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Users Manual

430-95520-001 (Rev. 04/05)

ABOptions/

Vol Inf

Back

Prime

For use with Lists: 12391, 20679-04,

and 11971-04 (-03 and above ONLY)

System Operating Manual

for use

with

for use

with

HOSPIRA, INC., LAKE FOREST, IL 60045, USA

Draft Manual- Not to be used

in a Clinical Situation.

Draft Manual- Not to be used

in a Clinical Situation.

Change History

430-95520-001 (Rev. 04/05)

Change History

Title

Description of

Changes Pages Affected

430-95520-001

(Rev. 04/05)

First Release All

430-95520-001 (Rev. 3/05)

Contents

Section 1, Descriptive Information . . . . . . . . . . . . . . . 1-1

PRODUCT DESCRIPTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

INDICATIONS FOR USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

user qualification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

CONVENTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

warnings, cautions, and notes . . . . . . . . . . . . . . . . . . . . . 1-3

PRECAUTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4

healthcare professionals and patient related . . . . . . . . . . 1-4

concurrent flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5

epidural administration . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

battery operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8

sets and accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

backpriming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

general . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10

bolus related . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10

artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11

GUIDENCE ON EMC COMPATIBILITY . . . . . . . . . . . . . . . . . . . . . . 1-13

FCC INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14

Section 2, Principles of Operation . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3

Section 3, Equipment Description . . . . . . . . . . . . . . . 3-1

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

INDICATORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4

DISPLAY SYMBOLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5

Contents

430-95520-001 (Rev. 3/05)

REAR CASE CONTROLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6

ADMINISTRATION SETS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7

PREPARING THE ADMINISTRATION SET . . . . . . . . . . . . . . . . . . . . 3-7

PRIMING THE ADMINISTRATION SET . . . . . . . . . . . . . . . . . . . . . . 3-8

LOADING THE CASSETTE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

PREPARING THE SECONDARY LINE . . . . . . . . . . . . . . . . . . . . . 3-10

DISCONTINUING ELECTRONIC FLOW

CONTROL & SETTING GRAVITY FLOW . . . . . . . . . . . . . . . . . . . 3-11

DISCONTINUING FLUID ADMINISTRATION . . . . . . . . . . . . . . . . . . 3-12

Section 4, Basic Operation . . . . . . . . . . . . . . . . . . . . .4-1

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

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

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

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

data retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

POWER ON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4

SIMPLE DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6

TITRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8

PIGGYBACK DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12

CONCURRENT DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-15

STOP AND START WITH ONLY 1 LINE PUMPING . . . . . . . . . . . . . 4-18

STOP AND START WITH BOTH LINES PUMPING . . . . . . . . . . . . . 4-19

BACKPRIMING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-20

CLEARING SETTINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-21

UPDATING DRUG LIBRARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-23

Section 5, Advanced Programs . . . . . . . . . . . . . . . . . .5-1

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

DOSE CALC (MG/MIN ON B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9

LOADING DOSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15

MULTISTEP PROGRAMMING . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-22

Section 6, Additional Features . . . . . . . . . . . . . . . . . . .6-1

SIMPLE DELIVERY USING DELAYED START . . . . . . . . . . . . . . . . . 6-1

PIGGYBACK WITH NURSE CALLBACK . . . . . . . . . . . . . . . . . . . . . 6-2

POSSIBLE NON-DELIVERY PROGRAMMED . . . . . . . . . . . . . . . . . . 6-4

USING THE STANDBY FEATURE . . . . . . . . . . . . . . . . . . . . . . . . . 6-4

SELECT OPTION- VOLUMES INFUSED, PRESSURE/POST INFUSION

430-95520-001 (Rev. 3/05)

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

VARIABLE RATE CAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10

EXAMPLES OF AUTOMATIC CALCULATION . . . . . . . . . . . . . . . . . 6-10

at startup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10

while running (titration) . . . . . . . . . . . . . . . . . . . . . . . . . . 6-10

at kvo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-11

CHANGING CCA WHILE INFUSING . . . . . . . . . . . . . . . . . . . . . . 6-12

AUTO-PROGRAMMING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-13

Section 7, Alarms and Troubleshooting . . . . . . . . . . . 7-1

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

RESPONSE TO ALARMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

GENERAL ALARMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3

LINE A ALARMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5

LINE B ALARMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

MALFUNCTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8

GENERAL MESSAGES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-9

Section 8, Cleaning, Maintenance, and Storage . . . . 8-1

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

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

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

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

Section 9, Specifications . . . . . . . . . . . . . . . . . . . . . . 9-1

PHYSICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

ELECTRICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

WIRELESS LAN DEVICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

VTBI RANGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

ENVIRONMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

DELIVERY RATE RANGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

AIR-IN-LINE ALARM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3

OCCLUSION ALARM AND LIMITS . . . . . . . . . . . . . . . . . . . . . . . . . 9-4

TIME TO DETECT DOWNSTREAM OCCLUSIONS . . . . . . . . . . . . . . 9-5

BOLUS VOLUME RELEASED AFTER DOWNSTREAM

OCCLUSIONS ARECORRECTED . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

DELIVERY ACCURACY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

ENTERAL & HIGH VISCOSITY FLUIDS EFFECTS . . . . . . . . . . . . . . 9-6

TRUMPET CURVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7

Contents

430-95520-001 (Rev. 3/05)

example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7

Section 10, Supplies and Accessories . . . . . . . . . . . .10-1

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

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

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

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

ACCESSORIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

general . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

networked application . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

Section 11, Warranty . . . . . . . . . . . . . . . . . . . . . . . . .11-1

Section 12, Default Drug Library (DDL) . . . . . . . . . . . 12-1

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 1

SECTION 1

Descriptive Information

The Plum A+ Volumetric Infusion System is designed to meet

the fluid delivery requirements of today’s evolving healthcare

environments. The infuser is a cassette based multi-function

infusion system. The Plum A+ allows two lines in and one line

out. The infuser can be used for standard, piggyback, or

concurrent delivery. Programming modes include:

• Standard Infusions

• Multistep Programming

• Loading Dose

• Dose Calculation

The Plum A+ is designed to deliver parenteral, enteral, or

epidural infusions over a broad range of infusion rates from

multiple fluid container types.

The Plum A+ is designed to be used in most areas of patient

care, including, but not limited to:

Product Description

The 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.

The Plum A+ host device contains a Connectivity Engine

peripheral module that provides wired Ethernet and wireless

• General Floor • Labor/Delivery/

Post Partum

• Burn Unit

• Medical/Surgical • OR/Anesthesia • Hemodialysis

• ICU/CCU • Post Op/Recovery • Oncology

• Pediatrics • Cardiac Cath Lab • Mobile Intensive

Care

• Neonatology • Emergency • Nutritional

1- 2 430-95520-001 (Rev. 04/05)

802.11b local area networking capabilities. This allows the

Hospira MednetTM networked application software for drug

library downloads and Auto-programming to the infuser.

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.

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.

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

(See Figure 3-1,

Priming Cassette)

Primary Only:

Attach an empty

container.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 3

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 USUALLY APPEARS IN FRONT OF A

PROCEDURE OR STATEMENT. IT CONTAINS INFORMATION THAT

COULD PREVENT IRREVERSIBLE PRODUCT DAMAGE OR HARDWARE

FAILURE. FAILURE TO OBSERVE A CAUTION COULD RESULT IN

SERIOUS PATIENT OR USER INJURY.

[BRACKETED

ALL CAPS]

Keys or buttons on

the device are

displayed in

[BRACKETED ALL

CAPS] or with a

graphic.

[START]

[Italic] Softkey Options

[Choose]

Initial Caps

lowercase

Screen displays and

device labels (as

appropriate)

Program

Dose Calculation

Bold Emphasis ...sets are supplied

Sterile and are

for....

CONVENTION APPLICATION EXAMPLE

1- 4 430-95520-001 (Rev. 04/05)

NOTE: A Note highlights information that helps explain a

concept or procedure.

This symbol directs the user to consult accompanying

documents.

When visible on the display, this symbol informs the

user to use CAUTION because the specified drug has

NOT been programmed with specified safety limits.

NOTE: Figures are rendered as graphic representations to

approximate the actual product. Therefore, figures may not

exactly reflect the product.

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.

HEALTHCARE PROFESSIONALS AND PATIENT RELATED

• In vitro studies have suggested that packed red blood cells

with unusually high hematocrit be diluted with blood-

compatible fluids, such as 0.9% sodium chloride injection, to

decrease hemolysis and increase flow rate.

• 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.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 5

• 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).

• Air bubbles may form distal to the cassette as result of

normal outgassing 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-in-line

alarm, requiring repriming.

• 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.

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 2.0 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.

1- 6 430-95520-001 (Rev. 04/05)

• If the critical drug (with half-life less than 6 minutes) is to be

infused at 2.0 to 5.0 mL/hr the other infusion 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.

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 DRUG

INFUSION RATE

MAXIMUM RATE OF

ACCOMPANYING INFUSION

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

2.0 - 5.0 mL/hr 10 Times the Critical Drug Rate

5.1 or Greater Any Desired Ratio

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 7

CRITICAL DRUGS

Examples of drugs with a short half-life (approximately 6

minutes or less when given IV) include:

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 all-

inclusive 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.

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.

Dobutamine Lidocaine

Dopamine Nitroglycerin

Epinephrine Nitroprusside

Epoprostenol Norepinephrine

Esmolol Oxytocin

Isoproterenol Procainamide

1- 8 430-95520-001 (Rev. 04/05)

• 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 signs of spinal cord compression

(disorientation, headache, transient neuralgias) and drug

overdose.

BATTERY OPERATION

• When the battery is removed from the Plum A+, do not

operate on patients. 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 the quality of the earth grounding source is in

doubt, use battery power.

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

power immediately.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 9

SETS AND ACCESSORIES

• Only compatible LifeCare PlumSets 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 Y-

injection site, below the filter.

• When infusing at low delivery rates (5.0 mL/hr or less) the

use of thick-walled microbore PlumSets 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 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.

1- 10 430-95520-001 (Rev. 04/05)

• 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.

• Values beyond a fields maximum hard limit will be diplayed

as dashes (-- -- --). The user must clear these fields using the

[CLEAR] key prior to entering new values.

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. 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.

BOLUS RELATED

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.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 11

• 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.

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

1- 12 430-95520-001 (Rev. 04/05)

or microcomputer might be 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.

• This equipment has been tested and found to comply with the

EMC limits for the Medical Device Directive 93/42/EEC (EN

55011 Class B and IEC/EN 60601-1-2:2001). These limits

are designed to provide reasonable protection against

harmful interference in a typical medical installation. The

equipment generates, uses and can radiate radio frequency

energy and, if not installed and used in accordance with the

instructions, may cause harmful interference to other devices

in the vicinity. However, there is no guarantee that

interference will not occur in a particular installation. If this

equipment does cause harmful interference with other

devices (radio or television reception), which can be

determined by turning the equipment off and on, the user is

encouraged to try to correct the interference by one or more

of the following measures:

• Reorient or relocate the receiving device

• Increase the separation between the equipment

• Connect the equipment into an outlet on a circuit

different from that to which the other device(s) is

connected

• Consult the manufacturer or field service technician for

help

• Portable and mobile RF communications equipment, such as

cellular telephones, 2-way radios, Bluetooth devices,

microwave ovens, in close proximity to this device may affect

wireless and wired communications with the Infusion pump

and/or the operation of the Infusion pump. Special

precautions need to be exercised regarding EMC, These

include:

• Use of a shielded Ethernet cable (CAT5 STP or better)

for plugging into the RJ45 Ethernet connector. Using

an unshielded Ethernet cable may result in increased

emissions.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 13

• Maintaining a minimum separation distance of 2 ½ ft

between the Infusion pump system and portable/

mobile RF communications equipment

• List Numbers 12391 and 11971 are compliant to IEC/EN

60601-1-2 (1993)

List Number 20679 is compliant to IEC/EN 60601-1-2 (2001)

and have been tested and found to comply with EMC limits

for the Medical Device Directive 93/42/EEC (EN 55011 Class

B and EN 60601-1-2:2001).

Guidance on EMC Compatibility

• There is a shared responsibility between manufacturers,

customers and users to ensure that Medical Equipment and

Systems are designed and operated as intended. Medical

electrical equipment needs special precautions regarding

electromagnetic compatibility and needs to be installed and

used according to the electromagnetic compatibility

information provided in this manual.

• The device is suitable for use in all establishments, including

domestic establishments. If extended operation during

power mains interruption is needed, use battery power.

• Always manage the electromagnetic environment.

• The guidance included in this manual provides information

needed to:

• Determine the device’s suitability for use in the

intended environment.

• Manage the electromagnetic environment to permit the

device to perform as intended without disturbing other

equipment.

• Separate the device from all other electronic equipment. If

the device must be used near other electrical equipment,

monitor the equipment to ensure there is no electromagnetic

interference.

• Devices should not be used adjacent to or stacked with other

equipment. If the device must be used adjacent to or stacked

1- 14 430-95520-001 (Rev. 04/05)

with other equipment, monitor the devices to verify normal

operation.

• USE ONLY components specifically labeled for use with the

Plum A+ Infusion System to help ensure the device operates

as intended.

• If you suspect external RF sources or other equipment are

influencing device operation, contact the biomedical

engineering department for additional guidelines concerning

electromagnetic immunity.

• Contact the biomedical engineering department for additional

information in the technical service manual concerning

operating devices near RF sources.

FCC Information

U.S. Pat. No. 5,681,285 FCC ID: STJ-20677

IC: 5627A-20677

US FCC (FEDERAL COMMUNICATIONS COMMISSION)

STATEMENT

• This device complies with part 15 of the FCC Rules.

Operation is subject to the following two conditions: (1) This

device may not cause interference, and (2) This device must

accept any interference, including that may cause undesired

operation of this device.

FCC INTERFERENCE STATEMENT

• This equipment has been tested and found to comply with the

limits for a Class B digital device, pursuant to Part 15 of the

FCC Rules. These limits are designed to provide reasonable

protection against harmful interference in a residential

installation. This equipment generates, uses, and can radiate

radio frequency energy. If not installed and used in

accordance with the instructions, it may cause harmful

interference to radio communications. However, there is no

guarantee that interference will not occur in a particular

installation. If this equipment does cause harmful interference

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 1- 15

to radio or television reception, which can be determined by

turning the equipment off and on, the user is encouraged to

try and correct the interference by one or more of the

following measures:

• Reorient or relocate the receiving antenna.

• Increase the distance between the equipment and the

receiver.

• Connect the equipment to an outlet on a circuit

different from that to which thereceiver is connected.

• Consult the dealer or an experienced radio/TV

technician for help.

• Changes or modifications not expressly approved by Hospira

could void the user's authority to operate the equipment.

RADIO FREQUENCY EXPOSURE STATEMENT

• The Wireless LAN radio device in the Connectivity Engine

peripheral board with this infusion device has been evaluated

and found compliant to the requirements of the following

Radio Frequency exposure standards:

• Federal Communications Commission, OET Bulletin

65 (Edition 97-01), Supplement C (Edition 01-01),

Evaluating Compliance with FCC Guidelines for

Human Exposure to Radio frequency Electromagnetic

Fields, July 2001.

• Industry Canada, Evaluation Procedure for Mobile and

Portable Radio Transmitters with respect to Health

Canada's Safety Code 6 for Exposure of Humans to

Radio Frequency Fields, Radio Standards

Specification RSS-102 Issue 1 (Provisional):

September 1999.

• Federal Communications Commission, OET Bulletin

65 (Edition 97-01), Supplement C (Edition 01-01),

Evaluating Compliance with FCC Guidelines for

Human Exposure to Radio frequency Electromagnetic

Fields, July 2001.

• The radiated output power of this Wireless LAN device is far

below the FCC radio frequency exposure limits. The Wireless

1- 16 430-95520-001 (Rev. 04/05)

LAN device has been evaluated with zero inches separation

of human body from the antenna and found to be compliant

with FCC RF exposure limits.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 1

SECTION 2

Principles of Operation

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 its

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

• Standard Programming

• Loading Dose

• Multistep Programming

LINE PROGRAMMING OPTIONS

• Drug List

• Nurse Call Back

• Delayed Start/Standby 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)

2- 2 430-95520-001 (Rev. 04/05)

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

• Battery Gauge

• Less than 8-Hour Battery Recharge Time

• Long battery life (3 hours) for emergency backup and

temporary portable operation

BIOMEDICAL

• Upgradability (Field)

• 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

OTHER FEATURES

• Nonpulsatile volumetric accuracy

• Microprocessor control

• Large liquid crystal display (LCD) screen

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 3

• 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

COMMUNICATION

• Networked Communication (Ethernet & Wireless)

• Autoprogramming

• Drug Library Download

Definitions

TERM DEFINITION

Administration

Set

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.

Alarm A condition requiring operator

intervention that invokes both audible

and visible alarm indicators. Confirmation

of the condition usually is required.

Alert While entering a program, a visual

warning that informs the clinician of the

violation of a hospital-defined rule set,

e.g., a dose limit for a specific drug.

Alternate Units Dose Rate units that may be selected.

Alternate Units are any units other than

mL/hr.

Alternate Units

Parameters

Drug Amount, Diluent, Patient Weight (if

applicable), and Dose Rate.

2- 4 430-95520-001 (Rev. 04/05)

Auto-Program A physician order sent to the infuser.

Auto-Program

(new)

An auto-program is considered “new” if

either of the following conditions are met:

A) There is no program on the associated

line. B) The drug and concentration in the

auto-program is different from a

currently-programmed drug and

concentration.

Auto-Program

(titration)

An auto-program is considered a

“titration” if the drug and concentration in

the auto-program match the currently-

programmed drug and concentration.

Non-promotion titration programs include

some subset of the following: Rate, Dose,

Duration. Promotion titration programs

include some subset of the following:

Rate, Dose, Duration, Patient Weight,

Dosing Units, Drug Amount, Drug Units,

Diluent Amount.

Awake CE The CE is considered awake when the

infuser is powered on with battery power

and the battery is above the low battery

threshold or is plugged into AC.

Backpressure Resistance to fluid flow on the Distal or

output portion of the Administration Set,

usually expressed as PSIG.

Backprime Removal of air or fluid from the 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.

Basic Delivery A single-step delivery specifying rate,

VTBI, and duration only. Drug name may

or may not be specified.

Biomed Mode The name for the non-delivery or service

mode of Infuser operation.

TERM DEFINITION

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 5

Bolus A single uninterrupted discrete volume of

fluid delivered over a discrete period of

time.

Cassette A Hospira standard Plum Macro 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.

Caution Contains information which could

prevent hardware failure, irreversible

damage to equipment, or loss of data.

Channel Distal Line output to the patient.

Cleared Program Same as Cleared Settings, but restricted

to the program delivery settings for an

individual line.

Cleared Settings Programmed delivery settings for both

lines and the general control parameters

are at their default values.

Clinical Care

Area (CCA)

An area of the hospital for which

authorized hospital staff has allowed use

of up to 149 specific drugs, plus No Drug

Selected. The clinician selects a CCA

after turning on the Infuser. The hospital

may create from one to eighteen CCA’s.

Concentration For Dose Calculation based Line A or B

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”.

TERM DEFINITION

2- 6 430-95520-001 (Rev. 04/05)

Concurrent

Delivery

Simultaneous delivery of two fluids at

independent flow rates.

Concurrent Mode 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.

Connectivity

Engine (CE)

A component of the infuser that controls

ethernet and wireless communication

between the MMU and Infuser processor.

Continue Rate

(CR)

An option used to provide fluid delivery at

the current fluid delivery rate when the

VTBI becomes zero.

Default Drug

Library (DDL)

A drug list of 99 drug names, default units

and default concentrations, plus ‘No Drug

Selected’. Does not contain Soft or Hard

Limits. The DDL is a subset of Plum A+

Version 11.3 drug list. The Infuser

functions initially with the DDL.

Deliver Together A Biomed Delivery option setting, which

selects default of Piggyback or

Concurrent delivery mode.

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) The volume of fluid used with the Diluent

Unit (e.g., 250 mL), which dilutes the drug

to be infused.

TERM DEFINITION

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 7

Distal Downstream (output) from the Cassette

portion of the Administration Set.

Door The lever-operated, bottom-hinged,

Cassette holder on the front of the

Mechanism.

Dose (Rate) Delivery rate times drug concentration.

Dose Calculation Allows programming Dose Rates in

alternative units of measure. Dose

Calculation can be used in Simple

Delivery, Loading Dose, and Multistep.

Drug Amount The mass or quantity of the drug

premixed with a Diluent to express the

Concentration for the Line being

programmed.

Drug Library Drug names available for use with the

Infuser in the selected CCA, and each

drug’s concentration, units of measure,

and dose limits, as determined by

authorized hospital staff. The Drug

Library is based on hospital-defined best

practices. The Drug Library is customized

and downloaded into the Infuser by

authorized hospital personnel using

Hospira MedNet Networked software.

Duration The time period used to deliver a VTBI at

an existing Delivery Rate or as set by the

operator.

Enteral Delivery via an intestinal route.

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.

TERM DEFINITION

2- 8 430-95520-001 (Rev. 04/05)

Filling Head

Height (FHH)

The gravity induced Proximal Line

pressure due to fluid height in source

container above the Distal Line output

level.

Flow Rate The resulting rate of fluid flow. (See Rate

and Dose.)

Fluid Delivery

Begin

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.

Hard Limit The dosing amount (upper and/or lower

amount) that when assigned to a drug

cannot be overridden. Defined by the

hospital for each drug in its Drug Library.

The hard limits for a particular drug may

vary across different CCAs.

Infuser A Plum A+ device, not including the

disposable administration set.

Initialized

Position

The plunger is in the Plunger Park

Position, and each valve is in the Valve

Home Position.

Key Any of the marked locations on the front

panels intended for user input via a

pressing action.

KVO (Keep Vein Open) Internally selected

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.

Line A Inlet tubing on the top center of Cassette

when viewed after it has been loaded in

Mechanism Door.

TERM DEFINITION

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 9

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.

MedNet software Networked application software used to

define and download the custom drug

library to the Infuser.

TERM DEFINITION

2- 10 430-95520-001 (Rev. 04/05)

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.

MMS Medication Management Suite- a product

suite that will be used to support safe and

efficient caregiver administration of

intravenous medications.

MMU Medication Management Unit- the MMU is

a product of the MMS and provides

external communications with infusers

and other systems supporting medication

management. It supports drug library

downloads and status/log updates to the

infusers. MMU also delivers a variety of

pre-built and custom reports related to

the infuser activities.

Network-Enabled

Module

The hardware that facilitates

communication between the infuser and

the network.

Note A Note explains something new, gives

tips on performing an activity, or provides

a reminder of necessary preparations.

Override The clinician acknowledges an Alert,

confirms and proceeds with a program

containing a parameter that falls outside

the hospital-defined Soft Limits.

Parenteral Delivery via other than an intestinal route,

such as intravenous (IV) injection.

TERM DEFINITION

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 11

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

Infusion will stop Line A and infuse Line

B until VTBI completes.

Piggyback Mode 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.

Plunger Park

Position

The position of the pumping plunger that

allows the cassette to be withdrawn from

the Infuser without restriction, with an

opened Door.

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.

TERM DEFINITION

2- 12 430-95520-001 (Rev. 04/05)

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

Rounding To round-off to the closest whole number

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

would round to 25).

Rule Sets The compilation of Soft and Hard Limits

associated with a drug entry.

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.

TERM DEFINITION

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 2- 13

Soft Limit The dosing amount (upper and/or lower

amount) that when assigned to a drug can

be overridden based on confirmation.

Defined by the hospital for each drug in

its Drug Library. The soft limits for a

particular drug entry may vary across

CCAs.

Standard

Programming

(see Basic Delivery)

Standby A delivery program state that 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.

System The Plum A+ Infuser system with its

associated accessories and

Administration Sets.

Tall-Man

Lettering

Tall-Man lettering uses upper-case letters

in combination with lower-case letters to

help clinicians differentiate among

sound-alike or look-alike drug names.

Certain Hospira Default Library drug

names are displayed in Tall-Man lettering.

Truncate To round-down to the last whole number

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

Units A Drug Amount (without a quantity of

mass referent) adopted as the United

States Pharmacopoeia (USP) standard of

measure for use in a Concentration.

VI Volume Infused.

VTBI Volume To Be Infused – The volume of

fluid or IV solution (remaining) for

delivery by a program or Therapy step

from a Line.

TERM DEFINITION

2- 14 430-95520-001 (Rev. 04/05)

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/.

TERM DEFINITION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 1

SECTION 3

Equipment Description

Front Panel Display and Keypad

Back

Prime

Options/

Vol Inf

Line A Flow

Indicator

Status Region

Working Region

Message Region

Status

Region

Working

Region

Message

Region

Start and

Stop Keys

Charging/

Line

Indicator

ON/OFF

Key

Line B Flow

Indicator

LCD

Battery

Charge

Indicator

Numeric

Keys

(Up/Left)

Selection

Key

(Down/

Right)

Silence

Key

Numeric Field

Clear Key Decimal Point

Key

Softkey Label

Softkey

Selector

Draft Manual- Not to be used

in a Clinical Situation.

3- 2 430-95520-001 (Rev. 04/05)

Operating Keys

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. It brings up the

Confirmation screen. If all

informtion appears correct, select

[Yes] to start program.

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.

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 3

The [SILENCE] key is used to

silence an audible alarm during

actions to correct its cause.

The [SELECT] key (or ) is used

to move the highlighting cursor

between the programming fields.

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. It is also used to clear the

displayed dashes (-- -- --) that

occur when entering values

beyond the pre-programmed hard

limits. It WILL NOT clear the entire

program.

The [DECIMAL POINT] key is used

to manually enter numbers other

than whole numbers (i.e., 1.2 mL).

Draft Manual- Not to be used

in a Clinical Situation.

3- 4 430-95520-001 (Rev. 04/05)

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.

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.

Cancel/

Back

Standby Enter

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 5

Display Symbols

Battery Capacity Symbol (located

on right side of message region on

display) indicates relative charge

with number of white boxes from

left to right.

Cautionary Symbol is displayed to

alert the user that the infuser is

being operated without rule sets

(soft or hard limits). Read the drug

package insert for information on

proper usage.

Soft Limit Override Symbol

indicates the programmed soft

limits upper (up arrow) or lower

(down arrow) have been

overridden.

NOTE: The infuser will display

the rule set icon from the first step in a situation where a 2-step

process is completed and the infuser is stopped after going to

KVO.

The "Wireless Connection

Available" icon is displayed when

the device is receiving a wireless

signal. The infuser will connect to

the network if a wireless network

access point is recognized.

Draft Manual- Not to be used

in a Clinical Situation.

3- 6 430-95520-001 (Rev. 04/05)

It may appear on any Main Delivery

Screen whether pumping or stopped. It

also may appear regardless of Auto-

Programming. However, in a wireless

network environment, Auto-

Programming will not be successful if

the icon is not visible during the Auto-

Program transfer. If wireless Auto-

Programming is desired and the icon is

not displayed on the Main Delivery

Screen, try relocating the pump

towards the wireless access point until the icon is displayed.

The icon will not be displayed if the infuser is communicating

via an ethernet connection.

Rear Case Controls

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.

STOPPED PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

10.

Dose 2

mg/min

mcg/kg/min

MedSurg

Lidocaine

Dose Calculation

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 7

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.

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 Ethernet port is used to

connect to a local area connection.

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

Draft Manual- Not to be used

in a Clinical Situation.

3- 8 430-95520-001 (Rev. 04/05)

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:

1Make sure flow regulator is closed.

2Insert piercing pin into container outlet with

a twisting motion.

3Fill 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.

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 9

Priming the Administration Set

1Invert the cassette.

2Turn the flow regulator counter-clockwise

until a drop of fluid is seen in the pumping

chamber.

3Turn the cassette upright, then prime the

remainder of the administration set.

4Push 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.

1Open the cassette door by lifting up the

handle.

Draft Manual- Not to be used

in a Clinical Situation.

3- 10 430-95520-001 (Rev. 04/05)

2Insert 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 DRUG

COMPATIBILITY, CONCENTRATION, DELIVERY RATES, AND VOLUMES

ARE ALL SUITABLE FOR CONCURRENT DELIVERY OR PIGGYBACK

DELIVERY (SECONDARY FOLLOWED AUTOMATICALLY BY PRIMARY)

MODES.

The Plum A+ features concurrent or piggyback delivery modes

when program requires administering more than one fluid.

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 18- or 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

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 3- 11

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:

1With cassette door closed: Loosen and

remove white cap, then discard. Add

secondary tubing or syringe.

2Open all proximal clamps before pressing

[START].

3Set up per operating instructions.

(See Sections 4 - 6 of this manual.)

4Syringe: Secure the container to the

cassette door using the optional container

support arm (List 12095-03).

Discontinuing Electronic Flow

Control & Setting Gravity Flow

CAUTION: BEFORE OPENING DOOR, CLOSE CLAMP ON PRIMARY

OR SECONDARY SET OR REMOVE SECONDARY CONTAINER FROM

SECONDARY PORT TO PREVENT MIXING OF PRIMARY AND SECONDARY

FLUIDS.

If electronic flow needs to be stopped, the precision flow

regulator on the cassette can be used to manually set and

Draft Manual- Not to be used

in a Clinical Situation.

3- 12 430-95520-001 (Rev. 04/05)

maintain fluid flow in a gravity mode (see the following

graphics).

Discontinuing Fluid Administration

PRESS STOP

OPEN DOOR & REMOVE CASSETTE

SET GRAVITY RATE BY

TURNING FLOW REGULATOR

COUNTER-CLOCKWISE

NOTE: FLOW REGULATOR CLOSES

AUTOMATICALLY WHEN DOOR IS OPENED

TO PREVENT ACCIDENTAL FREE FLOW

NOTE: CASSETTE SHOULD BE

IN UPRIGHT POSITION

NOTE: IF DOOR OPEN ALARM OCCURS, TURN PUMP OFF

STOP

PRESS STOP

CLOSE DOOR

DISCARD SET AND FLUID

CONTAINER PER HOSPITAL

PROCEDURE

OPEN DOOR, REMOVE CASSETTE

STOP

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 1

SECTION 4

Basic Operation

Getting Started

UNPACKING

CAUTION: PRODUCT DAMAGE MAY OCCUR UNLESS PROPER

CARE IS EXERCISED DURING UNPACKING AND INSTALLATION. DO NOT

USE THE PLUM A+ IF IT APPEARS DAMAGED IN ANY WAY. THE

BATTERY MAY NOT BE CHARGED UPON RECEIPT.

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.

Inspect thoroughly for damage.

CAUTION: IF THE PLUM A+ APPEARS TO BE DAMAGED, CONTACT

HOSPIRA, INC.

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: 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,

CELLULAR TELEPHONES, OR 2-WAY RADIOS, IT IS POSSIBLE THAT

THE NORMAL OPERATION OF A SENSOR OR MICROCOMPUTER MIGHT

sec04.fm Page 1 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 2 430-95520-001 (Rev. 04/05)

BE DISRUPTED. OPERATION OF THE INFUSER UNDER THESE

CONDITIONS SHOULD BE AVOIDED.

TANDEM CARRIER INSTRUCTIONS

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: DO NOT PLACE THE PLUM A+ IN SERVICE IF IT FAILS

THE SYSTEM SELF-TESTS.

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 the earth grounding source is in doubt,

use battery power.

sec04.fm Page 2 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 3

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: WHEN THE BATTERY IS REMOVED FROM THE PLUM

A+, DO NOT OPERATE ON PATIENTS. USE OF A PROPERLY

MAINTAINED AND CHARGED BATTERY HELPS CONFIRM PROPER

OPERATION.

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.

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.

sec04.fm Page 3 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 4 430-95520-001 (Rev. 04/05)

Power On

1Press to Power On the

Plum A+ and the System Self-

Tests Screen is displayed.

After self-testing successfully

completes, the display will

proceed to 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).

CAUTION: WHEN THE BATTERY IS REMOVED FROM THE PLUM

A+, DO NOT OPERATE ON PATIENTS. USE OF A PROPERLY

MAINTAINED AND CHARGED BATTERY HELPS CONFIRM PROPER

OPERATION.

2To 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.

If Infuser ID Entry screen appears,

consult your hospital’s biomed

personnel.

HOSPIRA Plum A+

13.X Jan 31 2005 12:30:30

2005

System Self Test

In Progress

**SCREENS SHOWN IN THIS MANUAL

ARE EXAMPLES ONLY AND DON’T

NECESSARILY REFLECT ACTUAL

CLINICAL PRACTICE**

SETUP

Insert PLUM Set

Close Lever

sec04.fm Page 4 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 5

The Area Selection screen will

appear if your system has been

programmed with the Hospira

MedNet accessory. Use to

choose. If only one CCA has

been entered, it becomes the

default and this screen is

skipped.

NOTE: To change the CCA while infusing, see Section 6.8,

Changing CCA While Infusing.

If not using MedNet, the display will go straight to the

“Clear Settings ?” option.

Example of Clear Settings

Screen

3The on-screen message “Clear

Settings?” may appear. Select



[Yes] to clear all settings.

Clear ALL settings when

changing patients or multiple

programming parameters.

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.

Area Selection

Enter

Select, then Enter

Any Hospital, USA

MM/DD/YY XXYYZZ- 123456

ICU

MedSurg

Cardio

Urology

Psych

Recov

L&D

5 West

Renal

Neo ICU

OB/GYN

Oncol

Ad ICU

7 South

3 North

4 North

SETUPA B

Clear Settings?

Yes clears ALL settings

Yes No

sec04.fm Page 5 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 6 430-95520-001 (Rev. 04/05)

Simple Delivery

Example of MedNet Main

Delivery Screen (with cleared

settings). The selected area is

displayed at the bottom.

NOTE: For clarity, whole number font

sizes will appear larger than fractional

number font sizes (numbers on the right-side of the decimal).

1To Program a delivery rate, select



[A].

2To enter delivery rate, use

numeric keypad.

3Use to move down to the

VTBI field.

4To 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.

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

MedSurg

**SCREENS SHOWN IN THIS MANUAL

ARE EXAMPLES ONLY AND DON’T

NECESSARILY REFLECT CURRENT

ACTUAL PRACTICE**

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

00:00

MedSurg

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter value using keypad

5.5

00:00

MedSurg

sec04.fm Page 6 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 7

5Use to move down to the DURATION field.

If auto-calculated Duration is acceptable, skip to step

6Use keypad to change/enter

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 6.7 Examples of Automatic Calculation.

7Use to move from hours to minutes.

NOTE: The maximum hours allowed is 99 and the maximum

minutes is 59.

8Use keypad to enter minutes.

9Press .

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

Program Confirmation screen

will appear. If correct, press



[Yes] to begin infusion.

APROGRAM

Rate

VTBI

Duration

Program

Options

Cancel/

Back

Drug

List

Enter value using keypad

5.5

0.5

00:05

mL/hr

hr : min

MedSurg

APROGRAM

Drug

Rate

VTBI

Delivery will be:

mL/hr

Confirm Program?

No Drug Selected

Yes N o

MedSurg

sec04.fm Page 7 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 8 430-95520-001 (Rev. 04/05)

Example of Main Delivery

Screen just after being

programmed and started.

NOTE: The Line A Fluid Flow

Indicator also will flash to indicate

pumping.

NOTE: VTBI (volume to be infused)

values over 100 mL are displayed

truncated. This means that the

number displayed rounds-down to the last whole number (e.g.,

105.7 would be displayed as 105). An example would be the

Programming or Pumping screens.

NOTE: VI (volume infused) values over 100 mL are displayed

rounded. This means that the number displayed rounds-off to

the nearest number (e.g., 105.7 would be displayed as 106, but

105.3 would be displayed as 105). An example would be the

Program Options screen.

Titration

1Select Line



[A] (or



[B]) at

the Main Delivery Screen.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

MedSurg

PUMPING PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

41 20

MedSurg

sec04.fm Page 8 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 9

2Enter 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 6.7 Examples of

Automatic Calculation.

3Press .

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

Program Confirmation screen

will appear. If correct, press



[Yes] to begin infusion.

NOTE: During Titration, infuser

continues to deliver at previous parameters until new program is

confirmed.

Example of Main Delivery

Screen after being titrated.

NOTE: Volume Infused is an

incrementing value which is cleared



[Options/Vol Inf].

The following 3 screens are

examples of changed values.

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

03:20

MedSurg

APROGRAM

Drug

Rate

VTBI

Delivery will be:

mL/hr

Confirm Program?

No Drug Selected

Yes N o

MedSurg

PUMPING PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

41.

MedSurg

sec04.fm Page 9 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 10 430-95520-001 (Rev. 04/05)

Example of changed rate.

4From the Main Delivery

Screen, select



[A].

5Use 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).

6Press .

Program Confirmation screen will appear. If correct,

press



[Yes] to begin infusion.

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

value.

7Use to highlight the VTBI

field.

8Use the keypad to change the

VTBI value.

NOTE: When the VTBI is changed, the Duration is recomputed

with respect to the current Rate. To understand the Automatic

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

03:20

MedSurg

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter Value using keypad

100

06:40

MedSurg

Drug

List

sec04.fm Page 10 Monday, April 11, 2005 8:34 AM

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Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 11

Calculation feature, see Section 6.7 Examples of Automatic

Calculation.

9Press .

Program Confirmation screen will appear. If correct,

press



[Yes] to begin infusion.

NOTE: [START] accepts the change. Delivery is changed to the

new VTBI and DURATION and the display brings up the

Confirmation screen before returning to the Main Delivery

Screen.

Example of changed

DURATION field.

10 Use to highlight the

Duration field, then use the

keypad to change its value.

NOTE: When DURATION is

changed, RATE is automatically

recomputed using the current VTBI

value. To understand the Automatic

Calculation feature, see Section 6.7

Examples of Automatic Calculation.

11 Press .

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

Program Confirmation screen will appear. If correct,

press



[Yes] to begin infusion.

APROGRAM

Rate

VTBI

Duration

Program

Options

Cancel/

Back

Enter Value using keypad

150

100

00:40

mL/hr

hr : min

MedSurg

Drug

List

sec04.fm Page 11 Monday, April 11, 2005 8:34 AM

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in a Clinical Situation.

4- 12 430-95520-001 (Rev. 04/05)

NOTE: [START] accepts the change. Delivery is changed to the

new DURATION and RATE and the display brings up the

Confirmation screen before returning to the Main Delivery

Screen.

Piggyback Delivery

PIGGYBACK DELIVERY-

Infusion will stop Line A and

infuse Line B until VTBI

completes. Line A will

automatically restart.

1With Line A pumping, to

program a Piggyback delivery,

select



[B].

The Delivery Mode field is

highlighted.

NOTE: If an entry was previously

programmed, RATE is highlighted. If

no previous entries, MODE is

highlighted.

2If field reads “Concurrent”,

select



[Change Mode] to switch to

“Piggyback”.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

20 0

MedSurg

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Change

Mode

Cancel/

Back

Change using Change Mode

Piggyback

00:00

MedSurg

Drug

List

sec04.fm Page 12 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 13

3Select to highlight the

RATE field.

4To enter delivery rate, use

numeric keypad.

5Use to move down to the

VTBI field.

6To 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. To

understand the Automatic Calculation

feature, see Section 6.7 Examples of

Automatic Calculation.

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter value using keypad

Piggyback

200

00:00

MedSurg

Drug

List

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter value using keypad

Piggyback

200

100

00:30

MedSurg

Drug

List

sec04.fm Page 13 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 14 430-95520-001 (Rev. 04/05)

7Use to move down to the

DURATION field.

(Optional) Use keypad to

change duration.

When all parameters are

displayed, changing any one

parameter will result in other

parameters automatically being

computed.

8Press .

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

Program Confirmation screen will appear. If correct,

press



[Yes] to begin infusion.

NOTE: If Line A has a Delay Start remaining or is stopped, a

message will appear warning of a possible non-delivery (see

section 6.4).

Example of Main Delivery

Screen just after being

programmed and started.

PROGRAM

Mode

Rate

VTBI

Duration

Program

Options

Cancel/

Back

Enter value using keypad

Piggyback

133

100

00:45

mL/hr

hr : min

MedSurg

Drug

List

DELAYED PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

5.5

20 0.

133

MedSurg

sec04.fm Page 14 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 15

Concurrent Delivery

CONCURRENT DELIVERY-

Simultaneous delivery of two fluids at

independent flow rates.

CAUTION: CONSULT DRUG

LABELING TO CONFIRM DRUG

COMPATIBILITY, CONCENTRATION,

DELIVERY RATES, AND VOLUME ARE ALL

SUITABLE FOR CONCURRENT AND

PIGGYBACK DELIVERY MODES. SEE

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.

1With pumping started on line A, to program a

Concurrent delivery rate, select



[B].

The Delivery Mode field is

highlighted.

NOTE: If an entry was previously

programmed, RATE is highlighted. If

no previous entries, MODE is

highlighted.

If field reads “Piggyback”,

select



[Change Mode] to

switch to “Concurrent”.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

MedSurg

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Change

Mode

Cancel/

Back

Change using Change Mode

Piggyback

00:00

MedSurg

Drug

List

sec04.fm Page 15 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 16 430-95520-001 (Rev. 04/05)

Verify change to “Concurrent”

mode.

2Use to highlight Rate field.

3To enter delivery rate, use

numeric keypad.

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.

4Use to move down to the VTBI field.

5To 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. To

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Change

Mode

Cancel/

Back

Change using Change Mode

Concurrent

00:00

MedSurg

Drug

List

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter value using keypad

Concurrent

00:00

MedSurg

Drug

List

PROGRAM

Mode

Rate

VTBI

Duration

Program

Options

Cancel/

Back

Enter value using keypad

Concurrent

100

10:00

mL/hr

hr : min

MedSurg

Drug

List

sec04.fm Page 16 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 17

understand the Automatic Calculation feature, see Section 6.7

Examples of Automatic Calculation.

6Use to move down to the DURATION field.

(Optional) Enter values for desired hours and

minutes.

NOTE: When Duration is entered, Rate is automatically

computed.

7Press .

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

Program Confirmation screen will appear. If correct,

press



[Yes] to begin infusion.

Example of a concurrent

delivery.

PUMPING PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

20.

MedSurg

sec04.fm Page 17 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 18 430-95520-001 (Rev. 04/05)

Stop and Start with only 1 Line

Pumping

1Press at the Main

Delivery Screen.

NOTE: If



[A] (or



[B]) is selected

prior to pressing [STOP], the display

will return to the programming

screen. Select



[Cancel/Back] to return to the Main

Delivery screen.

Example of STOPPED

delivery.

2To discontinue infusion, press

3Clamp secondary tubing if

connected.

4Open door, remove set and close door. Or, press

to resume infusion.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

100

MedSurg

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

100

MedSurg

sec04.fm Page 18 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 19

Stop and Start with Both Lines

pumping

1Press at the Main

Delivery Screen.

2Select



[Stop A],



[Stop B],



[Stop All].

NOTE: If



[A] (or



[B]) is selected

prior to [STOP], the display will show

the programming screen. Select



[Cancel/Back] to return to the Main

Delivery screen.

Example of stopped infusion.

NOTE: This is an example using



[Stop All].

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

PUMPING PUMPING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

3 20.

MedSurg

PUMPING PUMPING

Rate

mL/hr

Vol Inf

Cancel

3 20.

Stop

All

Stop

Choose line(s) to stop:

MedSurg

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

3 20.

Back

Prime

MedSurg

sec04.fm Page 19 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 20 430-95520-001 (Rev. 04/05)

3To resume infusion,

press .

4Select



[Start A],



[Start B], or



[Start All].

Or, to discontinue infusion,

press .

5Clamp secondary tubing if connected.

6Open door, remove set and close door.

Backpriming

BACKPRIMING- Removal of air or

fluid from the proximal line and

cassette airtrap.

1To initiate a backprime, select



[Back Prime].

NOTE: Backpriming is available only

when all delivery is stopped.

Secondary container is necessary to

receive the air.

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Cancel

3 20.

Start

All

Start

Choose line(s) to start:

MedSurg

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

5.5

Back

Prime

MedSurg

sec04.fm Page 20 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 21

2Select and hold



[Back Prime] until fluid

pumped from line A to line B

has expelled the air from

cassette air trap into

Secondary container.

NOTE: Fluid flow is at maximum rate

possible.

3Upon release of



[Back Prime], the cassette test is

performed to confirm readiness for pumping.

Pressing will resume programmed delivery.

Clearing Settings

1Press at the Main

Delivery Screen.

Clear ALL settings when

changing patients or multiple

programming parameters.

BACKPRIMING

Rate

mL/hr

Vol Inf

Options/

Vol Inf

5.5

Back

Prime

Release Backprime to Stop

MedSurg

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

MedSurg

sec04.fm Page 21 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 22 430-95520-001 (Rev. 04/05)

2Select Line



[A] (or B if active)

from the stopped Main Delivery

Screen.

NOTE: If Line A or B is programmed

with a Therapy (i.e., 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].

3Select



[Yes].

Clear ALL settings when

changing patients or multiple

programming parameters.

Example screen of “Cleared

Settings”.

4Select



[Cancel/Back] to

return to the Main Delivery

screen or program new

settings.

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

5.5

Back

Prime

MedSurg

PROGRAMA

Clear Line A Settings?

Yes No

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter Value using keypad

00:00

MedSurg

Drug

List

sec04.fm Page 22 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 4- 23

Updating Drug Library

If a new Drug Library is

available, the New Drug Library

Install screen will be displayed.

1Select



[Yes] to begin the

installation (It may take up to

an hour).

Select



[No] to skip the

installation and continue using

the current library.

Example screen of Library

Installing.

Library Install

Yes N o

New Drug Library

Available

The Installation may

take up to an hour.

Ensure pump is

connected to AC power.

Install Now?

Library Install

Installing

New Drug Library

The Installation may

take up to an hour.

Ensure pump is

connected to AC power.

sec04.fm Page 23 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

4- 24 430-95520-001 (Rev. 04/05)

NOTES

sec04.fm Page 24 Monday, April 11, 2005 8:34 AM

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 1

SECTION 5

Advanced Programs

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.

Standard

Program

(Dose Calculation)

Allows programming Dose Rates in alternative

units of measure. Dose Calculation can be used

in Simple Delivery, Loading Dose, and

Multistep.

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.

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.

Draft Manual- Not to be used

in a Clinical Situation.

5- 2 430-95520-001 (Rev. 04/05)

Dose Calc (mcg/kg/min on A)

DOSE CALCULATION- Allows programming Dose

Rates in alternative units of measure. Dose

Calculation can be used in Simple Delivery, Loading

Dose, and Multistep.

Clear ALL settings when changing patients or

multiple programming parameters.

The Area Selection screen will

appear if your system has been

programmed with the MedNet

accessory.

Use to select CCA and

bring you to the Main Delivery

Screen.

NOTE: To change the CCA while

infusing, see Section 6.8, Changing CCA While Infusing.

1Select



[A] at the Main

Delivery Screen.

Area Selection

Enter

Select, then Enter

Any Hospital, USA

MM/DD/YY XXYYZZ- 123456

ICU

MedSurg

Cardio

Urology

Psych

Recov

L&D

5 West

Renal

Neo ICU

OB/GYN

Oncol

Ad ICU

7 South

3 North

4 North

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

MedSurg

**SCREENS SHOWN IN THIS MANUAL

ARE EXAMPLES ONLY AND DON’T

NECESSARILY REFLECT CURRENT

ACTUAL PRACTICE**

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 3

The Line A Programming

screen appears.

2Select



[Drug List] for Dose

Calculation programming.

The Drug List Screen appears,

in mainly alphabetical order.

NOTE: Default entry is “No Drug

Selected”.

3Use 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.

4Select



[Enter] to indicate selection and advance to

the Therapy selection screen.

Based on this selection, assume the hospital has set

the following rules for the Med/Surg Area:

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

00:00

MedSurg

AMedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

No Drug Selected

Albumin 5%

Aldesleukin

Alfentanil

Alteplase

Amikacin

Amiodarone

25 grams/500 mL

2.6 mg/50 mL

10 mg/250 mL

50 mg/50 mL

100 mg/100 mL

100 mL

150 mg/100 mL

AMedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

Antibiotic

DOBUTamine

Docetaxel

DOPamine

Heparin

250 mg/500 mL

500 mg/500 mL

100 mg/250 mL

___ ___/___ mL

400 mg/250 mL

800 mg/250 mL

25,000 units/500 mL

Draft Manual- Not to be used

in a Clinical Situation.

5- 4 430-95520-001 (Rev. 04/05)

Soft upper limit of 8 mcg/kg/min

Hard upper limit of 12 mcg/kg/min

NOTE: The SOFT and HARD limits are not displayed. However,

the limit is provided if a value is programmed outside the

acceptable range. Typically, the pharmacy will set the limit.

The Select Therapy screen for

Line A appears.

5Select



[Choose] to select

Standard Program (Dose Calc)

and continue.

If selected drug has been

programmed with established

dosing units and concentration,

skip to step 8.

The Program Dose Calc

screen appears.

NOTE: Cursor defaults to package

insert (or hospital) recommended

dose units associated with the

selected drug.

6Select



[Choose] to continue.

Or, use to change the units

to use in the delivery.

If desired, select



[Page Down] to see more units of

measure.

APROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

DOPamine

AProgram Dose Calc

Choose Back

Select, then Choose

mL/hr

mcg/kg/min

mcg/kg/hr

mcg/min

mcg/hr

mg/kg/hr

mg/min

mg/hr

grams/hr

ng/kg/min

mmol/min

mmol/hr

mEq/hr

DOPamine

Page

Down

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 5

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 (or hospital) recommended

concentration units associated with

the selected drug.

7Select



[Choose] to continue. Or, use to change

the Container Concentration units to use in the

delivery.

The next page of the Program

Dose Calc screen appears to

provide for entry of delivery

program parameters.

The Concentration and Volume

fields are filled in per drug

selection.

8Use keypad to enter desired

values. Once each value is entered, use to

highlight the next programming field.

NOTE: The Concentration elements and weight value must be

entered before the [SELECT] key allows access to remaining

fields.

AProgram Dose Calc

Choose Back

Select, then Choose

Drug Conc in Container

mcg

grams

DOPamine

AProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

00: 00

mcg/kg/min

hr : min

mL/hr

DOPamine

Draft Manual- Not to be used

in a Clinical Situation.

5- 6 430-95520-001 (Rev. 04/05)

9Continue 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 6.7

Examples of Automatic Calculation.

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 automatically

updated.

NOTE: At this point, programming is complete unless



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

Features, for more information.

12 Press .

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

AProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

00: 00

26.

mcg/kg/min

hr : min

mL/hr

DOPamine

AProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

250

09: 30

26.

mcg/kg/min

hr : min

mL/hr

DOPamine

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 7

Because the Dose falls outside

the soft limits, the infuser

beeps three times (Invalid Key

Warning), and generates the

error message:

“Dose > 8. Override?”

13 Select



[Yes].

NOTE: A SOFT limit override will be recorded in the History

Events Log.

This will bring up the PROGRAM

CONFIRMATION screen.

14 If Dose, Drug, Conc., Weight &

Rate appear correct, select



[Yes] to begin program.

NOTE: If the selected drug has been

pre-programmed with dosing units

and concentration, the concentration

drug amount or diluent volume cannot be changed whether

delivering or stopped. The only way to change to a different

concentration is to clear the program.

However, if selected drug has not been pre-programmed (or still

operating with the DDL), the concentration can be changed for

a program.

AProgram Dose Calc

Yes No

Dose > 8. Override?

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

250

09: 30

26.

mcg/kg/min

hr : min

mL/hr

DOPamine

AProgram Dose Calc

Yes N o

Dose

Drug

Conc

Weight

Rate

Delivery will be:

400

mcg/kg/min

mL/hr

Confirm Program?

DOPamine

250 mL

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

5- 8 430-95520-001 (Rev. 04/05)

The Main Delivery screen

appears displaying the

information just entered.

NOTE: The Program Type and Drug

are displayed as well as the Dose

Rate and Dose Units.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

mcg/kg/min

DOPamine

MedSurg

Dose

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 9

Dose Calc (mg/min on B)

DOSE CALCULATION- Allows programming Dose

Rates in alternative units of measure. Dose

Calculation can be used in Simple Delivery, Loading

Dose, and Multistep.

Clear ALL settings when changing patients or

multiple programming parameters.

1Select



[B] at the Main

Delivery Screen.

The Line B Programming

screen appears.

2Select



[Drug List].

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

mcg/kg/min

DOPamine

MedSurg

Dose

Dose Calculation

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Change

Mode

Cancel/

Back

Change using Change Mode

Piggyback

00:00

MedSurg

Drug

List

Draft Manual- Not to be used

in a Clinical Situation.

5- 10 430-95520-001 (Rev. 04/05)

The Drug List Screen appears,

in mainly alphabetical order.

NOTE: Default entry is “No Drug

Selected”.

3Use 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.

4Select



[Enter] to indicate selection and advance to

the Program Selection screen.

The Select Program screen for

Line B appears.

5Select



[Choose] to continue.

MedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

No Drug Selected

Albumin 5%

Aldesleukin

Alfentanil

Alteplase

Amikacin

Amiodarone

25 grams/500 mL

2.6 mg/50 mL

10 mg/250 mL

50 mg/50 mL

100 mg/100 mL

100 mL

150 mg/100 mL

MedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

Labetalol

Lepirudin

Lidocaine

Liposyn 10%

Liposyn 20%

Milrinone

200 mg/200 mL

100 mg/250 mL

1 grams/250 mL

2 grams/500 mL

4 grams/500 mL

100 mL

500 mL

200 mcg/100 mL

PROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

Lidocaine

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 11

If selected drug has been programmed with

established dosing units and concentration, skip to

step 8.

The Program Dose Calc

screen appears.

NOTE: Cursor defaults to package

insert (or hospital) recommended

dose units associated with the

selected drug.

6Select



[Choose] to continue.

Or, use to change the units

to use in the delivery.

If desired, select



[Page Down] to see more units of

measure.

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.

7Select



[Choose] to continue. Or, use to change

the Container Concentration units to use in the

delivery.

BProgram Dose Calc

Choose Back

Select, then Choose

Lidocaine

mL/hr

mcg/kg/min

mcg/kg/hr

mcg/min

mcg/hr

mg/kg/hr

mg/min

mg/hr

grams/hr

ng/kg/min

mmol/min

mmol/hr

mEq/hr

Page

Down

Program Dose Calc

Choose Back

Select, then Choose

Drug Conc in Container

mcg

grams

Lidocaine

Draft Manual- Not to be used

in a Clinical Situation.

5- 12 430-95520-001 (Rev. 04/05)

The next page of the Program

Dose Calc screen appears to

provide for entry of delivery

program parameters.

8Use keypad to enter desired

values. Once entered, use

to highlight the next field.

NOTE: If selected drug has established Rule Sets (e.g., non-

blank concentration), the Mode field will be highlighted upon

entry to this screen.

9To change the Piggyback Delivery Mode default,

scroll down to Mode using , then select



[Change Mode].

NOTE: Delivery Mode Option is available on Line B, its default

is Piggyback, and the Weight field is gone.

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 6.7 Examples of

Automatic Calculation.

BProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

500

grams

Dose

VTBI

Duration

Rate

00: 00

mg/min

hr : min

mL/hr

Mode Piggyback

Lidocaine

BProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc 2

500

grams

Dose

VTBI

Duration

Rate

500

16 : 40

mg/min

hr : min

mL/hr

Mode Concurrent

Lidocaine

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 13

NOTE: The Duration field temporarily changes to dashes when

the computed value is larger than what can be displayed.

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.

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

12 To start the delivery, press

This will bring up the PROGRAM

CONFIRMATION screen.

13 If Dose, Drug, Conc., Weight, &

Rate appear correct, select



[Yes] to begin program.

NOTE: If the selected drug has been

pre-programmed with dosing units

and concentration, the concentration drug amount or diluent

volume cannot be changed whether delivering or stopped. The

only way to change to a different concentration is to clear the

program.

However, if selected drug has not been pre-programmed (or still

operating with the DDL), the concentration can be changed for

a program.

Program Dose Calc

Yes N o

Dose

Drug

Conc

Weight

Rate

Delivery will be:

mg/min

grams

mL/hr

Confirm Program?

Lidocaine

500 mL

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

5- 14 430-95520-001 (Rev. 04/05)

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

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

10.

Dose 2

mg/min

mcg/kg/min

MedSurg

Lidocaine

Dose Calculation

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 15

Loading Dose

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.

Clear ALL settings when changing patients or

multiple programming parameters.

The Area Selection screen will

appear if your system has been

programmed with the MedNet

accessory.

Use to select CCA and

bring you to the Main Delivery

Screen.

NOTE: To change CCA while

infusing, see Section 6.8, Changing CCA While Infusing.

1Select



[A] (or



[B]) at the

Main Delivery screen.

Area Selection

Enter

Select, then Enter

Any Hospital, USA

MM/DD/YY XXYYZZ- 123456

ICU

MedSurg

Cardio

Urology

Psych

Recov

L&D

5 West

Renal

Neo ICU

OB/GYN

Oncol

Ad ICU

7 South

3 North

4 North

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

5- 16 430-95520-001 (Rev. 04/05)

The selected Line (A or B)

Programming screen appears.

2Select



[Drug List].

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.

3Select



[Enter] to indicate

selection and advance to the

Program selection screen.

The Select Program screen for

Line A (or B) appears.

NOTE: This example shows line A

being programmed.

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

00:00

MedSurg

AMedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

No Drug Selected

Albumin 5%

Aldesleukin

Alfentanil

Alteplase

Amikacin

Amiodarone

25 grams/500 mL

2.6 mg/50 mL

10 mg/250 mL

50 mg/50 mL

100 mg/100 mL

100 mL

150 mg/100 mL

APROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 17

4Use to scroll down to

Loading Dose.

5Select



[Choose] to continue.

The next page of the Program

Loading Dose screen appears.

6Select



[Choose] to continue.

Or, use to change the units

to use in the delivery.

If desired, select



[Page

Down] to see more units of measure.

The Loading Dose

Programming screen appears.

7The default field is Rate. Since

a “Fluid Challenge” is being

performed in this example,

press to advance to the

VTBI field.

APROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

AProgram Loading Dose

Choose Back

Select, then Choose

mL/hr

mcg/kg/min

mcg/kg/hr

mcg/min

mcg/hr

mg/kg/hr

mg/min

mg/hr

grams/hr

ng/kg/min

mmol/min

mmol/hr

mEq/hr

Page

Down

AProgram Loading Dose

Cancel/

Back

Program

Options

Enter value using keypad

Duration

hr : min

00 : 00

VTBI

mL/hr

Rate

Draft Manual- Not to be used

in a Clinical Situation.

5- 18 430-95520-001 (Rev. 04/05)

8Enter value using keypad.

9Use to highlight the next

field.

10 Enter Duration using keypad.

The Rate value is automatically

calculated. To understand the

Automatic Calculation feature,

see Section 6.7 Examples of

Automatic Calculation.

11 After the values for loading

dose Step-1 are entered, use

to highlight the

maintenance dose, Step-2.

NOTE: The Loading Dose program

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.

AProgram Loading Dose

Cancel/

Back

Program

Options

Enter value using keypad

Duration

hr : min

00 : 00

mL/hr

Rate

VTBI

250

AProgram Loading Dose

Cancel/

Back

Program

Options

Enter value using keypad

mL/hr

500

Rate

VTBI

250

Duration

hr : min

00 : 30

00 : 00

AProgram Loading Dose

Cancel/

Back

Program

Options

Enter value using keypad

Duration

hr : min

00 : 30

00 : 00

mL/hr

500

Rate

VTBI

250

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 19

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



[Program

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.

14 Enter a delay time (less than

24 hours) using the keypad.

NOTE: Not available if a delivery is

taking place on the line.

NOTE: Nurse Callback cannot be

changed while a delivery is taking

place on the line.

15 Select



[Enter] to accept the changes and return to

the Program Loading Dose screen.

AProgram Loading Dose

Cancel/

Back

Program

Options

Enter value using keypad

Duration

hr : min

00 : 30

10 : 00

mL/hr

500

Rate

VTBI

250

750

AProgram Options

Cancel/

Back

Enter

Standby

Enter Value using keypad

Delay Start for 00:00 hr:min

Callback No

Loading Dose

AProgram Options

Cancel/

Back

Enter

Yes/No

Change using Yes/No

Delay Start for 00:05 hr:min

Callback Yes

Loading Dose

Draft Manual- Not to be used

in a Clinical Situation.

5- 20 430-95520-001 (Rev. 04/05)

NOTE:



[Cancel/Back] returns the fields to their original value

and displays the previous screen.

16 To start the delivery, press .

This will bring up the PROGRAM

CONFIRMATION screen.

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

17 If Drug and Rate appear

correct, select



[Yes] to begin

program.

The Main Delivery Screen

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 delay

period has expired, the Plum

A+ starts “Pumping”. This is

indicated where “Delayed”

previously was displayed.

Program Loading Dose

Drug

Rate

VTBI

Delivery will be:

500

250

mL/hr

Confirm Program?

No Drug Selected

Yes N o

MedSurg

DELAYED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

500

Loading Dose

MedSurg

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

500

Loading Dose

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 21

After the Step-1 has

completed, the Main Delivery

Screen changes to the second

step.

NOTE: A flashing “Callback Line A”

message and the audio alarm sound

indicates activation of that option.

18 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 complete”

message and the audible alarm

sounds.

NOTE: The KVO rate will change to

the rate of 1.0 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.

19 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.

STOPPED

Options/

Vol Inf

N105 Callback Line A

PUMPING

Rate

mL/hr

Vol Inf

250 0

Maintenance Dose

MedSurg

STOPPED

Options/

Vol Inf

N161 Line A VTBI complete

KVO

Rate

mL/hr

Vol Inf

1000 0

Maintenance Dose

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

5- 22 430-95520-001 (Rev. 04/05)

Multistep Programming

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.

Clear ALL settings when changing patients or

multiple programming parameters.

The Area Selection screen will

appear if your system has been

programmed with the MedNet

accessory.

Use to select CCA and

bring you to the Main Delivery

Screen.

NOTE: To change CCA while

infusing, see Section 6.8, Changing CCA While Infusing.

1Select



[A] at the Main

Delivery screen.

Area Selection

Enter

Select, then Enter

Any Hospital, USA

MM/DD/YY XXYYZZ- 123456

ICU

MedSurg

Cardio

Urology

Psych

Recov

L&D

5 West

Renal

Neo ICU

OB/GYN

Oncol

Ad ICU

7 South

3 North

4 North

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 23

The Line A Programming

screen appears.

2Select



[Drug List].

The Drug List Screen appears,

in mainly alphabetical order.

NOTE: Default entry is “No Drug

Selected”.

3Use to highlight desired

drug name.

When list does not contain

desired drug name or drug

class name, select



[Page Down] (or



[Page

Up]) until it shows, then use

to highlight choice.

4Select



[Enter] to indicate selection and advance to

the Program Selection screen.

APROGRAM

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Drug

List

Enter Value using keypad

00:00

MedSurg

AMedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

No Drug Selected

Albumin 5%

Aldesleukin

Alfentanil

Alteplase

Amikacin

Amiodarone

25 grams/500 mL

2.6 mg/50 mL

10 mg/250 mL

50 mg/50 mL

100 mg/100 mL

100 mL

150 mg/100 mL

AMedSurg

Page

Down

Cancel/

Back

Enter

Select, then Enter

Tirofiban

Tobramycin

Vancomycin

VinCRIStine

5 mg/100 mL

40 mg/50 mL

80 mg/100 mL

500 mg/100mL

100 mL

50 mL

Draft Manual- Not to be used

in a Clinical Situation.

5- 24 430-95520-001 (Rev. 04/05)

The Select Program screen for

Line A (or B) appears.

NOTE: This example shows line A

being programmed.

5Use to scroll down to

Multistep.

6Select



[Choose] to continue.

If selected drug has been

programmed with established

dosing units and concentration,

skip to step 9.

The Program Multistep screen

appears.

NOTE: Cursor defaults to package

insert recommended dose units

associated with the selected drug.

7Use key to highlight the

units to use in the delivery.

8Select



[Choose] to continue.

If desired, select



[Page Down] to see more units of

APROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

VinCRIStine

APROGRAM

Choose Back

Select, then Choose

Standard Program

Loading Dose

Multistep

VinCRIStine

AProgram Multistep

Choose Back

Select, then Choose

VinCRIStine

mL/hr

mcg/kg/min

mcg/kg/hr

mcg/min

mcg/hr

mg/kg/hr

mg/min

mg/hr

grams/hr

ng/kg/min

mmol/min

mmol/hr

mEq/hr

Page

Down

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 25

measure.

The Multistep Programming

screen appears.

9Rate 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.

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

00 : 00

VTBI

VinCRIStine

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

01 : 00

00 : 00

VTBI

VinCRIStine

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

01 : 00

00 : 00

VTBI

100

VinCRIStine

Draft Manual- Not to be used

in a Clinical Situation.

5- 26 430-95520-001 (Rev. 04/05)

NOTE: When Step-4 is programmed,

using [SELECT] 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 [SELECT] 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

To see the previous steps,

select



[Prev Steps].

15 To start the delivery, press

This will bring up the

Confirmation screen.

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

01 : 00

08 : 15

01 : 00

VTBI

825

100

VinCRIStine

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

00 : 00

VTBI

VinCRIStine

Program Multistep

Drug

Rate

VTBI

Delivery will be:

mL/hr

Confirm Program?

VinCRIStine

Yes N o

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 5- 27

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

Rate

mL/hr

Vol Inf

Options/

Vol Inf

27.

VinCRIStine

Step 1

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

100

652 0

VinCRIStine

Step 2

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

01 : 00

08 : 15

01 : 00

VTBI

825

100

VinCRIStine

Draft Manual- Not to be used

in a Clinical Situation.

5- 28 430-95520-001 (Rev. 04/05)

If Rate value is changed, the

Duration will automatically

change.

NOTE: Only the current delivering

step and future steps can be

changed.

18 To start the delivery, press

This will bring up the

Confirmation screen.

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

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.

AProgram Multistep

Cancel/

Back

Enter value using keypad

Program

Options

Steps

Rate

mL/hr

Duration

hr : min

01 : 00

06 : 36

01 : 00

VTBI

825

125

VinCRIStine

Program Multistep

Drug

Rate

VTBI

Delivery will be:

125

825

mL/hr

Confirm Program?

VinCRIStine

Yes N o

MedSurg

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

125

658 0

VinCRIStine

Step 2

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 1

SECTION 6

Additional Features

Simple Delivery Using Delayed

Start

1Before or after entering the

simple delivery program, select



[Program Options].

NOTE: To program a Delayed Start

using an advanced program (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 Select

Program mode.

The Default screen for

Program Options appears.

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Change

Mode

Cancel/

Back

Drug

List

Change using Change Mode

Concurrent

250

50:00

MedSurg

BProgram Options

Cancel/

Back

Enter

Standby

Enter Value using keypad

Delay Start for 00:00 hr:min

Callback No

Draft Manual- Not to be used

in a Clinical Situation.

6- 2 430-95520-001 (Rev. 04/05)

2Enter values for desired hours

and/or minutes.

3Select



[Enter] to confirm

delayed start.

CAUTION: VERIFY ALL VALUES

BEFORE STARTING INFUSION.

4Press to confirm

programming.

Line B is delayed for the time

entered.

NOTE: Delayed line drip indicator is

solid, not flashing. It will begin

flashing when actually pumping.

Piggyback with Nurse Callback

1After programming in desired

values for both lines, select



[Program Options].

NOTE: To set a nurse callback, the

infuser must be stopped. This

function can be selected either before

or after entering the Piggyback

delivery program.

BProgram Options

Cancel/

Back

Enter

Standby

Enter Value using keypad

Delay Start for 01:00 hr:min

Callback No

PUMPING DELAYED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

125

850 0

MedSurg

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter value using keypad

Piggyback

200

100

00:30

MedSurg

Drug

List

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 3

The default screen for Program

Options appears.

Use to highlight “Callback”

field and select



[Yes/No], if

necessary to obtain “Yes”, then

select



[Enter].

NOTE: Callback default of Yes or No is a biomedical setting and

must be configured using the Hospira MedNet accessory.

CAUTION: VERIFY ALL VALUES BEFORE STARTING INFUSION.

2Press to confirm

program setting and return to

Main Delivery screen.

At end of Piggyback delivery,

with Callback enabled for the

line, Callback alarm is issued.

3Press to clear alarm.

BProgram Options

Cancel/

Back

Enter

Yes/No

Change using Yes/No

Delay Start for 00:00 hr:min

Callback Yes

PROGRAM

Mode

Rate

VTBI

Duration

mL/hr

hr : min

Program

Options

Cancel/

Back

Enter value using keypad

Piggyback

200

100

00:30

MedSurg

Drug

List

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

5.5

0.3100

200

N104 Callback Line B

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

6- 4 430-95520-001 (Rev. 04/05)

Possible Non-Delivery Programmed

NOTE: Whenever a valid [START]

key is pressed, the device checks the

delivery program(s) for non-delivery

conditions (such as Line B Piggyback

without Line A or delayed start) that

could permit a period of non-delivery.

If so, the display presents this

warning screen.

1Select



[Yes] to continue with

delivery. Or, select



[No] to cancel.

Using the Standby Feature

Standby is a feature that

enables the clinician to

program the infuser up to 23:

59 minutes in advance of

Starting.

1If Line A is infusing, select



[A] or



[B] to access

program screen of line to be

placed on Standby.

2Select



[Program Options].

3Select



[Standby].

PROGRAM

Yes N o

Attention: Line A is stopped or

delayed. Line B in piggyback mode

gives no KVO or alarm at dose end.

Continue anyway?

AProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

250

09: 30

26.

mcg/kg/min

hr : min

mL/hr

DOPamine

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 5

4Confirm the information

displayed is correct, then select



[Yes] to place program on

Standby mode.

NOTE: This example screen shows a

Dose Calculation Program with a

Standby. It looks similar to the

Program Confirmation screen with

the substitution of “Put delivery in

Standby” replacing “Confirm

Program”. Selecting



[Yes] confirms both the Program

and the Standby.

5Press to remove

Standby and start the infusion.

AProgram Dose Calc

Yes N o

Dose

Drug

Conc

Weight

Rate

Delivery will be:

400

26.

mcg/kg/min

mL/hr

Put delivery in Standby?

DOPamine

250 mL

MedSurg

STANDBY STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

mcg/kg/min MedSurg

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

6- 6 430-95520-001 (Rev. 04/05)

Select Option- Volumes Infused,

Pressure/Post Infusion Rate, and

Lighting/Contrast

1To select Options Screen,

select



[Options/Vol Inf].

2Use to highlight an option.

3Select



[Choose] to select the

Volumes Infused screen.

This will bring up the Volumes

Infused screen which defaults

to Total Volume.

4Use to scroll to Line A or B.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

393 0

MedSurg

DOPamine

Dose Calculation

OPTIONS

Choose

Change

CCA Back

Select, then Choose

Release 13.x - xx/xx/xx

Volumes Infused

Pressure/Post Infusion Rate

Lighting/Contrast

Any Hospital, USA

MM/DD/YY XXYYZZ-123456

OPTIONS

Enter Cancel/

Back

Press CLEAR to clear value

Volumes Infused

Line A

Line B

Total Vol

393

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 7

5To reset Line A (or B) Volume

Infused,use to highlight

and press .

6To restore the cleared quantity,

select



[Cancel/Back].

7To reset all volumes, use to

highlight Total Vol, then press

8To restore all quantities, select



[Cancel/Back] softkey.

OPTIONS

Enter Cancel/

Back

Press CLEAR to clear value

Volumes Infused

Line A

Line B

Total Vol

393

DOPamine

Dose Calculation

OPTIONS

Enter Cancel/

Back

Press CLEAR to clear value

Volumes Infused

Line A

Line B

Total Vol

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

6- 8 430-95520-001 (Rev. 04/05)

9When clearing of quantities is completed, select



[Enter] to return to the Main Delivery screen.

10 Select



[Options/Vol Inf] from

the Main Delivery screen to

return to the Options screen.

11 Use to highlight the

Pressure/Post Infusion Rate

option.

12 Select



[Choose] to continue.

NOTE: Prior to changing Pressure/Post Infusion Rate, infuser

must be stopped.

13 Use to highlight Continue

Rate or Distal Pressure Limit

field.

14 Continue Rate allows a choice

when VTBI is completed.

Select



[KVO/Rate].

• KVO- The infuser will revert to a fixed KVO of 1 mL/hr or the

last programmed Rate, whichever is less.

• Rate- The infuser will continue at the Rate programmed.

NOTE: Option will be for both line A and line B selections.

15 To change Distal Pressure Limit when highlighted,

OPTIONS

Choose

Change

CCA Back

Select, then Choose

Release 13.x - xx/xx/xx

Volumes Infused

Pressure/Post Infusion Rate

Lighting/Contrast

Any Hospital, USA

MM/DD/YY XXYYZZ-123456

OPTIONS

Enter Cancel/

Back

Change using KVO/Rate

Pressure/Post Infusion Rate

Continue Rate

Distal Pressure Limit

Distal Pressure

KVO

psi

KVO/

Rate

DOPamine

Dose Calculation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 9

enter value between 1.0 and 15.0 psi.

16 Select



[Enter] to keep changes and return to the

Main Delivery screen, or



[Cancel/Back] to restore

original values and return to the Options screen.

NOTE: Continue Rate default of KVO or Rate must be

configured using the Hospira MedNet software.

17 Select



[Options/Vol Inf] from

the Main Delivery screen to

return to the Options screen.

18 Use to highlight Lighting/

Contrast Option.

19 Select



[Choose] to continue.

20 Press to highlight Backlight

Intensity or Display Contrast.

21 While viewing display for

desired effect, select either



[Increase Setting] or



[Decrease Setting] to change

level.

22 Select



[Enter] to keep change(s) and return to the

Main Delivery screen, or



[Cancel/Back] to restore

previous settings and return to the Options screen.

OPTIONS

Choose

Change

CCA Back

Select, then Choose

Release 13.x - xx/xx/xx

Volumes Infused

Pressure/Post Infusion Rate

Lighting/Contrast

Any Hospital, USA

MM/DD/YY XXYYZZ-123456

OPTIONS

Enter Cancel/

Back

Use Inc/Decrease Settings

Lighting/Contrast

Backlight Intensity

Display Contrast

Decrease

Setting

Increase

Setting

Draft Manual- Not to be used

in a Clinical Situation.

6- 10 430-95520-001 (Rev. 04/05)

Variable Rate Cap

NOTE: Variable Rate Cap is used to set the maximum rate

values to be accepted by the device. The clinician cannot

change it once it has been programmed. It must be configured

using the Hospira MedNet software.

Examples of Automatic Calculation

AT STARTUP

Initial programming allows the clinician to enter two of the three

programming parameters (Rate, VTBI, or Duration) and the

third is automatically calculated. (Refer to table below)

WHILE RUNNING (TITRATION)

Changing two parameters after startup of the infusion will allow

for the re-calculation of the third parameter.

1st Action 2nd Action [AUTOCALC]

enter RATE enter VTBI [DURATION]

enter VTBI enter DURATION [RATE]

enter RATE enter DURATION [VTBI]

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 11

NOTE: VTBI will not be re-calculated if the Rate and Duration

are changed. VTBI must be cleared and then the new VTBI re-

entered. The new VTBI will automatically calculate a new Rate.

AT KVO

Audible KVO alarm will sound, clinician will need to re-set the

appropriate settings.

1st Action 2nd Action [AUTOCALC]

change RATE keep VTBI [DURATION]

change RATE change VTBI [DURATION]

change VTBI keep RATE [DURATION]

change DURATION keep VTBI [RATE]

change VTBI change DURATION [RATE]

change RATE change DURATION Recalculates [RATE]

based on previous

VTBI and new

DURATION

1st Action 2nd Action [AUTOCALC]

enter VTBI keep RATE [DURATION]

enter DURATION keep RATE [VTBI]

change RATE enter VTBI [DURATION]

enter DURATION enter VTBI [DURATION]

enter VTBI enter DURATION [RATE]

change RATE change DURATION [VTBI]

Draft Manual- Not to be used

in a Clinical Situation.

6- 12 430-95520-001 (Rev. 04/05)

Changing CCA While Infusing

1Select



[Options/Vol Inf] from

the Main Delivery screen.

2Select



[Change CCA].

3Press to highlight desired

CCA, then select



[Enter] to

confirm the change.

The delivery continues until

VTBI equals zero, or you stop

the program and clear the

settings.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

0.20

mcg/kg/min

DOPamine

Dose Calculation

Dose

OPTIONS

Choose

Change

CCA Back

Select, then Choose

Release 13.x - xx/xx/xx

Volumes Infused

Pressure/Post Infusion Rate

Lighting/Contrast

Any Hospital, USA

MM/DD/YY XXYYZZ-123456

Area Selection

Enter

Select, then Enter

Any Hospital, USA

MM/DD/YY XXYYZZ- 123456

ICU

MedSurg

Cardio

Urology

Psych

Recov

L&D

5 West

Renal

Neo ICU

OB/GYN

Oncol

Ad ICU

7 South

3 North

4 North

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 13

The message bar informs the

user of the changed CCA.

When VTBI reaches zero

(infusion is competed), VTBI

may no longer be incremented.

To program, the user must first

select



[Back], then press the

key.

Auto-Programming

Auto-Programming is a new feature for the Hospira Plum A+

line of infusion pumps. It can only be used if the feature has

been installed in conjunction with your Hospital Information

System (HIS) and Barcode Point-Of-Care (BPOC) Unit. It works

by scanning barcode labels for the patient, pump, and IV bag

using a BPOC Unit, such as a PDA. This information is then

transferred to the pump utilizing either it’s wireless antenna or

RJ-45 Ethernet connector. The feature reduces the number of

steps needed to program an infusion.

NOTE: If the physician’s order for an auto-program therapy

exceeds the capabilities of the pump or is above a hospital

defined hard drug limit, the infusion parameters for auto-

programming will be rejected and the order will need to be re-

checked.

PUMPING STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

26.3

0.30

mcg/kg/min

DOPamine

Dose Calculation

ICU

Dose

Line A using prior CCA

APROGRAM

Back

Press Back,

then press STOP key.

This program was started under a

previous CCA.

Draft Manual- Not to be used

in a Clinical Situation.

6- 14 430-95520-001 (Rev. 04/05)

NOTE: It is important that biomed personnel ensure that the

barcode identification label affixed to each infuser corresponds

to the correct Connectivity Engine Identification Number. This

way the correct order will be sent to the appropriate infuser.

1Power On the pump as

described in Section 4.2.

2After the CCA has been

selected, the pump is ready for

auto-programming.

NOTE: The Auto-Program feature

must begin on the Main Delivery

Screen (with the desired line STOPPED).

3Following your hospital’s procedure, activate your

BPOC Unit.

4Scan the patient wristband to pull up the patient’s

task list on the BPOC Unit.

5Scan the IV bag. IV Task and documentation with

Order Details is displayed on the BPOC.

NOTE: If the scanned medication does not exist in the Hospira

MedNet Rx Rules medication library, that medication will display

on the pump as “No Drug Selected”.

6Scan the barcode of the available pump channel that

is not currently infusing (A or B).

STOPPED STOPPED

Rate

mL/hr

Vol Inf

Options/

Vol Inf

Back

Prime

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 6- 15

7Programming screen is auto-

filled.

8Verify ALL parameters. If

changes are desired, the

infusion parameters can be

manually changed using the

keypad on the pump.

9Press to display the Confirmation screen.

10 Select



[Yes] to confirm

programming and begin

infusion.

The BPOC will reconfirm that

the pump parameters match

the order.

11 Complete the transaction on

the BPOC Unit or document

the process per hospital

procedure.

AProgram Dose Calc

Program

Options

Cancel/

Back

Enter value using keypad

Conc

Weight

400

250 mL

Dose

VTBI

Duration

Rate

250

09: 30

26.

mcg/kg/min

hr : min

mL/hr

DOPamine

AProgram Dose Calc

Yes N o

Dose

Drug

Conc

Weight

Rate

Delivery will be:

400

mcg/kg/min

mL/hr

Confirm Program?

DOPamine

250 mL

MedSurg

Draft Manual- Not to be used

in a Clinical Situation.

6- 16 430-95520-001 (Rev. 04/05)

NOTES

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 1

SECTION 7

Alarms and Troubleshooting

Warning Messages

NOTE: Other error and warning messages will occur when

appropriate for the current selection context. For instance, when

a change to a required parameter would result in clearing some

delivery settings, the warning message will appear when that

field is selected. When an input error has just been made, the

three quick beeps of an Invalid Key Warning will sound and an

appropriate warning message will be shown to explain the

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Stop delivery then turn

off

Attempting to turn the

infuser off while a

delivery is in progress.

Stop all lines, then turn

infuser off.

Warning: Replace

Battery

The battery current

charge is greater than

200 mA/hr.

The battery voltage is

less than the depleted

threshold and charge

level is higher than the

low charge threshold.

Replace battery.

Warning: Charger

Service

The charging circuitry is

not behaving as

expected (charge

voltage is not changing)

and can reduce battery

life.

Silence key is pressed.

Warning: Low Battery Pump not plugged in to

AC power.

Plug into AC power, only

about 30 minutes of

battery life remains.

Draft Manual- Not to be used

in a Clinical Situation.

7- 2 430-95520-001 (Rev. 04/05)

problem. All such messages will be cleared or replaced by

another message upon the next valid input key press.

Response to Alarms

1Disable Lockout by confirming back switch is in the down

position or press the decimal key followed by 9, 6, & 3 on the

keypad.

2Press [SILENCE] key.

3Identify/Observe Alarm condition.

4Correct Alarm condition (see following tables).

5Press [START] to resume infusion.

NOTE: Alarm messages begin with an alphanumeric code for

tracking purposes only. If troubleshooting does not correct the

problem, record the code number and contact technical

support.

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 3

General Alarms

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

N100 Unrecognized

cassette

Attempting to use

unrecognized cassette.

Turn off or insert

recognized cassette.

N101 No Action

Alarm

Pump programming

incomplete.

Press [START] or

continue

programming.

N102 Infuser Idle 2

Minutes

Pump is ON without

operator input.

Standby time has

elapsed.

Begin programming or

turn infuser OFF.

Re-enter all

programmed data.

N103 Memory Failure The infuser did not

accept the previous

programmed data.

Re-enter all

programmed data.

N230 Prox Air,

Backprime

When the total proximal

air detected exceeds the

limit.

Check for clamps, or

empty containers on

line A or B. Correct as

necessary. Backprime

into line B tubing or

syringe.

N180,

N181,

N186

Distal

Occlusion

Distal line kinked, IV site

clotted or positional,

pressure limit set too

low.

Check distal tubing,

check IV site, reset

pressure limit.

See page 1-14 for

detailed instructions

for avoiding a bolus

following a distal

occlusion.

N187 Neg Distal

Occlusion

Pump too high above

patient or defective set.

Lower infuser or

replace set.

N233,

N234

Distal Air When air is detected at

the distal sensor and

exceeds the limit.

Remove and reprime

cassette using

standard technique.

Draft Manual- Not to be used

in a Clinical Situation.

7- 4 430-95520-001 (Rev. 04/05)

N250 Door open

while pumping

Pump door opened

while operating.

Close door with

cassette inserted.

N251 Cassette Test

Failure

Faulty cassette,

proximal or distal

occlusion or air in

cassette detected at

start up.

Check clamps,

manually reprime set,

close door. Backprime

into line B tubing or

syringe if appropriate.

If alarm recurs on

retest, replace set. If

alarm repeats, replace

infuser.

N252 Depleted

Battery

Too much time on

battery power.

Plug into AC (mains)

power.

N253 Hard lockout

Violation

The use of the [STOP]

key during delivery, or

opening the door, while

lockout is enabled.

Unlock lockout switch.

N254 Hard lockout

Enabled

Pressing of any key

except [STOP] during

delivery while any alarm

is active and lockout is

enabled.

Unlock lockout switch.

N255 Soft lockout

Violation

The use of the [STOP]

key during delivery, or

opening the door, while

lockout is enabled.

Unlock lockout by

pressing the decimal

key, followed by 9, 6, &

3 on the keypad.

N256 Soft lockout

Enabled

Pressing of any key

except [STOP] during

delivery while any alarm

is active and lockout is

enabled.

Unlock lockout by

pressing the decimal

key, followed by 9, 6, &

3 on the keypad.

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 5

Line A Alarms

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

N105 Callback Line A Alarm programmed by

user. Change in delivery

for Loading Dose to

Maintenance Step or for

any step in “Multistep”

program provided the

step is not the last step.

Press [SILENCE].

N161 Line A VTBI

complete

VTBI complete on line

Program new VTBI.

N185 Prox Occl A At

Startup

Proximal line

obstructed, line A

container (or syringe)

disconnected or

obstructed during non-

delivery (startup).

Examine line A for

kinks or closed

clamps. If there are

closed clamps, open

the clamps. Then,

open and close door.

Continue

programming. Replace

set if problem persists.

If clamps are not

opened prior to

completion of cassette

test, peak proximal

occlusion may recur.

For syringe, select



[Backprime].

Draft Manual- Not to be used

in a Clinical Situation.

7- 6 430-95520-001 (Rev. 04/05)

N184,

N190,

N191

Prox Occl A /

Air

Proximal line

obstructed, line A

container disconnect or

obstruction.

Examine line A for

kinks, closed clamps,

or air in cassette.

N232 Prox Air A,

Backprime

When proximal air

detected exceeds the

limit for the line.

Check for clamps, or

empty container.

Correct as necessary.

Backprime into line B

tubing or syringe.

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 7

Line B Alarms

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

N104 Callback Line

Alarm programmed by

user. Change in

delivery for piggyback

delivery, Loading Dose

to Maintenance Step,

or for any step in

“Multistep” program

provided the step is not

the last step.

Press [SILENCE].

N160 Line B VTBI

complete

VTBI complete on line

Program new VTBI.

N183 Prox Occl B

At Startup

Proximal line

obstructed, line B

container (or syringe)

disconnected or

obstructed during non-

delivery (startup).

Examine line B for kinks

or closed clamps. If there

are closed clamps, open

the clamps. Then, open

and close door. Continue

programming. Replace

set if problem persists.

If clamps are not opened

prior to completion of

cassette test, peak

proximal occlusion may

recur.

For syringe, select



[Backprime].

Draft Manual- Not to be used

in a Clinical Situation.

7- 8 430-95520-001 (Rev. 04/05)

Malfunctions

N182,

N188,

N189

Prox Occl B /

Air

Proximal line

obstructed, line B

container disconnected

or obstructed.

Examine line B for kinks,

closed clamps, or air in

cassette.

Occlusion caused by

empty container,

backprime into line B

tubing or syringe.

N231 Prox Air B,

Backprime

When proximal air

detected exceeds the

limit for the line.

Check for clamps, or

empty container. Correct

as necessary. Backprime

into line B tubing or

syringe.

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

E300 or

higher

Malfunction A failure has occurred

in the infuser’s internal

systems.

Record Malfunction

error code. Pump must

be turned OFF to clear

malfunction. If alarm

malfunction repeats,

replace infuser.

CODE MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 9

General Messages

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Cannot Standby in

Piggyback

Selection of



[Standby] when

Line B is in Piggyback

Mode.

Select



[Cancel/

Back].

Cannot Standby with

Delay

Selection of



[Standby] when

Delay time was entered

for program.



[Cancel/Back].

Changing CCA clears

program

Displays when other

than last-used Care

Area is highlighted.

N/A

Change Conc clears

entries

A program delivery

which has been stopped

and drug amount value

is selected. This is

displayed before any

screen or field message.

User can enter new

Concentration using

keypad, or press

[CLEAR] then make new

entry.

Change units clears

entries

A program delivery

which has been stopped

and user highlights

another concentration

unit for the same line.

User can select



[Back] to exit, or

use [SELECT] arrows to

highlight a new value.

Change Vol clears

entries

A program delivery

which has been stopped

and diluent value is

selected. This is

displayed before any

screen or field message.

User can enter new

Concentration volume

using keypad, or press

[CLEAR] then make

another entry.

Draft Manual- Not to be used

in a Clinical Situation.

7- 10 430-95520-001 (Rev. 04/05)

Concurrency alert Attempt to start a

multistep or loading

dose delivery whose

later steps would exceed

concurrent delivery limit

if delivery proceeds.

User can enter new

values using number

keypad, or use

[SELECT] arrows to

move to another field to

change the entry. User

can also press [CLEAR].

Concurrency violation Attempt to start a second

line with a delivery rate

that would exceed

concurrent delivery

upper limit immediately.

Or, concurrent delivery

attempt and rate for the

second line is less than

concurrent delivery

lower limit. Takes

precedence over “Rate

must be > n mL/hr”

message. The

combined delivery rate

must fall within the range

of 1.0 mL/hr – 500 mL/hr

or CCA-specific

Maximum Volumetric

Rate, with 0.5 mL/hr

minimum per line.

User can enter new

values using number

keypad, or use

[SELECT] arrows to

move to another field to

change the entry. User

can also press [CLEAR].

Decimal point not

allowed

Attempt to input Decimal

point when either not

used in field or a three-

digit whole number

already input.

Press [CLEAR] Hardkey.

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 11

Dose > [X.xx]. Override? Attempt to start program

with parameter that has

caused the Dose (or

Rate, if mL/hr program)

to be greater than the

upper soft limit

[uuuuuuuu] for the

selected drug and CCA.

Also includes placing

program in Standby, and

re-starting a stopped

program.

May be overridden by

selecting



[Yes].

Cleared by pressing of

[NUMERIC KEYS], [.],

[SELECT], [CLEAR] or

[STOP] hard keys, or



[Yes/No] softkeys. Also

cleared by the [ON/OFF]

key when the line is

stopped.

Dose < [X.xx]. Override? Attempt to start program

with parameter that has

caused the Dose (or

Rate, if mL/hr program)

to be less than the lower

soft limit [llllllll] for the

selected drug and CCA.

Also includes placing

program in Standby, and

re-starting a stopped

program.

May be overridden by

selecting



[Yes].

Cleared by pressing of

[NUMERIC KEYS], [.],

[SELECT], [CLEAR] or

[STOP] hard keys, or



[Yes/No] softkeys. Also

cleared by the [ON/OFF]

key when the line is

stopped.

Hard Lockout Enabled The Lockout Switch has

been enabled, no Alarm

is active, and any key

besides Stop is pressed.

Disable the Lockout

switch located on the

back of the device. (See

Section 3)

Illegal when Line

Delivering

Attempt to select

program other than

Dose Calculation while a

Basic program is

delivering on this line.

Select



[Cancel/

Back] or press

[CLEAR]. Pressing

[CLEAR] invokes

another message.

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

7- 12 430-95520-001 (Rev. 04/05)

Input digits > max

allowed

Attempt to input digit that

would exceed the

number of decimal

places allowed for

defined value except

Dose and Rate.

Press [CLEAR] hardkey.

Input value > max

allowed

Attempt to input number

that would cause field to

exceed its defined limit.

In the Drug amount,

Diluent amount, VTBI,

Duration, Patient

Weight, Distal pressure,

and Delayed Start time

fields, the Software shall

display ‘---‘, and the user

must press the Clear

hard key and input a

valid value.

Press [CLEAR] hardkey.

Maximum value reached The display contrast/

intensity has reached its

maximum value.

User can select



[Enter] or



[Cancel/Back].

Minimum value reached The display contrast/

intensity has reached its

minimum value.

User can select



[Enter] or



[Cancel/Back].

No delivery programmed Delivery attempt at Main

Delivery Screen when A

and B have both Rate

and VTBI equal to zero

(no delivery

programmed).

Select a line to program,



[Options] or



[Backprime].

Rate must be > 0 mL/hr Delivery attempt when

VTBI is non-zero but

rate is zero.

Use number keypad to

enter a value.

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 7- 13

Soft Lockout Enabled While the Soft Lockout is

enabled and no Alarm is

active, either 1) any key

besides Stop is pressed

during delivery, or 2) any

key is pressed while

stopped.

Disable the Soft

Lockout.

(See Section 3)

VTBI must be > 0 Delivery attempt when

rate is non-zero but

VTBI is zero.

Use number keypad to

enter a value.

Value is too high Attempt to move cursor

from field whose input

value is too high.

Use number keypad to

enter a value.

Value is too low Attempt to move cursor

from field requiring a

non-default value.

Use number keypad to

enter a value.

Weight change affects

Line A/B

Selecting the weight field

on line while a weight-

based program is

entered on other line.

Use number keypad to

enter a value.

Minimum Dose X.xx Attempt to start program

with Dose less than

lower hard Dose limit

n.nn.

Use number keypad to

enter a value.

Maximum Dose X.xx Attempt to start program

with Dose greater than

upper hard Dose limit

n.nn.

Attempt to input a Dose

greater than the upper

Hard Limit.

The Software will display

‘---‘, and the user must

press the [CLEAR] hard

key and input a valid

value.

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

7- 14 430-95520-001 (Rev. 04/05)

Minimum Rate X mL/hr Attempt to start mL/hr

program with Rate less

than lower hard Dose

limit nn.n.

Use number keypad to

enter a value.

Maximum Rate X mL/hr Attempt to start mL/hr

program with Rate

greater than the upper

Hard Limit or CCA

Maximum Volumetric

Rate n.

Attempt to input a Rate

greater than the upper

Hard Limit or CCA

Maximum Volumetric

Rate n.

The Software will display

‘---‘, and the user must

press the [CLEAR] hard

key and input a valid

value.

MESSAGE POSSIBLE CAUSE

CORRECTIVE

ACTION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 8- 1

SECTION 8

Cleaning, Maintenance, and

Storage

The cleaning, maintenance, and storage of the Plum A+ are

described in this section.

CLEANING AND SANITIZING

For proper maintenance of the Plum A+, observe the following

cleaning and sanitizing guidelines.

Establish a routine weekly schedule for cleaning the infuser. To

clean, proceed as follows:

• Turn the Plum A+ off using the [ON/OFF] switch

• Disconnect from AC (mains) power

The exposed surfaces of the Plum A+ may be cleaned with a

lint-free cloth dampened by one of the recommended cleaning

solutions in the following list or mild, nonabrasive soapy water.

Clean the cassette door with a soft, lint-free cloth, dampened

with one of the cleaning agents listed in the following table, or a

mild solution of soapy water. Use a small non-abrasive brush to

aid in cleaning the infusion system housing and subsystem

chassis components. To thoroughly clean the cassette

receptacle, disengage the cassette door from the door latch by

pressing the door release tab.

CAUTION: DO NOT ALLOW CLEANING SOLUTIONS TO SATURATE

THE AIR-IN-LINE DETECTORS OR ENTER THE DEVICE WHEN CLEANING

THE AIR-IN-LINE DETECTORS.

Draft Manual- Not to be used

in a Clinical Situation.

8- 2 430-95520-001 (Rev. 04/05)

On a routine basis, clean all of the elements behind the

cassette door using cotton-tipped swabs saturated with

cleaning solution. The cassette door may be unlatched from the

door handle to facilitate cleaning.

To unlatch the cassette door from its handle, tilt the device

back, open the cassette door, then push the door release tab to

open the door fully.

CLEANING

SOLUTION MANUFACTURER PREPARATION

CoverageTMHBV Steris Corporation, A

division of Calgon Vestal

Laboratories

Per manufacturer's

recommendation

Formula C TM Diversey Corporation Per manufacturer's

recommendation

Dispatch®Caltech Industries Per manufacturer's

recommendation

Precise®Caltech Industries Per manufacturer's

recommendation

Household bleach Various Per hospital procedures;

do not exceed one part

bleach in ten parts water

Manu-Klenz®Calgon Vestal

Laboratories

Per manufacturer's

recommendation

Sporicidin®Sporicidin International Per manufacturer's

recommendation

Super Edisonite®S. M. Edison Co. Per manufacturer's

recommendation

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 8- 3

CAUTION: TO AVOID MECHANICAL OR ELECTRONIC DAMAGE, DO

NOT IMMERSE THE PLUM A+ IN ANY FLUIDS OR CLEANING

SOLUTIONS.

CAUTION: DO NOT SPRAY CLEANING SOLUTIONS TOWARD ANY

OPENING IN THE INSTRUMENT.

CAUTION: CERTAIN CLEANING AND SANITIZING SOLUTIONS MAY

SLOWLY DEGRADE COMPONENTS MADE FROM SOME PLASTIC

MATERIALS. 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.

CAUTION: NEVER USE SHARP OBJECTS SUCH AS FINGERNAILS,

PAPER CLIPS, OR NEEDLES TO CLEAN ANY PART OF THE INFUSER.

CAUTION: DO NOT STERILIZE BY HEAT, STEAM, ETHYLENE OXIDE

(ETO), OR RADIATION.

CAUTION: 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.

BATTERY MAINTENANCE

CAUTION: DO NOT OPERATE THE INFUSER ON PATIENTS WITH THE

BATTERY REMOVED. USE OF A PROPERLY MAINTAINED AND

CHARGED BATTERY HELPS CONFIRM PROPER OPERATION.

CAUTION: IF THE LOW-BATTERY ALARM SOUNDS, CONNECT TO

AC (MAINS) POWER IMMEDIATELY.

The Plum A+ is battery powered for emergency backup and

temporary portable operation. A fully charged, new battery

provides 3 hours of operation at 125 mL/hr, or delivers 250 mL

total volume if pumping at a rate of 126 mL/hr or greater,

whichever occurs first.

NOTE: For optimum battery life, the Plum A+ should be

operated on battery power for three continuous hours at least

once every six months and then charged for a minimum of six

hours.

Draft Manual- Not to be used

in a Clinical Situation.

8- 4 430-95520-001 (Rev. 04/05)

The battery charges whenever connected to AC (mains) power.

If the infuser is switched OFF, recharge takes approximately six

hours. Recharge takes longer if the infuser is turned ON.

As a general rule, the more often the battery is partially

discharged and recharged, the sooner it will need to be

replaced. Consult a qualified biomedical technician for battery

replacement if necessary.

To maintain maximum battery charge and to prolong battery life,

connect the infuser to AC (mains) power whenever possible.

When the infuser is used without wireless, the operation times

may be proportionally longer.

STORAGE

To prolong the life of the Plum A+, observe the following storage

precautions:

• Store the away from excessive heat, cold, and humidity

• Store connected to AC (mains) power

• Switch the infuser OFF using the [ON/OFF] key

SERVICE

All servicing or adjustments to the Plum A+ should be referred

to qualified technical personnel. A technical service manual

may be ordered from the local Hospira sales office.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 1

SECTION 9

Specifications

Physical

Electrical

Dimensions: Approximately 8” X 8” X 6”, excluding pole clamp

protrusion and power cord storage.

Weight: Approximately 9.5 lbs. with battery.

Casing: High-impact plastic.

Power

Requirements:

120 V~, 50-60 Hz, 35 VA. Meets UL 60601-1.

Fuses: F1, F2, 250V~, 0.5 A. (internal)

Power Cord: Hospital-grade AC cord. 10 ft long, with

transparent plug and retainer plate.

Battery: One sealed, lead-acid, rechargeable 6 V battery,

internal to device.

Battery Life: With a new fully charged battery, the infuser

operates for a minimum of three hours at 125 mL/

hr or less, or delivers 250 mL if > 126 mL/hr. (Time

is measured from initial pumping to Depleted

Battery Alarm)

Recharge: The battery charges whenever the infuser is

connected to AC power. The recharge time is

approximately six hours with the device operating

at 125 mL/hr on one line.

Electrical

Leakage:

Meets IEC 60601-1 standard: Medical Electronic

Equipment, Part 1: General Requirements for

Safety.

9- 2 430-95520-001 (Rev. 04/05)

Wireless Lan Device

VTBI Range

NURSE-CALL

System:

Circuitry

Ratings:

NURSE-CALL alarm is factory set for Normally-

Open (NO)

Contact the Technical Services Center to make an

internal adjustment to change the device from

Normally-Open (NO) to Normally Closed (NC)

system.

Voltage-30 VDC Max

Current- 0.25 Amps Max

Contact Rating- 3 Watts Max

Standards: IEEE802.11b

Radio Technology: IEEE802.11b Direct Sequence

Spread Spectrum

Data Transfer

Rate:

11, 5.5, 2, 1 Mbps (auto sense)

FREQUENCY

RANGE

IEEE802.11b

Channels:

Transmit Power:

Antenna:

Certifications:

2412 - 2462 MHz

1-11 (FCC)

100mW (+20dBm) max

Integrated surface mount antenna

FCC Part 15.247 for US, IC

VTBI Range: 0.1 to 99.9 mL (in 0.1 mL increments)

100 to 9999 mL (in 1 mL increments)

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 3

Environment

Delivery Rate Range

Air-in-Line Alarm

Operating

Temperature:

5° to 40° C

Storage

Temperature:

-20° to 60° C

Atmospheric

Pressure:

0 - 10,000 feet (0 - 3,000m) or equivalent

pressure

Relative Humidity: 10 - 90% (40° C Max)

Lines A and B: 0.1 - 99.9 mL/hr (in 0.1 mL increments)

100 - 999 mL/hr (in 1 mL increments)

Concurrent

Delivery:

PlumSet:

0.5 mL/hr minimum for each line

500 mL/hr cumulative (A+B) maximum

KVO: 1.0 mL/hr or the last primary delivery rate,

whichever is less

PlumSet (Distal): Bolus 0.1 mL (100 microliters) or larger for

delivery rates less than 500 mL/hr.

Bolus 0.5 mL (500 microliters) or larger for

delivery rates equal to or greater than 500 mL/

hr.

Cumulative 0.25 mL out of 2.6 mL for delivery

rates less than 500 mL/hr.

Cumulative 0.50 mL out of 5.3 mL for delivery

rates equal to or greater than 500 mL/hr.

PlumSet

(Proximal):

Bolus at 0.5 mL, Total 1.0 mL

9- 4 430-95520-001 (Rev. 04/05)

Occlusion Alarm and Limits

Distal Occlusion: The DISTAL OCCLUSION alarm sounds after

the distal set tubing or set outlet fitting

becomes occluded.

Proximal

Occlusion:

The PROXIMAL OCCLUSION alarm sounds if

the tubing proximal to the cassette becomes

occluded.

Distal Pressure

Limit

(without alarm):

1 to 15 psig. The maximum pressure is user-

selectable. Factory default setting is 6 psig.

Maximum Infusion

Pressure:

20 psig

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 5

Time To Detect Downstream

Occlusions

Bolus Volume Released After

Downstream Occlusions Are

Corrected

RATE

OCCLUSION

ALARM

PRESSURE

SETTING

TYPICAL TIME

TO ALARM

(MACRO)

MAXIMUM TIME

TO ALARM

(MACRO)

25 mL/hr 6 psig

15 psig

38 seconds

98 seconds

47 seconds

106 seconds

1 mL/hr 6 psig

15 psig

17 minutes

45 minutes

22 minutes

49 minutes

* Baseline backpressure is 0 psig *

RATE

OCCLUSION

ALARM

PRESSURE

SETTING

TYPICAL

BOLUS

VOLUME

(MACRO)

MAXIMUM BOLUS

VOLUME (MACRO)

25 mL/hr 6 psig

15 psig

0.23 mL

0.55 mL

0.28 mL

0.63 mL

1 mL/hr 6 psig

15 psig

0.24 mL

0.59 mL

0.30 mL

0.70 mL

* Baseline backpressure is 0 psig *

9- 6 430-95520-001 (Rev. 04/05)

Delivery Accuracy

The Plum A+ Infuser was designed and manufactured to maintain

a volumetric delivery rate error of the total fluid delivered of less

than or equal to ± 5% over the course of 48 hours at a

programmed rate of 1 to 999 mL/hr during normal operating

conditions. For use of the device at rates below 1 mL/hr, the

delivery rate error is less than or equal to ± 10%.

Backpressure Effect- Positive backpressure on the distal line may

affect delivery accuracy by no more than 0.5% per psig (2% per

psig for rates between 0.1 and 0.9 mL/hr) for backpressures up to

15 psig. A typical deviation under these conditions is 0.3%.

Negative backpressure may affect delivery accuracy no more

than 2% for pressures up to -2 psig (56 inches of water). A typical

deviation under these conditions is 0.3%.

Filling Head Effect- Variations in filling head (such as container

height) may affect delivery accuracy by no more than 2% for

variations in the range -15 to +28 inches. A typical deviation under

these conditions is 0.5%.

Concurrent Delivery Effect- When both lines (A & B) are

delivering, the ratio of delivery for the fluid with the lowest rate

may be affected by as much as 5% for ratios up to 9 to 1. For

higher ratios, the absolute percentage of delivery for the lowest

rate may be affected by no more than 0.5%. When air is present

in the bubble trap, the absolute percentage of delivery for the

lowest rate may be affected by up to 2.0%. When variations in

container height are present, the absolute percentage of delivery

for the lowest rate may be affected by up to 2.5% for up to 24

inches of container height differences.

Enteral & High Viscosity Fluids

Effects

System delivery accuracy limits for each Enteral and High

Viscosity Fluid, such as those listed in the following table, can be

degraded by an additional maximum of 5%. System accuracy for

Enteral Fluids is defined only for rates of 1 to 200 mL/hr, with no

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 7

suspended air in the solution, and using an Hospira Plum enteral

set.

Trumpet Curves

The Trumpet Curve Graphs following the Example show

representative maximum and minimum percent flow rate

deviation from the programmed rate over time. This information

was developed in accordance with IEC 60601-2-24: 1998, Sub-

Clause 50.102. Refer to this standard for detailed information.

How to read a Trumpet Curve Graph (Refer to example on the

following page): The graphs following the Example plot flow rates

at 30 second intervals for the first 2 hours and for the 96th hour of

delivery. The graph plots mean delivery rate error (Average of 3

infusers) for the 2nd hour and the 96th hour as a straight line. The

graph also presents maximum and minimum average delivery

rate error for this interval plotted by averaging delivery errors over

intervals of 2, 5, 11, 19 and 31 minutes (“Trumpet Curve”).

EXAMPLE

From the Trumpet Curve Graph sample that follows, find the 5

minute interval (A) at the horizontal axis and read the

corresponding points (B) and (C) on the vertical axis. The values

are approximately +2.8% and -0.5%.

This means that at the rate of 25 mL/hr the average maximum

flow rate fluctuation for any 5 minute time interval during the 2nd

hour of operation was within the limits of +2.8% and -0.5% from

ENTERAL/HIGH VISCOSITY FLUIDS

Dextrose 20% to 50% concentration

Isomil Powder

Similac Powder

Ensure Plus HN

Twocal HN

Jevity

9- 8 430-95520-001 (Rev. 04/05)

the nominal rate. The average delivery rate error over the entire

2nd hour was +1.6% (D).

For other time intervals look at other points at the horizontal axis

and determine corresponding limits as above.

A trained professional can use the resulting graphs to select a infuser

with the appropriate startup and flow characteristics to suit the clinical

application.

NOTE: As an example of how the trumpet curves can be used,

consider the maximum and minimum deviations at the 5 minute

average interval. The upper curve provides the maximum

expected delivery rate error over a 5 minute interval, the lower

curve provides the minimum expected delivery rate error over a

5 minute interval. An example would be Dopamine administered

at 5 µgm/kg/min. At 5 minutes, the average drug delivery error

would be within the range of +2.8% and -0.5% of the expected

nominal rate.

0510 15 20 25 30

15.0%

10.0%

5.0%

0.0%

-5.0%

-10.0%

-15.0%

25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

PERCENT ERROR (%)

Observation Interval (minutes)

Max Mean

+Min

Average Delivery

Rate Error = +1.6%

Max Negative Error over 5

Minute Interval = -0.5%

Max Positive Error over 5

Minute Interval = +2.8%

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 9

25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

(Typical)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

(Typical)

-10

-5

0 10 20 30 40 50 60 70 80 90 100 110 120

Time (minutes)

Rate (ml/hr)

Actual Rate

Programmed Rate

25 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

(Composite of 3 Pumps)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

9- 10 430-95520-001 (Rev. 04/05)

25 ML/HR, 0 mm Hg DELIVERY HEAD , 96 HOURS

(Typical)

0 1020304050

Time (minutes)

Rate (ml/hr)

Actual Rate

Programmed Rate

25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS

(Typical)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

25 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS

(Composite of 3 Pumps)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 9- 11

1 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

(Typical)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

1 ML/HR, 0 mm Hg DELIVERY HEAD, START UP

(Typical)

-0.4

-0.2

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

0 10 20 30 40 50 60 70 80 90 100 110 120

Time (minutes)

Rate (ml/hr)

Actual Rate Programmed Rate

1 ML/HR, 0 mm Hg DELIVERY HEAD, STARTUP

(Composite of 3 Pumps)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

9- 12 430-95520-001 (Rev. 04/05)

1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS

(Typical)

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

0 1020304050

Time (minutes)

Rate (ml/hr)

Actual Rate Programmed Rate

1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS

(Typical)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

1 ML/HR, 0 mm Hg DELIVERY HEAD, 96 HOURS

(Composite of 3 Pumps)

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

0 5 10 15 20 25 30

Observation Interval (minutes)

Percent Error (%)

Max Min Mean

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 10- 1

SECTION 10

Supplies and Accessories

Administration Fluids

ADMINISTRATION FLUIDS

• All parenteral fluids

• Whole Blood

• Blood fractions

ENTERAL AND HIGH VISCOSITY FLUIDS

• Dextrose 20% to 50% concentration

• Isomil Powder

• Similac Powder

• Ensure plus HN

• TwoCal HN

• Packed red cells

CONTAINERS

• Dual Chamber Parenteral flexible container (Nutrimix)

• Large Volume Parenteral flexible plastic containers, including

premixed

• Large Volume Parenteral glass containers, including

premixed and nutritional

• Part Fill Parenteral flexible plastic containers, including ADD-

Vantage

• Part Fill Parenteral glass containers

• Small Volume Parenterals

• Syringes (may require special adapters)

• Top Filled Enteral bags

• Ready to hang Enteral solution containers

10- 2 430-95520-001 (Rev. 04/05)

Accessories

GENERAL

• Syringe Adapter- List# 11986-48

• Mini Pole- List# 12096-04

• Secondary Container Support- List# 12095-03

• Tandem Carrier- List# 12270-01

NETWORKED APPLICATION

• Hospira MedNetTM Medication Management Server Suite

(MMSS)

List# 20676-04

• *Hospira MedNetTM Plug ‘n Play Module

List# 20677

* = For use with Hospira Plum A+ Infusers

Lists 11971-04-03 & above, 12391-04, & 20679-04

NOTE: Contact Technical Support Operations at

1-800-241-4002 for current listing of accessories.

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 11- 1

SECTION 11

Warranty

Subject to the terms and conditions herein, Hospira, Inc., herein

referred to as Hospira, warrants that (a) the product shall

conform to Hospira's standard specifications and be free from

defects in material and workmanship under normal use and

service for a period of one year after purchase, and (b) the

replaceable battery shall be free from defects in material and

workmanship under normal use and service for a period of 90

days after purchase. Hospira makes no other warranties,

express or implied, as to merchantability, fitness for a particular

purpose, or any other matter.

Purchaser's exclusive remedy shall be, at Hospira's option, the

repair or replacement of the product. In no event shall Hospira's

liability arising out of any cause whatsoever (whether such

cause be based in contract, negligence, strict liability, other tort,

or otherwise) exceed the price of such product, and in no event

shall Hospira be liable for incidental, consequential, or special

damages or losses or for lost business, revenues, or profits.

Warranty product returned to Hospira must be properly

packaged and sent freight prepaid.

The foregoing warranty shall be void in the event the product

has been misused, damaged, altered, or used other than in

accordance with product manuals so as, in Hospira's judgment,

to affect its stability or reliability, or in the event the serial

number or lot number has been altered, effaced, or removed.

The foregoing warranty shall also be void in the event any

person, including the Purchaser, performs or attempts to

perform any major repair or other service on the product without

having been trained by an authorized representative of Hospira

and using Hospira documentation and approved spare parts.

For purposes of the preceding sentence, "major repair or other

service" means any repair or service other than the

Draft Manual- Not to be used

in a Clinical Situation.

11- 2 430-95520-001 (Rev. 04/05)

replacement of accessory items such as batteries and

detachable mains power cords.

In providing any parts for repair or service of the product,

Hospira shall have no responsibility or liability for the actions or

inactions of the person performing such repair or service,

regardless of whether such person has been trained to perform

such repair or service. It is understood and acknowledged that

any person other than an Hospira representative performing

repair or service is not an authorized agent of Hospira.

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 12- 1

SECTION 12

Default Drug Library (DDL)

NOTE: This list is only accurate if no custom drug library has

been developed using the Hospira MedNetTM accessory. Once

a custom drug library has been developed, this list will no longer

be accessable. Only Hospira personnel can re-install the DDL.

The information contained in this manual is current as of 11/01/

02. User must assure themselves that drug prescribing

information has not changed since the publication of this

manual.

Use drug manufacturer recommendations for IV administration

when using the Plum A+ infusion infuser.

DRUG NAME

DEFAULT DOSE

RATE

DEFAULT

CONCENTRATION

No Drug Selected mL/hr N/A

Abciximab mcg/kg/min mg/mL

Acyclovir mL/hr N/A

Albumin mL/hr N/A

Aldesleukin mL/hr N/A

Alfentanil mcg/kg/min mcg/mL

Alteplase (rt-PA) mg/kg/hr mg/mL

Amikacin mL/hr N/A

Aminophylline mg/hr mg/mL

Amiodarone mg/min mg/mL

Amphotericin B mL/hr N/A

Ampicillin mL/hr N/A

Atracurium mL/hr N/A

Azithromycin mL/hr N/A

Draft Manual- Not to be used

in a Clinical Situation.

12- 2 430-95520-001 (Rev. 04/05)

Bleomycin mL/hr N/A

Blood Products mL/hr N/A

Bretylium mg/min mg/mL

Carboplatin mL/hr N/A

Cefazolin mL/hr N/A

Cefepime mL/hr N/A

CefoPERAZONE mL/hr N/A

CefoTAXIME mL/hr N/A

CefoTETAN mL/hr N/A

CefoXITIN mL/hr N/A

CeftAZIDime mL/hr N/A

CeftIZOXime mL/hr N/A

Ceftriaxone mL/hr N/A

Cefuroxime mL/hr N/A

Cimetidine mL/hr N/A

Ciprofloxacin mL/hr N/A

Cisplatin mL/hr N/A

Clindamycin mL/hr N/A

Cotrimoxazole mL/hr N/A

Cytarabine mL/hr N/A

Diltiazem mg/hr mg/mL

DOBUTamine mcg/kg/min mg/mL

Docetaxel mL/hr N/A

DOPamine mcg/kg/min mg/mL

DOXOrubicin mL/hr N/A

Epinephrine mcg/min mg/mL

Epoprostenol ng/kg/min mg/mL

Eptifibatide mcg/kg/min mg/mL

DRUG NAME

DEFAULT DOSE

RATE

DEFAULT

CONCENTRATION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 12- 3

Erythromycin mL/hr N/A

Esmolol mcg/kg/min mg/mL

Etoposide mL/hr N/A

Famotidine mL/hr N/A

Fentanyl mL/hr N/A

Fluconazole mL/hr N/A

Flumazenil mL/hr N/A

Fluorouracil mL/hr N/A

Furosemide mL/hr N/A

Gatifloxacin mL/hr N/A

Gentamicin mL/hr N/A

Heparin units/kg/hr units/mL

Hydromorphone mL/hr N/A

Ifosfamide mL/hr N/A

Insulin units/hr units/mL

Labetalol mg/min mg/mL

Lepirudin mg/kg/hr mg/mL

Leucovorin mL/hr N/A

Levofloxacin mL/hr N/A

Lidocaine mg/min grams/mL

Lorazepam mL/hr N/A

Magnesium grams/hr grams/mL

Mannitol grams/hr grams/mL

Mesna mL/hr N/A

MethoHEXITAL mL/hr N/A

MethoTREXATE mL/hr N/A

Metoclopramide mL/hr N/A

Metronidazole mL/hr N/A

DRUG NAME

DEFAULT DOSE

RATE

DEFAULT

CONCENTRATION

Draft Manual- Not to be used

in a Clinical Situation.

12- 4 430-95520-001 (Rev. 04/05)

Midazolam mL/hr N/A

Milrinone mcg/kg/min mg/mL

Morphine mg/hr mg/mL

Nafcillin mL/hr N/A

NitroGLYCERIN mcg/min mg/mL

NitroPRUSSIDE mcg/kg/min mg/mL

Norepinephrine mcg/min mg/mL

Ofloxacin mL/hr N/A

Ondansetron mL/hr N/A

Oxacillin mL/hr N/A

Oxytocin mUn/min units/mL

Paclitaxel mL/hr N/A

Pantoprazole mg/min mg/mL

Penicillin mL/hr N/A

Pentobarbital mL/hr N/A

Phenylephrine mcg/min mg/mL

Piperacillin mL/hr N/A

Potassium mEq/hr mEq/mL

Procainamide mg/min grams/mL

Propofol mcg/kg/min mg/mL

Ranitidine mL/hr N/A

STREPTOkinase units/hr units/mL

Theophylline mg/kg/hr mg/mL

Ticar-clavulanate mL/hr N/A

Tirofiban mcg/kg/min mg/mL

Tobramycin mL/hr N/A

UROkinase mL/hr N/A

Vancomycin mL/hr N/A

DRUG NAME

DEFAULT DOSE

RATE

DEFAULT

CONCENTRATION

Draft Manual- Not to be used

in a Clinical Situation.

Plum A+ Infusion System

430-95520-001 (Rev. 04/05) 12- 5

Verapamil mL/hr N/A

VinCRIStine mL/hr N/A

DRUG NAME

DEFAULT DOSE

RATE

DEFAULT

CONCENTRATION

Draft Manual- Not to be used

in a Clinical Situation.

12- 6 430-95520-001 (Rev. 04/05)

NOTES

Plum A+ Infusion System

430-95520-001 (Rev. 04/05)

For customer service within the United States, contact:

1-877-9-HOSPIRA (1-877-946-7747)

For technical assistance, product return authorization, and to

order parts, accessories, or manuals within the United States,

contact Hospira, Inc. Technical Support Operations:

1-800-241-4002

To order parts using the online eCatalog, download technical

publications, technical training courses, and additional services,

visit the website at:

www.hospiraparts.com

After authorization, ship prepaid product returns to the following

address:

Hospira, Inc.

Technical Support Operations

755 Jarvis Drive

Morgan Hill, CA 95037

Outside the U.S., contact your local Hospira, Inc. sales office.

430-95520-001 (Rev. 04/05)

CAUTION: FEDERAL (USA) LAW RESTRICTS THIS INFUSER TO

SALE BY OR ON THE ORDER OF A PHYSICIAN OR OTHER LICENSED

PRACTITIONER.

WARNING

POSSIBLE EXPLOSION HAZARD EXISTS IF THE INFUSER

IS USED IN THE PRESENCE OF FLAMMABLE

ANESTHETICS.

Plum A+ Infusion Pump is a registered trademark of Hospira, Inc.

Hospira MedNet, LifeShield, and E.L.I. are trademarks of

Hospira Incorporated. CLAVE, Teflon, Formula C, Manu-Klenz, Super

Edisonite, Coverage, Sporicidin, Dispatch, and Precise are not

trademarks of Hospira.

C US

Class 1 Mains supply equipment using protective earth

IPX1Drip Proof

Medical Equipment Protected against dripping water

Type CF

Equipment providing adequate degree of protection against

electrical shock and suitable for application to patient

UL 60601-1

CSA 601.1

MCN 160992

Hospira 20677 PlumA + with MedNet Wireless Enabled Infuser User Manual Cover

Hospira, Inc. PlumA + with MedNet Wireless Enabled Infuser Cover

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