Avanos ambIT PreSet v1.5 User manual

.
MORE THAN PAIN RELIEF...
SUPERIOR PAIN CONTROL
CLINICIAN MANUAL
ambIT®PreSet v1.5 Pump
IP22

Become familiar with the ambIT
®
pump
Solution container
Tubing
clamp
BOLUS
button
ambIT
®
Pump
ON/OFF
switch
Tubing
clamp
Pump display
RUN/PAUSE button
Cassette
To solution container
(Side view of cassette)
Cassette shaft
To patient

i
Table of Contents
SECTION 1 - INTRODUCTION........................................................................................................1
1.1 DenitionsandSymbols.......................................................................................................1
1.1.1 Denitions ....................................................................................................................1
1.1.2 DenitionofSymbols..................................................................................................2
1.2 Warnings.................................................................................................................................5
1.2.1 Sterile, Disposable (Single-Use) Administration Set ..............................................7
1.2.2 Protection From Air Infusion.....................................................................................7
1.2.3 Protection From Unintended Bolus ..........................................................................7
1.2.4 Use of ambIT®PreSet v1.5 Pump in MRI Environment.........................................7
1.3 Indications for Use.................................................................................................................8
1.5 Infusion Patterns....................................................................................................................9
SECTION 2 - SET UP .........................................................................................................................11
2.1 Required Materials ..............................................................................................................11
2.2 ambIT
®
Cassette ...................................................................................................................12
2.3 Priming the Cassette ...........................................................................................................12
2.4 Attach Cassette to the Pump..............................................................................................15
2.5 Remove Cassette from the Pump......................................................................................15
2.6 Changing the Fluid Reservoir............................................................................................15
2.7 Battery Installation and Replacement...............................................................................15
2.7.1 Battery Installation ....................................................................................................16
2.7.2 Battery Replacement .................................................................................................16
2.8 Pump Power On and Off....................................................................................................17
SECTION 3 - PROGRAMMING INSTRUCTIONS ....................................................................18
3.1 General Information............................................................................................................18
3.2 ambIT®Pump User Interface .............................................................................................19
3.3 Program Options .................................................................................................................19
3.4 Programming the Pump.....................................................................................................21
3.4.1 Programming a Preset Infusion Protocol (PRO1 - 4)............................................21
3.4.2 Programming a Custom Infusion Protocol (PRO5)..............................................22
3.5 Moving Backward in Display While Programming.......................................................24
SECTION 4 - OPERATING INSTRUCTIONS .............................................................................26
4.1 Start Infusion........................................................................................................................26
4.2 Pause Infusion......................................................................................................................26
4.3 Resume Infusion ..................................................................................................................27
4.4 Silence Alarm .......................................................................................................................27
4.5 Bolus Activation...................................................................................................................27
4.6 Summary of Operating Controls.......................................................................................28
SECTION 5 - INFUSION HISTORY REPORTS...........................................................................29
5.1 Pump Infusion History.......................................................................................................29
5.2 Clearing Pump Infusion History.......................................................................................29
SECTION 6 - PATIENT LOCKOUT ...............................................................................................30
6.1 Accessing Lockout Mode....................................................................................................30
6.2 To Lock the Pump................................................................................................................30
6.3 To Unlock the Pump ...........................................................................................................31
SECTION 7 - ALARMS AND SIGNALS .......................................................................................32

ii
SECTION 8 - TROUBLESHOOTING.............................................................................................34
SECTION 9 - SPECIFICATIONS.....................................................................................................35
9.1. GeneralSpecicationsApplicabletoAllPumps ............................................................35
SECTION 10 - DELIVERY RATE ACCURACY............................................................................36
10.1 Data from Volumetric Accuracy Testing .........................................................................37
10.2 Factors That May Affect Volumetric Accuracy...............................................................38
SECTION 11 - GENERAL CARE INSTRUCTIONS....................................................................42
11.1 Warranty Information.........................................................................................................42
11.2 Cleaning and Disinfecting Instructions............................................................................43
SECTION 12 - ELECTROMAGNETIC IMMUNITY (EMC) ......................................................44
SECTION 13 - CUSTOMER ASSISTANCE ..................................................................................46

Section 1 • Introduction
1
SECTION 1 - INTRODUCTION
1.1 DenitionsandSymbols
1.1.1 Denitions
ANALGESIA: Relief from pain.
BASALFLOWRATE:Thecontinuousowrate.Itoccurswhenthepumpisnotdeliveringa
bolus.Thebasalowrateisadjustableandhasunitsofmillilitersperhour(ml/hr).
BOLUS: A volume of medication infused over a relatively short period of time.1The bolus
isinfusedatthebolusowrate.Abolusisdeliveredwhenapatientrequestsitbypushing
the BOLUS button. A bolus is sometime referred to as a PCA bolus. The bolus has units of
milliliters (ml).
BOLUSFLOWRATE:Theowrateatwhichabolusisdelivered.Itisahigherowratethan
thebasalowrate.IntheambIT®PreSet v1.5 pump,thebolusowrateis100ml/hrandis not
adjustable.
CAUTION: A caution usually appears in front of a procedure or statement. Failure to observe
acautioncouldresultinseriouspatientoruserinjury.Cautionsarefoundthroughoutthis
document emphasized with grey shading.
LOCKOUT TIME: The time between the end of one bolus and the start of the next bolus. The
lockout time has units of hours and minutes (hh:mm).
NOTE: A note highlights information that acts as a reminder or helps explain a concept or
procedure.
PCA: An acronym for patient controlled analgesia. If a pump is in PCA mode and the patient
has been prescribed a bolus volume, then PCA allows for a lay user to periodically give the
patient a bolus of medication. If the infusion is into the epidural space the PCA is referred to as
patient controlled epidural analgesia (PCEA).
VOLUMETOBEINFUSED:Thetotalamountofuidinthesolutioncontainerorreservoirto
be infused. The volume to be infused has units of milliliters (ml).
WARNING: A warning message contains special safety emphasis and must be observed at
all times. Warnings are found at Section 1.2, as well as throughout this document emphasized
with grey shading. Failure to observe a warning message is potentially life threatening.
1 Thebolusisdeliveredatahigherowratethanthebasalrate;therefore,foragivenvolume,thebolusisdeliveredfaster.

Section 1 • Introduction
2
1.1.2 DenitionofSymbols1.1.2 DenitionofSymbols
Consult instructions for use.Consult instructions for use.
International symbolInternational symbol meaningmeaning “Attention, consult accompanying“Attention, consult accompanying
documents.”documents.”
IEIEC symbol for “Type BF Applied Part.” (C symbol for “Type BF Applied Part.” (IECClassication:InternallyIECClassication:Internally
powered.)powered.)
TThehe ambIT® PreSet v1.5 complies with ES 60601-1:2012, 1st Edition,ambIT® PreSet v1.5 complies with ES 60601-1:2012, 1st Edition,
includingAmend.1;CSAC22.2NO.60601-1:2014,3rdEdition;IECincludingAmend.1;CSAC22.2NO.60601-1:2014,3rdEdition;IEC
60601-1:2005,includingCorr.2:2007andAmend.1:2012;IEC60601-1-60601-1:2005,includingCorr.2:2007andAmend.1:2012;IEC60601-1-
6:2013,Edition3.1;IEC60601-1-8:2012,Edition2.1;IEC60601-1-11:2015;6:2013,Edition3.1;IEC60601-1-8:2012,Edition2.1;IEC60601-1-11:2015;
60601-2-24:2012,Edition2;IEC62304:2006,1stEdition;IEC62366:2007,60601-2-24:2012,Edition2;IEC62304:2006,1stEdition;IEC62366:2007,
1stEdition,andAmend.1:2014;IEC60601-1-2:2014,4thEdition,2014-1stEdition,andAmend.1:2014;IEC60601-1-2:2014,4thEdition,2014-
02.02.
ProtectedagainstinsertionofngersandwillnotbedamagedorProtectedagainstinsertionofngersandwillnotbedamagedor
become unsafe during a specbecome unsafe during a speciedtestinwhichitisexposedtoiedtestinwhichitisexposedto
vertically or nearly vertically dripping water.vertically or nearly vertically dripping water.
Indicatesthemedicaldevicemanufacturer,asdenedinEUDirectivesIndicatesthemedicaldevicemanufacturer,asdenedinEUDirectives
90/385/EEC, 93/42/EEC and 98/79/EC.90/385/EEC, 93/42/EEC and 98/79/EC.
Indicates the date after which the medical device is not to be used.Indicates the date after which the medical device is not to be used.
Indicates the manufacturer’s batch code or lot number so that the batchIndicates the manufacturer’s batch code or lot number so that the batch
orlotcanbeidentied.orlotcanbeidentied.
Indicatesthemanufacturer’sserialnumbersothataspecicmedicalIndicatesthemanufacturer’sserialnumbersothataspecicmedical
devicecanbeidentied.devicecanbeidentied.
SinSingle-use only (cassettes)gle-use only (cassettes)
IP22

Section 1 • Introduction
3
KKeep away from heateep away from heat
KKeep dryeep dry
CaCaution:ution: This device is restricted to sale by or on the order of aThis device is restricted to sale by or on the order of a
physician.physician.
TeTemperature limitationmperature limitation
SteSterilized using irradiationrilized using irradiation
DEHP-freeuidpathDEHP-freeuidpath
NoNot made with natural rubber latext made with natural rubber latex
IndIndicates which tubing connects toicates which tubing connects to
the solution containerthe solution container
IndIndicates which tubing connects toicates which tubing connects to
the patientthe patient
BBolusolus
ProProgram lockoutgram lockout
BBolus lockout time in hours:minutesolus lockout time in hours:minutes
To patient
To solution container
Cassette
shaft
(side view of cassette)

Section 1 • Introduction
4
BoBolus volume in milliliterslus volume in milliliters
VoVolume in milliliterslume in milliliters
BasBasal infusion rate in ml/hral infusion rate in ml/hr
NumNumber of boluses deliveredber of boluses delivered
Number of bolus requestsNumber of bolus requests
Elapsed timeElapsed time
VolumVolume to be infusede to be infused
RRUN/PAUSE buttonUN/PAUSE button
BOBOLUS buttonLUS button
LowLow/dead battery indicator/dead battery indicator
Alarm indicatorAlarm indicator
ambITambIT®PreSet v1.5 displayPreSet v1.5 display
PumPump power onp power on
Pump poPump power offwer off

Section 1 • Introduction
5
BBattery orientationattery orientation
PrProgram lockout codeogram lockout code
ProgrProgram lockout modeam lockout mode
PumpPump program modeprogram mode
Review pReview pump programump program
Infusion history reportInfusion history report
PumPump infusion history clearedp infusion history cleared
1.2 Warnings
Federal (U.S.A.) law restricts this device to sale by or on the order of a physician.
Read instructions before use. The pump must be used strictly in accordance with these
instructions.
Safe use of this pump is the primary responsibility of the user. The user is responsible for
monitoring this pump. Contact clinical/technical support if pump appears to be operating
incorrectly.
All patients should be given a Patient Manual and instructed to read it carefully. The pump
must be used only by or on behalf of the person for whom it is prescribed.
Patients should never perform any function or push any button unless instructed by their
healthcare provider.
Do not allow the pump to get wet. If the pump is immersed in any liquid, it must be replaced
with a new pump.
Transport and storage conditions: -25ºC (-13ºF) withoutrelativehumiditycontrol;and+70ºC
(+158ºF)at relative humidity of up to 93%, non-condensing.

Section 1 • Introduction
6
The pump will warm from the minimum storage/transportation temperature to room
temperature (about 20ºC [68ºF]) in approximately 30 minutes. The pump will cool to room
temperature from the maximum storage/transportation temperature in about 35 minutes.
Operatingconditions:+5ºCto+40ºC(+41ºFto+104ºF);relativehumidityrangeof15%to93%,
non-condensing;andanatmosphericpressureof700hPato1060hPa(10.2 psi to 15.4 psi).
Never attempt to open the pump case. Only the battery cover may be removed when changing
batteries. If the pump is dropped, it must be replaced with a new pump.
This pump is not to be used for infusion of blood or blood products.
This pump is not to be used for infusion of life-sustaining medications.
Failure to follow manufacturer’s instructions while replacing batteries may result in loss of
program settings and report data. Dispose of batteries properly after use.
Contact the local authorities to determine the proper method of disposal of potentially
biohazardous parts and accessories.
Thispumpdoesnothaveanairin-linealarm.Acassettewithanaireliminationlteris
available and recommended for intravenous use or where infusion of air would cause a safety
hazard.
Safety hazards with the ambIT
®
pump, including under-infusion, may be associated with
external radio frequency (RF) interference or electromagnetic radiation. Typical equipment
that may generate such radiation includes x-ray machines, magnetic resonance imaging (MRI)
equipment, and any other non-shielded electrical equipment.
Do not use any other administration set other than the approved ambIT®cassettes. The pump
will not function properly with any other administration sets.
Do not use additional untested/unapproved components as their use may lead to under-
infusion and the potential of increased pain to the patient.
Nomodicationofthisequipmentisallowed.
The cassette tubing may cause strangulation if used improperly.
The pump should not be disassembled by any user. If equipment is tampered with to the point
it is ineffective, consult the prescribing physician.
Keep out of reach of animals or children.
Safety hazards are associated with the interconnection of other infusion systems. Refer to:
Terry, Judy (Ed.), Intravenous Therapy, W. B. Sanders Co. 1995, pp 192–193.
A single cassette should not be used for infusion volumes greater than two liters.
In order to minimize the possibility of infection, cassettes should be changed in accordance with
your institution’s policies.

Section 1 • Introduction
7
Before starting therapy, check that all connections are secure and that there are no leaks in the
uidpath.
Aftertheinfusionisnished,thepumpwillgivetheinfusioncompletealarmandcontinue
infusing at a KVO rate. The rate is dependent on the basal rate programmed. If the basal rate is
0.5ml/hr or greater, the KVO will be 0.5 ml/hr. If the basal rate is less than 0.5 ml/hr, then the
KVO is the basal rate. The KVO is not programmable.
Bolusandinfusionhistoryreportsshouldnevertaketheplaceofgoodclinicaljudgment.
Always perform a clinical evaluation whenever interpreting these reports.
Infusing viscous solutions (e.g., D25W) into high pressures (e.g., approaching 300mm Hg) may
decrease volumetric accuracy.
1.2.1 Sterile,Disposable(Single-Use)AdministrationSet
• Carefully examine each cassette before use. Make sure there are no damaged or
missing parts.
• Do not use a cassette if the outer package is torn, punctured, wet or damaged.
• Do not touch the sterile open end of tubing. Use the aseptic technique utilized by
your facility.
• Do not re-sterilize cassette.
1.2.2 ProtectionFromAirInfusion
• The solution must be provided in a non-vented, collapsible container.
• Remove all air from solution container and tubing before use.
• If infusion of air could cause harm to the patient, the ambIT®PreSet v1.5 pump
shouldbeusedwithaireliminationltersbecauseairdetectionisnotprovided.
1.2.3 ProtectionFromUnintendedBolus
• The unintended bolus volume that could be released into a patient prior to clearing
a downstream occlusion may be released by breaking the seal on the connection
between the pump and the catheter.
• Breaking the connection between the catheter and the pump may introduce
contaminationintotheuidpath.Donottrytocleartheunintendedbolusvolume
if any concerns exist about introducing contamination.
• The maximum unintended bolus volume released into the patient when occluded
on the downstream side is between 0.050 and 0.10 ml. One (1) stroke of an infusion
is 0.050 ml. Since these amounts are similar, there is no risk of over-infusing and the
unintended bolus may not need to be removed.
1.2.4 UseofambIT®PreSet v1.5 PumpinMRIEnvironment
Safety in MRI not evaluated. The ambIT®PreSet v1.5 pump has not been evaluated for
safety and compatibility in the MRI environment. It has not been tested for heating,
migration, or image artifact in the MRI environment. The safety of the ambIT®PreSet

Section 1 • Introduction
8
v1.5 pump in the MRI environment is unknown. Scanning a patient who has this
devicemayresultinpatientinjury
1.3 IndicationsforUse
The ambIT®PreSet v1.5 pump is intended for use by surgeons and anesthesiologists for
the peri-operative and post-operative infusion of local anesthetics and narcotics for pain
management and regional anesthesia. Routes of administration include intravenous,
subcutaneous, intramuscular, perineural and epidural. The ambIT®PreSet v1.5 pump is also
intendedtosignicantlydecreasenarcoticuseandpainwhenusedtodeliverlocalanesthetics
to surgical wound sites or in close proximity to nerves when compared with narcotic only pain
management.
1.4 Overview
The ambIT
®
PreSet v1.5pumpisdesignedfortheambulatoryinfusionofuidsand
medications in home and healthcare facilities. The pump has simple controls that are easily
operated by both caregivers and patients. The operator position with respect to the device is
considered arms length (no more than 0.5 meters direct view).
Ifanyoftheacronymsorwordsarenotunderstood,seetheDenitionsgiveninSection1.1.
The ambIT
®
PreSet v1.5pumpcontainsuptoveprogrammingoptionsonthebackofthe
pump and in the programming steps.
NOTE: Any use of the ambIT
®
PreSet v1.5 pump other than those indicated in this
manual is regarded as an off-label use. The ambIT
®
PreSet v1.5 pump is
notequippedwithanairdetectioncircuit;thereforeifinfusionofaircould
causeharmtothepatient,itisrecommendedtousealteredcassetteorair
eliminationlter.
NOTE: AvanosMedical,Inc.doesnotrecommendorendorseanyonespecic
medication to be used with the ambIT
®
PreSet v1.5 pump. The healthcare
provider is the sole individual who decides upon the prescribed medication,
programmed pump parameters, method and location of infusion.
NOTE: Thesuitabilityofthisproductforusewithanyspecicpatientistobe
determined solely by the healthcare provider. The healthcare provider should
understand the interaction between the infusion characteristics of the pump, the
physiological response of a patient to the drug (overall and at the infusion site),
the pharmacokinetics of the drug, any potential adverse effects, etc. This patient-
specicinformationshouldbereliedupontodecideifthepumpshouldbeused
to infuse any medication into any part of the patient’s body. The distributors
and Avanos Medical, Inc. can only provide general guidelines regarding the
setupandprogrammingofthepump.Theymayalsoprovidejournalarticles
referringtoapplications.Theyareneitherqualiednorpermittedtoprovide
specicrecommendationsfortreatinganyspecicpatient.Ingeneral,to
avoidcomplications,usethelowestowrate,volumeanddrugconcentration
required to produce the desired result.

Section 1 • Introduction
9
NOTE: The ambIT®PreSet v1.5 pump has a limited life of 2,000 ml total infusion. Once
2,000 ml has been reached, the pump will continue to infuse uninterrupted as
programmed, until the current infusion program is complete. After the infusion
beyond 2,000 ml has been completed, the next time the pump is powered on the
ALARM icon ( ) and “EOL” will appear in the display and a constant tone
will sound, indicating that the pump has reached its end of life and must be
replaced.
1.5 InfusionPatterns
The ambIT®PreSet v1.5 pump allows for the following three types of infusion patterns: (1)
basalowrateonly,(2)bolusonly,and(3)basalowrateandbolus.Thepumpsimplies
pump programming by providing the clinician with the option to choose from up to four
(4) preprogrammed infusion protocols (PRO1 - PRO4), or to program infusion parameters
individually (PRO5).
The different parameters of an infusion interact with each other to create an infusion pattern.
Examples of the infusion patterns are provided graphically in Figures 1-1 through 1-3 that
follow.Theowrates,volumesandlockouttimesdiscussedinthegraphsareexamplesonly.
Basal
165
Time (Minutes)
180
195
210
235
240
0
150
135
Flowrate (ml/hr)
75
90
105
120
0
15
30
45
60
10
Figure1-1
Basalowrateonlyinfusionpattern
ForFigure1-1,thebasalowrateis10ml/hr.Themaximumavailablebasalowrateis20ml
for PreSets pumps.
Figure1-2
Bolusonlyinfusionpattern

Section 1 • Introduction
10
The settings for Figure 1-2 are a bolus volume of 10 ml and a lockout time of 30 minutes. After
a bolus is requested and delivered, a lockout time begins. A bolus is delivered only when
the BOLUS button is pressed. During the lockout time, the pump will beep when a bolus is
requested, but no bolus will be delivered.
CAUTION: After programming the pump or clearing the history, a bolus will be delivered
immediatley, if requested,. The pump assumes that clearing history or
programming/reprogramming indicates that a new therapy is starting. Do not
clear the infusion history unless the pump is being used for a new infusion or
patient, as doing so will allow a bolus immediately once the infusion is started.
This may result in over-infusion.
Figure1-3
Basalowrateandbolusinfusionpattern
ForFigure1-3,thesettingsareabasalowrateof10ml/hr,abolusvolumeof10ml,anda
lockout time of 30 minutes.
WARNING: Aftertheinfusionisnished,thepumpwillgivetheinfusioncompletealarm
and continue infusing at a KVO rate. The rate is dependent on the basal rate
programmed. If the basal rate is 0.5 ml/hr or greater, the KVO will be
0.5 ml/hr. If the basal rate is less than 0.5 ml/hr, then the KVO is the basal rate.
The KVO rate is not programmable.
NOTE: Thebasalowrateisdiscontinuedwhileabolusisbeingdeliveredandresumes
once the bolus has been completed.

Section 2 • Set Up
11
SECTION 2 - SET UP
(See diagram on inside front cover)
The following steps must be accomplished sequentially to properly set up the pump:
1. Gatherrequiredmaterials(seeSection2.1);
2. Installnew,unused,AAalkalinebatteries(seeSection2.7);
3. Programthepump(seeSection3);
4. Primethecassette(seeSection2.3);
5. Verify that the cassette bottom disc is snapped closed before attaching the cassette to the
pump (see Section 2.2).
6. Attachthecassettetothepump(seeSection2.4);
7. Attach the long tubing of the cassette to the patient catheter
usingtheaseptictechniqueutilizedbyyourfacility;
8. Startinfusion(seeSection4.1);and,
9. Ensure the patient is instructed in the use of the pump and receives a patient manual.
WARNING: Protection from air infusion - The infusion solution must be provided in a non-
vented, collapsible container. Remove all air from solution container and tubing
before use.
NOTE: It is the responsibility of the healthcare provider to ensure that the lay user/
patient is educated in the proper use of the pump.
NOTE: It is the responsibility of the healthcare provider to modify any guidelines
provided to the lay user/patient along with the pump as appropriate for the
individual patient’s clinical status and medication provided.
2.1 RequiredMaterials
The ambIT®cassette is a sterile, disposable (single-use) administration set. The upstream (short)
tubing of the cassette connects to a non-vented, collapsible solution container. Once the cassette
has been primed, the downstream extension (long) tubing of the cassette connects to the
patient’s access device.
Contact Avanos Medical, Inc. to obtain a complete list of cassettes.
Accessories such as MediBag™ solution containers and carrying pouches may be added
as required by the therapy. Contact Avanos Medical, Inc. to obtain a complete listing of all
optional accessories.

Section 2 • Set Up
12
2.2 ambIT
®
Cassette
The cassette contains a rotary mechanism that pumps the infusion
solution at an accurate and controlled rate.
Duringcassettepriming,uidwillowfreelythroughthetubing
(Figure 1).
After priming, snap the cassette bottom disc into the body of the
cassette toclosetheuidpath. This prevents, thefreeowofuid
(Figure 2). When primed, the cassette simply snaps onto the pump.
WARNING: Ifaninfusionofaircouldcauseharmtothepatient,anaireliminationlter
should be used. The ambIT
®
cassette may be ordered with or without an
integratedaireliminationlter.
WARNING: The ambIT
®
PreSet v1.5 requires the use of an ambIT
®
cassette. Use of cassettes
not manufactured by Avanos Medical, Inc. may cause the pump to malfunction
and may cause an over-infusion or an under-infusion.
NOTE: If an ambIT
®
cassettealreadyhasalter,itisnotrecommendedtouseaseparate
aireliminationlter.Usingasecondltermaycausethepressuretoexceedthe
activation pressure for the pressure switch, causing an occlusion alarm (“OCL”
in display and a constant beep delayed for 3 minutes).
Cassette bottom disc (clear)
(Figure 2)
WARNING: Freeowwilloccuruntilthecassettebottomdiscissnappedinplace.No
alarm will sound if the cassette bottom disc is not snapped in place. Do not
attach the cassette to the patient until the cassette is placed on the pump or the
cassette bottom disc is snapped into place. Placing the cassette on the pump will
automaticallysnapthediscinplaceandpreventfreeow.
NOTE: Once the cassette bottom is snapped into place, the rollers engage and compress
thetubing,preventinguidfromowingunlessthepumpisrotatingand
movingtheuid.Ifadownstreamocclusionoccurs,thepumpwillalarmand
notify the user.
2.3 PrimingtheCassette
WARNING: Do not use a cassette if the outer package is torn, punctured, wet or damaged.
Do not touch the sterile open ends of the tubing. Use the aseptic technique
utilized by your facility.
WARNING: The cassette must be primed before use by removing all air from the solution
container and tubing.
WARNING: Do not connect the cassette to the patient until the cassette has been primed, the
cassette has been connected to the pump, and the pump has been programmed
to the desired therapy and checked per hospital protocol.
Top view of cassette
(Figure 1)

Section 2 • Set Up
13
Step #1 Remove the protective cover from the bottom of the cassette
(see illustration at left).
Step #2 Connect the solution container to the short tubing of the
cassette using the aseptic technique utilized by your facility.
Step #3 Release all clamps on the tubing.
Step #4 Invert the solution container to allow air to be evacuated
beforeprimingthecassettewithuid(seeillustrationatleft).
Step #5 Gentlysqueezethesolutioncontainertoforceuidandair
upward through the tubing and cassette. Continue until the
solutionhascompletelylledthetubingandallairbubbles
have been removed.
Step #6 Afterpriming,closetheuidpathbysnappingthecassette
bottom disc into the cassette body. This will prevent free
ow.
WARNING: Failure to properly snap the cassette bottom disc into the
cassettebodymayresultinincorrectowratesorfree-
owconditions. Placing the cassette on the pump will
snap the cassette disc bottom in place, if it is not done
prior.
NOTE: If the cassette bottom disc is snapped closed before the
priming process is complete, place the cassette onto the
pump (not attached to the patient) and use the instructions
below to complete the priming of the cassette.
CAUTION: Verify that all connections are secure, all clamps are opened, and that there are
noleaksintheuidpathbefore starting therapy.
If thelledsolutioncontainerisnotgoingtobeusedimmediately,clampthetubingandcapthe
connector with the protective cap provided to prevent contamination.
Always verify that the cassette bottom disc is snapped closed before attaching the cassette to the
pump.
Toprimethecassette,followthesesteps:
Protective cover

Section 2 • Set Up
14
ToremovetheairusingtheBOLUSbutton,completeSteps6aand
6b,asfollows:
Step #6a Program the pump to deliver a 20 ml bolus (see
Section 3.4).
Step #6b Start the infusion (see Section 4.1) and press the
BOLUS button (see Section 4.5) Once all the air has
beenremovedfromthecassettetubinganduid
reservoir, stop the pump by placing it in pause (see
Section 4.2).
If necessary to remove more than 20 ml of air from the
solution container and tubing, boluses can be repeated
quickly by clearing the history between each bolus (see
Section 5.2).
Once all the air has been removed from the cassette
tubinganduidreservoir,clearthehistoryand
program the pump to the desired settings.
Step #7 Bend or break away the wings of the protective cover.
Place the protective cover back onto the cassette
(insert cassette shaft into octagonal opening). Use the
protective cover to rotate the cassette shaft counter-
clockwise so silver dot makes one full rotation.
NOTE: The cassette shaft can also be rotated by hand.
Step#8 Make sure the patient is instructed in the proper use of
the pump.
NOTE: ThelterbondedtotheambIT
®
cassette tubing is
anair-eliminationlter(AEF).TheAEFhastwo
membranes. The larger membrane is a hydrophilic
membrane and the smaller membrane is a
hydrophobic membrane. The hydrophobic membrane
willnotallowwatertoowthroughit. However, in
conjunctionwithsome other liquids, such as organic
liquids, water may be permittedtoowthroughthe
hydrophobic membrane.
NOTE: Whenthelterisdry,boththehydrophilicmembraneandthehydrophobic
membrane will allow air through. Once the hydrophilic membrane comes in
contactwithwater(is“wetted”)airwillnotowthroughthemembraneuntil
the bubble point is reached. (The bubble point is the pressure required to force
air through the wetted hydrophilic membrane).
Bottom of protective cover
(round opening)
Top of protective cover
(octagonal opening)
Bend/break points
Cassette shaft
Rotate shaft
using protective
cover
Rotate shaft by
hand
OR
Silver dot

Section 2 • Set Up
15
2.4 AttachCassettetothePump
Insert the cassette onto the top of the pump, as shown. Align and gently
squeeze the tabs on the cassette to attach to the pump.
NOTE: Once the cassette has been properly placed on the pump,
free-ow(unimpededowduetoforcesnotgenerated
by the pump) cannot occur because the cassette disc
bottom has been snapped into place.
2.5 RemoveCassettefromthePump
To remove the cassette, press both cassette release tabs at the same time
and lift the cassette off the pump.
CAUTION: Do not remove the cassette while the green run light is
blinking.Alwaysplacethepumpinpausemoderst.
Failure to do so will cause the pump to sound an alarm
when the pump attempts to infuse medication.
NOTE: Due to the nature of the hydrophilic membrane, it is important to prime the
ambIT
®
cassettewithoutgettingwaterinthelter.Thiswillallowairtoow
throughveryeasily.Oncethelteriswet,itmaybemoredifculttoprime,
becausetheairhasamuchsmallerareatoowoutof(airwillonlyowoutof
the smaller hydrophobic membrane).
ambIT
®
pump
Tubing
on left side
of pump
Larger tab on
right side
Sensor
alignment
F
F
2.6 ChangingtheFluidReservoir
WARNING: Notfollowingyourfacility’sasepticprocedurestoproperlychangetheuid
reservoir may contaminatetheuidpath.Itisbeyondthescopeofthismanual
to provide aseptic technique training. If you are unsure of how to perform this
task, consult your facility or supervisor.
CAUTION: Donotuseasyringeasauidreservoir,becauseunder-infusionmayoccur.
Priortochangingtheuidreservoir,putthepumpinpausemodeby pushing the RUN/
PAUSE button (see Section 4.2). Failure to do so will cause the pump to alarm when the pump
attempts to infuse medication.
2.7 BatteryInstallationandReplacement
The pump is powered by two (2) AA 1.5V batteries.
NOTE: Avanos Medical, Inc. has not validated all types of batteries (non-alkaline,
rechargeable, specicbrands,previously-used,etc.);therefore,wecannotensure
thatanyspecicbatterywillpowerthepumpforaspecicperiodoftime.The

Section 2 • Set Up
16
battery condition and pump settings will determine how the battery will perform
with regard to the pump. For this reason, the time before the low battery alarm
occursandthetimebetweenlowanddeadbatteryalarmsisdifculttopredict
with non-alkaline or rechargeable batteries.
NOTE: Avanos Medical, Inc. recommends that the batteries be changed at the end of
each session or when the low battery alarm occurs.
The pump memory is designed to retain program settings and infusion history for up to six
months without power. Failure to follow the manufacturer’s instructions while replacing
batteries may result in loss of program settings and report data. Do not store batteries in the
pump.
2.7.1 BatteryInstallation
To install batteries:
If the pump is in run mode, place the pump in pause mode by pushing the RUN/PAUSE
button (see Section 4.2).
Step#1 Rotate the battery cap counter-clockwise until the line
( I ) on the pump is slightly to the right of the OFF
(O) position (i.e., until the battery cap stops or meets
resistance).
Step#2 Remove the battery cap and insert the batteries
according to the illustrations at the left.
Step#3 Place the battery cap onto the pump as illustrated to the
left (OFF symbol (O) on the battery cap slightly to the
left of the ( I ) mark on the pump).
Step#4 Rotate the battery cap clockwise to the OFF (O) position.
2.7.2 BatteryReplacement
WARNING: When reinstalling batteries, always verify that the
program settings are correct before restarting infusion.
To replace batteries:
CAUTION: Verify that the pump is in pause mode before removing
the batteries. Failure to do so may cause a loss of timing
and a delay in therapy. The pump will not sound an
alarm if it is turned off without being placed in pause
mode.
If the pump is in run mode, place the pump in pause mode by pushing
the RUN/PAUSE button (see Section 4.2).
Remove battery battery
cap
Insert batteries and replace
battery cap