Hospira Plum 360 with Hospira MedNet System User manual

Plum 360®with
Hospira MedNet®System
Quick Reference Card Software 15.02 and 15.10
Please refer to the System Operating
Manual for complete operating instructions.

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CONTENTS
Definition of Terms 3
Definition of Operating Keys –
Indicators – Display Symbols 3
Set Up PlumSet®6
Clinical Care Area (CCA) Selection 6
Change CCA During Infusion 6
Programming Line A/B
with a Custom Drug Library 7
Programming Line A/B
without a Drug List 8
Programming a Bolus
(for Plum 360 SW 15.1 and higher) 8
Nurse Callback 9
Titrate Rate On Line A/B 9
Address VTBI Complete Alarm 10
Backprime 10
Stop and Start
with 1 Line Pumping 11
Stop and Start
when Line A and B Pumping 11
Standby – A/B Delivery Screen 12
Delayed Start 13
Loading Dose 13
Multistep 14
Lock Keypad (Method #1) 14
Lock Keypad (Method #2) 15
Unlock the Keypad 15
Set the Post Infusion Rate 16
View/Clear Volumes Infused 16
Adjust Display Lighting
and Contrast 17
View CCA and Infuser Settings 17
Set Distal Pressure Alarm Limit 18
Discontinue Electronic Flow
Control and Setting Gravity Flow 18
Discontinue Fluid Administration 19
Alarms and Troubleshooting 19
High Priority Alarms 20
Medium Priority Alarms 23
Low Priority Alarms 24
Line A – High Priority Alarms 25
Line A – Medium Priority Alarms 27
Line B – High Priority Alarms 28
Line B – Medium Priority Alarms 30
Line A and B –
High Priority Alarms 32

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DEFINITION OF TERMS
Hospira MedNet®Software – Enhances safety at the point of care
with highly customizable drug libraries that guide users and help to
protect patients by alerting to hard and soft limits, upper and lower
dosing limits intended to help prevent infusion errors. These limits
are based on a hospital’s specic IV administration practices.
Lower Hard Limit (LHL): The lower limit that cannot be overridden.
Lower Soft Limit (LSL): The lower limit that can be overridden.
Upper Soft Limit (USL): The upper limit that can be overridden.
Upper Hard Limit (UHL): The upper limit that cannot be overridden.
Auto-Program: Auto-programming refers to the ability to receive
a remotely congured therapy from Hospira MedNet®software.
DEFINITION OF OPERATING KEYS –
INDICATORS – DISPLAY SYMBOLS
[ON/OFF] – Infuser power on and off.
[START] – Is the rst key to press to start a delivery.
For safety reasons, every delivery must be conrmed
by checking the programming and then pressing an
additional softkey, in response to a prompt.
[STOP] – Stops delivery. If 2 lines are pumping when
you press [STOP], you must press one of the following
softkeys: s [Stop A], s [Stop B], or s [Stop All] in
response to the prompt to specify which line(s) to stop.

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[SELECT] – Moves the cursor between elds on the display.
The top pair of arrows moves the cursor up or to the left.
The bottom pair of arrows moves the cursor down or to the right
[LOCK KEYPAD] – Pressing this key, followed by entering a
lock passcode disables all keys on the keypad except
[STOP] until a valid passcode is entered.
[AUDIO PAUSED] – Has two functions, temporarily silencing all
audio output for any active alarms for two minutes or temporarily
silencing keypad input sound feedback for two minutes if there
is no active alarm.
[C] – Clears all values in the currently highlighted eld. [C]
also clears the dashes (- - -) that are displayed when an
entry is invalid or a drug delivery parameter is beyond the
pre-programmed hard limits. NOTE: [C] will NOT clear an
entire program.
Caution – Appears on the display to tell the clinician to use
CAUTION because the specied drug has been programmed
without rule sets (soft or hard limits), and may have been
programmed outside of specied safety limits for that
specic drug.
Upper Soft Limit Override – Appears next to the drug name
when the dosage of the drug being infused is higher than the
upper soft limit set for the drug in the Custom Drug Library.

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Lower Soft Limit Override – Appears next to the drug name
when the dosage of the drug being infused is less than the
lower soft limit set for the drug in the Custom Drug Library.
Wireless Connection – Appears when the infuser is
communicating with the network using a wireless connection.
Hospira MedNet Connection – Appears when the infuser
is communicating with Hospira MedNet software over either a
wireless or Ethernet connection.
Battery Capacity – Shows the battery charge level when a
battery is installed in the infuser, or indicates that a battery is
not installed.
To maintain maximum battery charge and to prolong
battery life, connect the infuser to AC (mains) power
whenever possible.

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SET UP PLUMSET®
1Prime the set according to package instructions.
2Push in ow regulator to close.
3Insert primed cassette into the infuser, close door.
4Press [ON/OFF] to turn on the infuser.
CLINICAL CARE AREA (CCA) SELECTION
1Use to highlight the desired CCA.
2After you select the desired CCA, press s[Choose].
3The on-screen message “New Patient” may appear – press s[Yes]
to clear all settings or s[No] to continue.
NOTE: If no settings currently exist or all settings are 0, this screen will
be bypassed.
CHANGE CCA DURING INFUSION
1On the Delivery (A/B) screen, press s[Settings/Vol/CCA].
2Press s[Change CCA].
• The current CCA is indicated by arrows before and after the CCA.
3Use the [SELECT] sor tto highlight the new CCA.
4Press s[Choose].
5Press s[Previous Screen].
NOTE: New CCA is highlighted at the bottom of the screen.
NOTE: When the Delivery screen displays, the infuser will inform the
user that line is delivering under a prior CCA. Until a VTBI Complete
alarm occurs for the line, you can still titrate the infusion on that line
under the old CCA.

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PROGRAMMING LINE A/B WITH A CUSTOM DRUG LIBRARY
1On the Delivery (A/B) screen, select a line to program. If you are
programming a primary delivery, select Line A. If you are
programming a secondary delivery, select Line B.
2In the drug list, select the drug – You may use the alphanumeric
keypad to search.
3Select a clinical use (if applicable).
4Enter Weight (if applicable), Rate and/or Dose, VTBI, and Duration
as appropriate for the displayed program parameters. These values
can be entered in any order.
CAUTION: BEFORE STARTING DELIVERY, VERIFY THE VALUES.
5Press [START].
6Conrm the program.
7Press s[Yes] to start the infusion.
• If a maximum hard limit is exceeded, an alert appears. You cannot
proceed until the entry is cleared. Press the [C] key to clear the
entry and enter a new value.
• If a soft limit is exceeded, an alert appears when [START] is
pressed to conrm the program.
• When the alert displays:
— Select s[Yes] to override and continue to the conrmation
screen.
or
— Select s[No] to return to the program screen and edit the value.
When programming Line B with a non-Piggybackable drug (as dened in
the Custom Drug Library), the delivery mode for Line B defaults to
Concurrent and cannot be changed.
If there is a conrmed program on Line A with a drug that is non-interrupt-
ible when programming Line B, the delivery mode for Line B will default to
Concurrent and cannot be changed.
If Line A is not programmed, or is programmed with a drug that is interrupt-
ible, and the drug selected on Line B is Piggybackable, select Piggyback
or Concurrent as the delivery mode (the default is Piggyback).

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PROGRAMMING LINE A/B WITHOUT A DRUG LIST
1On the Delivery (A/B) Screen, select a line to program. If you are
programming a primary delivery, select Line A. If you are
programming a secondary delivery, select Line B.
2On the Program screen, enter the Rate, VTBI and Duration.
Values can be entered in any order.
• A Caution Symbol will appear on the Conrm Program screen
that alerts you that the infuser is being operated without rule sets.
3Press [START].
• Before starting delivery, verify the values.
4Press s [Yes] to start delivery.
PROGRAMMING A BOLUS (FOR PLUM 360_15.1 AND
HIGHER WITH HOSPIRA MEDNET SAFETY SOFTWARE)
• A Bolus can be delivered from either Line A or Line B (while in the
piggyback mode).
• A Bolus can be completed only if the following conditions are present:
—The line on which the bolus is to be delivered is currently infusing
—Bolus Dose is enabled within the medication’s selected prole
—Rule Sets permit the medication to be delivered by bolus
—There is adequate VTBI of the medication to complete
the bolus dose
—The device is in Piggyback mode (not Concurrent mode)
if the bolus is to be delivered on Line B

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1Press s [A].
2Press s[Bolus]. The Bolus softkey is available only if the medication
to be bolused is enabled in the drug library and is currently infusing.
3On the Bolus programming screen enter:
Dose: ___________________________________
Duration: ________________________________
The Rate and VTBI will be calculated.
4Press [START] for conrmation.
5Select s [Yes] to start the delivery.
NURSE CALLBACK
1On the programming screen, press s[Add Callback].
2Press [START] and conrm your order for accuracy.
3Press s[Yes] to start delivery.
Callback is available for Piggyback, Loading Dose, Multistep and
Bolus deliveries.
TITRATE RATE ON LINE A/B
1On the Delivery (A/B) screen, select s[A] or [B] – Line does not
have to be stopped to titrate Rate.
2Ensure Rate/Dose eld is highlighted and enter a new Rate/Dose.
3Press [START] and conrm your order for accuracy.
4Press s[Yes] to start the titration.

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ADDRESS VTBI COMPLETE ALARM
Upon completion of delivery, the screen shows a ashing “VTBI
completed Line A! – Add more VTBI or Clear Line A” message and the
audible alarm sounds.
You can change the default setting to one of the following:
— KVO: The infuser continues to deliver uid at a Keep Vein Open (KVO)
rate of 1 mL/hr. If the delivery rate of the infusion that just completed was
less than 1 mL/hr , the KVO rate will continue at the same delivery rate.
— RATE: The infuser continues to deliver uid at the programmed
rate, maintaining the therapeutic rate until the VTBI Complete
alarm can be resolved.
1Press [AUDIO PAUSED] to stop the alarm sound.
2Press s[A].
3Ensure the VTBI eld is highlighted – using the numeric keypad,
enter a new VTBI.
3Press [START] and conrm your order for accuracy.
4Press s[Yes] to start the titration.
BACKPRIME
Before you begin a backprime, ensure that there is a line or a syringe
on the secondary port to accept the backprimed uid or expelled air.
When you release s [Backprime] the infuser performs a cassette test.
1Press and hold s [Backprime] until uid pumped from Line A
to Line B clears air from the cassette and from Line B (if present).
NOTE: If you press and hold the [Backprime] key for two minutes,
a stuck key alarm sounds and the display screen shows Power Off then
On. Replace pump if alarm continues.

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2If the cassette test detects that there is still air in the line, repeat
Step1 until the cassette test is successful.
3Press [START] to restart the delivery. If two lines were pumping
when delivery stopped, press the appropriate softkey in response
to the prompt.
STOP AND START WITH 1 LINE PUMPING
1On the Delivery (A/B) screen, press [STOP].
2Press [START] to resume the infusion.
STOP AND START WHEN LINE A AND B PUMPING
1On the Delivery (A/B) screen, press [STOP].
2Press s [Stop All] or s [Stop A] or s [Stop B].
To Resume the infusion:
1Press [START].
2Press s [Start All] or s [Start A] or s [Start B].

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STANDBY – A/B DELIVERY SCREEN AND
CONFIRMATION SCREEN
Standby - Enables the clinician to postpone starting the delivery for a
period of 24-72 hours. Default is 72 hours.
If a line is in standby and the congured maximum standby time expires,
the program is cleared and the infuser alarms 2 minutes later if there
has been no interaction with the pump on either line.
To place the infusion in Standby – from the Delivery Screen:
1Press s[Standby] and select the
desired line to put in standby mode.
2On the Conrm Standby screen –
press s[Yes]
To place the infusion in Standby –
from the Confirmation Screen:
After entering program on desired line,
press [START]. From the Conrm
Program Screen:
1Press s[Standby] and select the
desired line to put in standby mode.
2On the Conrm Standby screen,
press s[Yes] to put the delivery
in standby mode.
To restart the infusion from Standby:
1Press [START].
The Cancel Standby screen displays. If both lines are in standby, the
infuser will give you the option to select a line.
2Select the appropriate softkey. Delivery resumes on the selected line(s).

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DELAYED START
1On the Program screen, press s[Delay].
2Enter time in hours and minutes up to 23:59 hh:mm and press
s[Done]. Delivery screen shows DELAYED and delay time countdown.
3Press [START] and s[Yes] to conrm to resume the infusion.
4To clear a delay, choose the line, press s[Delay], then change or
clear the delay settings, then press s[Done].
LOADING DOSE
1After your medication is selected, press s[Choose].
2Press s[Loading Dose] before entering any values on the
programming screen. The Program Loading Dose screen appears.
3Enter Rate and/or Dose, VTBI, and Duration as appropriate for the
parameters displayed for 1 (Loading Dose).
NOTE: On the Program Loading Dose screen, 1 represents the
Loading Dose and 2 represents the Maintenance Dose.
4After completely programming 1 (Loading Dose) navigate to 2
(Maintenance Dose) and program the Maintenance Dose parameters.
5When both Loading Dose and Maintenance Dose are programmed,
press [START].
6Conrm that all programming is correct, and then press s[Yes].

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MULTISTEP
1After your medication is highlighted, press s[Choose].
2Press s[Multistep] before entering any values on the programming
screen.
3Enter Rate and/or Dose, VTBI, and Duration as appropriate for the
parameters displayed for Step 1.
4After programming all values in 1 (Step 1), navigate to the 2 (Step 2),
and program that step.
5After programming all values in 2 (Step 2), continue with 3 (Step 3)
if desired.
6Press s[To Steps 4-10] to program additional steps if needed.
7When all steps are programmed, press [START].
8Conrm that all programming is correct, and then press s[Yes]
to start the delivery for 1 (Step 1).
LOCK KEYPAD (METHOD #1)
Using the Lock Keypad hardkey.
1Press the [LOCK KEYPAD] hardkey.
2The Passcode data entry screen appears on the display.
3Enter the passcode using the numeric keypad.
4Press the s[Enter] softkey.
When the keypad is locked, the lock symbol appears in the bottom
right corner of the delivery screen.

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LOCK KEYPAD (METHOD #2)
Via Settings/Vols/CCA
1At the main delivery screen, press [Settings/Vols/CCA] softkey.
2Press s[Lock Keypad] – the Passcode data entry screen appears
on the display.
3Enter Passcode to Lock using the numeric keypad.
4Press s[Enter] softkey.
When the keypad is locked, the lock symbol appears in the bottom
right corner of the delivery screen.
UNLOCK THE KEYPAD
1Press any key on the keypad to display the Passcode data entry
screen.
2Enter the passcode using the numeric keypad.
3Press the s[Enter] softkey.
NOTE: During an infusion, pressing [STOP] or opening the cassette
door, activates an alarm that cannot be silenced until the keypad is
unlocked.

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SET THE POST INFUSION RATE
1On the Main Delivery screen, press s[Settings/Vols/CCA].
The Settings/Vols/CCA screen appears, with the Post Infusion
Rate highlighted.
2Press s[Choose]. The Post Infusion Rate screen appears, with
the current setting highlighted.
3To change the current setting, press s[KVO/Rate]. To return to the
previous setting, press s[KVO/Rate] again.
4Press s[Done] to save your changes and return to the Settings/
Vols/CCA screen and then press s[Previous Screen] to return to
the delivery screen.
NOTE: When changing the Post
Infusion Rate from what is defaulted
on the device, the new change will
remain in place for any subsequent
infusions programmed on the
device unless manually changed
back or, when powering the device
back ON and s[Yes] is answered
to the “New Patient?” screen.
VIEW/CLEAR VOLUMES INFUSED
1On the Main Delivery screen, press s[Settings/Vols/CCA].
2Use [SELECT] to highlight Volumes Infused and then press s
[Choose].
• The Volumes Infused Screen displays the volumes infused on Line A,
Line B and the total infused.
3Document totals.
4Press s[Clear A] to clear the Line A total only (and subtract the
total from the Total Volume).
5Press s[Clear B] to clear the Line B total only (and subtract the
total from the Total Volume).
Verify that the
Post Infusion
Rate is appro-
priate for the
Infusion.

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6Press s[Clear Total] to clear all values, including the Total Volume.
7To return to the Settings/Vols/CCA screen, press s[Previous
Screen]. If you do not press a key in 30 seconds, the Delivery screen
automatically returns.
ADJUST DISPLAY LIGHTING AND CONTRAST
1On the Main Delivery screen, press s[Settings/Vols/CCA].
2Use [SELECT] to highlight Lighting/Contrast and press s[Choose].
The Lighting/Contrast screen appears, with the Backlight Intensity
highlighted.
3Use s[Increase Setting] and s[Decrease Setting] to adjust the
backlight intensity.
4Press [SELECT] to highlight Display Contrast.
5Use s[Increase Setting] and s[Decrease Setting] to adjust the
display contrast.
6Press s[Done] to save the current settings and return to the Settings/
Vols/CCA screen or press s[Previous Screen] to leave this screen
without saving changes.
7Press s[Previous Screen] to return to the Settings/Vols/CCA screen.
VIEW CCA AND INFUSER SETTINGS
1On the Main Delivery screen, press s[Settings/Vols/CCA].
2Select s[CCA Settings] and press s[Choose]. The CCA Settings
screen displays.
3Press s[Page Up] and s[Page Down] to view all the CCA and
infuser settings.
4When nished, press s[Previous Screen] to return to the Settings/
Vols/CCA screen. Press s[Previous Screen] again to return to the
delivery screen.

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SET DISTAL PRESSURE ALARM LIMIT
NOTE: Prior to changing the Distal Pressure Alarm Limit, the infuser
must be stopped.
1On the Main Delivery screen, press s[Settings/Vols/CCA].
2Change the Distal Pressure Alarm Limit.
CAUTION –––––––––––––––––––––––––––––––
DO NOT SET THE DISTAL PRESSURE ALARM LEVEL LOWER THAN 3
PSI (155 MMHG) OR HIGHER THAN 12 PSI (624 MMHG). SETTING THE
ALARM OUTSIDE OF THAT RANGE MAY RESULT IN UNRELIABLE
ALARM FUNCTIONING.
–––––––––––––––––––––––––––––––––––––––
3Use the keypad to press s[Done] to save your changes and return
to the Settings/Vols/CCA screen or press s[Previous Screen] to
view the settings without making changes.
4Press s[Previous Screen] to return to the Main Delivery screen.
DISCONTINUE ELECTRONIC FLOW CONTROL AND
SETTING GRAVITY FLOW
WARNING–––––––––––––––––––––––––––––––
CLOSE ALL CLAMPS BEFORE OPENING THE CASSETTE DOOR.
–––––––––––––––––––––––––––––––––––––––
1Press [STOP]. If two lines were pumping, press s[Stop All].
2Press s[ON/OFF] to turn off the infuser.
3Close all clamps.
4Open the cassette door and remove the cassette.

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5If only 1 line was pumping, open all clamps.
If 2 lines were pumping, you must choose one line for gravity ow.
Open the clamps on that proximal line and on the distal line. Make
sure one proximal line stays clamped.
6Holding the cassette upright, set gravity ow by turning the ow
regulator counter-clockwise.
7Check the drip chamber to measure the ow rate. Refer to the
administration set package for number of drops/mL.
DISCONTINUE FLUID ADMINISTRATION
1Press [STOP]. If two lines are pumping, press [Stop All].
2Press [ON/OFF] to turn off the infuser.
3Close all clamps.
4Detach the distal line from the patient access device.
5Open the cassette door and remove the cassette.
6Close the cassette door.
7Discard the set and uid container per hospital policy/procedure.
ALARMS AND TROUBLESHOOTING
The Plum 360 infuser has an intelligent alarm system that handles more
than one alarm at a time. Alarms are prioritized as high, medium, or low.
You can distinguish the priority by the number of beeps:
Priority Number of Beeps
High 10
Medium 3
Low 2

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HIGH PRIORITY ALARMS
Alarm Message
and Priority
Possible Cause Corrective Action
Power Off then On.
Replace pump if
alarm continues.
High
Malfunction. Power the infuser off,
and then on. Replace
infuser if this does
not clear the alarm.
Replace pump.
Audio alarm failure.
High
Audio alarm is OFF
but sensed ON, or
ON but sensed OFF.
Power off the infuser.
Replace pump.
Backlight failure.
High
Backlight voltage
out of range during
operation.
Power off the infuser.
Line B VTBI
complete
in prior CCA!
Press STOP key.
High
Line B delivery
VTBI=0; the line was
programmed under
a different CCA than
the CCA currently
used; and Line B
has a Concurrent
delivery programmed.
Stop the delivery
on Line B or open
the cassette door.
Distal OCCLUSION!
Resolve then
Backprime.
High
Distal occlusion
detected while
attempting to
backprime or during
cassette check.
Examine the
distalline for kinks.
Resolve the distal
occlusion and then
either backprime or
open and close the
cassette door.