Hospira Plum A+, Plum A+3 User manual

System Operating Manual

3

For Infusion Systems with v11.6 Software

For use with Lists: 12391-04, 12618-04,
12348-04, & 11971-04

Back

Prime

A

Options/

B

Vol Inf

430-95215-003 (Rev. 10/05)

Change History

Change History

Title

430-95215-001
(Rev. 04/05)

430-95215-002
(Rev. 07/05)

430-95215-003
(Rev. 10/05)

Description of
Change

First Release All

Second Release
Added IEC/EN 60601-1
Information

Third Release All

Pages
Affected

All
Section 1

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems i

Contents

1) DESCRIPTIVE INFORMATION. . . . . . . . . . . . . . . . 1-1

1.1 PRODUCT DESCRIPTION . . . . . . . . . . . . . . . . . . . . . . . . 1-2

1.2 I

NDICATIONS FOR USE . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

user qualification . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

1.3 C

ONVENTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4

warnings, cautions, and notes . . . . . . . . . . . . . . . . . . 1-5

1.4 P

RECAUTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6

artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6

guidance on emc compatibility . . . . . . . . . . . . . . . . . . 1-7

healthcare professionals and patient related . . . . . . . 1-7

concurrent flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10

epidural administration . . . . . . . . . . . . . . . . . . . . . . 1-11

battery operation . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-12

sets and accessories . . . . . . . . . . . . . . . . . . . . . . . . 1-12

backpriming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13

general . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13

cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13

2) PRINCIPLES OF OPERATION . . . . . . . . . . . . . . . . 2-1

2.1 FEATURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

line programming options . . . . . . . . . . . . . . . . . . . . . 2-1

plumset capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

air management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

biomedical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

other features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3

2.2 D

EFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3

430-95215-003 (Rev. 10/05)

ii Contents

3) EQUIPMENT DESCRIPTION . . . . . . . . . . . . . . . . . 3-1

3.1 OPERATING KEYS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

3.2 I

NDICATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

3.3 R

EAR CASE CONTROLS . . . . . . . . . . . . . . . . . . . . . . . . . 3-6

3.4 A

DMINISTRATION SETS . . . . . . . . . . . . . . . . . . . . . . . . . 3-8

preparing the administration set . . . . . . . . . . . . . . . . . 3-8

priming the administration set . . . . . . . . . . . . . . . . . . . 3-9

loading the cassette . . . . . . . . . . . . . . . . . . . . . . . . . 3-10

preparing the secondary line . . . . . . . . . . . . . . . . . . 3-10

3.5 D

ISCONTINUING ELECTRONIC FLOW CONTROL & SETTING

G

RAVITY FLOW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12

3.6 D

ISCONTINUING FLUID ADMINISTRATION . . . . . . . . . . . . 3-13

4) BASIC OPERATION . . . . . . . . . . . . . . . . . . . . . . . 4-1

4.1 GETTING STARTED . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

unpacking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

tandem carrier instructions . . . . . . . . . . . . . . . . . . . . . 4-2

system self-tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4-2

data retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4

4.2 P

OWER ON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4

4.3 S

IMPLE DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6

4.4 T

ITRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9

4.5 P

IGGYBACK DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . 4-11

4.6 C

ONCURRENT DELIVERY . . . . . . . . . . . . . . . . . . . . . . . 4-14

4.7 S

TOP AND START WITH ONLY 1 LINE PUMPING . . . . . . .4-17

4.8 S

TOP AND START WITH BOTH LINES PUMPING . . . . . . .4-18

4.9 B

ACKPRIMING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-20

4.10 C

LEARING PROGRAM SETTINGS . . . . . . . . . . . . . . . . . 4-21

5) THERAPIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

5.1 DOSE CALC (MCG/KG/MIN ON A) . . . . . . . . . . . . . . . . . . 5-2

5.2 D

OSE CALC (MG/MIN ON B) . . . . . . . . . . . . . . . . . . . . . . 5-8

5.3 L

OADING DOSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-14

5.4 M

ULTISTEP PROGRAMMING . . . . . . . . . . . . . . . . . . . . .5-21

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems iii

6) ADDITIONAL FEATURES . . . . . . . . . . . . . . . . . . . 6-1

6.1 SIMPLE DELIVERY USING DRUG LIST . . . . . . . . . . . . . . 6-1

6.2 S

IMPLE DELIVERY USING DELAYED START . . . . . . . . . . 6-4

6.3 P

IGGYBACK WITH NURSE CALLBACK . . . . . . . . . . . . . . . 6-5

6.4 P

OSSIBLE NON-DELIVERY PROGRAMMED . . . . . . . . . . . 6-7

6.5 U

SING THE STANDBY FEATURE . . . . . . . . . . . . . . . . . . . 6-7

6.6 S

ELECT OPTION- VOLUMES INFUSED, PRESSURE/POST

I

NFUSION RATE, AND LIGHTING/CONTRAST . . . . . . . . . . 6-9

6.7 V

ARIABLE RATE CAP . . . . . . . . . . . . . . . . . . . . . . . . . . 6-13

6.8 E

XAMPLES OF AUTOMATIC CALCULATION . . . . . . . . . . 6-13

at startup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-13

while running (titration) . . . . . . . . . . . . . . . . . . . . . . 6-13

at KVO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-14

7) ALARMS AND TROUBLESHOOTING . . . . . . . . . 7-1

7.1 WARNING MESSAGES . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

7.2 R

ESPONSE TO ALARMS . . . . . . . . . . . . . . . . . . . . . . . . 7-2

general alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

line a alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5

line b alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

malfunctions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8

8) MAINTENANCE AND STORAGE . . . . . . . . . . . . . 8-1

8.1 CLEANING, MAINTENANCE, AND STORAGE . . . . . . . . . . . 8-1

cleaning and sanitizing . . . . . . . . . . . . . . . . . . . . . . . 8-1

battery maintenance . . . . . . . . . . . . . . . . . . . . . . . . . 8-3

storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4

service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4

430-95215-003 (Rev. 10/05)

iv Contents

9) SPECIFICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

physical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

electrical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

vtbi range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

delivery rate range . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2

air-in-line alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

occlusion alarm and limits . . . . . . . . . . . . . . . . . . . . . 9-3

time to detect downstream occlusions . . . . . . . . . . . . 9-4

bolus volume released after downstream occlusions are

corrected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4

delivery accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4

enteral & high viscosity fluids effects. . . . . . . . . . . . . . 9-5

trumpet curves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-6

10) SUPPLIES AND ACCESSORIES . . . . . . . . . . . . 10-1

10.1 ADMINISTRATION FLUIDS . . . . . . . . . . . . . . . . . . . . . . 10-1

administration fluids . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

enteral and high viscosity fluids . . . . . . . . . . . . . . . . 10-1

containers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

10.2 A

CCESSORIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

11) WARRANTY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

12) DRUG LIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1

© Hospira, Inc. All Rights Reserved

This document and the subject matter disclosed herein are proprietary
information. Hospira retains all the exclusive rights of dissemination,
reproduction, manufacture and sale. Any party using this document
accepts it in confidence, and agrees not to duplicate it in whole or in
part nor disclose it to others without the written consent of Hospira.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 1

1) Descriptive Information

NOTE: In this manual, references to Plum A+ apply to
both systems unless otherwise noted.

Plum A+

®

Lists # 12391-04
and 11971-04

Plum A+®3
Lists # 12618-04
and 12348-04

CAUTION: THIS

IS TO BE USED

DEVICE

AN IV POLE WITH

WITH

6-WHEEL BASE AND

A

SHELF.

A

430-95215-003 (Rev. 10/05)

1- 2 1) Descriptive Information

The Plum A+ and Plum A+3 Volumetric Infusion Systems are
designed to meet the fluid delivery requirements of today’s
evolving healthcare environments. Both are cassette based multi­function infusion systems. The Plum A+ allows two lines in and
one line out while the Plum A+3 allows six lines in and three lines
out. Each pump can be used for standard, piggyback, or
concurrent delivery. Therapy modes include:

• Standard Infusions

• Multistep Programming

• Loading Dose

• Dose Calculation

The Plum A+ and Plum A+3 are designed to deliver parenteral,
enteral, or epidural infusions over a broad range of infusion rates
from multiple fluid container types.

Both are designed to be used in most areas of patient care,
including, but not limited to:

•General Floor •Labor/Delivery/
Post Partum

•Medical/Surgical •OR/Anesthesia •Hemodialysis

•ICU/CCU •Post Op/
Recovery

•Pediatrics •Cardiac Cath
Lab

•Neonatolgy •Emergency •Nutritional

•Burn Unit

•Oncology

•Mobile Intensive
Care

1.1 Product Description

Each system includes a pumping module (hereafter called the
infuser) and an assortment of disposable IV sets (hereafter called
a set), optional accessories, and this operator’s manual.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 3

A computer dataport is also provided to interface with a host
computer.

Accessory equipment connected to the analog and digital
interfaces must be certified according to the respective IEC
Standards (e.g. IEC 60950 for data processing equipment and
IEC 60601-1 for Medical Equipment). Furthermore, all
configurations shall comply with the system standard IEC 60601­1-1. Any person who connects additional equipment to the signal
input or output part configures a medical system, and is therefore
responsible for ensuring that the system complies with the
requirements of the system Standard IEC 60601-1-1. If in doubt,
consult the technical service department or your local
representative.

NOTE: Do not connect dataport while infusing.

1.2 Indications for Use

USER QUALIFICATION

The Plum A+ is intended for use at the direction or under the
supervision of licensed physicians or certified healthcare
professionals who are trained in the use of the infuser and the
administration of parenteral, enteral, and epidural fluids and
drugs and whole blood or red blood cell components. The training
should emphasize preventing related IV complications, including
appropriate precautions to prevent accidental infusion of air. The
epidural route can be used to provide anesthesia or analgesia.

430-95215-003 (Rev. 10/05)

1- 4 1) Descriptive Information

WARNING

ADMINISTER ONLY ANESTHETICS/ANALGESICS
APPROVED FOR EPIDURAL ADMINISTRATION (AS
INDICATED OR ALLOWED BY THE DRUGS’ FDA
APPROVED LABELING). EPIDURAL ADMINISTRATION
OF DRUGS OTHER THAN THOSE INDICATED FOR
EPIDURAL USE COULD RESULT IN SERIOUS INJURY TO
THE PATIENT.

1.3 Conventions

This section describes the conventions used throughout this
manual, as follows:

CONVENTION APPLICATION EXAMPLE

Italic Reference to a

section, figure, or
table

Function or mode
specific instructions

[BRACKETED
ALL CAPS]



[Italic] Softkey Options

Initial Caps
lowercase

Keys or buttons on
the device are
displayed in
[BRACKETED ALL
CAPS] or with a
graphic.

Screen displays and
device labels (as
appropriate)

(See Figure 3-1,

Priming
Cassette)

Primary Only:

Attach an empty
container.

[START]

or



[Choose]

Therapy

Dose Calculation

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 5

CONVENTION APPLICATION EXAMPLE

Bold Emphasis ...sets are

supplied Sterile

and are for....

WARNINGS, CAUTIONS, AND NOTES

Alert messages used throughout this manual are described
below. Pay particular attention to these messages.

WARNING

A WARNING MESSAGE CONTAINS SPECIAL SAFETY
EMPHASIS AND MUST BE OBSERVED AT ALL TIMES.
FAILURE TO OBSERVE A WARNING MESSAGE IS
POTENTIALLY LIFE THREATENING.

CAUTION: A CAUTION

PROCEDURE OR STATEMENT. IT CONTAINS INFORMATION

A

COULD PREVENT IRREVERSIBLE PRODUCT DAMAGE OR

THAT
HARDWARE
COULD RESULT IN SERIOUS PATIENT OR USER INJURY.

FAILURE. FAILURE TO OBSERVE A CAUTION

USUALLY APPEARS IN FRONT OF

NOTE: A Note highlights information that helps explain a

concept or procedure.

This symbol directs the user to consult accompanying
documents.

NOTE: Figures are rendered as graphic representations
to approximate the actual product. Therefore, figures
may not exactly reflect the product.

430-95215-003 (Rev. 10/05)

1- 6 1) Descriptive Information

1.4 Precautions

The Plum A+ has been designed and manufactured to be safe,
reliable, and easy to use. This section details precautions and
possible hazards.

For safe operation of the Plum A+, observe the following
precautions and hazards.

ARTIFACTS

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

• The Plum A+ system is designed to operate normally in
the presence of most encountered electromagnetic
interference (EMI) conditions. In the event of extreme
levels of interference, such as encountered next to an
electrosurgical generator, it is possible that the normal
operation of a sensor or microcomputer might be

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 7

disrupted. Even in this event, the outcome would likely be
a false alarm or detected system malfunction and would
not result in a hazard to patient or operator.

• Use of radio frequency emitting devices such as cellular
telephones and 2-way radios in close proximity of this
device may affect its operation.

HEALTHCARE PROFESSIONALS AND PATIENT RELATED

• Setting the primary rate greater than the secondary rate
will result in a more rapid infusion of any residual
secondary drug remaining in the line and the cassette.

• Consult drug labeling to confirm drug compatibility,
concentration, delivery rates, and volumes are all
suitable for secondary, concurrent and piggyback
delivery modes.

• Arrange tubing, cords, and cables to minimize the risk of
patient strangulation or entanglement.

• Before opening the door, close clamp on the primary line
or remove the secondary container from the secondary
port to prevent mixing of primary and secondary fluids.

• Although unlikely, failure of certain robust mechanical
components such as the anti-free flow mechanism or
valve control springs could cause fluid delivery limited to
the contents of the fluid container. Single fault failure of
certain electronic/motor control components would result
in no more than 5 mL of unexpected fluid delivery.

• A small amount of fluid is expelled from the set (less than

0.05 ml) each time the door is opened or closed with a
set installed. If potent drugs are being used, take
appropriate action to guard against overmedication of the
patient.

• Before disconnecting a syringe from the cassette, pull up
the plunger slightly to avoid spilling the fluid. For rigid
containers, close the upper slide clamp, open the
cassette door, then remove and invert the cassette (ports
down).

430-95215-003 (Rev. 10/05)

1- 8 1) Descriptive Information

• Air bubbles may form distal to the cassette as result of
normal out-gassing of dissolved air in the fluid. This may
occur if chilled solution is in use, if the infuser is mounted
significantly above the patient, or when using certain
fluids known to routinely outgas. In these cases, an air
eliminating filter may be used.

• Repeated opening and closing of the door may defeat the
proximal air-in-line alarm and may cause a distal air-in­line alarm, requiring repriming.

• In vitro studies have suggested that packed red blood
cells with unusually high hematocrit be diluted with blood­compatible fluids, such as 0.9% sodium chloride
injection, to decrease hemolysis and increase flow rate.

• The screen displays the VTBI (volume to be infused) in
integers when value is above 99.9. Any fraction of a
milliliter delivered is not displayed, but is retained in
memory.

• For Plum A+3 users, be aware that changing the weight
on one device does NOT change the weight on the other
two devices. Patient weight must be changed on each
device when delivering weight-based therapy dependent
on medication requirements.

CONCURRENT FLOW

GUIDELINES

When delivering short half-life critical drugs (see Critical Drugs,
this section) using the Plum A+ in the Concurrent mode, the

following delivery rate guidelines should be observed:

• If the critical drug (with half-life less than 6 minutes)
is to be infused at less than 2 mL/hr, the other
infusion should be no faster than 5 times the critical
drug’s rate. Dopamine, for example, delivered at 1.5
mL/hr should not be accompanied by an infusion
programmed any faster than 7.5 mL/hr.

• If the critical drug (with half-life less than 6 minutes)
is to be infused at 2 to 5 mL/hr the other infusion

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 9

should be no faster than ten times the critical drug’s
rate. Dopamine, for example, delivered at 3.5 ml/hr
should not be accompanied by an infusion
programmed any faster than 35 mL/hr.

• If the critical drug (with half-life less than 6 minutes)
is to be infused at 5.1 mL/hr or greater, the other
infusion can be programmed at any desired rate.

NOTE: The total of the primary rate plus the secondary
rate cannot exceed 500 mL/hr.

430-95215-003 (Rev. 10/05)

1- 10 1) Descriptive Information

These guidelines apply only when infusing short half-life critical
drugs in Concurrent mode. Individual patient responses may vary

requiring adjustment of delivery rates.

DELIVERY RATE GUIDELINES

SHORT HALF-LIFE (LESS

THAN 6 MINUTES) CRITICAL

RUG INFUSION RATE

D

0.5 - 1.9 mL/hr 5 Times the Critical Drug Rate

2 - 5 mL/hr 10 Times the Critical Drug Rate

5.1 or Greater Any Desired Ratio

CRITICAL DRUGS

Examples of drugs with a short half-life (approximately 6 minutes
or less when given IV) include:

Dobutamine Lidocaine

Dopamine Nitroglycerin

Epinephrine Nitroprusside

Epoprostenol Norepinephrine

Esmolol Oxytocin

Isoproterenol Procainamide

MAXIMUM RATE OF

CCOMPANYING INFUSION

A

For these drugs, the concurrent flow guidelines should be
followed when the infusion rate of the drug will be 5 mL/hr or less.

NOTE: This list of critical drugs is not intended to be all­inclusive of critical drugs or drugs with a short half-life.

The clinician should become familiar with the pharmacodynamics
of any critical drug before administration.

This information is presented to inform clinicians of a rare
situation that could be misinterpreted if they are unfamiliar with
this phenomenon.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 11

EPIDURAL ADMINISTRATION

• Recommended use of the epidural route is to provide
anesthesia or analgesia for periods up to 96 hours.

• This device can be used to administer only those
anesthetics/analgesics approved for epidural
administration (as indicated or allowed by the drugs’ FDA
approved labeling). Epidural administration of drugs
other than those indicated for epidural use could result in
serious injury to the patient.

• For epidural administration, the use of Hospira catheters,
Plum sets without Y-sites, and "epidural" stickers
indicating ongoing epidural administration are
recommended.

• Administration of drugs via the epidural route should be
limited to personnel familiar with associated techniques
and patient management problems. Proper epidural
placement of the catheter is essential since catheter
migration could result in intravascular or intrathecal
administration. Facilities practicing epidural
administration must be equipped with resuscitative
equipment, oxygen, naloxone, and other resuscitative
drugs. Adequate monitoring equipment (e.g., Oximetry)
is recommended for continuous monitoring of the patient
during epidural administration. Patients must be
observed frequently for side effects in a fully-equipped
and staffed environment for at least 24 hours following
completion of drug administration by the epidural route.
DELAYED RESPIRATORY DEPRESSION FOLLOWING
CONTINUOUS EPIDURAL ADMINISTRATION OF
PRESERVATIVE-FREE MORPHINE SULFATE HAS
BEEN REPORTED.

• The epidural space has 58 openings through which fluid
can exit. Pressure buildup during administration is
transient. However, if a large volume of fluid is
administered over a short time period, the pressure will
take longer to return to normal. If overdelivery occurs
during administration, observe the patient closely for

430-95215-003 (Rev. 10/05)

1- 12 1) Descriptive Information

signs of spinal cord compression (disorientation,
headache, transient neuralgias) and drug overdose.

BATTERY OPERATION

• Do not operate the Plum A+ on patients when the battery
is removed. Use of a properly maintained and charged
battery helps confirm proper operation.

• The battery may not be fully charged upon receipt.
Connect the infuser to AC power for at least six hours.

• Use AC power whenever possible. Connect to AC power
during storage to ensure a fully charged battery for
emergencies. If quality earth grounding source is in
doubt, use battery power.

• If the low-battery alarm sounds, connect the infuser to AC
power immediately.

SETS AND ACCESSORIES

• Only compatible LifeCare Plum Sets can be used with
the Plum A+. See individual set instructions for additional
information.

• Administration sets should be changed per CDC
guidelines or healthcare provider policy. Discard after
use.

• LifeCare IV infusion sets with integral nonblood filters are
not for use in the administration of blood, blood products,
emulsions, suspensions, or any medications not totally
soluble in the solution being administered. These
medications may be administered through the lower Y­injection site, below the filter.

• When infusing at low delivery rates (5 mL/hr or less) the
use of thick-walled microbore Plum sets is
recommended. This will reduce the amount of the fluid
bolus that may be delivered when a distal line occlusion
is released.

• Syringes must be larger than 3 cc. Use syringe adapter
(List 11986-48) when using syringes smaller than 10cc.
Some 10cc syringes may require use of a syringe

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 1- 13

adapter. Syringes larger than 10cc may be attached
directly to the secondary port of the cassette. Use of a
syringe adapter may decrease the occurrence of
proximal occlusion alarms.

• Use a 19-gauge or larger needle or catheter at the
venipuncture site for viscous fluids if operating at rates
greater than 500 ml/hr.

See Section 10 for information on sets and accessories.

BACKPRIMING

• Backpriming is not recommended for reconstituting
secondary containers containing dry powders.

• To avoid pressurization when backpriming into a
syringe, the user must confirm there is sufficient
empty space to accept the backprimed fluid.

GENERAL

• Possible explosion hazard exists if used in the
presence of flammable anesthetics.

• Do not place Plum A+ in service if it fails the self-test.

• Do not operate the Plum A+ with the case opened.

• Keep the cassette door securely closed while the
infuser is not in use, to avoid cassette door damage.

• The Plum A+3 is to be used with an IV pole with a 6­wheel base and a shelf.

CLEANING

For more information on cleaning the infuser, see Section 8.

• To avoid mechanical or electronic damage, do not
immerse the Plum A+ in any fluids or cleaning solutions.

• Do not spray cleaning solutions toward any opening in
the instrument.

• Certain cleaning and sanitizing solutions may slowly
degrade components made from some plastic materials.

430-95215-003 (Rev. 10/05)

1- 14 1) Descriptive Information

Using abrasive cleaners or cleaning solutions not
recommended by Hospira may result in product damage.
Do not use compounds containing combinations of
isopropyl alcohol and dimethyl benzyl ammonium
chloride.

• Never use sharp objects such as fingernails, paper clips,
or needles to clean any part of the infuser.

• Do not sterilize by heat, steam, ethylene oxide (ETO), or
radiation.

• To avoid infuser damage, cleaning solutions should only
be used as directed. The disinfecting properties of
cleaning solutions vary; consult the manufacturer for
specific information.

Use the following procedure to avoid the administration of a bolus
following a distal occlusion (i.e., a closed distal clamp):

• If a secondary container is in use, clamp proximal
tubing before opening cassette door.

• Open cassette door and remove the cassette.

• Open the flow regulator briefly to dissipate the
pressure and then close it.

• Eliminate the source of occlusion (closed clamp).

• Reinsert the cassette and close the cassette door.

• Open all clamps and resume infusion.

NOTE: When troubleshooting an occlusion where all
clamps are in the OPEN position, use care to avoid
delivery of a bolus by opening the flow regulator to
release any built-up pressure. Close the clamp between
the cassette and the patient before opening the flow
regulator to relieve the pressure. See Section 7, Alarms

and Troubleshooting, for more information.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 1

2) Principles of Operation

2.1 Features

The Plum A+ is a dual-line volumetric infusion system designed
to meet the growing demand for hospital-wide, as well as
alternate site and home healthcare, standardization. With it’s
primary line, secondary line, and piggyback fluid delivery
capability, the Plum A+ is suited for a wide range of medical/
surgical and critical care applications. Full compatibility with
LifeCare Plum Series administration sets and accessories and
the LifeShield® and CLAVE® needleless protection systems,
makes the Plum A+ a convenient and cost-effective infusion
system.

PROGRAMS

• Dose Calculation

• Loading Dose

• Multistep Programming

LINE PROGRAMMING OPTIONS

• Drug List

• Nurse Call Back

• Delayed Start Setting

• Concurrent delivery

•Titration

• Micro 0.1-99.9 mL/hr (in 0.1 mL increments) flow
rate range for both lines

• Macro 100-999 mL/hr (in 1 mL increments) flow
rate range for both lines

• Automated Secondary drug delivery (Piggyback)

• Standby Setting

430-95215-003 (Rev. 10/05)

2- 2 2) Principles of Operation

PLUMSET CAPABILITIES

• Anti Free-Flow Protection

• Direct Connection for syringe delivery

AIR MANAGEMENT

•Air Trap

• Air Removal/Backpriming

• Air Detection-Proximal

• Air Detection-Distal

BATTERY

NOTE: The Plum A+3 utilizes three batteries.

• Battery Gauge

• Six Hour Battery Recharge Time

• Long battery life (6 hours) for emergency backup
and temporary portable operation

BIOMEDICAL

• Serial Communication

• Upgradability (Field- for List 12391 only)

• Variable Rate Cap

• Alarm History

• Nurse Call Relay Connector

OPTIONS

• Volumes Infused (A, B, Total Volume)

• KVO at dose end (1 ml/hr or less depending on
delivery rate) or Continue Rate (CR) to continue
at the current rate

• Variable Distal Pressure Settings

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 3

OTHER FEATURES

• Nonpulsatile volumetric accuracy

• Microprocessor control

• Large liquid crystal display (LCD) screen

• Panel back illumination on mains power

• Lockout switch

• Standard syringe use

• Parenteral and nonparenteral (enteral) fluid
delivery

• Blood and blood products delivery

• Wide range of Standard and Specialty
administration sets

• Password protected keypad lock

2.2 Definitions

TERM DEFINITION

Administration
Set

Alarm A condition requiring operator

Alert While entering a program, a visual

The sterile, disposable assembly with
flexible tubing that connects to a
source fluid container for input to the
Cassette pumping chamber and to
some output device for administration
to the patient.

intervention that invokes both audible
and visible alarm indicators.
Confirmation of the condition usually
is required.

warning that informs the clinician of
the violation of a hospital-defined rule
set, e.g., a dose limit for a specific
drug.

430-95215-003 (Rev. 10/05)

2- 4 2) Principles of Operation

TERM DEFINITION

Alternate Units Dose Rate units that may be selected.

Alternate Units are any units other than
mL/hr.

Alternate Units
Parameters

Backpressure Resistance to fluid flow on the Distal or

Backprime Removal of air or fluid from the

Basic Delivery A single-step delivery specifying rate,

Biomed Mode The name for the non-delivery or

Bolus A single uninterrupted discrete volume

Cassette A Hospira standard Plum Macro

Caution Contains information which could

Channel Distal Line output to the patient.

Drug Amount, Diluent, Patient Weight
(if applicable), and Dose Rate.

output portion of the Administration
Set, usually expressed as mmHg.

proximal tubing and Cassette air trap
by rapid pumping of fluid from Line A
to an output receptacle on Line B. No
fluid delivered distal to the cassette
during a Backprime.

VTBI, and duration only. Drug name
may or may not be specified.

service mode of Infuser operation.

of fluid delivered over a discrete period
of time.

Cassette that contains the actual
pumping chamber with inlet and outlet
valves. It also contains access ports to
diaphragms for proximal and distal line
pressure sensing and chambers for air
trapping and air quantity
measurement.

prevent hardware failure, irreversible
damage to equipment, or loss of data.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 5

TERM DEFINITION

Cleared
Program

Cleared
Settings

Concentration For Dose Calculation based Line A or B

Concurrent
Delivery

Concurrent
Mode

Continue Rate
(CR)

Default Drug
Library (DDL)

Deliver
Together

Same as Cleared Settings, but
restricted to the program delivery
settings for an individual line.

Programmed delivery settings for both
lines and the general control
parameters are at their default values.

delivery programming of premixed
drugs, the concentration consists of
Drug Amount (in micrograms [mcg],
milligrams [mg], grams,
milliequivalents [mEq], millimols
[mmols], or units [USP Units]) and
Diluent (Volume in milliliters [mL]).
Abbreviated on screen displays as
“Conc”.

Simultaneous delivery of two fluids at
independent flow rates.

The Line B control selection mode that
allows either Line A or Line B (or both)
of the Mechanism to be programmed
for delivery that completes with KVO or
CR. Line A operation is unaffected by
Line B delivery.

An option used to provide fluid
delivery at the current fluid delivery
rate when the VTBI becomes zero.

A drug list of 99 drug names, default
units and default concentrations, plus
‘No Drug Selected’.

A Biomed Delivery option setting,
which selects default of Piggyback or
Concurrent delivery mode.

430-95215-003 (Rev. 10/05)

2- 6 2) Principles of Operation

TERM DEFINITION

Delivery Mode The normal operational mode for the

Infuser, either Concurrent or
Piggyback, during which fluid delivery
may occur.

Delivery Rate The delivery rate (as Volume/Time)

assigned by the operator or calculated
from other delivery parameters.

Device The Plum A+ IV Infusion Device

(Infuser), not including the disposable
administration sets.

Diluent
(Volume)

Distal Downstream (output) from the

Door The lever-operated, bottom-hinged,

Dose (Rate) Delivery rate times drug concentration.

Dose
Calculation

Drug Amount The mass or quantity of the drug

Duration The time period used to deliver a VTBI

Enteral Delivery via an intestinal route.

The volume of fluid used with the
Diluent Unit (e.g., 250 mL), which
dilutes the drug to be infused.

Cassette portion of the Administration
Set.

Cassette holder on the front of the
Mechanism.

Allows programming Dose Rates in
alternative units of measure. Dose
Calculation can be used in Simple
Delivery, Loading Dose, and Multistep.

premixed with a Diluent to express the
Concentration for the Line being
programmed.

at an existing Delivery Rate or as set by
the operator.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 7

TERM DEFINITION

Error A condition resulting in an audible

warning and often an accompanying
message, such as an invalid key press,
resulting from an operator attempt to
make an input that is not valid for the
current operational context. Not a
Malfunction.

Filling Head
Height (FHH)

Flow Rate The resulting rate of fluid flow. (See

Fluid Delivery
Begin

Infuser A Plum A+ device, not including the

Initialized
Position

Key Any of the marked locations on the

KVO (Keep Vein Open) Internally selected

The gravity induced Proximal Line
pressure due to fluid height in source
container above the Distal Line output
level.

Rate and Dose.)

The time required, measured from the
initial start of a keypad press, for a
digit in the third decimal place of a
scale measuring grams to change
when pumping water, the delivery tube
is fluid filled, and the end of the
delivery tube is immersed.

disposable administration set.

The plunger is in the Plunger Park
Position, and each valve is in the Valve
Home Position.

front panels intended for user input via
a pressing action.

minimal delivery rate, the lesser of 1.0
mL/Hr or actual Rate, intended to
provide sufficient fluid flow to
decrease the potential for clotting at
the IV infusion site.

430-95215-003 (Rev. 10/05)

2- 8 2) Principles of Operation

TERM DEFINITION

Line A Inlet tubing on the top center of

Cassette when viewed after it has been
loaded in Mechanism Door.

Line B Inlet connector on the top right of

Cassette when viewed after it has been
loaded in Mechanism Door.

Loading Dose Allows programming of an initial

infusion rate for a specific volume,
followed automatically by a
maintenance rate from the same
container (e.g., a fluid challenge). If
Dose Calc is used, the Loading Dose
and Maintenance Dose are in the same
unit of measure, over the same period
of time (mcg/min), from the same
container.

Macro Cassette The Plum Cassette as part of an

Administration Set whose attainable
delivery performance is for general
purpose uses.

Malfunction One of a number of conditions that

indicate a failure of the Infuser. These
conditions usually require a repair
action.

Mechanism The provider of the physical activities

of: 1) valve control for Line selection
and inlet to or outlet from the Cassette;

2) Plunger extension and retraction for
changing fluid volume of the Cassette
pumping chamber.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 9

TERM DEFINITION

Multistep Allows a sequential program to deliver

up to 10 steps; fluid volumes and
delivery rates may be programmed for
each step. The program may be
entered based on Rate and Volume or
Volume and Time. If Dose Calc is used,
the delivery steps are in the same unit
of measure, over the same period of
time, from the same container.

Note A Note explains something new, gives

tips on performing an activity, or
provides a reminder of necessary
preparations.

Parenteral Delivery via other than an intestinal

route, such as intravenous (IV)
injection.

Patient Weight The Alternate Units Parameter whose

value entry is required with Dose rates
(quantity/time) having the third
parameter of weight, such as mcg/kg/
min.

Piggyback
Delivery

Piggyback
Mode

Plunger Park
Position

Infusion will stop Line A and infuse
Line B until VTBI completes.

The Line B control selection mode that
requires Line A delivery suspension
while Line B delivers and then its
resumption when Line B VTBI
completes. If Line A is not programmed
and started, Line B delivery just stops
when its VTBI completes. Line A
operation is delayed for duration of its
interruption by Line B.

The position of the pumping plunger
that allows the cassette to be
withdrawn from the Infuser without
restriction, with an opened Door.

430-95215-003 (Rev. 10/05)

2- 10 2) Principles of Operation

TERM DEFINITION

POST Power On Self Tests. Startup

initialization and test of critical
hardware modules and software
functions, to determine Infuser
readiness for its Intended Use.

Power On When the power is first applied to the

Infuser processor. It occurs when
Infuser is in the off condition and the
AC power is applied or during battery
operation when the ON/OFF key is
pressed.

Pressure The measured fluid pressure for

Proximal Line A, Proximal Line B, or
the Distal line when a fully primed
administration set is loaded into a
Mechanism with the Cassette Door
closed.

Programs A Concentration-based extension to

basic Volume/Rate delivery for Dose
Rate applications. Softkey-selected
types are: 1) Standard Program for
single rate delivery; 2) Loading Dose
for up to two steps of delivery at
differing rates; 3) Multistep for up to
ten steps of delivery at differing rates.
Loading Dose and Multistep include
the basic Delivery Rate option.

Protocol In the medical field, hospital-approved

procedures. For devices with an
electronic communications interface,
the format and content of messages
being exchanged.

Proximal Upstream (input, as Line A and/or B)

with respect to the Cassette portion of
the Administration Set.

Rate See Delivery Rate

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 2- 11

TERM DEFINITION

Rounding To round-off to the closest whole

number (e.g., 25.5 would round to 26,
but 25.4 would round to 25).

Screen That active portion of the LCD

assigned to a delivery or other user
interactive display operation.

Softkey A front panel key whose function label

is on the bottom portion of the display
screen just above its location, so that
label may be changed to indicate
differing key functions within the
operational context of the defined
screens.

Standard
Programming

Standby A delivery program state that

System The Plum A+ Infuser system with its

Truncate To round-down to the last whole

Units A Drug Amount (without a quantity of

VI Volume Infused.

(see Basic Delivery)

resembles a delayed start for a line in
all respects, but status display of
STANDBY instead of DELAYED. A
press of the START key (and a Start
Softkey if necessary) will begin the
programmed delivery.

associated accessories and
Administration Sets.

number (e.g., 103.7 would be 103).

mass referent) adopted as the United
States Pharmacopoeia (USP) standard
of measure for use in a Concentration.

430-95215-003 (Rev. 10/05)

2- 12 2) Principles of Operation

TERM DEFINITION

VTBI Volume To Be Infused – The volume of

fluid or IV solution (remaining) for
delivery by a program or Therapy step
from a Line.

Warning Audible indication at the defined

Warning sound level, often
accompanied by a brief message, to
advise operator that: 1. Input was
attempt to use a function in wrong
sequence, with wrong values, or at
wrong time (resulting in an Invalid Key
Warning); 2. Input was properly related
to a function (resulting in a Valid Key
Warning). (The Low Battery Warning is
an exception, using the Alarm
Indication sound level.)

Weight The Alternate Units Parameter whose

value entry is required with Alternate
Units for Dose that include /kg/.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 1

3) Equipment Description

Line A Flow
Indicator

Status
Region

Working
Region

Message
Region

Softkey Label
Softkey
Selector

Start and
Stop Keys

Charging/
Line
Indicator

ON/OFF
Key

Status Region

Working Region

Message Region

Back

Prime

AB

Options/

Vol Inf

Line B Flow

Indicator

LCD

Battery

Charge

Indicator

Numeric

Keys

(Up/Left)

Direction

Keys

(Down/

Right)

Silence

Key

Numeric Field
Clear Key

Basic Layout of Front Panel Display and

Decimal Key

Keypad

430-95215-003 (Rev. 10/05)

3- 2 3) Equipment Description

3.1 Operating Keys

NOTE: For Plum A+3, all

three pumps act as
individual Plum A+’s.

The [ON/OFF] key is
used to control the
power of the Plum A+.

NOTE: All deliveries must

be stopped in order to turn
the power off.

NOTE: To confirm proper
shutdown of infuser, do
not unplug until “double
beep” is heard
(approximately 5
seconds). If “double beep” is not heard, the infuser will
turn itself back ON sensing the AC power was lost and
revert to battery back-up power.

The [START] key is used to
begin infusion and as final
confirmation of
programming.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 3

The [STOP] key is used to
stop the current delivery
on one line; used in
conjunction with soft keys
to stop delivery on both
lines.

The [SILENCE] key is used
to silence an audible alarm
during actions to correct
its cause.

The [SELECT] keys
(or ) are used to

move the highlighting
cursor between the
programming fields.

430-95215-003 (Rev. 10/05)

3- 4 3) Equipment Description

The numeric keys are used
to enter values for any
highlighted field requiring
numeric data.

The [CLEAR] key will
cause a highlighted
numeric field to be cleared
in preparation for data
entry.

The [Decimal] key is used
to manually enter numbers
other than whole numbers
(i.e., 1.2 mL).

.

Softkeys are located at the
bottom of the main display
and serve a variety of
functions. What each key
does is indicated by the
text in the display above
the actual softkey.

Drug

List

Standby Enter

Cancel/

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 5

3.2 Indicators

The Charge/Line Indicator
is illuminated to indicate
the battery is currently
charging.

NOTE: If the device is plugged

into AC power, with a battery
installed, and the Charge
Indicator is not illuminated,
contact technical support.

The fluid drop symbol,
when flashing, indicates
an active infusion on Line
A and/or Line B.

Battery Capacity Symbol
(located on right side of
message region on
display) indicates relative
charge with number of
white boxes from left to
right.

430-95215-003 (Rev. 10/05)

3- 6 3) Equipment Description

3.3 Rear Case Controls

NOTE: For Plum A+3, each control applies to all three

pumps

The audio level rotary
knob, located on the back,
adjusts the alarm audio
level.

The toggle switch, located
below the audio level
control, activates the
lockout function when the
lever is placed in the “up”
position, disabling all front
panel keys except [STOP].

Password Protected
Keypad Lock may also be
used. It both locks and
unlocks the keypad by
pressing the Decimal key,
followed by 9, 6, & 3.

NOTE: For Plum A+3, keypad lock applies to individual

pump in use.

NOTE: Pressing of a key while lockout is active results in the
display of the lockout enabled message. This action is
recommended to confirm each lockout activation.

430-95215-003 (Rev. 10/05)

.

Plum A+ Infusion Systems 3- 7

NOTE: If the lockout switch is put in the “Locked” position
while the infuser is off, the [ON/OFF] key allows the unit to
turn on.

The connector located
below the lockout switch
is the Nurse Call Relay
Connector, for providing
remote notification of a
nurse call event.

The RS-232 DataPort is
used to interface with a
host computer.

NOTE: Do not connect dataport while infusing.

The Equipotential Post
(located on the back of
Plum A+3) is a terminal for
connection of an
equipotential conductor.

430-95215-003 (Rev. 10/05)

3- 8 3) Equipment Description

3.4 Administration Sets

The Plum A+ is compatible with a wide range of LifeCare Plum
series administration sets. Become familiar with the set
components before preparing the administration set.

Primary Line

Flow Regulator

Pumping Chamber

Secondary
Inlet Port
(Capped)

Finger Grip

Patient Line

Air Trap

PREPARING THE ADMINISTRATION SET

NOTE: For detailed instructions, see administration set

packaging.

WARNING

ARRANGE TUBING, CORDS, AND CABLES TO
MINIMIZE THE RISK OF PATIENT STRANGULATION
OR ENTANGLEMENT.

Use the aseptic technique to prepare the administration set for
priming, then proceed as follows:

Make sure flow regulator is closed.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 9

Insert piercing pin into container outlet with
a twisting motion.

Fill Drip chamber to about 1/2 full or to the
score mark. Do not completely fill.

NOTE: To avoid getting Distal Air Alarms,

confirm the fluid bag is positioned higher
than the infuser. This should be set up
prior to priming the cassette.

PRIMING THE ADMINISTRATION SET

Invert the cassette.

Turn the flow regulator counter-clockwise
until a drop of fluid is seen in the pumping
chamber.

Turn the cassette upright, then prime the
remainder of the administration set.

430-95215-003 (Rev. 10/05)

3- 10 3) Equipment Description

Push in the flow regulator to close. Confirm
there is no flow.

LOADING THE CASSETTE

To load the primed cassette into the plum A+, proceed as follows.

Open the cassette door by lifting up the
handle.

Insert cassette into door guides. Close the
cassette door. Confirm there is no flow and
no kinks appear in tubing.

NOTE: If flow is observed, close the tubing

clamps and replace the administration set.

NOTE: The administration set should be
changed per CDC guidelines or healthcare
provider policy. Discard after use.

PREPARING THE SECONDARY LINE

CAUTION: CONSULT THE DRUG LABELING TO CONFIRM

COMPATIBILITY, CONCENTRATION, DELIVERY RATES,

DRUG
AND VOLUMES ARE ALL SUITABLE FOR CONCURRENT
DELIVERY
AUTOMATICALLY

The Plum A+ features concurrent or piggyback delivery modes
when therapy requires administering more than one fluid.

OR PIGGYBACK DELIVERY (SECONDARY FOLLOWED

BY PRIMARY) MODES.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 11

In addition to standard containers, the Plum A+ can use syringes
on the secondary port. The secondary line can be prepared
without removing or repriming the cassette.

Before preparing the secondary line, observe the following
guidelines:

• Review the backpriming function.

• Attach the secondary container using an 18­or 19- gauge, 31 mm (or shorter) needle, if the
cassette secondary inlet port has a piercing
reseal.

• Syringes must be larger than 3 cc. Use
syringe adapter (List 11986-48) when using
syringes smaller than 10cc. Some 10cc
syringes may require use of a syringe
adapter. Syringes larger than 10cc may be
attached directly to the secondary port of the
cassette. Use of a syringe adapter may
decrease the occurrence of proximal
occlusion alarms.

• When using a syringe adapter, retract the
plunger to draw approximately 1 mL of fluid
into the syringe to clear air from the adapter
filter.

To prepare the secondary line, use aseptic technique and
proceed as follows:

With cassette door closed: Loosen and
remove white cap, then discard. Add
secondary tubing or syringe.

Open all proximal clamps before pressing
[START].

430-95215-003 (Rev. 10/05)

3- 12 3) Equipment Description

Set up per operating instructions. (See
Sections 4 - 6 of this manual.)

Syringe: Secure the container to the

cassette door using the optional container
support arm (List 12095-03).

3.5 Discontinuing Electronic Flow Control & Setting Gravity Flow

CAUTION: BEFORE OPENING DOOR, CLOSE CLAMP ON

PRIMARY
CONTAINER
PRIMARY

If electronic flow needs to be stopped, the precision flow regulator
on the cassette can be used to manually set and maintain fluid
flow in a gravity mode (see the following graphics).

OR SECONDARY SET OR REMOVE SECONDARY

FROM SECONDARY PORT TO PREVENT MIXING OF

AND SECONDARY FLUIDS.

1

PRESS STOP

STOP

3

SET GRAVITY RATE BY
TURNING FLOW REGULATOR

2

OPEN DOOR & REMOVE CASSETTE

NOTE: FLOW REGULATOR CLOSES
AUTOMATICALLY WHEN DOOR IS OPENED
TO PREVENT ACCIDENTAL FREE FLOW

NOTE: IF DOOR OPEN ALARM OCCURS, TURN PUMP OFF

COUNTER-CLOCKWISE

NOTE: CASSETTE SHOULD BE
IN UPRIGHT POSITION

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 3- 13

3.6 Discontinuing Fluid Administration

1

PRESS STOP

STOP

3

CLOSE DOOR

4

DISCARD SET AND FLUID
CONTAINER PER HOSPITAL

2

OPEN DOOR, REMOVE CASSETTE

PROCEDURE

430-95215-003 (Rev. 10/05)

3- 14 3) Equipment Description

NOTES

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 1

4) Basic Operation

4.1 Getting Started

UNPACKING

CAUTION: PRODUCT DAMAGE MAY OCCUR UNLESS

PROPER
INSTALLATION
DAMAGED
UPON

Inspect the Plum A+ packaging for possible shipping damage. If
damage is found, contact the delivery company immediately.

Use care when unpacking the infuser. Retain the packing slip and
save all packing material in case the infuser is damaged or fails
the infuser self-test and has to be returned to Hospira.

CARE IS EXERCISED DURING UNPACKING AND

. DO NOT USE THE PLUM A+ IF IT APPEARS

IN ANY WAY. THE BATTERY MAY NOT BE CHARGED

RECEIPT.

Inspect thoroughly for damage.

CAUTION: I

CONTACT HOSPIRA.

To set up, connect the AC (mains) cord to a properly grounded
receptacle, unless temporary battery operation is desired.

NOTE: Use AC (mains) power whenever possible. Store
the infuser connected to AC (mains) to confirm a fully
charged battery for emergencies.

NOTE: If the quality of the earth grounding source is in
doubt, use battery power.

CAUTION: T

OPERATE
ENCOUNTERED
CONDITIONS. IN THE EVENT OF EXTREME LEVELS OF

F THE PLUM A+ APPEARS TO BE DAMAGED,

HE PLUM A+ SYSTEM IS DESIGNED TO

NORMALLY IN THE PRESENCE OF MOST

ELECTROMAGNETIC INTERFERENCE (EMI)

430-95215-003 (Rev. 10/05)

4- 2 4) Basic Operation

INTERFERENCE, SUCH AS ENCOUNTERED NEXT TO AN
ELECTROSURGICAL
OR 2-WAY RADIOS, IT IS POSSIBLE THAT THE NORMAL
OPERATION
DISRUPTED
CONDITIONS

OF A SENSOR OR MICROCOMPUTER MIGHT BE
. OPERATION OF THE INFUSER UNDER THESE

SHOULD BE AVOIDED.

GENERATOR, CELLULAR TELEPHONES,

TANDEM CARRIER INSTRUCTIONS

NOTE: The Plum A+3 is NOT to be used with the tandem

carrier. It is only to be used with the Plum A+ and other
single-channel devices.

The Plum A+ may be safely and conveniently mounted on an IV
stand or on a tandem carrier mounted on an IV stand.

Always mount the tandem carrier (List#
12270-01) to the pole before attaching
the infuser(s) to the tandem carrier.

Make sure tandem carrier clamp is
attached firmly to pole.

Make sure infusers are firmly attached
to tandem carrier.

This section details the Plum A+ instrument setup procedures.

SYSTEM SELF-TESTS

The infuser performs a suite of System Self-Tests when power is
applied to confirm readiness for use.

Failure during the Self-Tests is reported as a Malfunction
Condition.

CAUTION: D

THE SYSTEM SELF-TESTS.

FAILS

O NOT PLACE THE PLUM A+ IN SERVICE IF IT

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 3

Connect the AC power (mains) cord to an AC power receptacle,
then confirm that the Charging/Line indicator illuminates (above
the [ON/OFF] key on the front panel).

A systematic self-testing of the processing, delivery, and safety
systems is performed whenever the Plum A+ is turned on, to
verify readiness for operation.

NOTE: If the quality of earth grounding source is in doubt,
use battery power.

Press the [ON/OFF] key to turn the power on. Check screen
display and listen for a beep to indicate the audio is working. Wait
for the self-tests to complete. If successful, put a fully primed
macro cassette into the cassette door and close the door. See
Loading Cassette in Section 3 for details of correct procedure.

When the Charging/Line indicator is off and the battery symbol on
the display is flashing, this indicates that the Plum A+ is operating
on low battery power and should be recharged.

CAUTION: D

THE BATTERY REMOVED. USE OF A PROPERLY

WITH
MAINTAINED
PROPER

OPERATION.

O NOT OPERATE THE PLUM A+ ON PATIENTS

AND CHARGED BATTERY HELPS CONFIRM

To confirm battery is fully charged, connect the Plum A+ to AC
(mains) power for a minimum of six hours while in the OFF mode.

If an alarm occurs during the power on self-test, identify the alarm
message, then take corrective action (see Section 7, Alarms and
Troubleshooting).

Turn infuser OFF, then back ON. If the self-test alarm recurs,
remove the infuser from service and contact the local Hospira
representative.

The infuser performs a suite of System Self-Tests when power is
applied to confirm readiness for use.

430-95215-003 (Rev. 10/05)

4- 4 4) Basic Operation

Failure during the Self-Tests is reported as a Malfunction
Condition.

DATA RETENTION

Delivery program settings and programming option selections are
retained in non-volatile memory. If the Plum A+ has been turned
off for longer than four hours, all delivery settings are cleared and
programming option selections are restored to their default
selections for next use.

4.2 Power On

1) Press to turn on the
Plum A+ and you will see
the System Self-Tests
screen.

HOSPIRA Plum A+

Release XX.XX

Copyright Hospira

2005

System Self Test

In Progress

CAUTION: THE INFUSER MUST BE

INITIALLY
OTHERWISE THE DATAPORT MAY NOT
OPERATE

After self-testing
successfully completes,
the display will proceed to

STARTED ON AC POWER,

PROPERLY.

**SCREENS SHOWN IN THIS MANUAL

ARE EXA MPL ES ONLY AND DON’T

NECESSARILY REFLECT ACTUAL

CLINICAL PRACTICE**

the next screen.

Programming the infuser may begin during the
cassette check phase of the start-up testing.

NOTE: If battery is missing or defective, a “Battery not
installed” message with a “Continue without battery” prompt
will appear (AC power only).

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 5

CAUTION: DO NOT OPERATE THE PLUM A+ ON PATIENTS

THE BATTERY REMOVED. USE OF A PROPERLY

WITH
MAINTAINED
PROPER

AND CHARGED BATTERY HELPS CONFIRM

OPERATION.

2) To set up the Plum A+,
insert selected Plum Set
and close cassette holder
door lever.

NOTE: If cassette is already

inserted, this screen is skipped.

Example of Clear Settings
Screen

3) The on-screen message
“Clear Settings?” may
appear. Select  [YES] to
clear all settings.

Clear ALL settings when
changing patients or
multiple programming
parameters.

SETUP

Insert PLUM Set

Close Lever

SETUPA

Clear Settings?

Yes clears ALL settings

Yes No

B

NOTE: This clears all delivery parameters, such as Rate and
VTBI on both lines, as well as setting items, such as the KVO
and Nurse Callback options, to their default values.

NOTE: If no settings currently exist or all settings are zero,
this screen will be bypassed.

430-95215-003 (Rev. 10/05)

4- 6 4) Basic Operation

4.3 Simple Delivery

Example of Main Delivery

STOPPED STOPPED

A

screen (with cleared
settings).

**SCREENS SHOWN IN THIS

MANUAL ARE EXA MPL ES ONLY AND

DON’T NECESSARILY REFLECT

ACTUAL CLINICAL PRACTICE**

NOTE: For clarity, whole number
font sizes will appear larger than partial number font sizes
(numbers on the right-side of the comma).

Back

Prime

Rate

0

mL/hr

Vol Inf

00

mL

B

A

1) To Program a delivery rate, select  [A].

2) To enter delivery rate, use

A

PROGRAM

numeric keypad.

Rate

3) Use key to move
down to the VTBI field.

VTBI

Duration

Enter Value using keypad

Program

Options

00:00

Therapy

0

0

0

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 7

4) To enter VTBI amount,
use keypad.

NOTE: While the VTBI is being

entered, the duration is
automatically computed. If the
computed value is greater than
99:59, dashes (- -) appear in place
of hours.

5) Use key to move
down to the DURATION field.

6) Use keypad to change the
hours part of duration if
desired.

NOTE: When all parameters are

displayed, changing any one
parameter will result in other
parameters automatically being
computed. To understand the
Automatic Calculation feature, see

Section 6.8 Examples of Automatic
Calculation.

A

PROGRAM

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

A

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

5.

00:00

Therapy

PROGRAM

5.

0.

00:05

Therapy

5

0

5

5

mL/hr

mL

hr : min

Cancel/

Back

mL/hr

mL

hr : min

Cancel/

Back

7) Use to move from hours to minutes.

NOTE: The maximum hours allowed is 99 and the maximum

minutes is 59.

8) Use keypad to change minutes.

CAUTION: VERIFY ALL VALUES BEFORE STARTING

INFUSION

.

430-95215-003 (Rev. 10/05)

4- 8 4) Basic Operation

9) Press to begin
infusion.

Example of Main Delivery
Screen just after being
programmed and started.

NOTE: The Line A Fluid Flow
Indicator also will flash to indicate
pumping.

PUMPING STOPPED

A

Rate

5.

5

mL/hr

Vol Inf

0.

1

mL

A

B

0

0

Options/

B

Vol Inf

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 9

4.4 Titration

1) Select Line  [A]
(or  [B]) at the Main
Delivery Screen.

2) Enter the desired Rate
using the keypad.

NOTE: When Rate is changed, the

duration is automatically
recomputed using the current
VTBI. To understand the Automatic
Calculation feature, see Section

6.8 Examples of Automatic
Calculation.

CAUTION: V

INFUSION

ERIFY ALL VALUES BEFORE STARTING

.

PUMPING PUMPING

A

25

41 20

A

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

Rate

mL/hr

Vol Inf

mL

A

PROGRAM

03:20

Therapy

15

50

B

50

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

3) After any change,
press to initiate new

Rate and return to the
Main Delivery Screen.

NOTE: Volume Infused is an

incrementing value which is
cleared in



[OPTIONS/VOL INF].

PUMPING PUMPING

A

15

41.

Rate

mL/hr

Vol Inf

6

mL

B

A

50

20

Options/

Vol Inf

B

430-95215-003 (Rev. 10/05)

4- 10 4) Basic Operation

The following 3 screens are examples of
changed values.

Example of changed rate.

4) From the Main Delivery
Screen, select  [A].

A

Rate

VTBI

Duration

PROGRAM

15

50

03:20

5) Use keypad to change the
RATE value.

NOTE: The display time is only

accurate to ± one minute. As
shown in this example, the delivery shows 3 hours and 20
minutes (not 3 minutes and 20 seconds).

NOTE: [START] accepts the change. Delivery is changed to
the new RATE and DURATION and display returns to Main
Delivery Screen.

Example of Changed VTBI

Enter Value using keypad

Program

Options

A

Therapy

PROGRAM

value.

6) Use key to highlight
the VTBI field.

Rate

VTBI

Duration

15

100

06:40

mL/hr

mL

hr : min

Cancel/

Back

mL/hr

mL

hr : min

Enter Value using keypad

7) Use the keypad to change
the VTBI value.

Program

Options

Therapy

Cancel/

Back

NOTE: When the VTBI is changed,
the Duration is recomputed with respect to the current Rate.
To understand the Automatic Calculation feature, see Section

6.8 Examples of Automatic Calculation.

NOTE: [START] accepts the change. Delivery is changed to
the new VTBI and DURATION and display returns to Main
Delivery Screen.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 11

Example of changed

A

PROGRAM

DURATION field.

Rate

8) Use to highlight the
Duration field, then use

the keypad to change it’s
value.

VTBI

Duration

Enter Value using keypad

Program

Options

NOTE: When DURATION is
changed, RATE is automatically
recomputed using the current VTBI value. To understand the
Automatic Calculation feature, see Section 6.8 Examples of

Automatic Calculation.

NOTE: [START] accepts the change. Delivery is changed to
the new DURATION and RATE and display returns to Main
Delivery Screen.

CAUTION: V

INFUSION

ERIFY ALL VALUES BEFORE STARTING

.

15

100

00:40

Therapy

4.5 Piggyback Delivery

mL/hr

mL

hr : min

Cancel/

Back

PIGGYBACK DELIVERY­Infusion will stop Line A
and infuse Line B until
VTBI completes. Line A will
automatically restart.

1) With Line A pumping, to
program a Piggyback



delivery, select

[B].

430-95215-003 (Rev. 10/05)

PUMPING STOPPED

A

Rate

5.

5

mL/hr

Vol Inf

20 0

mL

A

B

5

Options/

B

Vol Inf

4- 12 4) Basic Operation

The Delivery Mode field is
highlighted.

NOTE: If an entry was previously
programmed, RATE is highlighted.
If no previous entries, MODE is
highlighted.

2) If field reads
“Concurrent”, select



[CHANGE MODE] to

switch to “Piggyback”.

3) Select to highlight the
RATE field.

4) To enter delivery rate, use
numeric keypad.

5) Use key to move
down to the VTBI field.

PROGRAM

Mode

Piggyback

Rate

VTBI

Duration

Change using Change Mode

Program

Change

Options

Mode

PROGRAM

Mode

Rate

VTBI

Duration

Enter value using keypad

Program

Options

0
0

00:00

Therapy

Piggyback

200

0

00:00

Therapy

mL/hr

mL

hr : min

Cancel/

Back

mL/hr

mL

hr : min

Cancel/

Back

B

B

6) To enter VTBI amount,

PROGRAM

B

use keypad.

Mode

Piggyback

NOTE: While the VTBI is being
entered, the duration is
automatically computed. If the
computed value is greater than
99:59, dashes (- -) appear in place
of hours. To understand the

Rate

VTBI

Duration

Enter value using keypad

Program

Options

200

100

00:30

Therapy

mL/hr

mL

hr : min

Cancel/

Back

Automatic Calculation feature, see

Section 6.8 Examples of Automatic
Calculation.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 13

7) Use key to move

PROGRAM

down to the DURATION

Mode

field.

(Optional) Use keypad to
change duration.

Enter value using keypad

Program

Options

Rate

VTBI

Duration

Piggyback

133
100

00:45

Therapy

When all parameters are
displayed, changing any
one parameter will result in
other parameters
automatically being
computed.

CAUTION: VERIFY ALL VALUES BEFORE STARTING

INFUSION

.

8) Press to begin infusion.

NOTE: If Line A has a Delay Start remaining, a message will

appear warning of a possible non-delivery (see section 6.4).

mL/hr

mL

hr : min

Cancel/

Back

B

9) Select  [YES] to continue.

Example of Main Delivery
Screen just after being
programmed and started.

430-95215-003 (Rev. 10/05)

DELAYED PUMPING

A

Rate

5.

5

mL/hr

Vol Inf

20 0.

mL

A

B

133

1

Options/

B

Vol Inf

4- 14 4) Basic Operation

4.6 Concurrent Delivery

CONCURRENT DELIVERY-

PUMPING STOPPED

A

B

Simultaneous delivery of two
fluids at independent flow rates.

CAUTION: C

LABELING
COMPATIBILITY
DELIVERY RATES, AND VOLUME ARE

SUITABLE FOR CONCURRENT AND

ALL
PIGGYBACK

ONSULT DRUG

TO CONFIRM DRUG

, CONCENTRATION,

DELIVERY MODES. SEE

Rate

5.

5

mL/hr

Vol Inf

0.

1

mL

A

0

0

Options/

B

Vol Inf

SECTION 8 FOR INFORMATION ON
CONCURRENT FLOW, SEE SECTION 9

FOR DELIVERY RATE RANGES.

NOTE: In concurrent mode with certain alarm conditions, one
line may stop while the other line may continue to deliver.

1) With pumping started on line A, to program a
Concurrent delivery rate, select  [B].

The Delivery Mode field is

PROGRAM

B

highlighted.

Mode

Piggyback

NOTE: If an entry was previously
programmed, RATE is highlighted.
If no previous entries, MODE is
highlighted.

If field reads “Piggyback”,

Rate

VTBI

Duration

Change using Change Mode

Program

Change

Options

Mode

0
0

00:00

Therapy

mL/hr

mL

hr : min

Cancel/

Back

select  [CHANGE MODE] to
switch to “Concurrent”.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 15

Verify change to

PROGRAM

“Concurrent” mode.

Mode

Concurrent

2) Use to highlight Rate
field.

3) To enter delivery rate, use

Rate

VTBI

Duration

Change using Change Mode

Program

Options

00:00

Change

Therapy

Mode

PROGRAM

numeric keypad.

Mode

Concurrent

NOTE: When Rate for Line A plus
Rate for Line B is greater than valid
rate ranges, a “Concurrency
violation” message will explain why
second line did not start. See

Section 9.3 for valid delivery rate
ranges.

NOTE: “Concurrency violation” may not be displayed if unit is
displaying “VTBI Complete”. The device will not start and an
invalid keypress sound will occur when START is pressed.

Rate

VTBI

Duration

Enter value using keypad

Program

Options

00:00

Therapy

10

0
0

0

mL/hr

mL

hr : min

Cancel/

Back

mL/hr

mL

hr : min

Cancel/

Back

B

B

4) Use key to move down to the VTBI field.

5) To enter VTBI amount,

PROGRAM

use keypad.

Mode

Concurrent

NOTE: While the VTBI is being
entered, the duration is
automatically computed. While the
computed value is greater than
99:59, dashes (- -) appear in place
of hours. To understand the

Rate

VTBI

Duration

Enter value using keypad

Program

Options

10

100

10:00

Therapy

mL/hr

mL

hr : min

Cancel/

Back

430-95215-003 (Rev. 10/05)

B

4- 16 4) Basic Operation

Automatic Calculation feature, see Section 6.8 Examples of
Automatic Calculation.

6) Use key to move down to the DURATION
field.

(Optional) Enter values for desired hours and
minutes.

NOTE: When Duration is entered, Rate is automatically
computed.

CAUTION: V

INFUSION

ERIFY ALL VALUES BEFORE STARTING

.

7) Press to begin infusion and return to the
Main Delivery screen.

Example of a concurrent

PUMPING PUMPING

A

B

delivery.

Rate

20.

5.

5

mL/hr

Vol Inf

4

A

mL

10

1

Options/

B

Vol Inf

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 17

4.7 Stop and Start with only 1 Line Pumping

1) Press at the Main
Delivery Screen.

NOTE: If  [A] (or  [B]) is

selected prior to [STOP], the line is
stopped, the display will show the
programming screen. Select



[CANCEL/BACK] to return to the

Main Delivery screen.

Example of STOPPED
delivery.

2) To discontinue infusion,

press .

3) Clamp secondary tubing
if connected.

4) Open door, remove set

PUMPING STOPPED

A

Rate

mL/hr

Vol Inf

5

8.

mL

A

STOPPED STOPPED

Rate

mL/hr

Vol Inf

5

8.

mL

A

Back

Prime

A

Back

Prime

100

100

B

0

0

Options/

B

Vol Inf

B

0

0

Options/

B

Vol Inf

and close door. Or, press to resume
infusion.

430-95215-003 (Rev. 10/05)

4- 18 4) Basic Operation

4.8 Stop and Start with Both Lines pumping

1) Press at the Main
Delivery screen.

2) Select  [STOP A],



[STOP B], or



[STOP ALL].

NOTE: If  [A] (or  [B]) is

selected prior to [STOP], the
display will show the programming
screen. Select
to return to the Main Delivery
screen.



[CANCEL/BACK]

PUMPING PUMPING

A

25

AB

25

Choose line(s) to stop:

Stop

All

Rate

mL/hr

Vol Inf

3 20.

PUMPING PUMPING

3 20.

mL

B

A

Rate

mL/hr

Vol Inf

mL

StopAStop

B

50

4

Options/

Vol Inf

50

4

Cancel

B

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 19

Example of stopped

STOPPED STOPPED

A

infusion.

Rate

mL/hr

Vol Inf

3 20.

mL

A

STOPPED STOPPED

NOTE: This is an example using



[STOP ALL].

CAUTION: V

BEFORE STARTING INFUSION.

ERIFY ALL VALUES

3) To resume infusion,

25

Back

Prime

AB

press .

Rate

mL/hr

Vol Inf

3 20.

mL

StartAStart

4) Select  [START A],



[START B], or



[START ALL].

Or, to discontinue

25

Choose line(s) to start:

Start

All

infusion, press .

5) Clamp secondary tubing if connected.

B

50

4

Options/

B

Vol Inf

50

4

Cancel

B

6) Open door, remove set and close door.

430-95215-003 (Rev. 10/05)

4- 20 4) Basic Operation

4.9 Backpriming

BACKPRIMING- Removal of air

STOPPED STOPPED

A

or fluid from the proximal line
and cassette airtrap.

1) To initiate a backprime,

Rate

5.

5

mL/hr

Vol Inf

8.

9

mL

0

0

select  [BACK PRIME].

NOTE: Backpriming is available

only when all delivery is stopped.
Secondary container is necessary
to receive the air.

2) Select and hold



[BACK PRIME] until fluid

pumped from line A to
line B has expelled the air
from cassette air trap into

Back

Prime

A

5.

8.

A

BACKPRIMING

Rate

5

mL/hr

Vol Inf

9

mL

Options/

B

Vol Inf

0

0

Secondary container.

NOTE: Fluid flow is at maximum

rate possible.

Release Backprime to Stop

Back

A

Prime

Options/

B

Vol Inf

3) Upon release of  [BACK PRIME], the cassette
test is performed to confirm readiness for

B

B

pumping. Pressing will resume
programmed delivery.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 4- 21

4.10 Clearing Program Settings

1) Press at the Main
Delivery Screen.

Clear ALL settings when
changing patients or
multiple programming
parameters.

Use  [CLEAR PROGRAM]
when changing ONLY Line A or B.

2) Select Line A (or B if
active) from the stopped
Main Delivery Screen.

3) Select



[CLEAR PROGRAM].

NOTE: If Line A or B is

programmed with Dose
Calculation, Rate, VTBI and
Duration will not display values.
The values to be cleared may be
viewed in applicable programming
screen under



[DRUG LIST].

PUMPING STOPPED

A

Rate

5.

5

mL/hr

Vol Inf

0.

1

mL

A

A

PROGRAM

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

Clear

Program

5.

03:20

Therapy

22

B

5

0

0

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

430-95215-003 (Rev. 10/05)

4- 22 4) Basic Operation

4) Select  [YES].

Clear ALL settings when
changing patients or
multiple programming
parameters.

Use  [CLEAR PROGRAM]
when changing ONLY Line
A or B.

Example screen of
“Cleared Program”.

5) Select  [CANCEL/BACK] to
return to the Main
Delivery screen or
program new settings.

PROGRAMA

Clear Line A Settings?

Yes No

A

PROGRAM

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

0

0

00:00

Therapy

mL/hr

mL

hr : min

Cancel/

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 1

5) Therapies

Allows programming Dose Rates in

Dose

Calculation

Loading

Dose

Multistep

alternative units of measure. Dose
Calculation can be used in Simple Delivery,
Loading Dose, and Multistep.

Allows programming of an initial infusion
rate for a specific volume, followed
automatically by a maintenance rate from
the same container (e.g., a fluid challenge). If
Dose Calc is used, the Loading Dose and
Maintenance Dose are in the same unit of
measure, over the same period of time
(mcg/min), from the same container.

Allows a sequential program to deliver up to
10 steps; fluid volumes and delivery rates
may be programmed for each step. The
program may be entered based on Rate and
Volume or Volume and Time. If Dose Calc is
used, the delivery steps are in the same unit
of measure, over the same period of time,
from the same container.

NOTE: During programming, user must identify desired drug
with softkey drug list prior to setting program parameters.

Use drug manufacturer recommendations for IV
administration when using the Plum A+ infuser.

430-95215-003 (Rev. 10/05)

5- 2 5) Therapies

5.1 Dose Calc (mcg/kg/min on A)

OSE CALCULATION- Allows programming

D

Dose Rates in alternative units of measure.
Dose Calculation can be used in Simple
Delivery, Loading Dose, and Multistep.

Clear ALL values when changing patients or
multiple programming parameters.

Use



[CLEAR PROGRAM] when changing ONLY

Line A or B.

1) Select  [A] at the Main
Delivery screen.

**SCREENS SHOWN IN THIS

MANUAL ARE EXA MPL ES ONLY AND

DON’T NECESSARILY REFLECT

ACTUAL CLINICAL PRACTICE**

The Line A Programming
screen appears.



2) Select

[THERAPY] for

Dose Calculation
programming.

STOPPED STOPPED

A

Rate

0

mL/hr

Vol Inf

00

Back

Prime

A

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

mL

B

A

PROGRAM

0

0

00:00

Therapy

0

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 3

The Drug List screen
appears, in mainly
alphabetical order.

NOTE: Default entry is “No Drug
Selected”. This selection may be
used later to remove an incorrect
or unwanted drug name from the
display.

3) Use to highlight
desired drug name.

When list does not contain
desired generic drug name
or group name select



[PAGE DOWN] (or  [PAGE

UP]) until it shows, then

use to highlight
choice.

A

Program Drug List

No Drug Selected

Abciximab

Aldesleukin

Alteplase (rt-PA)

Select, then Enter

PageUpPage

Down

A

Program Drug List

Dexmedetomidine HCI

Dobutamine

Docetaxel

Dopamine

Doxorubicin
Epinephrine

Select, then Enter

Epoprostenol

PageUpPage

Down

Acyclovir

Albumin

Alfentanil

Amikacin

Enter

Diltiazem

Enter

Cancel/

Back

Cancel/

Back

4) Select  [ENTER] to indicate selection and
advance to the Program Selection screen.

The Program Selection
screen for Line A appears.

5) Select  [CHOOSE] to
select Dose Calculation

A

Dopamine

PROGRAM

Dose Calculation

Loading Dose

Multistep

and continue.

Select, then Choose

Choose Back

430-95215-003 (Rev. 10/05)

5- 4 5) Therapies

The Program Dose Calc
screen appears.

NOTE: Cursor defaults to package
insert recommended dose units
associated with the selected drug.

6) Select  [CHOOSE] to

continue. Or, use to
change the units to use in
the delivery.

The Container
Concentration Selection
screen appears whenever
the selected Dose Units
are gram-based (e.g.,
grams, mg, mcg, or ng)
otherwise this screen is
skipped.

NOTE: Cursor defaults to package
insert recommended concentration
units associated with the selected
drug.

Program Dose Calc

A

Dopamine

mL/hr

mcg/kg/min

mcg/kg/hr
mcg/min
mcg/hr
mg/kg/hr
mg/min
mg/hr

Select, then Choose

Choose Back

Program Dose Calc

A

Dopamine

Drug Conc in Container

mcg

mg

grams

Select, then Choose

Choose Back

grams/hr
ng/kg/min
units/kg/hr
units/min
units/hr
mUn/min
mEq/hr

7) Select  [CHOOSE] to continue. Or, use
to change the Container Concentration units
to use in the delivery.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 5

The next page of the
Program Dose Calc screen
appears to provide for
entry of delivery program
parameters.

8) Use keypad to enter
desired values. Once

Program Dose Calc

A

Dopamine

Conc
Weight

Enter value using keypad

Program
Options

Dose
VTBI
Duration
Rate

400

70mgkg

00: 00

each value is entered, use

to highlight the next

programming field.

NOTE: The Concentration elements and weight value must

be entered before the [SELECT] keys allow access to
remaining fields.

9) Continue to enter values
using the keypad, and
advancing to the next

field using .

NOTE: As the Dose value is

entered, the Rate is automatically
calculated. To understand the
Automatic Calculation feature, see

Section 6.8 Examples of Automatic
Calculation.

Program Dose Calc

A

Dopamine

Conc
Weight

Dose
VTBI
Duration
Rate

Enter value using keypad

Program
Options

40070mgkg250 mL

00: 00

26.

0
0

0

10

0

3

250 mL

mcg/kg/min
mL
hr : min
mL/hr

Cancel/

Back

mcg/kg/min
mL
hr : min
mL/hr

Cancel/

Back

430-95215-003 (Rev. 10/05)

5- 6 5) Therapies

10) Use to scroll down to
the VTBI field.

11) Enter a value for VTBI
using the keypad.

NOTE: As the VTBI value is

entered or changes, Duration is

Program Dose Calc

A

Dopamine

Conc
Weight

Dose
VTBI
Duration
Rate

Enter value using keypad

Program

Options

40070mgkg250 mL

250

09: 30

26.

10

3

mcg/kg/min
mL
hr : min
mL/hr

Cancel/

Back

automatically updated.

NOTE: At this point, programming is complete unless



[PROGRAM OPTIONS] are desired. See Section 6, Additional

Features, for more information.

12) After entering the desired VTBI value and any
desired  [PROGRAM OPTIONS], press to

begin program.

This will bring up the
PROGRAM CONFIRMATION
screen which appears for
all units of measure except
mL/hr.

CAUTION: VERIFY ALL VALUES

BEFORE SELECTING
STARTING INFUSION.



[YES] AND

Program Dose Calc

A

Delivery will be:

Dose
Drug
Conc
Weight

Yes No

10

mcg/kg/min

Dopamine

400

mg

70

Confirm Program?

kg

250 mL

NOTE: The Concentration drug
amount or Diluent volume cannot be changed while a
delivery is in progress.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 7

The Main Delivery screen
appears displaying the
information just entered.

NOTE: The Therapy Type and
Drug are displayed as well as the
Dose Rate and Dose Units.

PUMPING STOPPED

A

Dopamine

Dose Calculation

26.

mcg/kg/min

Rate

3

mL/hr

Vol Inf

00

mL

10

A

0

Options/

B

Vol Inf

B

430-95215-003 (Rev. 10/05)

5- 8 5) Therapies

5.2 Dose Calc (mg/min on B)

OSE CALCULATION- Allows programming

D

Dose Rates in alternative units of measure.
Dose Calculation can be used in Simple
Delivery, Loading Dose, and Multistep.

Clear ALL values when changing patients or
multiple programming parameters.

Use  [CLEAR PROGRAM] when changing ONLY
Line A or B.

1) Select  [B] at the Main
Delivery screen.

The Line B Programming
screen appears.



2) Select

[THERAPY].

PUMPING STOPPED

A

Dopamine

Dose Calculation

26.

mcg/kg/min

Mode

Rate

VTBI

Duration

Change using Change Mode

Program

Options

Rate

3

mL/hr

Vol Inf

00

mL

10

A

PROGRAM

Piggyback

00:00

Change

Mode

B

0
0

Therapy

0

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

B

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 9

The Drug List screen
appears, in mainly
alphabetical order.

No Drug Selected

Abciximab

Aldesleukin

Alteplase (rt-PA)

Select, then Enter

PageUpPage

Down

Acyclovir

Albumin

Alfentanil

Amikacin

Enter

3) Use to highlight
desired drug name.

When list does not contain
desired generic drug name
or group name select



[PAGE DOWN] (or



[PAGE UP]) until it shows,

Select, then Enter

PageUpPage

Leucovorin

Levofloxacin

Lidocaine

Lipids

Lorazepam

Magnesium Infusion

Mannitol

Mesna

Enter

Down

then use to highlight
choice.

4) Select  [ENTER] to indicate selection and
advance to the Therapy Selection screen.

Cancel/

Back

Cancel/

Back

BProgram Drug List

BProgram Drug List

The Program Select screen
for Line B appears.



5) Select

[CHOOSE] to

continue.

PROGRAM

Dose Calculation

Loading Dose

Multistep

Select, then Choose

Choose Back

B

Lidocaine

430-95215-003 (Rev. 10/05)

5- 10 5) Therapies

The Program Dose Calc
screen appears.

NOTE: Cursor defaults to
manufacturer package insert
recommended dose units
associated with the selected drug.

6) Select  [CHOOSE] to

continue. Or, use to
change the units to use in
the delivery.

The Container
Concentration Selection
screen appears whenever
the selected Dose Units
are gram-based (e.g.,
grams, mg, mcg, or ng)
otherwise this screen is
skipped.

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

mg/min

mg/hr

Select, then Choose

Choose Back

Program Dose Calc

Drug Conc in Container

mcg

mg

grams

Select, then Choose

Choose Back

grams/hr
ng/kg/min
units/kg/hr
units/min
units/hr
mUn/min
mEq/hr

Lidocaine

BProgram Dose Calc

Lidocaine

B

NOTE: Cursor defaults to
manufacturer package insert
recommended concentration units
associated with the selected drug.

7) Select  [CHOOSE] to continue. Or, use
to change the Container Concentration units
to use in the delivery.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 11

The next page of the
Program Dose Calc screen
appears to provide for
entry of delivery program
parameters.

8) Use keypad to enter
desired values. Once

Conc 00grams

Mode Piggyback

Dose
VTBI
Duration
Rate

Enter value using keypad

Program
Options

mL

00: 00

0
0

0

mg/min
mL
hr : min
mL/hr

entered, use to
highlight the next field.

9) To override the Piggyback Delivery Mode
default, scroll down to Mode using , then

select  [CHANGE MODE].

NOTE: Delivery Mode option is available on Line B and its

default is Piggyback. The weight field is independent of Line
A unless Line A selected drug is weight-based. In that
scenario, the Line A weight information applies to Line B.

10) Continue entering
desired values using the

keypad. Use to
advance to the next field.

NOTE: When entering the RATE,

with a VTBI value entered, the
DOSE and DURATION fields are
automatically updated. To
understand the Automatic
Calculation feature, see Section 6.8 Examples of Automatic

Calculation.

Conc 2

Mode Concurrent

Dose
VTBI
Duration
Rate

Enter value using keypad

Program
Options

500

grams
mL

500

16 : 40

30

2

mg/min
mL
hr : min
mL/hr

BProgram Dose Calc

Lidocaine

Cancel/

Back

BProgram Dose Calc

Lidocaine

Cancel/

Back

NOTE: The Duration field temporarily changes to dashes
when the computed value is larger than what can be
displayed.

430-95215-003 (Rev. 10/05)

5- 12 5) Therapies

11) Continue entering the RATE value, if desired.

NOTE: As Rate is entered, the Duration and Dose are

automatically adjusted as individual numbers are entered.

NOTE: If the Duration value is changed, the Rate and Dose
are automatically adjusted.

NOTE: At this point, programming is complete unless



[Program Options] are desired. See Section 6, Additional

Features, for more information.

12) Press to begin
program.

This will bring up the
PROGRAM CONFIRMATION
screen which appears for
all units of measure except

Program Dose Calc

Delivery will be:

Dose
Drug
Conc
Weight

Confirm Program?

Yes No

mL/hr.

CAUTION: VERIFY ALL VALUES

BEFORE SELECTING
STARTING INFUSION.

NOTE: The Concentration drug

amount or Diluent volume cannot be changed while a
delivery is in progress.



[YES] AND

2

Lidocaine

2

70

mg/min

grams
kg

B

500 mL

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 13

Upon , the Main
Delivery screen shows
delivery status for both A
and B lines.

NOTE: See Delivery Rate Range
in Section 9. The ratio of
concurrent rates has
recommendations specified in

Section 1.4.

STOPPED PUMPING

A

Dopamine

Dose Calculation

26.

3

10.

mcg/kg/min

A

Rate

mL/hr

Vol Inf

mL

Dose

Lidocaine

Dose Calculation

30

1

2

mg/min

Options/

B

Vol Inf

B

430-95215-003 (Rev. 10/05)

5- 14 5) Therapies

5.3 Loading Dose

OADING DOSE- Allows programming of an

L

initial infusion rate for a specific volume,
followed automatically by a maintenance rate
from the same container (e.g., a fluid
challenge). If Dose Calc is used, the Loading
Dose and Maintenance Dose are in the same
unit of measure, over the same period of time
(mcg/min), from the same container.

Clear ALL values when changing patients or
multiple programming parameters.

Use  [CLEAR PROGRAM] when changing ONLY
Line A or B.

1) Select  [A] (or  [B]) at

STOPPED STOPPED

A

B

the Main Delivery screen.

Rate

0

mL/hr

Vol Inf

00

Back

Prime

mL

A

0

Options/

B

Vol Inf

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 15

The selected Line (A or B)
Programming screen
appears.

2) Select  [THERAPY].

The Drug List Screen
appears, in mainly
alphabetical order.

NOTE: Default entry is “No Drug
Selected”. This process will guide
you through a “fluid challenge”, so
“No Drug Selected” will be entered.

3) Select  [ENTER] to
indicate selection and
advance to the Therapy
selection screen.

A

PROGRAM

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

A

Select, then Enter

PageUpPage

00:00

Therapy

Program Drug List

No Drug Selected

Abciximab

Acyclovir

Albumin

Aldesleukin

Alfentanil

Alteplase (rt-PA)

Amikacin

Enter

Down

0

0

mL/hr

mL

hr : min

Cancel/

Back

Cancel/

Back

The Select Therapy screen
for Line A (or B) appears.

NOTE: This example shows line A
being programmed.

430-95215-003 (Rev. 10/05)

A

Select, then Choose

PROGRAM

Dose Calculation

Loading Dose

Multistep

Choose Back

5- 16 5) Therapies

4) Use to scroll down to
Loading Dose.

5) Select  [CHOOSE] to
continue.

The next page of the
Program Loading Dose
screen appears.

6) Select  [CHOOSE] to
continue. Or, use to

change the units to use in
the delivery.

The Loading Dose
Programming screen
appears.

7) The default field is Rate.
Since a “fluid Challenge”
is being performed in this

example, press to
advance to the VTBI field.

A

Select, then Choose

A

Select, then Choose

A

Enter value using keypad

Program

Options

PROGRAM

Dose Calculation

Loading Dose

Multistep

Choose Back

Program Loading Dose

mL/hr

mcg/kg/min
mcg/kg/hr
mcg/min
mcg/hr
mg/kg/hr
mg/min
mg/hr

grams/hr
ng/kg/min
units/kg/hr
units/min
units/hr
mUn/min
mEq/hr

Choose Back

Program Loading Dose

Rate

VTBI

mL

mL/hr

0

0

1
2

0

0

Duration

hr : min

00 : 00
00 : 00

Cancel/

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 17

8) Enter value using keypad.

9) Use to highlight the
next field.

10) Enter Duration using
keypad. The Rate value is
automatically calculated.
To understand the
Automatic Calculation
feature, see Section 6.8

Examples of Automatic
Calculation.

Program Loading Dose

A

Rate

VTBI

mL/hr

mL

0

1
2

Enter value using keypad

Program
Options

Program Loading Dose

A

1
2

Enter value using keypad

Program

Options

Rate
mL/hr

500

250

0

0

VTBI

mL

250

0

0

Duration

hr : min

00 : 00
00 : 00

Cancel/

Duration

hr : min

00 : 30
00 : 00

Cancel/

Back

Back

11) After the values for
loading dose Step-1 are

entered, use to
highlight the maintenance

dose, Step-2.

NOTE: The Loading Dose therapy

has two steps. The first is the
loading dose followed by the
maintenance dose. These words
will appear on the main screen as
each step is delivered.

Program Loading Dose

A

Rate

VTBI

mL

250

Duration

hr : min

00 : 30

0

00 : 00

Cancel/

Back

mL/hr

500

1

75

2

Enter value using keypad

Program

Options

430-95215-003 (Rev. 10/05)

5- 18 5) Therapies

12) Enter the set of desired
values for Step-2 of the
program.

13) Select  [PROGRAM

OPTIONS] to select a

Delayed Start or Standby.

NOTE: At this point, programming
is complete unless

Options] are desired. See Section
6, Additional Features, for more
information.

NOTE: Nurse Callback enables an
alarm when a change in the
delivery on a line occurs such as
completing Step-1 and starting
Step-2. Or on line B, a piggyback
delivery is completed and line A is
starting its delivery.



[Program

Program Loading Dose

A

Rate

VTBI

mL
250

750

Enter

Duration

hr : min

00 : 30
10 : 00

mL/hr

500

1

75

2

Enter value using keypad

Program

Options

A

Program Options

Delay Start for 00:00 hr:min

Callback No

Enter Value using keypad

Standby

Cancel/

Back

Cancel/

Back

14) Enter a delay time (less

A

Program Options

than or equal to 24 hours)
using the keypad.

Delay Start for 00:05 hr:min

NOTE: Not available if a delivery is

Callback Yes

taking place on the line.

NOTE: Nurse Callback cannot be
changed while a delivery is taking

Change using Yes/No

Yes/No

Enter

Cancel/

Back

place on the line.

15) Select  [ENTER] to accept the changes and

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 19

return to the Program Loading Dose screen.

NOTE:  [CANCEL/BACK] returns the fields to their original

value and displays the previous screen.

CAUTION: V

INFUSION.

ERIFY ALL VALUES BEFORE STARTING

16) Press to begin program.

The Main Delivery Screen

A

appears.

NOTE: The words “DELAYED” and
“Loading Dose” appear in the
upper-left corner. These indicate
the options which have been
selected.

After the programmed

A

delay period has expired,
the Plum A+ starts
“Pumping”. This is
indicated where “Delayed”
previously was displayed.

DELAYED STOPPED

Loading Dose

500

Loading Dose

500

Rate

mL/hr

Vol Inf

00

mL

B

A

PUMPING STOPPED

Rate

mL/hr

Vol Inf

00

mL

0

Options/

Vol Inf

0

B

B

A

Vol Inf

Options/

B

430-95215-003 (Rev. 10/05)

5- 20 5) Therapies

After the Step-1 has
completed, the Main
Delivery screen changes to
the second step.

PUMPING

A

Maintenance Dose

75

250 0

STOPPED

Rate

mL/hr

Vol Inf

mL

0

NOTE: A flashing “Callback Line A”
message and the audio alarm
sound indicates activation of that
option.

N105 Callback Line A

A

Options/

B

Vol Inf

17) The user should acknowledge the Callback
message and stop the audio alarm by

pressing .

Upon completion of
delivery, the screen shows
a flashing “Line A VTBI

A

Maintenance Dose

1

complete” message and
the audible alarm sounds.

NOTE: The KVO rate will change
to the rate of 1 mL/hr or less
depending on delivery rate and
“Pumping” mode changes to
“KVO”. If Continue Rate option was selected, pumping
continues at original rate.

1000 0

N161 Line A VTBI complete

KVO

mL/hr

Vol Inf

A

Rate

STOPPED

mL

B

0

Options/

Vol Inf

B

B

18) Press to stop alarm sound.

NOTE: Warning message continues to flash and audio alarm

will return after a two minute period of silence, unless delivery
is stopped or VTBI of last line is changed.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 21

5.4 Multistep Programming

ULTISTEP- Allows a sequential program to

M

deliver up to 10 steps; fluid volumes and
delivery rates may be programmed for each
step. The program may be entered based on
Rate and Volume or Volume and Time. If Dose
Calc is used, the delivery steps are in the same
unit of measure, over the same period of time,
from the same container.

Clear ALL values when changing patients or
multiple programming parameters.

Use  [CLEAR PROGRAM] when changing ONLY
Line A or B.

1) Select  [A] at the Main
Delivery screen.

430-95215-003 (Rev. 10/05)

STOPPED STOPPED

A

Rate

0

mL/hr

Vol Inf

00

Back

Prime

mL

B

A

0

Options/

Vol Inf

B

5- 22 5) Therapies

The Line A Programming
screen appears.

2) Select  [THERAPY].

The Drug List Screen
appears, in mainly
alphabetical order.

3) Use to highlight
desired drug name.

When list does not contain
desired generic drug name
or group name, select



[PAGE DOWN] (or  [PAGE

P]) until it shows, then

U

A

PROGRAM

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

A

Select, then Enter

PageUpPage

A

Select, then Enter

PageUpPage

00:00

Therapy

Program Drug List

No Drug Selected

Abciximab

Acyclovir

Albumin

Aldesleukin

Alfentanil

Alteplase (rt-PA)

Amikacin

Enter

Down

Program Drug List

Ticar-clavulanate

Tirofiban

Tobramycin

TPN

Urokinase

Vancomycin

Vecuronium

Verapamil

Enter

Down

0

0

mL/hr

mL

hr : min

Cancel/

Back

Cancel/

Back

Cancel/

Back

use to highlight
choice.

4) Select  [ENTER] to indicate selection and
advance to the Therapy selection screen.

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 23

The Select Therapy screen
for Line A (or B) appears.

NOTE: This example shows line A
being programmed.

5) Use to scroll down to
Multistep.

6) Select  [CHOOSE] to
continue.

The Program Multistep
screen appears.

NOTE: Cursor defaults to package
insert recommended dose units
associated with the selected drug.

7) Use key to highlight
the units to use in the
delivery.

A

TPN

Select, then Choose

A

TPN

Select, then Choose

A

TPN

Select, then Choose

PROGRAM

Dose Calculation

Loading Dose

Multistep

PROGRAM

Dose Calculation

Loading Dose

Multistep

Program Multistep

mL/hr

mcg/kg/min
mcg/kg/hr
mcg/min
mcg/hr
mg/kg/hr
mg/min
mg/hr

Choose Back

Choose Back

grams/hr
ng/kg/min
units/kg/hr
units/min
units/hr
mUn/min
mEq/hr

Choose Back

8) Select  [CHOOSE] to
continue.

430-95215-003 (Rev. 10/05)

5- 24 5) Therapies

The Multistep
Programming screen
appears.

9) Rate is the default field.
Enter value using keypad.

10) Use to highlight the
Duration or VTBI field.

NOTE: The VTBI value is

automatically computed when the
Duration value is entered. If VTBI
is entered, the Duration value is
automatically computed.

11) Use to drop down to
Step-2, Rate field.

12) Enter the set of desired
values for Step-2 of the
program. Continue
process for each
additional Step.

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

1

0

2

0

3

0

4

Enter value using keypad

Program

Options

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

50

1

0

2

0

3

0

4

Enter value using keypad

Program

Options

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

50

1

100

2

0

3

0

4

Enter value using keypad

Program

Options

0
0
0
0

More
Steps

0
0
0

More
Steps

0
0
0

More
Steps

Duration

hr : min

00 : 00
00 : 00
00 : 00
00 : 00

Cancel/

Duration

hr : min

01 : 00

00 : 00
00 : 00
00 : 00

Cancel/

Duration

hr : min

01 : 00
00 : 00
00 : 00
00 : 00

Cancel/

Back

Back

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 25

NOTE: When Step-4 is
programmed, using the [SELECT]
keys to advance will highlight
another item on this screen.

13) When Step-4 is
programmed, select



[MORE STEPS] to

program up to 10 Steps.

NOTE: Using the [SELECT] keys

will not advance you to the
additional steps.

14) To set up Steps 5 through
10, enter desired values
as performed for Steps 1
through 4.

To see the previous steps,
select  [PREV STEPS].

NOTE: Confirmation screen will
appear ONLY if using weight­based program.

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

50

1
2
3
4

Enter value using keypad

Program

Options

A

TPN

5
6
7
8
9

10

Enter value using keypad

Program

Options

825

100

75

75

50

50

Program Multistep

VTBI

Rate

mL/hr

mL

0

0
0
0
0
0

More

Steps

0
0
0
0
0
0

Prev

Steps

Duration

hr : min

01 : 00
08 : 15
01 : 00

01 : 00

Cancel/

Duration

hr : min

00 : 00
00 : 00
00 : 00
00 : 00
00 : 00
00 : 00

Cancel/

Back

Back

CAUTION: V

ERIFY ALL VALUES BEFORE STARTING

INFUSION.

15) Press to begin program.

430-95215-003 (Rev. 10/05)

5- 26 5) Therapies

The Main Delivery screen
displays Step-1 in the
upper-left corner.

NOTE: In units other than mL/hr,
the Dose rate and units also will be
displayed.

Example of Multistep
Screen Pumping on Step-2.

16) To change a program
parameter while pumping,
select  [A].

NOTE: The “*” in a Step number

field indicates the step is delivering
or “d” indicates each completed
step.

17) Enter a value using the
keypad.

PUMPING STOPPED

A

TPN
Step 1

27.

50

Rate

mL/hr

Vol Inf

5

mL

A

PUMPING STOPPED

A

TPN
Step 2

100

652 0

Rate

mL/hr

Vol Inf

mL

A

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

50

d

3
4

Enter value using keypad

Program

Options

100

825

75

75

50

50

B

B

More
Steps

0

0

Options/

Vol Inf

0

Options/

Vol Inf

Duration

hr : min

01 : 00
08 : 15
01 : 00
01 : 00

Cancel/

B

B

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 5- 27

If Rate value is changed,
the Duration will
automatically change.

NOTE: Only the current delivering
step and future steps can be
changed.

CAUTION: V

BEFORE STARTING INFUSION.

ERIFY ALL VALUES

NOTE: The Values are now

updated on the Main Delivery
Screen.

The infuser reverts to KVO
when last Step completes.

The last step can be
restarted by entering a new
VTBI value.

Program Multistep

A

TPN

Rate

VTBI

mL/hr

mL

50

50

d

3
4

Enter value using keypad

Program

Options

PUMPING STOPPED

A

TPN
Step 2

125

658 0

125

825

75

75

50

50

Rate

mL/hr

Vol Inf

mL

A

More

Steps

B

Duration

hr : min

01 : 00
06 : 36
01 : 00
01 : 00

Cancel/

0

Options/

Vol Inf

Back

B

430-95215-003 (Rev. 10/05)

5- 28 5) Therapies

NOTES

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 6- 1

6) Additional Features

6.1 Simple Delivery Using Drug List

1) Select Line  [A] (or 

[B]) at the Main Delivery

screen.

**SCREENS SHOWN IN THIS MANUAL

ARE EXA MPLE S ONLY AND DON’T

NECESSARILY REFLECT ACTUAL

CLINICAL PRACTICE**

The Line A Programming
screen appears.

2) Select



[PROGRAM OPTIONS].

The default screen for
Program Options appears.

STOPPED STOPPED

A

Rate

0

mL/hr

Vol Inf

00

Back

Prime

A

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

A

mL

B

A

PROGRAM

0

0

00:00

Therapy

Program Options

0

Options/

Vol Inf

mL/hr

mL

hr : min

Cancel/

Back

B

3) Select



[DRUG LIST].

Delay Start for 00:00 hr:min

Callback No

Enter Value using keypad

Drug

List

Standby

Enter

Cancel/

Back

430-95215-003 (Rev. 10/05)

6- 2 6) Additional Features

The Drug List Screen
appears, in mainly
alphabetical order.

4) Use to highlight
desired drug name.

When list does not contain
desired generic drug name
or group name select



[PAGE DOWN] (or  [PAGE

UP]) until it shows, then

A

Program Drug List

No Drug Selected

Abciximab

Aldesleukin

Alteplase (rt-PA)

Select, then Enter

PageUpPage

Down

A

Program Drug List

Dexmedetomidine HCI

Dobutamine

Dopamine

Doxorubicin

Epinephrine

Select, then Enter

Epoprostenol

PageUpPage

Down

Acyclovir

Albumin

Alfentanil

Amikacin

Enter

Diltiazem

Docetaxel

Enter

use to highlight
choice.

5) Select  [ENTER] to indicate selection and
return to the Program Options screen. Or,
select  [CANCEL/BACK] if no choice is
acceptable.

Cancel/

Back

Cancel/

Back

Drug name is now visible
in the upper-left corner.



6) Select



[CANCEL/BACK] to return

[ENTER] or

A

Program Options

Dopamine

Delay Start for 00:00 hr:min

Callback No

to the Line Programming
screen.

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

Enter Value using keypad

Drug

List

Standby

Enter

Cancel/

Back

430-95215-003 (Rev. 10/05)

Plum A+ Infusion Systems 6- 3

Notice the drug name
remains in the upper-left
corner.

7) Enter a RATE using the
keypad.

8) Use to highlight the
VTBI field and enter a
value. The DURATION will
be automatically calculated.

9) Press to begin
program and return to the
Main Delivery screen.

Notice the drug name
remains in the upper-left
corner.

A

PROGRAM

Dopamine

Rate

VTBI

Duration

Enter Value using keypad

Program

Options

PUMPING STOPPED

A

Dopamine

5

1

0.

A

250

50:00

Therapy

Rate

mL/hr

Vol Inf

mL

B

5

mL/hr

mL

hr : min

Cancel/

Back

0

0

Options/

Vol Inf

B

430-95215-003 (Rev. 10/05)

6- 4 6) Additional Features

6.2 Simple Delivery Using Delayed Start

1) Before or after entering
the simple delivery
program, select



[PROGRAM OPTIONS].

NOTE: To program a Delayed Start
using a Therapy (i.e., Dose Calc)
you must first select which line you
want (A or B), next select



[DRUG LIST], and then



[PROGRAM OPTIONS]. If you
program the Delayed Start first, it
will be cleared upon entry into
Program mode.

The Default screen for
Program Options appears.

PROGRAM

Mode

Concurrent

Rate

VTBI

Duration

Change using Change Mode

Program

Change

Options

Mode

Delay Start for 00:00 hr:min

Callback No

Enter Value using keypad

Drug

Standby

List

250

50:00

Therapy

Enter

5

mL/hr

mL

hr : min

Cancel/

Back

Cancel/

Back

B

BProgram Options

430-95215-003 (Rev. 10/05)