Ambit PIB-PCA User manual

Dr A Ruthven – Version 1.2 – November 2021
Page 1 of 2
For the initial set-up of the ambIT PIB-PCA pump. For pump management see the ambIT WARD guide.
For pump assistance contact the pain team (bleep 5247 RIE / 3934 SJH) or on-call anaesthetist (bleep 2140
RIE / 3948 SJH) out of hours.
See NHS Lothian Clinical Companion App (RIE Anaesthesia – Department Guidelines – Regional) for:
• Video tutorials demonstrating pump setup and operation (very useful if pump if unfamiliar with pump).
• PDF versions of this guide and the ward guide.
• Link to manufacturer’s manual.
The ambIT app (search app store for ‘ambIT Pump Training’) is also useful for learning pump setup.
YOU NEED
1. ambIT pump
2. 2 x new AA batteries
3. ambIT cassette (giving set)
4. Black carry bag
5. A bag of local anaesthetic, at least 200ml in volume:
a. First choice 200ml 0.125% levobupivacaine
b. Second choice 250ml 0.125% bupivacaine
6. Prescription chart, depending on type of catheter (peripheral nerve or fascial plane / wound)
PRIMING THE CASSETTE
1. Remove orange protective cover from bottom of cassette & keep to one side.
2. Spike bag of local anaesthetic with cassette tubing and check clamp open.
Spiking requires sustained force & twisting motion – ensure spike inserted to the hilt (see figure 1).
3. To remove air and prime the system, invert bag of local anaesthetic so tubing is uppermost and manually
squeeze bag to force air then fluid through to end of tubing (see figure 2).
If air cannot be squeezed through tubing, the spike is not inserted far enough into the bag (see figure 1).
4. Push the cassette disc down on all sides so it clicks (see figure 3).
5. Snap off wings from orange protective cover & use it to wind cassette disc anti-clockwise until the silver
dot makes one full revolution (see figure 4). Now discard the protective cover.
Note the orange cover has a large hole and a small hole – engage the small hole with the cassette pin.
6. Attach the cassette to the top of the pump by snapping it into place – it will only fit one way.
FIGURE 1
silver dot
wind orange cover
anticlockwise until dot
makes 1 full revolution
FIGURE 4
FIGURE 3
orange
protective
cover
cassette disc
FIGURE 2
ambIT SET-UP guide
RIE / SJH

Dr A Ruthven – Version 1.2 – November 2021
Page 2 of 2
PROGRAMMING THE PUMP
1. Open the white battery cap by twisting anticlockwise and pulling. Insert 2 x new AA batteries.
2. Turn on the pump – replace the white battery cap and twist it clockwise until black and white lines align.
3. The pump will be in pause mode – a flashing ; will be displayed.
4. Clear the pump history (READ THIS ENTIRE STEP BEFORE STARTING):
• Press and hold !!for 2 seconds – pump beeps & displays ‘Hx’.
• Release and immediately then re-press and hold for 2 seconds – pump beeps & displays ‘Hx O’.
• The history has now been cleared. If ‘Hx O’ was not displayed, repeat this step until it is.
5. The pump remains in pause mode – a flashing ; will be displayed.
6. Press and hold both and ! together for 2 seconds until a beep is heard & PRO is displayed briefly.
7. Flashing PIb should be displayed. If not, press to cycle through modes until PIb is displayed.
8. Press and hold !!until a beep is heard to select PIb mode.
9. Set the desired dose (d) i.e. programmed intermittent bolus volume by tapping to increase / !to
decrease (see prescription charts for suggested doses). Do not press and hold buttons to change faster.
10. Press and hold !!until a beep is heard to confirm the dose & repeat for the decimal.
11. Int will be displayed then disappear. Set the bolus interval to 4:00 (4 hours) in the same way (tap
and !!to change, press and hold !!to confirm).
12. Set the ‘volume to be infused’ to the same as the volume of the attached local anaesthetic bag.
Note volumes vary between drug manufacturers – please check carefully when programming pump.
13. A flashing ;signifies programming is complete. The pump remains in pause mode.
14. Press !to review programming. The settings will be displayed then the pump resumes pause mode.
15. If you have made an error at any point you must repeat the entire process (go back to step 6).
STARTING THE PROGRAM
Do this ASAP after loading dose given (even if pump not yet attached to catheter)
1. Press to start the program. If you have not already reviewed the program settings, these will be
displayed in sequence and you then need to press again to start the program.
2. A flashing green light under !!shows that the program is running. The display should show 0.0ml.
Do not press !!within 60 seconds of starting the program or an initial bolus will be delivered.
If !!is pressed in error and an inadvertent bolus is started, see box below.
3. If the display shows a volume other than 0.0ml, the history has not been successfully cleared. Press
to pause the pump and repeat step 4 under ‘programming the pump’ above, then press to restart.
4. Place pump & local anaesthetic in black carry bag, being careful not to kink tubing within the bag.
5. Document date/time program started on prescription chart.
REVIEWING THE CURRENT PROGRAM SETTINGS
1. Press to pause the pump – a flashing ;is displayed.
2. Press ! – the display shows ‘Rx’ then cycles through:
• Program type (should always be set to PIb)
• Programmed intermittent bolus volume (e.g. 20-30ml)
• Dosing interval (should always be set to 4:00 i.e. 4 hours)
• Volume to be infused remaining
3. The pump remains in pause mode with a flashing ;displayed.
4. Press !to restart the program. !!flashes green to show the pump is running & the display shows
the total volume infused since the history was last cleared.
STOPPING AN INADVERTENT INITIAL BOLUS
1. Press to enter pause mode and stop bolus administration. A flashing ;is displayed.
2. Clear the pump history (READ THIS ENTIRE STEP BEFORE STARTING):
• Press and hold !!for 2 seconds – pump beeps & displays ‘Hx’.
• Release and immediately then re-press and hold for 2 seconds – pump beeps & displays ‘Hx O’.
• The history has now been cleared. If ‘Hx O’ was not displayed, repeat this step until it is.
3. Press !to restart program. !!flashes green to show the pump is running & the display shows 0.0ml.