifacts on voltage-sensing equipment,
such as ECG, EMG, and EEG machines. These artifacts vary at a rate that is
associated with the infusion rate. If the monitoring machine is not operating
correctly or has loose or defective connections to its sensing electrodes, these
artifacts may be accentuated so as to simulate actual physiological signals. To
determine if the abnormality in the monitoring equipment is caused by the
infusion device instead of some other source in the environment, set the infusion
device so that it is temporarily not delivering fluid (if clinically acceptable).
Disappearance of the abnormality indicates that it was probably caused by
electronic noise generated by the infusion device. Proper setup and maintenance
of the monitoring equipment should eliminate the artifact. Refer to the appropriate
monitoring system documentation for setup and maintenance instructions.

14 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Introduction.fm Page 15 Thursday, November 11, 2004 3:04 PM

 The GemStar pump, when connected to the GemStar AC adaptor, has been tested

and found to comply with EMC/EMI limits in accordance with IEC/EN
60601-1-2 (2001). When connected to other power sources and/or optional system
components, the GemStar system complies with EMC/EMI limits in accordance
with IEC/EN 60601-1-2 (1993). These limits are designed to provide reasonable
protection against harmful interference in a typical medical installation. The
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 with 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 or more of the following measures:

 Reorient or relocate the receiving device
 Increase the separation between the equipment
 Connect the equipment to an outlet on a circuit different from that to which

the other device is connected

 Consult the manufacturer or field service technician for help
 The use of portable and mobile RF equipment may have an impact on this and

other pieces of medical equipment

1. Introduction

Regarding Handling and Maintenance

 Use proper care during unpacking, installation, and operation of the pump. If the

pump is inadvertently mishandled, check connections and programmed data to
ensure there is no damage. Refer to Chapter 14 Operation Test for further
information.

 ALWAYS avoid dropping or hitting the pump. If the pump is dropped or hit,

ALWAYS check connections and programmed data.

 NEVER use sharp objects (e.g., fingernails, pens, pencils, or other probes) to

program or clean the pump.

 Use care not to damage the silicone seals around the sensor bodies in the cassette

pocket.

 To avoid mechanical or electronic damage, NEVER submerge pump in water or

other fluids and avoid fluid spills. If the pump becomes wet, dry it immediately
with a dry, lint-free cloth. Check connections and programmed data.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 15

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1. Introduction

 Some cleaning and sanitizing compounds may slowly degrade components made

from some plastic materials. DO NOT use compounds containing combinations of
isopropyl alcohol and dimethyl benzyl ammonium chloride (i.e., alcohol wipes).

 DO NOT sterilize by heat, steam, ethylene oxide (ETO), or radiation. Apply

disinfectants to the outside surface of the pump only. DO NOT use abrasive
cleaners or materials on the pump. Using abrasive cleaners or cleaning solutions
not recommended by Hospira may result in product damage.

 Please comply with local disposal and recycling regulations as appropriate for

disposable batteries, rechargeable battery packs, medical electronic components,
and pump sets.

16 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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The minimum elements required for using the GemStar Pump are:

 GemStar Pump

 Appropriate power source

 Appropriate GemStar Pump Set

 Appropriate fluid container

 Patient-access device

Overview

Chapter 2

Basic Operation

To start a therapy:

1 Determine the program settings. Refer to the appropriate therapy chapter for a

worksheet that may be copied and used to record program settings.

2 Select a power source. Refer to Selecting a Power Source on page 18.

3 Prime the pump set. Refer to GemStar Pump Set on page 29.

4 Load the cassette into the pump. Refer to Loading the Cassette on page 32.

5 Power-on the pump and go to the Programming Menu. Refer to Powering On

the Pump on page 24.

6 Select the appropriate optional system components, such as a bolus cord.

7 Select the therapy type and enter a program. Refer to the appropriate therapy

chapter for detailed instructions.

8 Press [

START] to begin delivery.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 17

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2. Basic Operation

Selecting a Power Source

The GemStar Pump may be powered by one or more of the following:

Power Source Description Ambulatory Hospital Home

GemStar
AC Mains Adaptor
(USA)

GemStar
AC Mains Adaptor
(Universal)

GemStar Docking
Station

GemStar Battery
Pack

Disposable Batteries Two disposable AA alkaline or

Wall-mount adaptor plugs into a
1 10 VAC mains supply.

Tabletop adaptor plugs into a
100–240 VAC mains supply.

Plugs into a 100–240 VAC Volt
mains supply while mounted on an
I.V. pole. The docking station’s
internal batteries power the
GemStar Pump during periods of
transport.

The battery pack’s internal
batteries power the GemStar
Pump during periods of transport
or when use of AC power is not
desirable.

lithium batteries (available from
local sources)

••

••

•••

•••

•••

CAUTION: To ensure proper pump operation, ALWAYS replace BOTH

batteries with fresh, disposable AA batteries when a change is
required.

DO NOT use rechargeable batteries in the battery compartment.
Ensure two fresh, disposable AA batteries are installed for backup

power when using other power sources (e.g, docking station,
battery pack). The pump will continue to operate on backup power
if the external power source fails.

18 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Installing Disposable Batteries

1 Flip open the tab of the battery door on

the bottom of the pump.

2 With the pump keypad facing up, hold

onto the tab and turn the battery door to
the left (counterclockwise) until it is
released from the battery compartment.

3 Pull the door free and remove any

existing batteries.

4 Install two fresh, disposable AA

batteries into the battery compartment.
Ensure the batteries are inserted as
shown.

5 Return the battery door to the battery

compartment.

2. Basic Operation

6 Turn the battery door to the right

(clockwise). Ensure the battery door is
secured under the slot.

7 Flip closed the tab of the battery door to

lock in place.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 19

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2. Basic Operation

Connecting the GemStar AC Mains Adaptor

1 Connect the cord of the AC mains adaptor to the connector labeled “3 VDC” on

the bottom of the pump.

2 Plug the AC mains adaptor into a standard wall outlet.

CAUTION: ALWAYS connect to a grounded AC mains power source when

using the AC mains adaptor. USE ONLY AC mains adaptors
specifically labeled for use with the GemStar Pump.

When removing the cord from the bottom of the pump, firmly
grasp the connector and pull straight out. DO NOT twist or bend
the cord or connector.



Note: The green LED on the pump remains lit when connected to AC mains
power.

20 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Using the GemStar Rechargeable Battery Pack

Use the GemStar AC Mains Adaptor (List 13026-01 [USA] or 13072-01 [Universal])
to recharge the GemStar Battery Pack.

CAUTION: ALWAYS connect to a grounded AC mains outlet when using AC

mains adaptor.

Use only AC mains adaptors specifically labeled for use with the
GemStar Pump to charge the battery pack.

During charging, the battery pack is warm. If the battery pack
becomes hot to the touch, IMMEDIATELY unplug AC mains
power and contact Hospira Technical Support Operations.

2. Basic Operation





Note: A charged battery pack will last approximately 24 hours when the pump is
infusing at rates less than 125 mL/hr.

To connect the battery pack:

1 Line up the connectors on the top of the battery

pack with the holes on the bottom of the pump.

2 Snap the battery pack into place.

1

To release the battery pack:

1 Press the release button on the battery pack.

2 Pull the battery pack straight out from the pump.

Note: When the pump is connected to the battery
pack, the pump’s green LED flashes and the battery
pack light is off.

When the pump is connected to the battery pack at
power-on, the pump displays

Hospira GemStar Manual 430-00897-A02 (Rev. 02/05) 21

USING EXT BATT.

430-00897-002.book Page 22 Friday, October 22, 2004 2:38 PM

2. Basic Operation

To recharge the battery pack:

1 Plug the pin connector of the AC mains adaptor into the port on the bottom of the

battery pack.

2 Plug the AC mains adaptor into a standard wall outlet.

3 Leave the battery pack connected to the AC mains adaptor for at least 8 hours to

recharge the battery pack

CAUTION: When removing the cord from the bottom of the pump, firmly

grasp the connector and pull straight out. DO NOT twist or bend
the cord or connector.



Note: The battery pack light is yellow while the battery pack is charging. When the
battery pack is charged, the battery pack light is green.

22 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Connecting to the GemStar Docking Station

Connecting the Pump

1 Mount the docking station to the I.V. pole and tighten

the knob.

2 Line up the connectors on the bottom of the pump with

the connectors on the docking station.

3 Slide the pump into the docking station until it snaps

into place.

4 Connect the docking station to AC mains power.

2. Basic Operation



Note: The docking station light is yellow while the docking station is charging. When
the docking station is charged, the light is green.

Disconnecting the Pump

To remove the pump:

1 Press the release button on the top of the docking

station.

2 Slide the pump out.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 23

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2. Basic Operation

Powering On the Pump

CAUTION: If the pump does not display the self-test or if beeps do not sound at

power-on, check all power connections and install two fresh,
disposable AA batteries. If the problem continues, contact Hospira
Technical Support Operations before using the pump.





Note: If a cassette is not properly loaded, the pump will alarm after the power-on test is
complete.

1 Press [ON/OFF] to power-on the pump. The pump

completes a self-test and displays the time and date. No
response is required.

GEMSTAR 7

UNIT SELF-TEST

TIME IS 10:00 AM

FRI, JUN 11, 04

Note: The self-test takes approximately 30 seconds to complete. If the pump is
locked, lock symbols appear at the beginning and end of the second line:

UNIT SELF-TEST .

2 The pump checks for available power sources. Respond to the display message as

shown in the following table:.

Display Message Power Source(s) User Response

No message displays AC power and

disposable batteries.

LOW BATTERIES

ENTER TO CONFIRM

NO INTERNAL BATT

NO POWER LOSS

ALARM AVAILABLE

ENTER TO CONFIRM

AC power and weak
(low voltage)
disposable batteries;
or weak disposable
batteries only.

No disposable
batteries or dead
disposable batteries;
and external power.

No response required, the pump goes
to the next step.

Press to confirm.

Power-off the pump and install two
fresh, disposable AA batteries as a
backup power source.

Press to confirm.

Power-off the pump and install two
fresh, disposable AA batteries as a
backup power source.

YES

ENTER

YES

ENTER

24 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Display Message Power Source(s) User Response

2. Basic Operation



USING BATTERIES

ENTER TO CONFIRM

USING EXT BATT

ENTER TO CONFIRM

Disposable batteries
only.

External batteries
(docking station
battery or battery
pack) and disposable
batteries.

Press to confirm.
If an external power source is in use,

ensure the connections are secure.
Press to confirm.

If an AC mains adaptor is in use,
ensure the connections are secure.

YES

ENTER

YES

ENTER

Note: To power-off the pump, press and hold until the display clears. The pump
cannot be powered off during a CHECK CASSETTE alarm (except during

PROGRAMMING mode). Refer to Chapter 12 Troubleshooting for information on

clearing a CHECK CASSETTE alarm.

For more information on: Refer to the following pages:



Setting the clock Set Clock in Chapter 10 Options Menu, on page 108.
Locking the keypad Keypad Lock in Chapter 10 Options Menu, on

page 104.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 25

Basic_Operation.fm Page 26 Friday, November 12, 2004 8:32 AM

2. Basic Operation

Accessing the Programming Menu

After power-on, the pump checks its memory for a stored program. Respond to the
display message as shown in the following table:

Display Message Condition User Response

The pump displays the
Programming Menu.

1 RESUME PROGRAM
2 CLR PROG&SHIFT

3 CLR PROG,SHIFT

AND HISTORY

Pump memory
is clear.

A program is
currently stored
in pump
memory.

> To enter a new program: Select a therapy

from the Programming Menu and enter a
new program. Refer to the appropriate
therapy chapter for instructions.

> To continue the current program, press [1].
> To reset the current program:

1 Press [1].
2 Press [CHANGE] to display the Change

Menu and select

NEW CONTAINER.

f

> To enter a new program and clear shift

totals: Press [2]. The pump clears the
program and shift totals from memory and
enters PROGRAMMING mode.

> To enter a new program, clear shift totals,

and clear history: Press [3]. The pump
clears the program, shift totals, and history
from memory and enters PROGRAMMING
mode.

Tip: To enter a new program when the pump is already powered on:

1 Press [STOP] to place the pump in STOP mode.

2 Press [CHANGE] to display the Change Menu.

3 Select NEW PROGRAM. The pump clears the current program and

displays the Programming Menu.

26 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Programming the Pump

Programming Overview

The pump’s menu system provides step-by-step guidance through all of the
programming steps. Refer to the appropriate therapy chapter for detailed
programming instructions.

Programming worksheets are available at the end of each therapy chapter. Each
worksheet lists the minimum and maximum value (program range) allowed for that
therapy. If a number outside of the program range is entered, the pump displays the
minimum or maximum value allowed.

1 Select the desired therapy from the Programming Menu.

2 Respond to display messages and enter requested values.

Note: Program entries can be changed any time before the Program Review is



complete. Press [BACK-UP] to return to previous program displays and make
changes as desired.

2. Basic Operation

3 Review the program, if required. Press to begin review. Press [

when done.

SAVING PROGRAM displays. The pump stores the program in memory and then

4

STOP mode.

enters

Tip: If you enter an incorrect number during programming, press [CHANGE]



BEFORE pressing [
correct number.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 27

YES/ENTER] to reset the number to zero. Then enter the

YES/ENTER]

430-00897-002.book Page 28 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Programming Tips

The following table explains how to use the keypad during programming:

Key Function

[0] - [9] Press the number keys to select menu items and to enter numeric values.

Note: Some menu items require pressing two number keys to select that items.

For example, when selecting a unit of measure for a weight dosed program, the
menu may display as:

01 mcg/kg/mg
02 mcg/kg/hr
03 mcg/kg/min
04 mg/kg/min

To select mg/kg/min, press [

0][4].

Press to accept entries or to continue when done viewing a display.

YES

ENTER

Press during programming and alarm conditions to display information

about the current condition.

Press or to scroll through display messages.

Press to insert a decimal point in a numeric value.

When entering a numeric value during programming, press before

pressing to reset the value to zero.

YES

ENTER

Press to return to a previous display, to exit the Options Menu, or to exit

the

HELP mode.

28 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Starting a New Container

Note: The NEW CONTAINER function is not available when the pump is in FULL Lock.



Refer to Chapter 10 Options Menu, page 97 for more information on locking the
keypad.

To repeat the current program with a new container:

2. Basic Operation

1 From the
2 Select

CONTAINER

3 Review the program. Press to begin review.
4 Press [

STOP mode, press [CHANGE] to display the Change Menu.

NEW CONTAINER from the Change Menu. The pump displays NEW

START] to begin delivery.

GemStar Pump Set

The GemStar Pump Set is a sterile, single-use, disposable pump set. It is designed for
one-time use only and should be properly discarded after use.

Fluid path and areas beneath undisturbed protective set
covers are sterile and nonpyrogenic in the intact unit
package.

Contact a Hospira representative for more information on selecting the appropriate
pump set configuration. Additional disposable components, such as air-eliminating
filters and extension sets, may be added to the line as required. To use a GemStar
Pump Set, follow the instructions included with the set.

Note: GemStar Pump Sets contain an anti-siphon valve to reduce the potential for



gravity flow at a typical 36-inch head height.

False occlusion alarms and fluid delivery inconsistencies may occur when pumping
viscous fluids in microbore tubing at rates greater than 500 mL/hr.

for several seconds and clears the amount infused from memory.

STERILE

2

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 29

430-00897-002.book Page 30 Friday, October 22, 2004 2:38 PM

2. Basic Operation

A typical GemStar Pump Set is shown below:

1 Piercing Pin 6 Tubing

2 Proximal End 7 Slide Clamp

3 Cassette 8 Secure Lock

4 Flow Stop (open / close ) 9 Anti-Siphon valve

5 Distal End

30 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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WARNING: ALWAYS prime the pump set to remove air from the

cassette, tubing, and injection sites prior to connecting to
the patient. ALWAYS disconnect the pump set from the
patient prior to priming or purging. Arrange tubing, cords,
and cables to minimize the risk of patient strangulation or
entanglement.

Failure to use the anti-siphon valve may result in
unrestricted flow.

CAUTION: USE ONLY GemStar Pump Sets with the GemStar Pump. Use of

unauthorized sets may result in injury to the patient or damage to
the pump.

To prevent contamination, use aseptic technique with all fluid-path
connections. Remove protective coverings as assembly progresses.

2. Basic Operation

Opening the Pump Set

1 Open the GemStar Pump Set package and

remove the contents.

2 Remove the protective covers from the fluid

container administration port and the pump set.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 31

Basic_Operation.fm Page 32 Friday, November 12, 2004 8:57 AM

2. Basic Operation

Loading the Cassette

1 Identify the four black cassette latches inside the casse tte pocket.

2 Line up the cassette as shown

(with the flow stop button facing
the pump).

3 Insert the cassette into the cassette

pocket by pushing firmly along the
entire cassette until it is firmly
seated.

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2. Basic Operation

4 Verify that all four cassette latches

are securely holding the cassette.

CAUTION: Ensure the cassette
is properly installed. When
properly installed, all four
cassette latches are visibly
holding the cassette securely in
the cassette pocket.

5 Place the tubing in the

tubing channel.

Releasing the Cassette

1 Close the CAIR® (roller) clamp or

slide clamp on the distal line.

2 Push down on the cassette release

(large black button) on the top of
the pump.

3 Remove the cassette.

Note: When the cassette is

Note: Ensure the tubing is behind





Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 33

the tubing guide (at the distal
end).

Note: The pump cannot be
powered off during a CHECK
CASSETTE alarm (except during

PROGRAMMING mode). Refer to

Chapter 12 Troubleshooting for
information on clearing a CHECK
CASSETTE alarm.



released from the pump, the
cassette flow stop automatically
closes, preventing free flow.

430-00897-002.book Page 34 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Priming a GemStar Pump Set

Priming Pump Sets WITHOUT a Drip Chamber

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.

1 Push down on the flow stop to

close the cassette.

2 Hold the container with the

administration port toward the
ceiling and insert the piercing pin.

3 Push down on the flow stop to

open (priming position) the
cassette.

4 Invert the cassette approximately

45°.

5 While holding the rotated cassette,

squeeze or roll the container to
remove air from the container and
cassette.

6 Return the cassette to the upright

position. Continue priming until
fluid fills the tubing.

34 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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2. Basic Operation

7 Push down on the flow stop to

close the cassette.

8 Load the cassette.

CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Note: Ensure the tubing is behind



the tubing guide (at the distal
end).

CAUTION: When priming is
complete, ensure no fluid flows
at the distal end of the pump set.
If flow is observed, DO NOT use
the pump set.

9 Connect the pump set to the

patient-access device.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 35

430-00897-002.book Page 36 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Priming Pump Sets WITHOUT a Drip Chamber Using the PURGE Key

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.



Note: The PURGE function is available only if there is a program in the pump.

1 Push down on the flow stop to

close the cassette.

2 Hold the container with the

administration port toward the
ceiling and insert the piercing pin.



3 Load the cassette.

CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Note: Ensure the tubing is behind
the tubing guide (at the distal
end).

4 Program desired therapy.

36 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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5 Press [PURGE].

2. Basic Operation



PURGE

6 The pump displays

SET?

Press [YES/ENTER].

HELP

PRIME THE

7 While holding the container with

the administration port toward the
ceiling, press and hold [

PURGE].

Note: Purge rate is 250 mL/hr.
The pump purges for up to 2
minutes each time you press
and hold [

Continue using the [

PURGE].

PURGE]

key until fluid fills the tubing.
Ensure all air is removed
from the container, cassette,
and tubing.

CAUTION: When priming is
complete, ensure no fluid
flows at the distal end of the
pump set. If flow is observed,
DO NOT use the pump set.

8 Connect the pump set to the

patient-access device.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 37

430-00897-002.book Page 38 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Priming Pump Sets WITH a Drip Chamber

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.

When using a vented chamber, ALWAYS use an
air-eliminating filter OR set the air sensitivity to
either ON or 2 mL.

1 Push down on the flow stop to

close the cassette.

2 Insert the piercing pin into the

container. Suspend the container
on an I.V. Pole.

3 Squeeze the drip chamber until

filled halfway.

4 Push down on the flow stop to

open (priming position) the
cassette.

®

5 Ensure the CAIR

(roller) clamp

is open.

6 Invert the cassette approximately

45°.

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2. Basic Operation

7 While holding the rotated cassette,

remove air from the container and
cassette.

8 Return the cassette to the upright

position. Continue priming until
fluid fills the tubing.

9 Push down on the flow stop to

close the cassette.



CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Note: Ensure the tubing is behind
the tubing guide (at the distal
end).

10 Load the cassette.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 39

CAUTION: When priming is
complete, ensure no fluid flows
at the distal end of the pump set.
If flow is observed, DO NOT use
the pump set.

11 Connect the pump set to the

patient-access device.

430-00897-002.book Page 40 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Priming Pump Sets WITH a Drip Chamber Using the PURGE Key

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.

When using a vented set, ALWAYS use an air-eliminating
filter OR set the air sensitivity to either ON or 2 mL.



Note: The Purge function is available only if there is a program in the pump.

1 Push down on the flow stop to

close the cassette.

2 Insert the piercing pin into the

container. Suspend the container
on an I.V. Pole.

3 Squeeze the drip chamber until

filled halfway.

4 Push down on the flow stop to

open (priming position) the
cassette.

5 Ensure the CAIR

is open.

®

(roller) clamp

40 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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2. Basic Operation



6 Load the cassette.

CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Note: Ensure the tubing is behind
the tubing guide (at the distal
end).

7 Program the desired therapy.

8 Press [

9 The pump displays

10 Press and hold [



11 Connect the pump set to the

PURGE].

PURGE

PRIME THE

SET?

Press [YES/ENTER].

PURGE].

Note: Purge rate is 250 mL/hr.
The pump purges for up to 2
minutes each time you press and

PURGE

hold [

Continue using the [
until fluid fills the tubing. Ensure
all air is removed from the
container, cassette, and tubing.

CAUTION: When priming is
complete, ensure no fluid flows
at the distal end of the pump set.
If flow is observed, DO NOT use
the pump set.

patient-access device.

].

PURGE] key

HELP

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 41

430-00897-002.book Page 42 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Priming Pump Sets Using Pre-filled Vials

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.

CAUTION: When using pre-filled vials, the system may underdeliver at low

flow rates.

1 If using a pump set with the

Y-extension, use the slide clamp to
close off the KVO (Keep Vein
Open) side of the tubing.

2 Open the upper and lower slide

clamps.

3 Push down on the flow stop to

close the cassette.

4 Connect the pump set to a Hospira

pre-filled vial and injector.

5 Push down on the flow stop to

open (priming position) the
cassette.

42 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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2. Basic Operation

6 Hold the vial and set upright

(vertically) on a flat surface with
the pump set extending from the
top.

7 Slowly push down on the injector

until fluid flows at the distal end of
the tubing, which indicates that all
air is cleared from the vial,
injector, cassette, and tubing.

8 Push down on the flow stop to

close the cassette.

9 If the set includes a KVO

Y-extension, close the slide clamp
below the pre-filled vial and open
the slide clamp on the KVO side.
Prime the KVO Y-extension.

10 Load the cassette.

CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 43

430-00897-002.book Page 44 Friday, October 22, 2004 2:38 PM

2. Basic Operation

Note: Ensure the tubing is behind



the tubing guide (at the distal
end).

CAUTION: When priming is
complete, ensure no fluid flows
at the distal end of the pump set.
If flow is observed, DO NOT use
the pump set.

11 Connect the pump set to the

patient-access device.

44 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Priming Pump Sets with Extensions

WARNING: Failure to use the anti-siphon valve may result in

unrestricted flow.

2. Basic Operation

1 Push down on the flow stop to

close the cassette.

2 Hold the container with the

administrative port toward the
ceiling and insert the piercing pin.

3 Push down on the flow stop to

open (priming position) the
cassette.

4 Invert the cassette approximately

45°.

5 While holding the rotated cassette,

squeeze or roll the container to
remove air from the container and
cassette.

6 Return the cassette to the upright

position. Continue priming until
fluid fills the tubing.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 45

430-00897-002.book Page 46 Friday, October 22, 2004 2:38 PM

2. Basic Operation

7 Push down on the flow stop to

close the cassette.

8 Connect the extension set to the

pump set.

9 Load the cassette.

CAUTION: Ensure all four
cassette latches are clearly
visible after the cassette is
installed. Refer to Loading the
Cassette on page 32.

Note: Ensure the tubing is behind





the tubing guide (at the distal
end).

10 Program the desired therapy.

11 Press [

12 The pump displays

13 Press and hold [

PURGE].

PURGE

SET?

Press [YES/ENTER].

Note: Purge rate is 250 mL/hr.
The pump purges for up to 2
minutes each time you press and

PURGE].

hold [

Continue using the [
until fluid fills the tubing. Ensure
all air is removed from the
container, cassette, and tubing.

HELP

PRIME THE

PURGE].

PURGE] key

CAUTION: When priming is
complete, ensure no fluid flows
at the distal end of the pump set.
If flow is observed,
DO NOT use the pump set.

14 Connect the pump set to the

patient-access device.

46 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

430-00897-002.book Page 47 Friday, October 22, 2004 2:38 PM

Total Parenteral Nutrition (TPN)

Therapy Features and Specifications

This therapy allows programming of Total Parenteral Nutrition (TPN) protocols.

 Taper Up and Taper Down may be programmed to gradually increase and

decrease the infusion rate at the beginning and end of a therapy. If Taper Down is
selected during programming, the pump allows auto tapering if the continuous
delivery is stopped before the programmed volume has been infused.

 Set an optional KVO (Keep Vein Open) during programming.

Tip: The Programming Worksheet at the end of this chapter lists the minimum and



maximum values allowed for this protocol. Use copies of the programming
worksheet to record program values before programming the pump.

Chapter 3

TPN Programming Tips

The following table explains how to use the keypad during TPN programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or continues
when done viewing a display.

Displays information during
programming and alarm
conditions.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 47

Scrolls through program
review and help messages.
The up arrow inserts a
decimal point in a numeric
value.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous display,
exits the Options Menu, and
exits the

HELP mode.

430-00897-002.book Page 48 Friday, October 22, 2004 2:38 PM

3. Total Parenteral Nutrition (TPN)

TPN Programming

1 Select TPN from the Programming Menu.

2 Select the TPN delivery mode.

3 Enter the total VTBI (Volume To Be Infused).









Note: Maximum VTBI is 9600 mL minus any taper amount.

4 Enter the Taper Up and Taper Down times (if applicable).

Note: Time is entered in hours:minutes (00:00). For one hour thirty minutes,
press [1] [3] [0]; not [9] [0].

5 Enter the total time to infuse.

6 Enter the KVO rate. If no KVO is desired, press [

displayed is zero.

Note: KVO runs after Taper Down until the total container is
infused.

7 Enter the container size (VTBI + KVO).

Note: If KVO is programmed, increase the container size to accommodate the
desired KVO volume.

8 Select the air sensitivity, if required.

9 Review the program. Press to begin review.

10 If using the

WARNING: ALWAYS disconnect the pump set from the patient before

PURGE key to prime the pump set, press [PURGE] now.

priming or purging.

YES/ENTER] while the value

48 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

TPN.fm Page 49 Wednesday, November 10, 2004 8:42 AM

Changing a TPN Program

3. Total Parenteral Nutrition (TPN)



Can be changed
before is pressed

•VTBI

• Taper times

• Total TPN time

START

Can be changed at any
time

• KVO rate

• Increase container size
only

• Air sensitivity

Cannot be
changed

• Delivery mode

Note: Y ou cannot change a pr ogram when the pump is in FULL or CONTAINER
Lock.

To change a program:

1 From the
2 As each message displays, make the desired changes or press [

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

YES/ENTER] to

accept the current setting.

3 Review the program. Press to begin review.
4 Press [

START] to begin infusion.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 49

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3. Total Parenteral Nutrition (TPN)

TPN Auto Taper Down

Auto Taper Down is available only if a Taper Down time was entered during
programming. Auto Taper Down may be activated when the continuous delivery
portion of a TPN with Taper Down protocol is stopped. Auto Taper Down is not
available while the pump is in an alarm condition.



1 Press [

2 Enter the Auto Taper Down time.

3 Press [

STOP] during TPN delivery.

The pump displays

• Press [NO] to return to the STOP mode. Then press [START] to continue
therapy.

• Press [

The maximum Auto Taper Down time is three hours OR two times the remaining
volume divided by the continuous infusion rate, whichever is less.

Note: Time is entered in hours:minutes (00:00). For one hour thirty minutes,
press [1] [3] [0]; not [9] [0].

Taper Down.

YES/ENTER] to set Auto Taper Down.

YES/ENTER] to return to the RUN mode, then press [START] to begin Auto

DO YOU WANT AUTO TAPERING?

50 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

TPN.fm Page 51 Wednesday, November 10, 2004 8:42 AM

3. Total Parenteral Nutrition (TPN)

GemStar

®

TPN Programming Worksheet

GIVE:

Parameters Selections and/or Values to be

Entered

Therapy TPN N/A
Delivery Mode

VTBI (Volume To Be
Infused)

Taper Up

Taper Down  No

Total Time to Infuse

 Continuous
 Continuous + Taper Down
 Continuous + Taper Up
 Continuous + Taper Up and Down

mL 1 - 9600 mL*

 No
 Yes hrs:min 1 min - 3 hrs

 Yes hrs:min 1 min - 3 hrs**

Programmable
Ranges

N/A

hrs:min 1 min - 24 hrs

KVO (Keep Vein Open)

Container Size

(VTBI + KVO) mL 9999 mL max
Air Sensitivity

* Maximum VTBI is 9600 mL minus any taper amount.
** Programmable ranges for taper down are 1 minute to 3 hours OR 2 times the

remaining volume divided by the continuous delivery rate, whichever is less.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 51

 No KVO Rate: 0.0
 Yes KVO Rate: 1.0 - 5.0 mL/hr

 On Alarms at approx. 0.5 mL of air
 2 mL Alarms at approx. 2 mL of air
 Off No alarm

N/A

430-00897-002.book Page 52 Friday, October 22, 2004 2:38 PM

Notes

52 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

PainMgmt.fm Page 53 Friday, November 12, 2004 8:24 AM

Therapy Features and Specifications

This therapy allows programming of a continuous only , bolus only, or continuous with
bolus delivery .

6 In Continuo us + Bolus protocol s, you can enter zero for either the continuous rate

or the bolus dose when entering or changing a program. The continuous rate and
bolus dose cannot be zero at the same time.

6 The default bolus delivery rate is 125 mL/hr.
6 A loading dose may be set during programming, which can be delivered after

programming and priming are complete. The default loading dose rate is 125
mL/hr.

6 Priming using [PURGE] is only allowed before [START] is pressed or after one of

the following events occur:

6 Complete Review of New Program
6 New Container
6 Air-in-Line Alarm

Chapter 4

Pain Management

CAUTION: When using pre-filled vials, the system may underdeliver at low

flow rates.

Note: New Container is allowed only when at least 1/2 of the container volume has

d

f

been infused or 1 hour has elapsed since starting the infusion.

The use of a lockbox is recommended with pain management protocols. Refer to
Chapter 15 Optional System Components, page 153, for instructions on using a
lockbox with the GemStar Pump.

Tip: The Programming W or ksheet at the e nd of this chap ter list s the min imum and
maximum values allowed for this protocol. Use copies of the programming
worksheet to record program values before programming the pump.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 53

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4. Pain Management

Pain Management Programming Tips

The following table explains how to use the keypad during pain management
programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information
during programming and
alarm conditions.

Pain Management Programming

1 Select PAIN MANAGEMENT from the Programming Menu.

2 Select the delivery mode.



Note: If Continuous + Bolus is selected, the continuous delivery rate or bolus dose
can be set to zero through the CHANGE menu without reprogramming the pump.

3 Select the unit of measure and concentration as required.

Scrolls through program
review and help
messages. The up arrow
inserts a decimal point in
a numeric value. The
down arrow toggles units
of measure when entering
concentrations.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous
display, exits the Options
Menu, and exits the

HELP mode.

54 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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4 Set the continuous delivery rate.

Note: The pump only delivers in increments of 0.1 mL. Values entered in a Pain



Management therapy may be rounded to the nearest 0.1 mL. For example, at a
concentration of 15 mg/mL, a rate of 5 mg rounds to 4.5 mg.

5 mg = 0.333 mL

4.5 mg = 0.3 mL

When a value is rounded, the pump sounds four quick beeps, displays ROUNDING
for a few seconds, and then displays the rounded value. Press
accept the rounded value and continue to the next step.

5 Program a loading dose as required.

6 Program a bolus dose with lockout time and dose limit as required.

Regarding a 1-Hour or 4-Hour Dose Limit: The hour dose limit is the
maximum volume (continuous plus bolus or bolus only amount) that can be
delivered over the selected period. When the programmed dose limit is reached,
the continuous delivery stops and a new bolus is not allowed. As the oldest
delivery amounts age out of the 1-hour or 4-hour dose limit record, the pump
accepts bolus requests or resumes continuous delivery (if programmed).

4. Pain Management

[YES/ENTER] to

Note: If a 1-hour or 4-hour dose limit is programmed, a bolus in progress will stop





Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 55

when the amount infused reaches the dose limit.

Loading doses are included in a 1-hour or 4-hour dose limit. A dose limit in effect
could prevent the delivery of a loading dose.

7 If programmed in units of mcg or mg, the line displaying the units flashes. Enter

the container size in proper unit measure.

Note: To enter the total in mL when programming a concentration, press to
move to the mL line. Enter the mL value when

8 Select the air sensitivity, if required.

9 Review the program. Press to begin review.

10 If using the PURGE key to prime the pump set, press [

WARNING: ALWAYS disconnect the pump set from the patient before

priming or purging.

mL flashes on the display.

PURGE] now.

430-00897-002.book Page 56 Friday, October 22, 2004 2:38 PM

4. Pain Management

Bolus Delivery

Set bolus doses and delivery limits during programming. The default bolus dose
delivery rate in a pain management protocol is 125 mL/hr.

A bolus cord is available for patient bolus requests. Refer to Connecting the Bolus
Cord in Chapter 15 Optional System Components, on page 156, for more
information.

Delivering a Bolus Dose



From the

RUN mode, press either the bolus button [+] on the top of the pump or the

button on the end of the bolus cord to begin bolus dose delivery. The pump flashes

BOLUS DELIVERY on the display and the amount infused accrues as the delivery

progresses.

When the bolus dose is complete, the pump does the following:

 Records the bolus request and delivery amount to the event and bolus history logs

 Adds the delivered boluses to the total bolus amount in the program amounts

 Resets the bolus lockout time (if applicable) and ignores other bolus requests until

the lockout time has elapsed

 Continues programmed infusion

Note: ALL bolus requests are recorded to the event and bolus history logs.

If the bolus delivery does not start, it could be locked out by one of the following
conditions:

 Bolus lockout period

 Loading dose delivery in progress

 Bolus dose delivery in progress

 Bolus per-hour limit

 1-hour or 4-hour dose limit

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Bolus Dose Interruptions

Bolus deliveries may be interrupted by:

 Pressing [STOP]

 An alarm condition

To continue bolus delivery after an interruption:

1 Press [START]. The pump displays COMPLETE BOLUS NOW?

2 Respond as follows:

To do this: Press this key: Bolus lockout time is set to:

4. Pain Management

Deliver the remaining
bolus amount

Clear the undelivered
bolus amount

Loading Dose Delivery

You can set a loading dose during programming, if desired. A loading dose can be
delivered after programming and priming are complete.



Note: Loading dose amounts are included in a 1-hour or 4-hour dose limit.

Delivering a Loading Dose

1 After priming and programming, press [

2 The pump displays

begin loading dose.

When the loading dose is complete, the pump does the following:

 Automatically begins programmed infusion

 Records the dose amount to the history log

 Resets the bolus lockout time (if applicable) and ignores other bolus requests until

the lockout time has elapsed

The time of delivery completion

The time the bolus was
interrupted

START].

DELIVER THE LOADING DOSE NOW? Press [YES/ENTER] to

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430-00897-002.book Page 58 Friday, October 22, 2004 2:38 PM

4. Pain Management

Loading Dose Interruptions

Loading dose deliveries can be interrupted by:

 Pressing [STOP]

 An alarm condition

To continue a loading dose:

1 Resolve the interruption.

2 Press [

START]. The pump displays COMPLETE THE LOADING DOSE?

3 Respond as follows:

To do this: Press this key:

Deliver the remaining loading dose amount

Clear the remaining loading dose amount

Changing a Pain Management Program

Can be changed at any time Cannot be changed



• Delivery rate

• Bolus

• Bolus lockout

Note: You cannot change a program when the pump is in FULL or CONTAINER
Lock. With a

RATE CHANGE Lock, the continuous delivery rate and bolus amount

can be changed within the set ranges.

Although the delivery mode cannot be changed, if Continuous + Bolus is
programmed, the continuous rate or bolus amount can be changed to zero. The
minimum values set with a

• Container size

• Air sensitivity

• Dose limit amount

RATE CHANGE Lock could restrict this function.

• Delivery mode

• Unit of measure

• Concentration

• Dose limit type

58 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

430-00897-002.book Page 59 Friday, October 22, 2004 2:38 PM

To change a program:

1 From the

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

4. Pain Management

2 As each message displays, make the desired changes or press [

accept the current setting.

3 Review the program. Press to begin review.

4 Press [

START] to begin delivery.

YES/ENTER] to

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 59

430-00897-002.book Page 60 Friday, October 22, 2004 2:38 PM

4. Pain Management

GemStar

®

Pain Management Programming Worksheet

GIVE:

Parameters Selections and/or Values to be

Entered

Therapy Pain Management N/A
Delivery Mode

Unit of
Measure

Continuous
Rate

Loading Dose

Bolus Dose 0 - 2500 mg

Bolus Lockout

Optional Dose
Limit

 Continuous
 Bolus Only
 Continuous + Bolus

 Concentration: mg/mL

 Concentration: mcg/mL
 mL

 No

 Yes Amount:

minutes 5 - 999 min

 4-hour limit Amount:

Programmable Ranges

N/A

0.1 - 100 mg/mL

1 - 1000 mcg/mL

0.1 - 2500 mg/hr
1 - 25000 mcg/hr

0.1 - 25.0 mL/hr

0.1 - 2500 mg
1 - 25000 mcg

0.1 - 25.0 mL

0 - 25000 mcg
0 - 25.0 mL

4X rate - 400 mL, 40000 mg,
400000 mcg*

 1-hour limit Amount:

 # boluses/hourNumber:
 No dose limit

Rate - 100 mL, 10000
mg, 100000 mcg*

1 - 12

*For continuous plus bolus
delivery.

Note: For Bolus Only, the 1-hour or 4-hour dose limit minimum is 1 bolus dose.

Container Size 0.1 - 99999 mg

1 - 9999000 mcg

0.1 - 9999 mL

Air Sensitivity

60 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

 On Alarms at approx. 0.5 mL of air
 2 mL Alarms at approx. 2 mL of air
 Off No alarm

N/A

Intermittent.fm Page 61 Wednesday, February 2, 2005 2:24 PM

Therapy Features and Specifications

This therapy allows programming of multiple doses at regular intervals.

 Optional KVO (Keep Vein Open) can be set during programming.

 The pump can be disconnected from the patient between dose deliveries. A call

back alarm can be set to alert the patient or caregiver to reconnect the pump before
the next scheduled delivery begins. The pump must remain powered on for the
call back alarm to function. At the set time before each dose, the pump produces
an audible and visual alarm and flashes

Tip: The Programming Worksheet at the end of this chapter lists the



minimum and maximum values allowed for this protocol. Use copies of the
programming worksheet to record program values before programming the
pump.

Chapter 5

Intermittent

START on the display.

Intermittent Programming Tips

The following table explains how to use the keypad during intermittent programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information
during programming and
alarm conditions.

Hospira GemStar Manual 430-00897-A02 (Rev. 02/05) 61

Scrolls through program
review and help
messages. Toggles
between AM and PM in
time-based entries. The
up arrow inserts a decimal
point in numeric values.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous
display, exits the Options
Menu, and exits the

HELP mode.

430-00897-002.book Page 62 Friday, October 22, 2004 2:38 PM

5. Intermittent

Intermittent Programming

1 Select INTERMITTENT from the Programming Menu.

2 Enter the dose amount in mL.

3 Enter the infusion time for each dose in hours:minutes (00:00).

For example, press [

4 Enter the frequency of dose deliveries.

For example, press [

5 Enter the total number of doses in the container.

To determine the number of doses in the container, divide the volume in the
container by the dose amount.

6 Enter the KVO rate in mL.

KVO delivers before a delayed start time, between doses, and after the last dose
until the total container is infused.

4] [0] if each dose is to deliver for 40 minutes.

4] [0] [0] to start a dose every four hours.

If no KVO is desired, press [

7 Enter the container size.

The pump automatically calculates the minimum container size required to deliver
the number of programmed doses and KVO between doses.





62 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Note: If KVO is desired before a delayed start, increase the container size to
include the desired KVO volume.

8 Select the air sensitivity, if required.

Note: DO NOT press [YES/ENTER] after selecting the air sensitivity. If
[YES/ENTER] is accidentally pressed and a call back alarm is not desired, press
[

BACK-UP] to return to the beginning of step 9 and press [NO].

9 The pump displays

• Press [NO] if you do not want to set the call back alarm.

• Press [

Enter the time before the next dose that the alarm should sound. For example,
press [
scheduled delivery.

YES/ENTER] to set the call back alarm.

1] [0] to set the alarm to sound 10 minutes before the start of the next

SET CALL BACK ALARM FOR NEXT DOSE?

YES/ENTER] while the value displayed is zero.

Intermittent.fm Page 63 Wednesday, November 10, 2004 8:43 AM

Note: When programming the call back alarm, be sure to allow enough time for the



patient or caregiver to reconnect the pump to the patient and to press [
BEFORE the scheduled dose start time.

10 The pump displays the current time.

• If the displayed time is correct, press [

• To set the clock, press [

5. Intermittent

START]

YES/ENTER].

OPTIONS].

11 The pump displays the current time and

• P ress [YES/ENTER] to begin delivery when the pump enters the RUN mode.

• Press [





Note: When entering the time in 12-hour format, press or to toggle between
AM and PM.

12 Review the program. Press to begin review.
13 If using the

WARNING: ALWAYS disconnect the pump set from the patient before

Note: The call back alarm works only when the pump is powered on AND in the

STOP mode. DO NOT power-off the pump while it is disconnected from the patient

if you have set the call back alarm.
When the alarm sounds, press [

Then reconnect the pump to the patient.

Tip: To use a delayed start without specifying a start time:

NO] to set a delayed start time. The pump displays SET START TIME.

Enter the desired start time and press [

PURGE key to prime the pump set, press [PURGE] now.

priming or purging.

SILENCE] to silence the alarm for three minutes.

START NOW?

YES/ENTER] when done.



1 Press [YES/ENTER].
2 Complete the program review.
3 Power-off the pump.
4 When the pump is powered on again, complete the program review, then

press [

START] to begin delivery.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 63

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5. Intermittent

Intermittent Delivery Interruptions

Missed Start Time

 If the programmed start time is missed, it can be changed through the Options

Menu. Refer to Next Dose in Chapter 10 Options Menu, on page 111.

 If the pump remains in the STOP mode and the first dose is missed, press [START]

to begin delivery immediately and all remaining doses will be shifted.

 If the pump is programmed with a delayed start time and is then powered off

before [
programmed start time.

For example, the current time is 10:00 PM. The user sets the delayed start time for
10:30 PM and then powers off the pump. The user does not power on the pump
until 10:40 PM, which is 10 minutes AFTER the scheduled start time. The pump
does not begin delivery until 10:30 PM the FOLLOWING day.

START] is pressed, the pump will skip to the NEXT occurrence of the

Dose Interruptions

To understand how interruptions are resolved, compare the normal Intermittent
delivery diagram below for a 1-hour dose every four hours, to the interruption
diagrams shown in the examples:

12123456789101112

Dose Delivered -

 If an Intermittent dose is interrupted and the pump is placed in the RUN mode

during the on or off cycle of the current dose, the dose continues delivery from the
point where it was interrupted and all remaining doses are shifted.

For example, in the following diagram, an intermittent dose was started at 2:00.
The dose was interrupted during the current dose cycle and was started again
before the end of the current dose cycle.

64 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

430-00897-002.book Page 65 Friday, October 22, 2004 2:38 PM

12123456789101112

Dose Delivered - Dose Interrupted -

 If an Intermittent dose is interrupted and the pump is placed in the RUN mode

after the off cycle of the current dose, the next dose begins delivery. All remaining
doses are shifted if necessary.

For example, in the following diagram, an intermittent dose was started at 2:00. It
was interrupted during the current delivery cycle at 2:30, but was not started again
until after the current delivery cycle at 6:45:

5. Intermittent

12123456789101112

Dose Delivered - Dose Interrupted -

 When the dose is complete, the start time for the Next Dose displays. To change

the start time refer to Chapter 10 Options Menu, page 97.

 Any missed Intermittent doses, except the first dose, are added to the end of the

delivery schedule.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 65

Intermittent.fm Page 66 Wednesday, November 10, 2004 8:44 AM

5. Intermittent

Changing an Intermittent Program



Can be changed at
any time

• Dose parameters

• KVO rate

• Container size

• Air sensitivity

• Call back alarm

Can be changed if no
dose is in progress

• Next dose start time • Current time

Cannot be changed

START

after is pressed

Note: You cannot change a program when the pump is in FULL or CONTAINER
Lock.

To change a program:

1 From the

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

2 As each message displays, make the desired changes or press [YES/ENTER] to

accept the current setting.

3 Review the program. Press to begin review.
4 Press [

START] to begin delivery.

66 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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5. Intermittent

GemStar

®

Intermittent Programming Worksheet

GIVE:

Parameters Selections and/or Values to be Entered Programmable

Ranges

Therapy Intermittent N/A

Dose Amount

0.1 - 9600 mL

Infusion Time
Per Dose

Dose
Frequency

Number of
Doses Per
Container

KVO
(Keep Vein
Open)

Container
Size*

Air Sensitivity

Call Back
Alarm

Start Time

 No KVO Rate: 0.0

 Yes KVO Rate:

 On Alarms at approx. 0.5 mL of air
 2 mL Alarms at approx. 2 mL of air
 Off No alarm

 No
 Ye s

Alarm: hrs:min before start

 Start immediately after programming

hrs:min 1 min - 24 hrs

(Infusion time per
dose + 1 min) to 96 hrs

hrs:min

1 - 999

0.1 -5.0 mL/hr

0.1 - 9999 mL
N/A

1 min to time between
doses

 Start time:

Specify AM or PM if not 24-hour clock.

* The pump automatically calculates the minimum container size required to deliver the number of

12:00 AM - 11:59 PM or
00:00 - 23:59

programmed doses and KVO between doses. If KVO is desired before a delayed start, increase the
container size to include the desired KVO volume.

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Notes

68 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Continuous.fm Page 69 Wednesday, February 2, 2005 2:38 PM

Therapy Features and Specifications

This therapy allows programming of a continuous delivery.

 Optional KVO (Keep Vein Open) can be set during programming.

 The rate can be titrated while the pump is infusing.

 An optional secondary container can be “piggybacked” on the primary container

during regular delivery using a GemStar Piggyback Pump Set. Refer to
Piggybacking in this chapter for more information.

Tip: The Programming Worksheet at the end of this chapter lists the minimum



and maximum values allowed for this protocol. Use copies of the programming
worksheet to record program values before programming the pump.

Chapter 6

Continuous

Continuous Programming Tips

The following table explains how to use the keypad during continuous programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information
during programming and
alarm conditions.

Hospira GemStar Manual 430-00897-A02 (Rev. 02/05) 69

Scrolls through program
review and help
messages. The up arrow
inserts a decimal point in a
numeric value.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous
display, exits the Options
Menu, and exits the

HELP mode.

430-00897-002.book Page 70 Friday, October 22, 2004 2:38 PM

6. Continuous

Continuous Programming

1 Select CONTINUOUS from the Programming Menu.

2 Select the unit of measure and concentration as required.

3 Enter the rate.

4 Enter the VTBI (Volume to be Infused).

5 Enter the KVO rate, if desired.

KVO runs after the programmed VTBI until the total container is infused. If no



KVO is desired, press [

6 Enter the container size (VTBI + KVO).

VTBI is the default value on the

Note: If KVO is programmed, increase the container size to include the KVO
delivery.

To enter the total in mL when programming a concentration, press to move to
the mL line. Enter the mL size when

7 Select the air sensitivity, if required.

YES/ENTER] while the value displayed is zero.

CONTAINER display.

mL flashes on the display.

8 Review the program. Press to begin review.

9 If using the PURGE key to prime the pump set, press [

WARNING: ALWAYS disconnect the pump set from the patient before

priming or purging.

70 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

PURGE] now.

430-00897-002.book Page 71 Friday, October 22, 2004 2:38 PM

Rate Titration

To titrate the rate while the pump is infusing:

1 In the



2

RUN mode, press the number key for the new rate. Press [YES/ENTER].

For example: if the current rate is 100 mL/hr, press [
the rate to 50 mL/hr.

Note: You have approximately five seconds after pressing a key to press another
numeric key, the decimal key, or [
seconds, the rate does not change and the delivery continues as previously
programmed.

NEW RATE displays with the new value.

• Press [

• Press [

YES/ENTER] within 10 seconds to accept the change and begin delivery

at the new rate.

NO] to continue delivery at the previously programmed rate.

6. Continuous

5] [0] [YES/ENTER] to change

YES/ENTER]. If no key is pressed within five

Piggybacking

Piggybacking with the GemStar Pump requires a GemStar Primary Piggyback Pump
Set with a proximal Y-site backcheck valve and a secondary piggyback set with an
extension hook. The secondary container must be higher than the primary
container. Refer to the instructions included with the piggyback pump set for more
information.

WARNING: When using the pump for secondary delivery (piggybacking),

ensure the fluids being infused are chemically and physically
compatible.

The piggyback rate and piggyback VTBI display until the secondary container has
been delivered. Then the primary infusion continues.



Note: The piggyback infusion amount is NOT added to the primary programmed
infusion amount.

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6. Continuous

Preparing for Secondary Delivery (Piggybacking)

1 Ensure a primary piggyback pump set with a

proximal Y-site backcheck valve is in place.

2 Use the extension hook from the secondary set

to suspend the primary container from the I.V.
pole.

3 Prepare the secondary set according to the

instructions included with the set.

4 Attach a needle or blunt cannula (if appropriate)

and prime the secondary set.

5 Suspend the secondary container from the I.V.

pole.

Note: When using a secondary container of



500 mL or greater, ensure the bottom of the
secondary container is at least 7 inches (17.8
cm) above the fluid level in the primary
container. Use additional extension hooks if
necessary.

6 Connect the secondary set to the proximal Y-site

(or proximal luer port).

72 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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Programming a Secondary Delivery (Piggybacking)

6. Continuous







Note: To distinguish the piggyback delivery from the
primary delivery, PIGGYBACK displays and the piggyback
VTBI counts down to completion. For example, a
piggyback rate of 250 mL/hr with a remaining VTBI of

218.5 mL will display as shown.

Tip: Prepare and set up containers BEFORE programming the pump for piggyback
delivery.

1 Press [

2 Enter the dose amount for the secondary container.

3 Enter the infusion time for the secondary container.

4 Open the slide clamp or CAIR

5 Press [

Note: Primary flow stops until the secondary VTBI is delivered; then primary flow
continues. Any remaining secondary fluid will be delivered at the primary rate. The
maximum piggyback rate is 300 mL/hr. For secondary rates above 300 mL/hr, flow
may occur from the primary container.

Changing a Piggyback Delivery

1 Press [

CHANGE] and select PIGGYBACKING from the Change Menu.

®

(roller) clamp on the tubing of the secondary

container.

YES/ENTER] to begin piggyback delivery.

CHANGE] and select PIGGYBACKING from the Change Menu.

PIGGYBACK

RATE 250.0 mL/hr

VTBI 218.5 mL

2 Press [

3 Enter the new piggyback dose amount and press [

4 Set the infusion time for the secondary container.

5 Press [



Note: You must know the amount that has already been delivered. When the piggyback
dose amount is changed, the pump begins a new VTBI countdown.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 73

CHANGE] to reset the dose amount to zero.

YES/ENTER].

YES/ENTER] to begin piggyback delivery.

430-00897-002.book Page 74 Friday, October 22, 2004 2:38 PM

6. Continuous

Canceling a Piggyback Delivery

1 Press [

2 Press [

3 Press [

CHANGE] and select PIGGYBACKING from the Change Menu.

CHANGE] to reset the dose amount to zero.

YES/ENTER] to cancel piggyback delivery.

Changing a Continuous Program

Can be changed at any time Cannot be changed



• Delivery rate

•VTBI

• KVO rate

Note: You cannot change a program when the pump is in FULL or CONTAINER Lock.

To change a program:

1 From the

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

2 As each message displays, make the desired changes or press [YES/ENTER] to

accept the current setting.

3 Review the program. Press to begin review.

4 Press [

START] to begin delivery.

• Container size

• Air sensitivity

• Piggybacking

• Unit of measure

• Concentration

74 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

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6. Continuous

GemStar

®

Continuous Programming Worksheet

GIVE:

Parameter Selections and/or Values to be

Entered

Therapy Continuous N/A

Unit of Measure

 Concentration: mg/mL

 Concentration: mcg/mL
 mL

Rate 0.1 - 9999 mg/hr

VTBI

(Volume To Be
Infused)

KVO

 No KVO Rate: 0.0

(Keep Vein
Open)

 Yes KVO Rate:

Container Size

(VTBI + KVO)

Air Sensitivity

 On Alarms at approx. 0.5 mL of air
 2 mL Alarms at approx. 2 mL of air
 Off No alarm

Piggyback Dose
Amount 1 - 7200 mL

Piggyback
Infusion Time

hrs:min

Programmable Ranges

0.1 - 1000 mg/mL

1 - 1000 mcg/mL

1 - 999900 mcg/hr

0.1 - 1000 mL/hr

0.1 - 99999 mg

1 - 9999000 mcg

0.1 - 9999 mL

0.1 - 5.0 mL/hr

0.1 - 99999 mg

1 - 9999000 mcg

0.1 - 9999 mL

N/A

1 min or
dose amount / 300 mL/hr to 24
hrs or dose amount / 0.1 mL/hr

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Notes

76 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

430-00897-002.book Page 77 Friday, October 22, 2004 2:38 PM

Therapy Features and Specifications

This therapy allows programming of delivery rate as a function of body weight.

 The air sensitivity in a Weight Dosed program is automatically set to ON. This

setting can be changed through the Options Menu after programming is complete.
Refer to Air Sensitivity in Chapter 10 Options Menu, on page 107.

 The pump automatically delivers KVO (Keep Vein Open) after the programmed

VTBI (Volume To Be Infused) has completed.

 The rate can be titrated while the pump is infusing.

Chapter 7

Weight Dosed

Tip: The Programming Worksheet at the end of this chapter lists the minimum and



maximum values allowed for this protocol. Use copies of the programming worksheet
to record program values before programming the pump.

WARNING: When using a vented drip set, ALWAYS use an air-

eliminating filter OR set the air sensitivity to either ON or
2 mL.

CAUTION: When infusing short-half-life drugs (i.e., those dosed with units of

mcg/kg/min) at very low rates (0.8 mL/hr or less) the rate may be too
slow for that drug. Consider using a lower drug concentration with
these drugs so a pump rate above 0.8 mL/hr can be used.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 77

430-00897-002.book Page 78 Friday, October 22, 2004 2:38 PM

7. Weight Dosed

Weight Dosed Programming Tips

The following table explains how to use the keypad during weight dosed programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information during
programming and alarm
conditions.

Weight Dosed Programming

1 Select WEIGHT DOSED from the Programming Menu.
2 Select the unit of measure.





Note: If two numbers appear before a menu time (e.g., 02), press both number
keys to select that item.

3 Enter the patient weight, if required.
4 Enter the concentration:

• Enter the value for the unit of measure when it flashes on the display.

• Press [

Tip: Press to toggle between units of measure.

YES/ENTER] to confirm.

Scrolls through program review and
help messages. The up arrow inserts a
decimal point in a numeric value.

Clears a numeric value (resets to zero)
during programming.

Returns to a previous display, exits the
Options Menu, exits the

HELP mode.

5 Enter the rate.



78 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

Note: The pump automatically displays the mL/hr equivalent even when another
unit of measure is selected.

6 Enter the VTBI.
7 Review the program. Press to begin review.

WeightDosed.fm Page 79 Wednesday, November 10, 2004 8:45 AM

8 If using the PURGE key to prime the pump set, press [PURGE] now.

WARNING: ALWAYS disconnect the pump set from the patient before

priming or purging.

Auto KVO

When the programmed VTBI has completed delivery, Auto KVO delivery begins
automatically and the empty container alarm sounds.

7. Weight Dosed



Note: Auto KVO delivers even while the empty container alarm sounds. Press

SILENCE] to quiet the alarm for 2 minutes.

[

If the weight dosed rate is: Auto KVO delivers at:

Greater than or equal to 1 mL/hr 1 mL/hr
Less than 1 mL/hr The weight dosed rate

Rate Titration

To titrate the rate while the pump is infusing:

1 In the

For example: if the current rate is 4.0 mg/kg/hr, press [
the rate to 5.0 mg/kg/hr.

Press to enter the rate in mL/hr. When using units other than mL/hr , the pump
automatically adjusts the mL/hr value.

Note: You have approximately five seconds after pressing a key to press another



numeric key, the decimal key, or [YES/ENTER]. If no key is pressed within five
seconds, the rate does not change and the delivery continues as previously
programmed.

2

NEW RATE displays with the new value.

• Press [

• P ress [

RUN mode, press the number keys for the new rate. Press [YES/ENTER].

5] [YES/ENTER] to change

YES/ENTER] within 10 seconds to accept the change and begin delivery

at the new rate.

NO] to continue delivery at the previously programmed rate.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 79

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7. Weight Dosed

VTBI Titration

To titrate the VTBI while the pump is infusing:

1 Press [

2 Press the number keys for the new VTBI. Press [



3

CHANGE] and select TITRATE VTBI.

For example: if the current VTBI is 50 mL, press [
the VTBI to 100 mL.

Note: You have approximately five seconds after pressing a key to press another
numeric key, the decimal key, or [
seconds, the VTBI does not change and the delivery continues as previously
programmed.

NEW VTBI displays with the new rate.

• Press [

• Press [

YES/ENTER] within 10 seconds to accept the change and begin delivery

with the new VTBI.

NO] to continue delivery at the previously programmed VTBI.

YES/ENTER]. If no key is pressed within five

Changing a Weight Dosed Program

Can be changed at any time Cannot be changed

• Delivery rate

•VTBI

• Patient weight



Note: You cannot change a program when the pump is in FULL or CONTAINER Lock.

YES/ENTER].

1][0][0][YES/ENTER] to change

• Unit of measure

• Concentration (amount of drug)

To change a program:

1 From the

2 As each message displays, make the desired changes or press [

accept the current setting.

3 Review the program. Press to begin review.

4 Press [

80 Hospira GemStar Manual 430-00897-002 (Rev. 10/04)

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

YES/ENTER] to

START] to begin delivery.

WeightDosed.fm Page 81 Wednesday, November 10, 2004 8:46 AM

GemStar® Weight Dosed Programming Worksheet

GIVE:

7. Weight Dosed

Parameter Selections and/or Values to be Entered Programmable

Ranges

Therapy Weight Dosed N/A
Unit of Measure**

 mcg/kg/min
 mcg/kg/hr
 mcg/min
 mg/kg/min
 mg/kg/hr
 mg/min
 mL/hr
 mg/hr

 mcg/hr
 grams/hr
 ng/kg/min
 U/kg/hr
 U/min
 U/hr
 mU/min
 mEq/hr

N/A

Patient Weight (When programming in kg/min or kg/hr)

2.0 - 200.0 kg
Concentration
(2 entries are

required. Use
to toggle)

(For all units of measure EXCEPT mL/hr)

mg U mEq
in in in

mL mL mL

0.1 - 9999000 mg

0.1 - 99999999 U

0.1 - 9999 mEq

0.1 - 9999 mL
Rate

(see below *)

VTBI
(Volume To Be
Infused)

* Programmable Ranges for Rate (not all units of measure are available in all pump configurations):

0.001 - 833 mg/kg/min 0.1 - 1000 mL/hr 0.001 - 99999999 U/min

0.001 - 500000 mg/kg/hr 0.001 - 999999 mg/hr 0.001 - 99999999 U/hr

0.001 - 16666 mg/min 0.001 - 9999999 mcg/hr 0.001 - 999999999 mU/min

0.001 - 166666 mcg/kg/min 0.001 - 999 grams/hr 0.001 - 999 mEq/hr

0.001 - 9999999 mcg/kg/hr 0.009 - 999 ng/kg/hr

0.002 - 166666 mcg/min 0.001 - 99999999 U/kg/hr

** If two numbers appear before a menu item (e.g., 02), press both number keys to select that item.

CAUTION: When infusing short-half-life drugs (i.e., those dosed with units of mcg/kg/min) at very low
rates (0.8 mL/hr or less) the rate may be too slow for that drug. Consider using a lower drug

0.1 - 9999 mL

concentration so a pump rate above 0.8 mL/hr can be used.

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Notes

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Therapy Features and Specifications

This therapy allows quick programming of delivery rate in milliliters (mL) only.

 The air sensitivity is automatically set to ON. This setting can be changed through

the Options Menu after programming is complete. Refer to Air Sensitivity in
Chapter 10 Options Menu, on page 107.

 The pump automatically delivers KVO (Keep Vein Open) after the programmed

VTBI (Volume To Be Infused) is complete.

 The rate can be titrated while the pump is infusing.

 An optional secondary container can be “piggybacked” onto the primary container

during regular delivery using a GemStar Piggyback Pump Set. Refer to
Piggybacking in this chapter for more information.

 A program review is not required and is available only through the Options Menu.

Chapter 8

mL/hr Only

Tip: The Programming Worksheet at the end of this chapter lists the minimum and



maximum values allowed for this protocol. Use copies of the programming worksheet
to record program values before programming the pump.

WARNING: When using a vented set, ALWAYS use an air-eliminating

filter OR set the air sensitivity to either ON or 2 mL.

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mLhr.fm Page 84 Wednesday, November 10, 2004 9:39 AM

8. mL/hr Only

mL/hr Programming Tips

The following table explains how to use the keypad during mL/hr programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information
during programming and
alarm conditions.

Scrolls through program
review and help
messages. The up arrow
inserts a decimal point in
a numeric value.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous
display, exits the Options
Menu, exits the
mode.

HELP

mL/hr Only Programming

1 Select mL/hr Only from the Programming Menu.
2 Enter the rate.
3 Enter the VTBI.
4 If using the PURGE key to prime the pump set, press [

WARNING: ALWAYS disconnect the pump set from the patient before

priming or purging.

PURGE] now.



Note: A program review is not required for mL/hr Only programs.

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Auto KVO

When the programmed VTBI has completed delivery, Auto KVO delivery begins
automatically and the empty container alarm sounds.

8. mL/hr Only



Note: Auto KVO delivers even while the empty container alarm sounds. Press
[SILENCE] to quiet the alarm for 2 minutes.

If the weight dosed rate is: Auto KVO delivers at:

Greater than or equal to 1 mL/hr 1 mL/hr

Less than 1 mL/hr The programmed rate

Rate Titration

To titrate the rate while the pump is infusing:

1 In the

For example, if the current rate is 100 mL/hr, press [
the rate to 50 mL/hr.

Note: You have approximately five seconds after pressing a key to press



2

NEW RATE displays with the new value.

• Press [

• Press [

RUN mode, press the number keys for the new rate. Press [YES/ENTER].

5] [0] [YES/ENTER] to change

another numeric key, the decimal key, or [
pressed within five seconds, the rate does not change and the delivery
continues as previously programmed.

YES/ENTER] within 10 seconds to accept the change and begin delivery

at the new rate.

NO] to continue delivery at the previously programmed rate.

YES/ENTER]. If no key is

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8. mL/hr Only

VTBI Titration

To titrate the VTBI while the pump is infusing:

1 Press [

2 Press the number keys for the new VTBI. Press [

For example: if the current VTBI is 50 mL, press [
the VTBI to 100 mL.

Note: You have approximately five seconds after pressing a key to press



NEW VTBI displays with the new rate.

3

• Press [

• Press [

Piggybacking

Piggybacking with the GemStar Pump requires a GemStar Primary Piggyback Pump
Set with a proximal Y-site backcheck valve and a secondary piggyback set with an
extension hook. The secondary container must be higher than the primary
container. Refer to the instructions included with the piggyback pump set for more
information.

WARNING: When using the pump for secondary delivery

CHANGE] and select TITRATE VTBI.

YES/ENTER].

1][0][0][YES/ENTER] to change

another numeric key, the decimal key, or [YES/ENTER]. If no key is
pressed within five seconds, the VTBI does not change and the delivery
continues as previously programmed.

YES/ENTER] within 10 seconds to accept the change and begin delivery

with the new VTBI.

NO] to continue delivery at the previously programmed VTBI.

(piggybacking), ensure the fluids being infused are
chemically and physically compatible.

The piggyback rate and piggyback VTBI display until the secondary container has
been delivered. Then the primary infusion continues.



Note: The piggyback infusion amount is NOT added to the primary programmed
infusion amount.

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Preparing for Secondary Delivery (Piggybacking)

1 Ensure a primary piggyback pump set with a

proximal Y-site backcheck valve is in place.

2 Use the extension hook from the secondary set

to suspend the primary container from the I.V.
pole.

3 Prepare the secondary set according to the

instructions included with the set.

4 Attach a needle or blunt cannula (if appropriate)

and prime the secondary pump set.

5 Suspend the secondary container from the I.V.

pole.

Note: When using a secondary container of



500 mL or greater, ensure the bottom of the
secondary container is at least 7 inches (17.8
cm) above the fluid level in the primary
container. Use additional extension hooks if
necessary.

8. mL/hr Only

6 Connect the secondary set to the proximal Y-site

(or proximal luer port).

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8. mL/hr Only

Programming a Secondary Delivery (Piggybacking)







Note: To distinguish the piggyback delivery from the primary
delivery,
counts down to completion. For example, a piggyback rate
of 250 mL/hr with a remaining VTBI of 218.5 mL will
display as shown.

Tip: Prepare and set up containers BEFORE programming the pump for piggyback
delivery.

1 Press [

2 Enter the dose amount for the secondary container.

3 Enter the infusion time for the secondary container.

4 Open the slide clamp or CAIR

5 Press [

Note: Primary flow stops until the secondary VTBI is delivered; then primary flow
continues. Any remaining secondary fluid will be delivered at the primary rate. The
maximum piggyback rate is 300 mL/hr. For secondary rates above 300 mL/hr, flow
may occur from the primary container.

Changing a Piggyback Delivery

1 Press [

2 Press [

PIGGYBACK displays and the piggyback VTBI

CHANGE] and select PIGGYBACKING from the Change Menu.

®

(roller) clamp on the tubing of the secondary set.

YES/ENTER] to begin piggyback delivery.

CHANGE] and select PIGGYBACKING from the Change Menu.

CHANGE] to reset the dose amount to zero.

PIGGYBACK
RATE 250.0
VTBI 218.5 mL

mL/hr

3 Enter the new piggyback dose amount and press [

4 Set the infusion time for the secondary container.

5 Press [



Note: You must know the amount that has already been delivered. When the piggyback
dose amount is changed, the pump begins a new VTBI countdown.

88 Hospira GemStar Manual 430-00897-A02 (Rev. 02/05)

YES/ENTER] to begin piggyback delivery.

YES/ENTER].

430-00897-002.book Page 89 Friday, October 22, 2004 2:38 PM

Canceling a Piggyback Delivery

8. mL/hr Only

1 Press [

2 Press [

3 Press [

CHANGE] and select PIGGYBACKING from the Change Menu.

CHANGE] to reset the dose amount to zero.

YES/ENTER] to cancel piggyback delivery.

Changing a mL/hr Only Program

Can be changed at any time

• Delivery rate

• Container size





Note: You cannot change a program when the pump is in FULL or CONTAINER Lock.

To change a program:

1 From the

2 As each message displays, make the desired changes or press [

accept the current setting.

3 Press [

Note: A program review is not required and is available only through the Change or
Options Menu.

STOP mode, press [CHANGE] and select CHANGE PROGRAM.

START] to begin delivery.

• Piggybacking

•VTBI

YES/ENTER] to

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8. mL/hr Only

GemStar

®

mL/hr Only Programming Worksheet

GIVE:

Parameter Selections and/or Values

to be Entered

Therapy mL/hr Only N/A

Rate

VTBI

(Volume To Be Infused) 0.1 - 9999 mL

Piggyback Dose
Amount

Piggyback Infusion
Time

hrs:min

Programmable Ranges

0.1 - 1000 mL/hr

1 - 7200 mL

1 min or
dose amount / 300 mL/hr to 24
hrs or dose amount / 0.1 mL/hr

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Therapy Features and Specifications

This therapy allows programming of multiple doses at specified times.

 Optional KVO (Keep Vein Open) can be set during programming.

 The default bolus delivery rate is 400 mL/hr.

Tip: The Programming Worksheet at the end of this chapter lists the minimum and



maximum values allowed for this protocol. Use copies of the programming worksheet
to record program values before programming the pump.

Chapter 9

Variable Time

Variable Time Programming Tips

The following table explains how to use the keypad during variable time
programming:

Key Function Key Function

[0] - [9] Selects menu items and

enters numeric values.

Accepts entries or
continues when done
viewing a display.

Displays information
during programming and
alarm conditions.

Scrolls through program
review and help
messages. Toggles
between AM and PM in
time-based entries.The up
arrow inserts a decimal
point in a numeric value.

Clears a numeric value
(resets to zero) during
programming.

Returns to a previous
display, exits the Options
Menu, and exits the

HELP mode.

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9. Variable Time

Variable Time Programming

1 Select VARIABLE TIME from the Programming Menu.

2 Select the phase type.

3 Select the unit of delivery.

4 Change the displayed time if necessary.

5 Enter the optional base rate with start and stop time.

6 If programming in Rates or Doses, go to step 7. If programming in Percentages,

set the daily amount. Then go to step 8.

Note: If programming in percentages, the total daily amount of all phases pro-



grammed must equal 100%.

7 Enter the phase information for each phase. Up to 24 phases can be programmed.





Note: When entering time in 12-hour format, press or to toggle
between AM and PM.

8 Enter the optional bolus dose and its lockout.

9 Enter the optional KVO.

10 Enter the container size.

The pump calculates the minimum container size required to deliver the phases,
base rate, and KVO for one day or in a 24-hour period. If delivering the protocol

for more than one day, multiply this amount by the number of days of
therapy.

Note: Increase the container size to include bolus deliveries.

11 Select the air sensitivity, if required.

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12 Review the program. Press to begin review.

9. Variable Time

13 If using the PURGE key to prime the pump set, press [

WARNING: ALWAYS disconnect the pump set from the patient before

priming or purging.

Note: With variable time programming, the pump keeps track of where it is in the



program each minute of the entire 24-hour period. For example, if Phase 1 is missed,
and the pump is placed in

RUN mode in the middle of Phase 2, it starts delivery

according to the program parameters from the middle of Phase 2.

Variable Time Delivery Interruptions

If a phase is interrupted and the
pump is placed in the

Before the end of the phase. The phase runs to its scheduled

After the end of the phase, but before
the beginning of the next start time.

In the middle of a phase and the phase
start was missed because of a program
interruption or a missed program start.

RUN mode:

PURGE] now.

Then:

stop time.
The next phase begins delivery at

the scheduled start time.
All applicable Base Rate or KVO

delivery infuses while waiting for the
start of the next phase.

The pump immediately begins
delivery of the current phase at its
current time-based point.

Hospira GemStar Manual 430-00897-002 (Rev. 10/04) 93