Deltec CADD-TPN 5700 User manual

Deltec
SIM S D elt ec, In c ., St . Pau l, M N 55112 U .S.A.
CADD-TPN®
Ambulatory Infusion System
Model 5700
Operator’s Manual
This online version differs
from the printed version.
Certain information that is
not intended for patients has
been removed.

This manual pertains only to the Deltec CADD-TPN®, Model 5700, ambulatory
infusion system.
The issue date of this Operator’s Manual is included for the clinician’s information.
In the event one year has elapsed between the issue date and product use, the
clinician should contact SIMS Deltec, Inc. to see if a later revision of this manual
is available.
WARNING:
It is intended that this Operator’s Manual only be utilized by clinicians. Do
not permit patients to have access to this manual or otherwise disclose to the
patient the security code of the pump or any information which would allow
the patient to have complete access to all programming and operating
functions.
CADD®and CADD-TPN®are registered trademarks of SIMS Deltec, Inc.
U. S. Patent Nos. 4,559,038; 4,565,542; 4,650,469 and D294,733; other patents pending.
DURACELL®is a registered trademark of DURACELL INC. EVEREADY®ENERGIZER®is a
registered trademark of UNION CARBIDE CORPORATION. ULTRALIFE®is a registered
trademark of ULTRALIFE Batteries, Inc. VELCRO®is a registered trademark of VELCRO USA,
INC.
ii

TECHNICAL ASSISTANCE
If you have comments or questions concerning the operation of the
CADD-TPN®system, please call this number: 800-426-2448.
Our staff is available to help clinicians twenty-four hours a day with the
programming and operation of the CADD-TPN®infusion system.
SIMS Deltec, Inc.
1265 Grey Fox Road
St. Paul, Minnesota 55112 U.S.A.
iii

iv
CONTENTS
1.0 INTRODUCTION ............................................................................. 1
2.0 GENERAL DESCRIPTION OF THE CADD-TPN®SYSTEM AND
ITS ACCESSORIES ........................................................................ 1
2.1 WARNINGS and CAUTIONS .................................................. 2
2.1.1 WARNINGS ................................................................. 2
2.1.2 CAUTIONS ................................................................... 3
2.2 Physical description of the pump display, function keys, and
set plate ................................................................................... 5
2.3 Description of the pump display and function keys ................. 6
2.4 System components and accessories ..................................... 7
2.5 Description of the CADD-TPN®administration set .................. 7
2.6 Understanding the continuous infusion mode and the tapering
modes ..................................................................................... 9
3.0 OPERATOR INSTRUCTIONS ........................................................ 11
3.1 Installing or replacing the battery and observing the pump
power-up test .......................................................................... 12
3.2 Programming the CADD-TPN®pump ....................................... 15
3.2.1 Preparing to program the CADD-TPN®pump ............... 15
3.2.2 Setting and changing the reservoir-residual volume
(RES VOL) ................................................................... 17
3.2.3 Setting and changing the infusion volume
(INFUSION ML) ............................................................ 18
3.2.4 Setting and changing the infusion period (HR:MIN) .... 19
3.2.5 Setting and changing the taper-up period (HR:MIN) ... 21
3.2.6 Setting and changing the taper-down period
(HR:MIN) ..................................................................... 23
3.2.7 Viewing the continuous infusion rate (ML/HR) ............. 24
3.2.8 Resetting the volume delivered (ML GIVEN) ................ 24
3.3 Removing a used administration set ........................................ 26
3.4 Preparing and attaching a new CADD-TPN®Administration
Set ........................................................................................... 27

v
3.5 Priming the administration set and add on anti-siphon valve
with the CADD-TPN®pump .................................................... 29
3.6 Selecting and programming the lock levels (LL0, LL1, and
LL2) ......................................................................................... 30
3.7 Operating the CADD-TPN®pump .......................................... 33
3.7.1 Summary of programming and record-keeping
displays ........................................................................ 33
3.7.2 Using the optional KVO (Keep Vein Open) mode ........ 35
3.7.3 Starting and stopping the pump .................................. 36
3.7.4 Tapering down immediately ........................................ 37
3.7.5 Starting the daily infusion ............................................ 38
3.7.6 Resuming delivery during the infusion period ............. 39
3.8 The External Power Source (EPS) system ............................. 40
3.9 Using the backpack and storing the system ............................ 40
4.0 REFERENCE SECTION ................................................................. 43
4.1 Glossary .................................................................................. 43
4.2 Pump maintenance and cleaning ............................................ 45
4.3 Equipment exposure to radiation or magnetic resonance
imaging (MRI) .......................................................................... 45
4.4 Alarms and troubleshooting chart ........................................... 46
4.4.1 The reservoir-residual volume (RES VOL) alarm ......... 50
4.4.2 The high pressure (HI P) alarm .................................... 50
4.4.3 The rate-too-high alarm ................................................ 50
4.4.4 The rate-too-low alarm ................................................. 51
4.5 Specifications (nominal) .......................................................... 52
4.5.1 Programming specifications ......................................... 52
4.5.2 General pump specifications ........................................ 53
4.6 Limited warranty ...................................................................... 55

vi

1
Description
1.0 INTRODUCTION
The Deltec CADD-TPN®Model 5700 Ambulatory Infusion System consists
of a pump and its related accessories.
The purpose of this manual is to help you, the healthcare professional, to
become familiar with the CADD-TPN®pump and its associated functions,
which are described in Section 2; and to instruct you in how to use those
functions, which are outlined in detail in Section 3. Section 4 is a general
reference section, containing other important information.
You should review these operating instructions carefully before using the
CADD-TPN®pump and its accessories. You should also become familiar
with all warnings and caution advisories to learn how to operate the system
properly.
2.0 GENERAL DESCRIPTION OF THE CADD-TPN®
SYSTEM AND ITS ACCESSORIES
The CADD-TPN®Model 5700 system is designed primarily for the
administration of nutritional and other solutions or fluids intravenously. The
system can also be used for intra-arterial and intraperitoneal infusion therapies.
Therapy should always be overseen by a physician or a certified, licensed
healthcare professional. The patient should be instructed in using and trouble-
shooting the pump. If used properly according to the instructions contained
in this manual, the pump provides programmed delivery of solutions at
controlled rates for continuous and “tapering” modes. The pump’s flexibility
allows it to be used in a variety of settings, including the home.

Description
2
2.1 WARNINGS and CAUTIONS
Read this entire Operator’s Manual before operating the CADD-TPN®
ambulatory infusion pump.
Failure to properly follow warnings, cautions, and instructions could result
in death or serious injury to the patient.
2.1.1 WARNINGS
• This Operator’s Manual should be used by clinicians only. Do not permit
patients to have access to this manual, as the information contained
would allow the patient complete access to all programming and operating
functions. Improper programming could result in death or serious injury
to the patient.
• For those patients who are likely to be adversely affected by unintended
operations and failures, including interrupted medication or fluid delivery
from the device, close supervision and provision for immediate corrective
action should be provided.
• If the pump is used to deliver life-sustaining medication, an additional
pump must be available.
• The pump is not to be used for delivery of blood or cellular blood
products.
• If the pump is dropped or hit, inspect the pump for damage. Do not use
a pump that is damaged or is not functioning properly. Contact Customer
Service to return the pump for service.
• Prior to starting infusion, inspect the fluid path for kinks, a closed clamp,
or other upstream obstructions, and remove any air to prevent air
embolism.
• Do not use rechargeable NiCad or nickel metal hydride (NiMH) batteries.
Do not use carbon zinc (“heavy duty”) batteries.
• Always have extra new batteries available for replacement.
• Ensure that the battery door is securely latched.
• Ensure that the cassette is properly attached.
• Close the fluid path tubing with the clamp before removing the

3
Description
administration set from the pump.
• Use only CADD-TPN* Administration Sets with an Add On Anti-Siphon
Valve to protect against: unregulated gravity infusion that can result from
an improperly attached reservoir, and delivery inaccuracies.
• System delivery inaccuracies may occur as a result of back pressure or
fluid resistance, which depends upon drug viscosity, catheter size, and
extension set tubing (for example, microbore tubing).
• Do not prime the fluid path with the tubing connected to a patient.
• For detailed instructions and warnings pertaining to administration sets,
please refer to the instructions supplied with those products.
• Frozen medication must be thawed at room temperature only. Do not heat
the administration set in a microwave oven.
2.1.2 CAUTIONS
• Do not operate the pump at temperatures below +2°C (36°F) or above
40°C (104°F).
• Do not store the pump at temperatures below -40°C (-40°F) or above
55°C (131°F). Do not store the pump with the administration set
attached.
• Do not expose the pump to humidity levels above 90% relative humidity.
• Do not store the pump for prolonged periods with the batteries installed.
• Do not immerse the pump in cleaning fluid or water or allow solution to
soak into the pump, accumulate on the keypad, or enter the battery
compartment.
• Do not clean the pump with acetone, other plastic solvents, or abrasive
cleaners.
• Do not expose the pump to therapeutic levels of ionizing radiation.
• Do not expose the pump directly to ultrasound.
• Do not use the pump in the vicinity of magnetic resonance imaging (MRI)
equipment.
• Do not use the pump near ECG equipment.

Description
4
• Do not sterilize the pump.
• Do not use the pump in the presence of flammable anesthetics or explosive
gases.
• Use only Deltec accessories as using other brands may adversely affect the
operation of the pump.
• Check appropriate medication stability for time and temperature to
assure stability with actual pump delivery conditions.

5
Description
2.2 Physical description of the pump display, function
keys, and set plate
The following diagram, Figure 1, illustrates the CADD-TPN®pump and its
functions.
Figure 1. CADD-TPN®pump display, function keys, and set plate.
Display (LCD)
Keyboard
Scroll keys
Set plate
RES VOL
ML/HR
GIVEN
STOP
LO BAT
INFUSION
TAPER
TAPER
PERIOD
HR : MIN
CADD-TPN

Description
6
2.3 Description of the pump display and function keys
Liquid Crystal Display (LCD). The screen or display panel that shows the
pump’s various control functions and the values you program for the pump
operation. In this manual, the term “display” is synonymous with display
panel or LCD.
STOP/START Key. The STOP/START key is used to start and stop the pump’s
pumping action.
SET/CLEAR Key. The SET/CLEAR key is used to enter new settings or
programming values into the computer’s memory. This key is also used to
clear or remove the volume given (ML GIVEN).
PRIME Key. Use the PRIME key to prime the fluid path and to remove air
bubbles from the fluid path.
LOCK Key. Use the LOCK key to restrict changes in the pump’s operation and
to find out which lock level the pump is in.
SELECT MODE Key. Use the SELECT MODE key to display the pump’s
programmed values; for example, reservoir-residual volume (RES VOL),
infusion volume, infusion period, taper-up period, taper-down period, infu-
sion rate, and volume given. If the pump is in the Stop mode, and you press
the SELECT MODE key, the pump will display the next mode. You will then
have to press the SELECT MODE key again to access another mode.
SCROLL Keys. Use the up or down SCROLL keys to increase or decrease the
pump operating values, which will appear on the pump’s display. If you press
and hold a SCROLL key, you can scroll through the operating values rapidly.

7
Description
2.4 System components and accessories
The CADD-TPN®system consists of the following components:
• CADD-TPN®pump, including
– Carrying case
– Battery (9-volt)
– Operator’s Manual with warranty information
– Set plate (non-sterile - for demonstration purposes only)
• External Power Source (EPS) System, including
– AC adapter
– Power pack (rechargeable)
– Battery adapter
– Battery door (notched)
• Backpack (with shoulder strap)
Other accessories:
• CADD-TPN®Administration Set (0.2 µ air-eliminating filter and Add On
Anti-Siphon Valve)
• CADD-TPN®Administration Set (1.2 µ air-eliminating filter and Add On
Anti-Siphon Valve)
• One-Liter Pump Pouch
2.5 Description of the CADD-TPN®Administration Set
The administration set is used to connect the fluid container to the patient’s
access device. You must use the Add On Anti-Siphon Valve supplied with the
administration set. The anti-siphon valve provides free flow protection, allows
one-way fluid delivery, and ensures pump accuracy. If the Add On Anti-
Siphon valve is not used, delivery inaccuracies of approximately 2.5% are
possible.

Description
8
___ 1800
___ 1600
___ 400
___ 200
8/11/99 D. Zurn, «TPN Set w/ASV, 21-7071»
Text callouts: 12/13 Helvetica
CADD-TPN
Anti-Siphon Valve
Male luer
connector with
protective cap
Injection site
Tubing clamp
Filter
Set plate
Bag
spike
Figure 2. Administration set without connections to the fluid
container or patient access device.
Figure 3. The administration set plate is inserted in the bottom of
the pump.
The administration set includes either a 0.2 µ or a 1.2 µ air-eliminating filter,
which is designed to remove air bubbles from the fluid path. However, periodic
visual inspection is recommended.
Procedures for attaching (or removing) the administration set are described
in Section 3.3 and 3.4. Priming the administration set is described in Section
3.5.

9
Description
2.6 Understanding the continuous infusion mode and the
tapering modes
The CADD-TPN®pump delivers solutions at continuous infusion rates, which
may include a programmable feature called “tapering.” With tapering, infusion
rates are gradually increased at the beginning of an infusion period, and/or
are gradually decreased at the end of an infusion period.
The pump can deliver solutions at a continuous infusion rate of 10–400
ml/hr with the power pack; or, it can deliver solutions at a continuous rate of
10–250 ml/hr with a 9-volt battery. An example of continuous infusion (without
any tapering) is illustrated in Figure 4. Two liters of solution are delivered
during a 10-hour infusion period at a continuous infusion rate of 200 ml/hr
(Figure 4).
Figure 4. Continuous infusion rate delivery of 2 liters of solution
during a 10-hour infusion period.
In addition, the CADD-TPN®pump can be programmed for gradual changes
(tapering) in the infusion rate at the beginning and/or end of the programmed
infusion period. Infusion rate changes can be made to occur very slowly or
quickly, depending on how the pump is programmed. An example of tapering
when two liters of solution are delivered during a 10-hour infusion period is
shown in Figure 5. The pump slowly increases the infusion rate in the first
04/13/94 D. Zurn “Contin Rate w/KVO TPN NoText”
TIME (HOURS)
01 23 45 678 910
400
250
200
150
100
50
0
Infusion Period
Continuous Rate (200 ML/HR)
KVO
Rate
5 ML/HR
DELIVERY RATE (ML/HR)
Two liters of solution administered

Description
10
hour of infusion. Between the second and ninth hours of infusion, the solution
is delivered at the continuous rate of 222 ml/hr. In the last hour, the infusion
rate decreases.
Figure 5. Automatic tapering. Two liters of solution are delivered
during a 10-hour infusion period by gradually increasing
and decreasing the rate of delivery.
NOTES:
(1) The clinician determines whether the patient requires tapering.
(2) After the taper-down period, the rate of infusion automatically switches
to 5 ml/hr (if applicable). This rate is referred to as the KVO (KEEP VEIN
OPEN) infusion rate. It permits a minimal amount of solution to flow
after the regular infusion volume has been delivered; and it occurs until
the RES VOL value is “0000”, or the pump enters the Stop mode.
If you intend to use the KVO mode, be sure that the volume in the fluid
container is sufficient for your needs. You must make sure that the RES
VOL value is large enough to include the priming volume and, if
applicable, the KVO delivery. (See Section 3.7.2.)
04/13/94 D. Zurn “TPN Notch Taper Graph NoText”
TIME (HOURS)
01 23 45 678 910
400
250
200
150
100
50
0
DELIVERY RATE (ML/HR)
INFUSION VOLUME
Continuous Rate
(222 ML/HR)
Infusion Period
KVO
Rate
5 ML/HR

11
Operating Instructions
3.0 OPERATOR INSTRUCTIONS
This section describes how to operate the CADD-TPN®system. It contains
detailed, step-by-step instructions to enable you to perform the following
tasks:
• Installing a battery and observing the power-up test ............................ (3.1)
• Programming the pump operations .............................................................. (3.2)
• Preparing to program the pump................................................................. (3.2.1)
• Setting and changing the reservoir-residual volume ......................... (3.2.2)
• Setting and changing the infusion volume............................................. (3.2.3)
• Setting and changing the infusion period ..............................................(3.2.4)
• Setting and changing the taper-up period ..............................................(3.2.5)
• Setting and changing the taper-down period ....................................... (3.2.6)
• Viewing the infusion rate ............................................................................... (3.2.7)
• Resetting the volume delivered ................................................................... (3.2.8)
• Removing a used administration set ............................................................ (3.3)
• Preparing and attaching a new CADD-TPN®Administration
Set .............................................................................................................................. (3.4)
• Priming the administration set with the pump........................................ (3.5)
• Programming the patient lock levels (LL0, LL1, and LL2) .............. (3.6)
• Starting and stopping the pump................................................................. (3.7.3)
• Tapering down immediately .........................................................................(3.7.4)
• Using the External Power Source (EPS) System...................................... (3.8)
• Using the backpack for portable operation or storing of
the system............................................................................................................... (3.9)

Operating Instructions
12
3.1 Installing or replacing the battery and observing the
pump power-up test
NOTE:
The pump can also be powered by the External Power Source (EPS) System.
(See Section 3.8.)
CAUTION:
If your delivery rate is more than 250 ml/hr, you must use the power pack
instead of a 9-volt battery to power the pump.
WARNING:
• Do not use rechargeable NiCad or nickel metal hydride (NiMH) batteries.
Do not use carbon zinc (“heavy duty”) batteries. They do not provide
sufficient power for the pump to operate properly, which could result in
death or serious injury to the patient.
• Always have new batteries available for replacement. If power is lost,
nondelivery of drug, and, depending on the type of drug being administered,
death or serious injury to the patient could result.
• If the pump is dropped or hit, the battery door or
tabs may break. Do not use the pump if the
battery door or tabs are damaged because the
batteries will not be properly secured; this may
result in loss of power, nondelivery of drug, and,
depending on the type of drug being administered,
death or serious injury to the patient.
In order to install or replace a battery, be sure to
place the pump in the Stop mode. Then, follow
these steps:
STEP 1: Push down and hold the battery door
release button while sliding the door off.
STEP 2: Remove the used battery.
11/04/96 D. Zurn
«Batt Compart Tabs 11/96»
11/26/96
D. Zurn
«Open
Locking
Door
11/96»

13
Operating Instructions
STEP 3: Install the battery in the compartment (bot-
tom-end first).
NOTE:
Be sure to match the polarity markings of the new
battery (+and –) with those on the battery com-
partment. If you put the battery in backwards, the
display panel will be blank, and you will not hear
a beeping sound.
Use a new, 9-volt alkaline or lithium battery to
power the pump. You may use any alkaline battery,
including DURACELL®Alkaline MN 1604 and
EVEREADY®ENERGIZER®Alkaline #522, for
example; or, use the ULTRALIFE®Lithium U9VL
battery. You may also use an external power source
to run the pump. (See Section 3.8.)
STEP 4: Place the battery door halfway over the
battery compartment and press the battery into
the compartment by pushing down on top of the
door with your thumb.
STEP 5: Slide the door closed. Ensure that the door
is latched by trying to remove the door without
pressing the release button.
WARNING: If a gap is present anywhere between the battery door and the
pump housing, the door is not properly latched. If the battery door becomes
detached or loose, the batteries will not be properly secured; this could result
in loss of power, nondelivery of drug, and, depending on the type of drug
being administered, death or serious injury to the patient.
The power-up sequence will start, and the pump will go through an electronic
self-test, which lasts about 50 seconds. All of the display indicators and the
11/04/96 D. Zurn
«Remove Batt 11/96»
11/04/96 D. Zurn
«Match Batt 11/96»
11/26/96
D. Zurn
Close
Locking
Door
11/96

Operating Instructions
14
software revision level will appear briefly.
STEP 6: Begin operation of the current program by pressing and holding the
STOP/START key to enter the Start mode (Section 3.7.3), or proceed to
Section 3.2 to program the pump.
NOTE:
You will not be able to change the delivery rate until the infusion period has
been completed, unless you stop the pump and reprogram in Lock Level 0.
The battery’s life is dependent on the volume of solution delivered and
temperature (Section 4.5.2). An alkaline battery will supply enough energy
for approximately 6 hours at 250 ml/hr. If you use an ULTRALIFE®lithium
battery, you should have power for approximately 18 hours at 250 ml/hr.
You must use the power pack for rates greater than 250 ml/hr. Be sure to stop
the pump before removing the battery, or up to 10 ml of solution may not be
accounted for by the ML GIVEN function. A battery’s power will be quickly
depleted at temperatures below +10°C (50°F).
CAUTION:
Do not store the pump for prolonged periods of time with the battery
installed. Battery leakage could damage the pump.