ICU Medical 16026 Symbiq One Channel Infusion System User Manual mds PHXopsmanual
Hospira, Inc. Symbiq One Channel Infusion System mds PHXopsmanual
Contents
- 1. User Manual Part 2
- 2. User Manual Part 1
- 3. User Manual Part 3
User Manual Part 1
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
System Operating Manual
For List Number 16026-04 (One-Channel Infuser)
The SYMBIQ™ Infusion System is designed for use by health care professionals. The Hospira
Customer Support hotline is available 24 hours a day (in the USA) to provide consultation and
technical assistance regarding the SYMBIQ™ Infusion System.
F
Refer to the Device Development Document for complete specifications and restrictions.
Hospira Technical Support Operations
1-800-241-4002
To order additional copies of this manual
(P/N 430-10599-001), call 1-877-946-7747
LOAD / EJECT
STOP
A
C
P
O
W
E
R
Emergency
Stop
On/Off
09:57 AM
Press Tab A to display Near Viewing Delivery screen.
A
13.1 mL / hr
13.1
mL / hr
103 mL
103
mL
VTBI
[ 400 mg / 250 mL ]
DOPamine
Rate
Settings Logs Lock
Mode
ICU
Alarm
DOPamine
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 1
Contents
WHAT IS IN THIS BOOK 5
CHAPTER 1: INTRODUCTION 7
Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Document Conventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Warnings and Cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Warnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
General Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Epidural Administration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Administration Sets and Delivery Cautions. . . . . . . . . . . . . . . . . . . . . . . . . 9
Battery Operation Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Unintended Bolus Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Cleaning Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
US FCC (Federal Communications Commission) Statement. . . . . . . . . . .11
FCC Interference Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Radio Frequency Exposure Statement . . . . . . . . . . . . . . . . . . . . . . . 12
Electrical Artifacts in Clinical Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CHAPTER 2: INFUSER OVERVIEW 15
Infuser Layout—Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Infuser Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Touchscreen Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Touchscreen Button Appearance. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Touchscreen Icons and Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Infuser Layout—Rear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Rear Infuser AC Power Outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Wireless Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Infuser Layout—Underside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Infuser Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Channel Level Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Channel Feature Availability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Program Level Features Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Device Level Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Date and Time Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Program Lock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CHAPTER 3: INFUSER OPERATIONS 33
Infuser Operations Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Power Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
AC Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Channel LEDs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Battery Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
A/C Power LED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Touchscreen Visibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Power Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Programming Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Program (Basic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
2 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Contents
Delivery Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Stop Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
General Programming Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Calculated Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Invalid Value Handling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Value Rounding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Biomed Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
CHAPTER 4: INFUSER PREPARATION 49
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Attaching an Infuser to an I.V. Pole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Infuser Configurations on an I.V. Pole . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Administration Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Preparing Administration Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Fluid Container Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Loading an Administration Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
To load a cassette:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Removing a Cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Ejecting a Cassette in an Emergency. . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
CHAPTER 5: PROGRAM (BASIC) THERAPY 71
Programming a Basic Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Specifying Medication Concentration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
End of Infusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Titrating an Infusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
CHAPTER 6: PIGGYBACK 83
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
CHAPTER 7: ADVANCED THERAPIES 87
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Intermittent Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
CHAPTER 8: PROGRAM OPTIONS 105
Deliver at End of Infusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
KVO Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Power Priming a Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Delayed Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Standby Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110
Alarm Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
Distal Occlusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Proximal Occlusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Infusion Complete Callback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Air-In-Line. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Nearing End Of Infusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Contents
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 3
CHAPTER 9: BOLUS 123
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Bolus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
CHAPTER 10: ALARM AND SYSTEM MESSAGES 127
Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Alarm Urgency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Alarm Appearance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Minimized Alarm Tabs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Alarm Silencing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Multiple Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
System Messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Exceeded Soft Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Exceeded Hard Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Invalid Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
CHAPTER 11: STORED DATA 137
Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Clinical Care Areas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Changing CCAs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
To display Program Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Clearing Program Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Shift Totals Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Clearing Shift Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Event Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Alarm Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Rule Set Alert Override Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Current Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Default Drug Library . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
High-Risk Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Using the Hospira MedNet® Service Suite (MMS) . . . . . . . . . . . . . . . . . . . . 149
Programming a Soft Outside limits Message . . . . . . . . . . . . . . . . . . . . . 150
Programming a Hard Limit Outside Limits Message . . . . . . . . . . . . . . . 150
CHAPTER 12: CLEANING, MAINTENANCE, AND STORAGE 151
Cleaning the Infuser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Cleaning Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Battery Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Battery Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Infuser Maintenance and Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Product Handling and Disposal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
CHAPTER 13: PRODUCT SPECIFICATIONS 155
Flow Rate Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Flow Continuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Trumpet Curves. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Sample Trumpet Curve. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
4 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Contents
APPENDIX A: SYSTEM MESSAGES AND TROUBLESHOOTING 161
APPENDIX B: ALARM MESSAGES AND TROUBLESHOOTING 171
APPENDIX C: ACCESSORIES, ADMINISTRATION SETS, AND COMPONENTS 179
APPENDIX D: GLOSSARY 181
APPENDIX E: DEFAULT DRUG LIBRARY (DDL) 187
INDEX 189
SYMBIQ™ INFUSION SYSTEM LICENSE & WARRANTY 195
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 5
What is in this book
Table 1 outlines the chapters and chapter contents of this manual.
Table 1: SYMBIQ™ Infusion System Operating Manual Contents
Chapter/Section Chapter Contents
Chapter 1 Introduction, warnings, and cautions.
Chapter 2 Infuser layout, features, and touchscreen icons and symbols.
Chapter 3 Clinical modes including Power, Programming, Delivery, and Stop.
Chapter 4 Attaching infusers to an I.V. pole, administration sets, and fluid container compatibility.
Chapter 5 Basic infusion therapy.
Chapter 6 Advanced infusion therapies.
Chapter 7 Supplemental deliveries and program options.
Chapter 8 Piggyback
Chapter 9 Bolus
Chapter 10 Alarm messages, alarm urgency, and system messages.
Chapter 11 Data storage and instructions on accessing data.
Chapter 12 Cleaning and service guidelines.
Chapter 13 Product technical specifications, flow rate accuracy.
Appendix A System messages, message criteria, and troubleshooting suggestions.
Appendix B Alarm messages, alarm criteria, and troubleshooting suggestions.
Appendix C Hospira accessories, administration sets, components, and list numbers.
Appendix D—Glossary Acronyms, expressions, terms, and their definitions.
Appendix E Default Drug Library (DDL) in tabular form.
6 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
What is in this book
NOTES:
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 7
Chapter 1: Introduction
The SYMBIQ™ Infusion System is a general purpose infuser designed to deliver fluids,
solutions, medications, agents, nutritionals, electrolytes, blood and blood products for parenteral,
enteral, intravenous, intra-arterial, subcutaneous, epidural, or irrigation routes of administration.
The SYMBIQ™ Infusion System is available as a one-channel system.
A cassette-based, multi-function device, the SYMBIQ™ Infusion System is powered by either
AC mains power or can be powered by the enclosed rechargeable battery. The SYMBIQ™
Infusion System delivers Basic therapy or Advanced therapies such as Multistep and Intermittent.
The SYMBIQ™ Infusion System is intended for use primarily in a hospital setting. Other care
areas where the infuser can be used include: Home Care, Nursing Homes, Mobile Intensive Care,
Ambulatory Infusion Centers, Hospice, Subacute Facilities, Outpatient/Surgical Centers, Long
Term Care, Urgent Care, Transport, and Physician Offices.
Intended Audience
The SYMBIQ™ Infusion System is intended for use at the direction of or under the supervision of
licensed physicians or certified healthcare professionals who are trained in the use of infusers and
the administration of parenteral, enteral, and epidural fluids and medications. Training should
emphasize preventing I.V. related complications including appropriate precautions to prevent
accidental infusion of air. Use the SYMBIQ™ Infusion System according to established hospital
or institution guidelines, policies, and procedures.
CAUTION: Federal (USA) law restricts this device to sale by or on the order of
physicians or other licensed health practitioners.
Document Conventions
Throughout this manual, the following conventions are used to call attention to warnings,
cautions, notes, and tips:
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 appears in front of a procedure or statement. It contains
information that could prevent product damage or hardware failure.
Failure to observe a caution could result in patient or user injury.
Note: A Note highlights information that helps explain a concept or procedure.
Tip: A Tip contains useful information, hints, and shortcuts that make the product easier to use.
Figures and graphics are rendered as representations to approximate the actual product.
Therefore, figures and graphics may not exactly reflect the product.
8 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 1: Introduction Warnings and Cautions
Warnings and Cautions
The SYMBIQ™ Infusion System is designed and manufactured to be safe, reliable, and easy to
use. This section describes possible hazards and explains how to prevent these hazards.
Warnings
• When infusing at low delivery rates (5.0 mL/hr or less), use microbore sets to reduce the
amount of the fluid bolus that may be delivered when a distal line occlusion is released.
• To ensure low-flow continuity at rates less than 1 mL/hr, use SYMBIQ™ administration sets
with microbore tubing.
• DO NOT use medications incompatible with silicone rubber or PVC plastic or medications
not stable under infusion conditions.
• Always prime the administration set to remove air from the cassette, tubing, and injection
sites prior to connecting to the patient. Always disconnect the administration set from the
patient prior to priming or purging.
• Arrange tubing, cords, and cables to minimize the risk of patient strangulation or
entanglement.
• Consult medication labeling to confirm medication compatibility, concentration, delivery
rates, and volumes are all suitable for desired delivery mode.
• When using the infuser for secondary deliveries (piggyback), ensure the fluids being infused
are both chemically and physically compatible.
• When an administration set is loaded in the infuser, a small amount of fluid is expelled each
time the cassette carriage is opened or closed. If potent medications are being used,
disconnect the administration set from the patient to prevent over medicating the patient.
• Delayed respiratory depression following continuous epidural administration of
preservative-free morphine sulfate has been reported.
• Administer only anesthetics and analgesics approved for epidural administration (as
indicated by the medication’s FDA approved labeling). Epidural administration of
medications other than those indicated for epidural use could result in serious patient injury.
General Cautions
• Federal (USA) law restricts this device to sale by or on the order of physicians or other
licensed health practitioners.
• DO NOT place the SYMBIQ™ Infusion System in service if it fails any of the diagnostic
self-tests.
• Before use, inspect the AC cord to check for defects.
• Before use, ensure the infuser has a functional battery installed. Use of a properly installed
and functional battery helps ensure the infuser operates properly.
• Only qualified biomedical technicians should access the infuser’s Biomed mode.
Warnings and Cautions Chapter 1: Introduction
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 9
• To prevent product damage, use proper care during unpacking and installation. DO NOT use
a SYMBIQ™ Infusion System if it appears damaged in any way.
• When a primary infuser is connected to an AC power main, never connect more than one
additional infuser in a series to the rear infuser AC power outlet; connecting more than one
additional infuser in a series may cause an electrical safety hazard (see “Rear Infuser AC
Power Outlet” on page 19 for more information).
• To prevent personal injury or product damage, make sure the pole clamp is tightened
properly and the infuser is securely attached.
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 medications’ FDA approved labeling).
Epidural administration of medications other than those indicated for epidural use could
result in serious injury to the patient.
• For epidural administration, the use of Hospira catheters, SYMBIQ™ sets without Y-sites,
and "epidural" stickers indicating ongoing epidural administration are recommended.
• Administration of medications 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 medications. 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
medication 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 medication overdose.
Administration Sets and Delivery Cautions
• USE ONLY SYMBIQ™ administration sets with the SYMBIQ™ Infusion System. Use of
unauthorized sets may result in injury to the patient or damage to the infuser.
• To prevent contamination, use aseptic techniques with all fluid-path connections. Remove
protective coverings as administration set assembly progresses.
• When priming is complete or when finished loading a cassette, ensure no fluid flows at the
distal end of the administration set. If fluid flow is observed, DO NOT use the administration
set.
10 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 1: Introduction Warnings and Cautions
• Before using a CLAVE® connector, ensure administration set and fluid compatibility. Do not
use needles to access the CLAVE® connector.
• To help prevent fluid flow, close ALL slide clamps before removing the cassette from the
infuser.
• In vitro studies suggest packed red blood cells with unusually high hematocrit be diluted with
blood-compatible fluids like 0.9% sodium chloride injection to decrease hemolysis and
increase flow rate.
• Before disconnecting a syringe from the CLAVE®, pull the plunger up slightly to avoid
spilling fluid. For rigid containers, close the upper slide clamp, open the cassette carriage,
remove and invert the cassette (ports down).
• Air bubbles may form in the administration set as result of normal outgassing of dissolved air
in the fluid. This may occur if using a chilled solution, if the infuser is mounted significantly
above the patient, when set is used for more than 24 hours, or when using certain fluids
known to routinely outgas. In these cases, an air eliminating filter may be used.
• Repeatedly opening and closing the cassette carriage may defeat the proximal air-in-line
alarm and may cause a distal alarm requiring repriming.
• The infuser screen displays the VTBI (volume to be infused) in whole numbers when a value
is above 99.9. Any fraction of a milliliter delivered is not displayed; however, it is retained in
memory.
• SYMBIQ™ administration sets with integral non-blood filters are not for 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 or via SYMBIQ™ administration sets with blood filters.
• Administration sets should be changed per CDC guidelines or hospital policy. Ensure
administration sets are properly discarded per CDC guidelines or hospital policy.
• USE ONLY SYMBIQ™ administration sets with the SYMBIQ™ Infusion System. Use of
unauthorized sets may result in injury to the patient or damage to the infuser. Hospira
Gemstar® administration sets are not compatible with the SYMBIQ™ Infusion System.
• DO NOT push the cassette carriage closed. Use the LOAD/EJECT button to open and close
the cassette carriage.
• If a cassette is manually ejected, the channel must not be used until it is reset in Biomed
mode.
• The Callback alarm activates if the amount of time between key presses are made exceeds
the No Keypress time limit configured for the current CCA or DDL.
• If patient information is stored, the infuser uses this information for default weight, height,
and BSA values when specifying dose rate parameters.
Battery Operation Cautions
• The battery may not be fully charged upon receipt. Connect the infuser to AC mains power
for at least six hours prior to initial use. Failure to fully charge the battery may significantly
reduce battery life.
Warnings and Cautions Chapter 1: Introduction
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 11
• Before connecting a patient to the infuser, ensure the infuser has a fully charged battery
installed for continuous infuser operation.
• If the low-battery alarm activates, connect the infuser to AC power immediately.
• Use AC power as the primary power source whenever possible. Before use, inspect the AC
cord to check for defects. 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, do not use
the infuser, use only battery power.
Unintended Bolus Delivery
• To avoid delivering a bolus when a distal occlusion occurs, disconnect tubing from the
patient while eliminating a distal occlusion.
Cleaning Cautions
• To avoid mechanical or electronic damage, DO NOT immerse the SYMBIQ™ Infusion
System in fluids or cleaning solutions. DO NOT spray cleaning solutions in or near infuser
openings. DO NOT allow cleaning solutions to saturate the air-in-line detectors or enter the
infuser when cleaning the air-in-line detectors.
• USE ONLY the recommended cleaning solutions and follow the manufacturer’s
recommendations. Using cleaning solutions not recommended by Hospira may result in
product damage. The disinfecting properties of cleaning solutions vary; consult the
manufacturer for specific information. See “Chapter 12: Cleaning, Maintenance, and
Storage” on page 151.
• 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.
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 these devices.
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
12 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 1: Introduction Warnings and Cautions
this equipment does cause harmful interference 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 the receiver 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.
• The radiated output power of this Wireless LAN device is far below the FCC radio frequency
exposure limits. The Wireless 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.
Electrical Artifacts in Clinical Settings
The SYMBIQ™ Infuser has been tested and found to comply with EMC/EMI limits in
accordance with:
• The use of portable and mobile RF equipment may have an impact on this and other pieces of
medical equipment
• Nonhazardous, low-level electrical potentials commonly occur 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. If the
monitoring equipment is not operating correctly or has loose or defective connections to its
sensing electrodes, these artifacts may be accentuated to the point of simulating 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, temporarily suspend
fluid delivery (a therapy should only be suspended if doing so does not pose a clinical risk to
the patient). Disappearance of the abnormality indicates 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.
Warnings and Cautions Chapter 1: Introduction
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 13
• The SYMBIQ™ Infusion System is designed to operate around normally encountered
electromagnetic interference (EMI) conditions. If extreme levels of interference like that
produced by an electrosurgical generator are encountered, normal operation of a sensor or
microcomputer might be disrupted.
• This equipment has been tested and found to comply with EMC/EMI limits in accordance
with 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, 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 is connected
- Consult the manufacturer or field service technician for help
• The use of portable and mobile RF equipment may have an impact on this and other pieces of
medical equipment.
• Use of radio frequency emitting devices (other than the wireless communication module if
installed in the SYMBIQ™ Infuser) such as cellular telephones and 2-way radios in close
proximity of this device may affect its operation. Take the following measures to correct
interference caused by these devices:
- Relocate or re-orient other radio frequency emitting devices
- Increase the distance between the infuser and other radio frequency emitting devices
- Do not connect other radio frequency emitting devices to the same AC power source used
by the infuser
14 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 1: Introduction Warnings and Cautions
NOTES:
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 15
Chapter 2: Infuser Overview
Chapter 2 describes the SYMBIQ™ Infusion System layout (front, rear, and bottom), infuser
buttons and touchscreen buttons, touchscreen icons and symbols, and the features that control the
infuser.
Many features of the SYMBIQ infuser system are configurable through the Hospira MedNet®
software. For details on facility-defined configuration, contact the facility software administrator.
Infuser Layout—Front
Figure 1 depicts the front of a one-channel SYMBIQ™ Infusion System and the infuser
touchscreen.
Figure 1: Front View and Touchscreen of the SYMBIQ™ Infusion System
Table 2 outlines the buttons and touchscreen elements that correspond to the numbers in Figure 1
above.
Table 2: Item Number and Corresponding Feature
Graphic # Feature Graphic # Feature
1Distal tubing guide 8SILENCE button
2Cassette carriage 9Emergency Stop button
3Cassette loader housing 10 CCA/Patient Information button
4Channel Identifier tab 11 Channel-level therapy buttons
5Proximal tubing guide 12 Programming screen
6Cassette LOAD/EJECT button 13 Help/status text area
7On/Off button 14 Battery indicator/AC power indicator
10
11
12
13
14
STOP
P
O
W
E
R
EmergencyStop
o
delete all entries. Options to
to continue.
Advanced
kg / min
1
3
5
1
mL/hr
mL
hh:mm
i
ne
CU
L
ogs Lock
Alarm
400 mg / 250 mL ]
Piggyback
Next
Cancel
Titration
7
610
4
11
12
13
14
2
3
9
5
1
8
LOAD / EJECT
STOP
A
C
P
O
W
E
R
EmergencyStop
On/Off
11:24 AM
Press fields to edit. Clear to delete all entries. Options to
edit program settings. Next to continue.
A
Program
Rate
(Calculated)
Dose
Advanced
Infusion
5mcg/kg/min
13.1
103
07:51
VTBI
Time
(Calculated)
mL/hr
mL
hh:mm
DOPamine
ICU
Settings Logs Lock
Mode
Options
Clear
Alarm
[ 400 mg / 250 mL ]
Piggyback
Bolus
Next
Cancel
Titration
0mL /hr
0mL
16 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Layout—Front
Infuser Buttons
Buttons on the infuser casing function in the following manner:
•LOAD/EJECT—opens and closes the cassette carriage
•On/Off—turns power on and off
•SILENCE—silences a silenceable alarm for a specified period of time, usually two minutes
•Emergency Stop—stops all channels, generates high urgency alarm
•Cleaning Lock (located on the rear of the infuser)—activates and deactivates the
touchscreen
Touchscreen Buttons
The SYMBIQ™ Infusion System touchscreen allows you to access and use on-screen buttons and
keypads. A membrane covers the LCD display so a single keypress does not cause significant
infuser pole movement nor is it mistaken for a double keypress. When an active touchscreen
button is pressed, the infuser sounds an audible valid key tone. The touchscreen also
accommodates a keypress whether you are wearing wet gloves, dry gloves, or no gloves.
Note: A triple-beep will sound when making entries that are touchscreen errors.
Touchscreen Button Appearance
The appearance of touchscreen buttons varies depending on their status. A touchscreen button can
be either active, depressed, selected, or unavailable. Table 3 depicts how touchscreen buttons
appear based on their status.
Note: Basic Program refers to functionality accessed by pressing the Program channel level
button.
Note: Document copies should be printed in color to differentiate between button statuses.
Table 3: Touchscreen Button Appearance
Touchscreen Button Status Touchscreen Button Appearance
Active
Depressed
Selected
Unavailable
Bolus
Infuser Layout—Front Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 17
Touchscreen Icons and Symbols
Table 4 describes and illustrates the various touchscreen icons and symbols.
Table 4: Touchscreen Icons and Symbols
On-Screen Item Description On-Screen Item Illustration
Horizontal navigation arrow buttons
Vertical short scroll bar (up and down
arrows scroll a list by one item)
Vertical hot scroll bar (white interior
arrows scroll a list by one item; each
yellow arrow increases the scrolling
increment by one item more than the
previous arrow)
Drop-down list field
End-of-list indicator (for drop-down
lists)
CCA/Patient information button
Select
ICU
18 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Layout—Front
Infusion running drip icon
Basic program icon
Multistep therapy icon
Intermittent therapy icon
Piggyback icon
Bolus icon
Upper hard limit icon (displays on a
channel tab when an upper hard limit
is overridden, and the program
confirmed on that channel)
Lower hard limit icon (displays on a
channel tab when a lower hard limit is
overridden, and the program
confirmed on that channel)
Upper soft limit icon (displays on a
channel tab when an upper soft limit is
overridden, and the program
confirmed on that channel)
Table 4: Touchscreen Icons and Symbols
On-Screen Item Description On-Screen Item Illustration
Infuser Layout—Front Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 19
Lower soft limit icon (displays on a
channel tab when a lower soft limit is
overridden, and the program
confirmed on that channel)
No rule set icon (displays on a
channel tab when a medication with
no defined dose or dose rate limits is
selected on a channel)
Device Status Bar has two rows. The
first row provides user adjustable
device settings of Mode, Settings,
Logs, Lock, and Alarm.
The second row displays Time, WiFi
Enabled Icon, and Battery Status.
Table 4: Touchscreen Icons and Symbols
On-Screen Item Description On-Screen Item Illustration
Settings Logs Lock
08:45 AM
Mode
Alarm
20 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Layout—Rear
Infuser Layout—Rear
Figure 2 depicts the rear layout of the SYMBIQ™ Infusion System.
Figure 2: Rear View and Layout of the SYMBIQ™ Infusion System
Table 5 outlines features on the rear of the infuser that correspond to the numbers in Figure 2
above.
Table 5: Item Number and Corresponding Feature
Graphic # Feature
1Quick travel release clamp
2Pole clamp
3Cleaning Lock
4Ethernet interface port
5Proximal tubing guide
6Carrying handle
7Minipole insertion location
8Nurse callback jack
9Pole clamp knob
10 AC power cord and rear infuser AC power outlet (specifically for one
additional SYMBIQ™ Infusion System only)
11 Battery compartment access door
6
34
9
5
2
11
110
8
7
Infuser Layout—Rear Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 21
Rear Infuser AC Power Outlet
The rear infuser AC power outlet on the back of the SYMBIQ™ Infusion System is specifically
designed to accommodate one additional SYMBIQ™ Infuser. Never connect more than one
additional infuser to the primary infuser connected to an AC power outlet; connecting any
additional infusers may cause an electrical safety hazard. Before use, inspect the AC cord to
check for defects.
Consider, for example, a primary infuser using AC (mains) power with a second infuser attached
to it using the rear infuser AC power outlet. Do not attach an additional infuser to the rear infuser
AC power outlet of the second infuser (Figure 3).
CAUTION: Never connect more than two infusers when using the rear infuser
AC power outlet; connecting more than two infusers may cause an
electrical safety hazard.
Figure 3: Incorrect Use of Rear Infuser AC Power Outlet
Instead, attach an additional infuser directly to an AC (mains) power source (Figure 4).
Figure 4: Correct Use of Rear Infuser AC Power Outlet
22 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Layout—Underside
Wireless Communication
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.
The SYMBIQ™ Infusion System supports wireless communication via an internal wireless
communications module and antennae. Use the SYMBIQ™ Infusion System’s wired or wireless
connectivity options to communicate with server-based networks or hospital local area networks.
Wireless communication to an infuser is direct rather than indirect through another infuser.
Infusers with the wireless module active display a wireless enabled icon on the touchscreen
(Figure 5).
Figure 5: Wireless Enabled Icon on Infuser Touchscreen
Infuser Layout—Underside
Figure 6 depicts the underside layout of the SYMBIQ™ Infusion System.
Figure 6: Bottom View and Layout of the SYMBIQ™ Infusion System
Settings Logs Lock
08:45 AM
Mode Alarm
2
3
4
1
Infuser Features Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 23
Table 6 outlines features on the bottom of the infuser that correspond to the numbers in Figure 6
above.
Infuser Features
The SYMBIQ™ Infusion System has three levels of features:
•Channel Level—accessed by buttons on the infuser touchscreen. Used to select therapies
and supplemental deliveries, these features include:
-Bolus—displays the Bolus programming screen (if a Bolus therapy is partially or fully
programmed) or the Bolus selection screen (if a Bolus therapy is not programmed)
-Program—displays the Basic Programming screen
-Advanced—displays the Advanced Therapies programming screen (if an Advanced
therapy is partially or fully programmed) or the Advanced Therapies selection screen (if
an Advanced therapy is not programmed)
-Piggyback—displays the Piggyback programming screen
•Program Level—accessed by pressing Options button, these features include:
-Power Prime—displays the Power Prime screen
-Delayed Start—displays the Delayed Start Time entry keypad
-Standby—displays the Standby drop-down list
-Alarm Options—displays alarm options:
- Distal Occlusion
- Proximal Occlusion
- Infusion Complete Callback
- Air-in-Line
- Nearing End of Infusion
Note: Alarm options set for a program apply only to that program.
•Device Level—accessed by buttons at the bottom of the infuser touchscreen. These buttons
control device level features including:
-Mode—displays the Biomed Mode Passcode entry screen
-Settings—displays the Settings Menu screen
-Logs—displays the Clinical Logs Menu screen
-Lock—displays the Program Lock/Unlock Passcode entry screen
-Alarm—displays active alarms
Table 6: Item Number and Corresponding Feature
Graphic # Feature Graphic # Feature
1Battery compartment access door 3 Distal tubing guide
2Cassette eject lever (EMERGENCY USE
ONLY) 4 Pole Clamp
24 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Features
Channel Level Features
Channel level features are accessed via buttons across the top of the touchscreen as depicted in
Figure 7. The default channel level screen is the Basic Program screen.
Figure 7: Channel Level Features
Use channel level buttons to access Bolus, Program, Advanced, and Piggyback programming
screens when available.
Channel Feature Availability
Selecting a channel level feature affects the availability of other channel level features. For
example, entering a single value on the Basic Program screen deactivates the Advanced button
until the Basic program is cleared. Similarly, entering a single value on an Advanced program
screen deactivates the Program button until the Advanced program is cleared
The Piggyback button is only available for a channel with a confirmed Basic program that has a
VTBI greater than zero.
For more information on programming therapies, see “Chapter 5: Program (Basic) Therapy” on
page 71, “Chapter 7: Advanced Therapies” on page 87, and “Chapter 8: Program Options” on
page 105.
12:45 PM
A
Program
Piggyback
Rate
Dose
Infusion
5mcg/kg/min
13.1
103
07:51
VTBI
Time
mL / hr
mL
hh:mm
DOPamine
Press fields to edit. Clear to delete all entries. Options to
edit program settings. Next to continue.
Bolus
Advanced
ICU
Next
Options
Clear
Settings Logs Lock
Mode
Cancel
Titration
Alarm
0mL/hr
0mL
(Calculated)
(Calculated)
[400 mg / 250 mL]
Infuser Features Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 25
Program Level Features Options
Program level features are accessed on the programming screen shown in Figure 8.
Figure 8: Program Level Features
While all options are visible on the Options screen, only options allowed for the selected therapy
and enabled for the selected Clinical Care Area (CCA) are available. For example, if the selected
therapy does not allow a delayed start or delayed start is not defined for the selected CCA, then
the delayed start option will not be available. During an infusion, the air-in-line and distal and
proximal occlusion settings are not accessible. For more information on CCAs, see “Clinical Care
Areas” on page 138.
The following features are selectable on the Options screen:
•Power Prime—moves a selected amount of fluid through the administration set tubing
•Deliver at End of Infusion—displays Deliver at End of Infusion drop-down list
•KVO Rate—displays KVO Rate Numeric Entry keypad
•Delayed Start—delay an infusion for up to 12 hours
•Standby—place the infuser in Standby mode for up to 24 hours until Start Program is
pressed
•Alarm Options—alarm options include:
- Distal Occlusion
- Proximal Occlusion
- Infusion Complete Callback
- Air-in-line
- Nearing End of Infusion
Program
Level
Features
A
Piggyback
KVO Rate
Delayed
Start
Deliver at End
of Infusion
Power Prime
1
--:--
Standby
hh:mm
mL/hr
Advanced
Yes
KVO
Alarm Options
Options
Program
03:04 PM
Select Amount
Bolus
Press button or field to select option to change. Done to
return to previous screen when finished.
ICU
Done
0mL/hr
0mL
Logs
Settings Lock
Mode
Alarm
26 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Features
Device Level Features
Device level features are accessed via buttons across the bottom of the infuser touchscreen
(Figure 9).
Figure 9: Device Level Features
Device level buttons are used to access the following features:
•Mode—displays the Biomed Mode Passcode Entry screen—if not in Delivery Mode and no
other device-level button is currently selected
•Settings—adjusts key press and alarm volumes, screen brightness, and time mode settings
•Logs—displays clinical logs including:
- Program Totals
- Shift Totals
- Event Log
-Alarm Log
- Rule Set Alert Override Log
- Current Program
For more information on Logs, refer to “Chapter 11: Stored Data” on page 137.
•Lock—displays the Program Lock/Unlock Passcode Entry screen
Settings
Use the settings button to access and adjust the infuser settings:
•Sound Volume—keypress volume and alarm volume
•Screen—screen brightness
12:45 PM
A
Program
Piggyback
Rate
Dose
Infusion
5mcg/kg/min
13.1
103
07:51
VTBI
Time
mL / hr
mL
hh:mm
DOPamine
Press fields to edit. Clear to delete all entries. Options to
edit program settings. Next to continue.
Bolus
Advanced
ICU
Next
Options
Clear
Settings Logs Lock
Mode
Cancel
Titration
Alarm
0mL/hr
0mL
(Calculated)
(Calculated)
[400 mg / 250 mL]
Infuser Features Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 27
•Time mode—time mode settings
To access sound volume settings:
1. From any infuser screen, locate and press Settings to display the Settings screen.
Figure 10: Settings button
2. On the Settings screen, press Sound Volume to display the Settings Sound Volume screen.
Figure 11: Settings Screen
3. On the Settings Sound Volume screen, press the Key Press Volume and Alarm Volume
buttons to adjust volume levels. The infuser sounds an audible tone for the selected volume
level.
Figure 12: Settings Sound Volume Screen
Note: Key Press Volume sets the volume for both valid and invalid key presses.
4. When finished adjusting settings on the Settings Sound Volume screen, press Save.
Other Settings Sound Volume screen buttons do the following:
- Low Urgency—press button for audible Low Urgency alarm tone at the current level
Settings Logs Lock
08:45 AM
Mode Alarm
3
4
28 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Features
- Medium Urgency—press button for audible Medium Urgency alarm tone at the current
level
- High Urgency—press button for audible High Urgency alarm tone at the current level
5. Cancel—displays the Settings Menu screen without saving changes
6. On the Settings screen, press Exit to return to the screen from which the Settings screen was
accessed.
Note: If no keys are pressed for two consecutive minutes, the Settings Sound Volume screen
reverts to the screen from which the Settings button was pressed.
To access brightness adjustment settings:
1. From any infuser screen, locate and press Settings to display the Settings screen.
2. On the Settings screen, press Screen to display the Settings Brightness screen. See Figure 11:
"Settings Screen" on page 27.
3. On the Settings Brightness screen, adjust the screen brightness by pressing Brightness
buttons. The infuser increases or decreases screen brightness to the selected level.
4. When finished adjusting settings on the Settings Brightness screen, press Save. Press
Cancel to return to the Settings Menu screen without saving changes.
Figure 13: Settings Brightness Screen
Note: If no keys are pressed for two consecutive minutes, the Settings Brightness screen
reverts to the previous screen.
5. On the Settings screen, press Exit to return to the previous screen.
Date and Time Settings
Access the time mode settings to specify 12-hour or 24-hour clock formats.
To set the time mode:
1. From any infuser screen, locate and press Settings to display the Settings screen.
2. On the Settings screen, press Date & Time to display the Settings Date & Time screen. See
Figure 11: "Settings Screen" on page 27.
3
4
3
Infuser Features Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 29
3. Press the Time Format field to specify 12-hour or 24-hour clock formats. Select the desired
time format button on the drop-down list.
Figure 14: Settings Date & Time Screen
4. When finished adjusting settings on the Settings Date & Time screen, press Save. Press
Cancel to return to the Settings Menu screen without saving changes.
5. On the Settings screen, press Exit to return to the screen from which the Settings screen was
accessed.
Figure 15: Settings Screen
Note: If no keys are pressed for two consecutive minutes, the Settings Date & Time screen
reverts to the previous screen.
Program Lock
An active program lock prohibits changes to any touchscreen field or parameter related to a
therapy program including:
• programming buttons
• date and time settings
The program lock is always available unless the Cleaning Lock is active, a system message is
active, or the infuser is in an active alarm state.
Settings: Date & Time
Month
Day
Year
Time Format
Time
12 Hour PM
Mar
03
2003
04:34 PM
Cancel Save
3
4
5
30 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Features
You cannot start or stop a therapy while the program lock is active using on-screen buttons.
However, pressing Stop Program on the touchscreen or pressing Emergency Stop does not
deactivate the program lock.
With the program lock active, you can access the following infuser features:
• screen navigation
• brightness and volume control
• logs and program parameters
• touchscreen Stop Program button
• Emergency Stop button
• view shift/program totals
With the Program Lock active, program-related fields and features related are not available. To
access program-related fields and features you must first de-activate the Program Lock.
To activate the program lock:
1. From any infuser screen, locate and press Lock. The Enter Code dialog box displays.
Figure 16: Accessing the Program Lock
02:30 PM
Press Stop to end infusion. Program button to edit program.
Advanced
DELIVERING PROGRAM
DOPamine
Dose: 5 mcg / kg / min
VTBI: 24.6 mL
Time: 00:04 hh:mm
Volume infused: 0.4 mL
[ 400 mg / 250 mL]
Stop
Program A
Rate: 13.1 mL /hr
Settings Logs Lock
Mode
Piggyback
Program
Bolus
ICU
Alarm
A
DOPamine
13.1 mL / hr
24.6 mL
Infuser Features Chapter 2: Infuser Overview
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 31
2. On the Enter Code dialog box, use the touchscreen keypad to key in a valid passcode, and
then press Enter. Press Cancel to return to the previous screen.
Figure 17: Enter Code Dialog Box (Activating)
Note: See authorized facility personnel for password.
3. The screen from which the program lock was accessed displays with the program lock
activated.
Figure 18: Program Lock Activated
Note: Entering an invalid passcode three consecutive times activates the Invalid Passcode
system message for each attempt. Entering an invalid passcode a fourth time closes
the Enter Code dialog box and displays the screen from which the program lock was
accessed without activating the program lock.
To deactivate the program lock:
1. On the touchscreen, locate and press Lock. The Enter Code dialog box displays.
11:23 AM
A
Program
Piggyback
Activating the program lock will prohibit
the user from changing program-related
settings.
Enter Code
DELIVERING PROGRAM
[400 mg / 250 mL]
DOPamine
Mode
Settings Logs
To activate program lock, Press number buttons for
passcode; then Enter. Cancel to exit.
1 3 42
Advanced
Bolus
Cancel Enter
ICU
Lock
Alarm
13.1 mL / hr
24.6 mL
DOPamine
10:32 AM
Lock
Alarm
Settings Logs
Mode
32 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 2: Infuser Overview Infuser Features
2. On the Enter Code dialog box, use the touchscreen keypad to key in a valid passcode, and
then press Enter. Press Cancel to return to the previous screen.
Figure 19: Enter Code Dialog Box (Deactivating)
3. The screen from which the program lock was accessed displays with the program lock
deactivated.
Figure 20: Program Lock Deactivated
Note: Entering an invalid passcode three consecutive times activates the Invalid Passcode
system message for each attempt. Entering an invalid passcode a fourth time closes
the Enter Code dialog box and displays the screen from which the program lock was
accessed without deactivating the program lock.
11:23 AM
A
Program
Piggyback
Unlocking the Infuser will allow the user
to change program-related settings.
Enter Code
DELIVERING PROGRAM
[400 mg / 250 mL]
DOPamine
Mode
Settings Logs
To unlock, Press number buttons for passcoade; then Enter
Cancel to exit.
1 3 42
Advanced
Bolus
Cancel Enter
ICU
Lock
Alarm
13.1 mL / hr
24.6 mL
DOPamine
02:30 PM
Press Stop to end infusion. Program button to edit program.
Advanced
DELIVERING PROGRAM
DOPamine
Dose: 5 mcg / kg / min
VTBI: 24.6 mL
Time: 00:04 hh:mm
Volume infused: 0.4 mL
[ 400 mg / 250 mL]
Stop
Program A
Rate: 13.1 mL /hr
Settings Logs Lock
Mode
Piggyback
Program
Bolus
ICU
Alarm
A
DOPamine
13.1 mL / hr
24.6 mL
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 33
Chapter 3: Infuser Operations
Chapter 3 describes the Infuser Basic Operations of the SYMBIQ™ Infusion System. This
includes a discussion of power on, power down, programming a therapy, and delivering a therapy.
Infuser Operations Overview
The infuser has four basic operations divided into four segments: power on, program, deliver and
stop.
•Power—to power on and power off the infuser
•Programming—to program the following therapies:
- Bolus (Bolus)
- Program (Basic therapy)
- Advanced (Multistep and Intermittent)
- Piggyback
•Delivery—to observe and monitor the progress of an infusion
•Stop—to stop the infuser
Power Modes
The Power mode is used to power on and power off the infuser.
AC Power
When attached to an AC mains power source, the SYMBIQ™ Infusion System uses AC power
regardless of the level of available battery power. Use AC power whenever possible; the battery is
intended as a backup or emergency power source. However, if the quality of the earth grounding
source is in doubt, use battery power.
Before initial use, connect the infuser to AC power for at least four hours to ensure the battery is
fully charged. Whenever connected to an AC power source, the infuser charges the battery.
Procedure to power on the infuser:
1. Ensure sure the infuser is securely attached to an I.V. pole and is connected to an AC power
source.
34 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Power Modes
2. Press and hold the On/Off button for one second, and then release.
Figure 21: On/Off Button
3. At power on, the Startup screen displays during diagnostic self-tests.
Figure 22: Infuser Startup Screen
The diagnostic self-tests take about ten seconds to complete. Once diagnostic self-tests complete,
a startup screen displays indicating whether any program, patient, distal and proximal occlusion,
or air-in-line sensitivity settings were saved.
CAUTION: DO NOT place the SYMBIQ™ Infuser in service if it fails any of the
diagnostic self-tests.
If the infuser has been powered off for less than five hours, previous patient information, program
information, and infuser settings are retained. The New Patient dialog box displays over the
Startup screen (Figure 23).
LOAD / EJECT
STOP
A
C
P
O
W
E
R
Emergency
Stop
On/Off
Infusion System
TM
Software Version XXX
Drug Library Version 0.01
Thursday February 20, 2006
02:19 AM
Copyright Hospira, Inc. 2004
Medical Center
SYMBIQ
PLEASE WAIT
WHILE PUMP INITIALIZES
Power Modes Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 35
Selecting No in the New Patient field and pressing Continue retains stored patient and program
information and displays the Startup screen. The Startup screen shows infuser status and provides
access to view both patient and program information. Selecting Yes in the New Patient field and
pressing Continue clears stored patient and program information and displays a blank Patient
Information screen.
Figure 23: New Patient Dialog Box
When a Drug Library contains one or more Clinical Care Areas (CCAs), you must specify a CCA
at power on. When prompted, either confirm the current CCA or select a new one.
Figure 24: Specifying a CCA
Channel LEDs
During diagnostic self-tests, the channel LEDs located just above the cassette carriage (Figure 25)
flash green once, yellow once, and red once.
Figure 25: Channel LED Location
OB
Recovery
ER
ICU
NICU
Channel
LED
Cassette
Carriage
36 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Power Modes
Table 7 outlines channel LED color and the conditions under which the channel LEDs illuminate.
During an alarm state, the color and flashing characteristics of both the channel LED and channel
alarm tab are the same.
Battery Power
The rechargeable battery provides up to four hours of power at 100 mL/hr.
The non-volatile battery life is sufficient to retain program parameters, delivery totals, patient
information (ID, weight, and height), clinician information, and logs.
CAUTION: Before use, ensure the infuser has a functional battery installed. Use
of a properly installed and functional battery helps ensure the infuser
operates properly.
The battery indicator icon is located in the lower right corner of the touchscreen. Table 8 shows
battery indictor icons and the associated battery life, power level, and alarm state for each
indicator icon. When the infuser is attached to an AC power source, the battery indicator icon
shows the current battery charge level.
Table 7: Channel LED Color and Conditions
Channel LED Color Conditions
Solid Green While in Delivery mode and delivery has not been
interrupted.
Flashing Green When the cassette carriage is either opening, closing, or
open, and during power priming.
Solid Yellow During a Low urgency condition.
Flashing Yellow During a Medium urgency condition.
Flashing Red During any High urgency condition.
Solid Red During a latched High alarm condition. A latched High
urgency condition notifies the user of a previous alarm
condition—which no longer exists—until the alarm is
cleared by the user.
Table 8: Battery Indicator Icons
Battery Indicator Icon Power Level Alarm State
Battery Indicators when Infuser is operating on battery power
Full (76%-100%): None
Three-quarters (51%-75%) None
Power Modes Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 37
If the Low Battery alarm activates, the battery has only enough charge remaining to continue the
current delivery rate for approximately 30 minutes. Immediately connect the infuser to AC power.
Note: As long as a low battery condition exists, the Low Battery alarm cannot be cleared, but it
may be minimized by pressing the alarm tab.
Half (50%)
Note: This indicator displays when the battery is at
half capacity—until the activation of the 30-min.
Low battery Alarm (see next indicator) when the
Infuser is operating on battery power:
30 minutes Low
15 minutes Medium
5 minutes High
Empty
Charging Battery Indicators when Infuser is operating on AC Power
AC power (infuser using AC power only, battery fully charged) None
Charging, capacity at 75% or greater but less than 100% capacity None
Charging, capacity at 25% or greater but less than 75% capacity None
Charging, capacity less than 25% None
Displays when the Infuser is powered on and no battery above the
Depleted Battery threshold is detected:
Battery icon location:
Note: Icon is located in the lower right corner of the device level area.
Table 8: Battery Indicator Icons (Continued)
Battery Indicator Icon Power Level Alarm State
Settings Logs Lock
08:45 AM
Mode
Alarm
38 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Power Modes
Do not use a SYMBIQ™ Infusion System without a properly functioning battery installed. If no
battery is detected at power on, the No Battery system message activates (Figure 26). In this case,
remove the infuser from service until a properly functioning battery can be installed.
Figure 26: No Battery System Message
CAUTION: Before use, ensure the infuser has a functional battery installed. Use
of a properly installed and functional battery helps ensure the infuser
operates properly.
A/C Power LED
The A/C power LED (Figure 27) is located on the front of the infuser just above the On/Off and
Emergency Stop buttons. When using AC power with a fully-charged battery, the A/C power
LED is lit green. When using A/C power with the battery charging, the A/C power LED flashes.
When using battery power only, the power LED is off.
Figure 27: Location of A/C Power LED
Touchscreen Visibility
If no keystrokes or button presses are made for a CCA-defined period of time (the default is two
minutes), the infuser enters Power Saving mode. Power Saving mode is marked by an 80%
reduction in touchscreen brightness.
A
Program
Piggyback
Rate
Dose
Infusion
5mcg/kg/min
13.1
103
07:51
VTBI
Time
mL / hr
mL
hh:mm
DOPamine
Bolus
Advanced
ICU
Next
Options
Clear
Cancel
Titration
0mL/hr
0mL
(Calculated)
(Calculated)
[400 mg / 250 mL]
NO BATTERY DETECTED
Battery removed or shorted. In the event of AC power
loss, infusion will stop.
Press here
to minimize.
00:00:09
LOAD / EJECT
STOP
A
C
P
O
W
E
R
Emergency
Stop
On/Off
Power Modes Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 39
Turning touchscreen away from direct sunlight improves visibility. Any infuser alarm state or
pressing the touchscreen restores brightness to normal levels.
Power Off
When power is removed from the infuser, it enters Power Down mode. During a normal power
down, all critical data is saved to the appropriate logs, the current program and all user-configured
settings are retained, and, if open, the cassette carriage closes. All alarm sensitivity settings are
also retained at power down.
To power down the infuser:
1. Ensure all infusions are stopped and the infuser is not in Delivery mode.
2. Press and hold the On/Off button for one second, and then release. The infuser powers off.
See Figure 21: "On/Off Button" on page 34.
Note: If the infuser is powered off before you complete or confirm a program, the partially
entered program is cleared the next time the infuser is powered on.
40 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Programming Mode
Programming Mode
Programming mode is used to program infusion therapies. Therapies and supplemental deliveries
available in programming mode include:
• Bolus
• Program (Basic)
• Advanced
• Piggyback
Program (Basic)
From this screen, you can access these features:
•Patient Information Button—displays patient information
•Channel Tab—displays the channel screen.
•Bolus—displays the Bolus program screen (Bolus button unavailable until a primary
infusion is programmed on the active channel)
• Advanced—displays the Advanced Therapy Selection screen
•Piggyback—displays the Piggyback program screen (Piggyback button unavailable until a
primary infusion is programmed on the active channel)
•Clear—if not in Delivery mode, removes all values entered on a programming screen
•Options—displays the Options screen
•Cancel Titration (if accessing the Basic Program screen to titrate the therapy) cancels all
changes made to the program
•Next—Displays the Confirm Program screen available only when all required program
parameters have been entered,
•Device Level Buttons—displays device level features.
Delivery Mode Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 41
Delivery Mode
Two types of screens display during Delivery mode—Near Viewing and Far Viewing. A Near
Viewing Delivery screen is shown in Figure 28.
Figure 28: Near Viewing Delivery Screen
The Near Viewing Delivery screen displays medication name (if enabled in the selected CCA),
concentration, dose rate (if applicable), time remaining, VTBI, volume infused, infusion status for
advanced therapies, and alarm name for the highest priority alarm if in an alarm state. On the Near
Viewing Delivery screen, both VTBI and Volume Infused values display with one decimal place
for values up to 100.
Note: The Near Viewing Delivery Screen shall only display the Dose label and value if a dose is
programmed.
The Far Viewing screen (Figure 29) is designed to have the rate and VTBI readable from a
distance of 15 feet. In addition, the pump displays medication name (if enabled in the selected
CCA), concentration, and, if in an alarm state, the alarm name for the highest priority alarm. On
02:30 PM
Press Stop to end infusion. Program button to edit program.
Advanced
DELIVERING PROGRAM
DOPamine
Dose: 5 mcg / kg / min
VTBI: 24.6 mL
Time: 00:04 hh:mm
Volume infused: 0.4 mL
[ 400 mg / 250 mL]
Stop
Program A
Rate: 13.1 mL /hr
Settings Logs Lock
Mode
Piggyback
Program
Bolus
ICU
Alarm
A
DOPamine
13.1 mL / hr
24.6 mL
42 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Stop Mode
the Far Viewing Delivery screen, VTBI values display with one decimal place for values less than
100. For values greater than or equal to 100, values display with no decimal.
Figure 29: Far Viewing Delivery Screen
Pressing LOAD/EJECT while in delivery mode does not eject the cassette; to eject a cassette, the
infuser must be in Stop mode.
Once the infuser completes a programmed therapy, the End of Infusion alarm activates. The
infuser transitions to a KVO (Keep Vein Open) delivery rate. Pending on programming, the
infuser continues to deliver at programmed rate or transitions to KVO.
Stop Mode
The SYMBIQ™ Infusion System stops in one of five ways:
1. Pressing Stop Program on the touchscreen.
2. Pressing Emergency Stop on the front of the infuser stops all channels.
Figure 30: Emergency Stop Button
08:47 AM
Press Tab A to display Near Viewing Delivery screen.
A
Rate
VTBI
mL
mL / hr
[400 mg / 250 mL]
DOPamine
13.1
1
96.
ICU
Settings Logs Lock
Alarm
A
DOPamine
Mode
13.1 mL / hr
96.1 mL
LOAD / EJECT
STOP
A
C
P
O
W
E
R
Emergency
Stop
On/Off
A
Advanced
DELIVERING PROGRAM
DOPamine
ICU
Bolus
A
!
DOPamine
Program Piggyback
Stop Mode Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 43
3. An active alarm state will stop the infusion.
4. When a programmed VTBI completes and there is no KVO.
5. A bolus is complete and Stop Infusion has been selected on the bolus setup screen.
When a delivery is manually stopped (by pressing Stop Program) and the VTBI has not
completely delivered, the Stop mode screen shows STOPPED across the banner as in Figure 31.
Figure 31: Stop Mode Screen—Manual Stop in a Basic Program
When a therapy is stopped due to an alarm state including Emergency Stop, the Stop mode screen
shown in Figure 32 displays
.
Figure 32: Stop Mode Screen—Alarm State
09:33 AM
Press Start to resume infusion. Program button to view or
edit program.
Advanced
Rate:
Dose
13. mL /hr
1
5mcg/kg/min
STOPPED PROGRAM
Repeat?
Bolus Program
Piggyback
ICU
Settings Logs Lock
Mode
DOPamine
[400 mg / 250 mL]
VTBI
Volume Infused
Time Remaining:
105 mL
0mL
08:00 hh:mm
Start
Program A
Alarm
A
DOPamine
13.1 mL / hr
105 mL
Press Start to resume infusion. Program button to view or
edit program.
Advanced
STOPPED PROGRAM
Bolus Program
Piggyback
ICU
Start
Program A
A
DOPamine
Emergency Stop button pressed.
Infusion(s) stopped.
Press here to
clear alarm.
EMERGENCY STOP
00:00:09
Rate:
Dose
13. mL /hr
1
5mcg/kg/min
Repeat?
DOPamine
[400 mg / 250 mL]
VTBI
Volume Infused
Time Remaining:
105 mL
0mL
08:00 hh:mm
13.1 mL / hr
105 mL
44 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Stop Mode
While in Stop mode, you can:
• access the current programmed therapy
• access the lock/unlock functionality
• access programming mode to start a new program or change a current program
• start a programmed therapy or continue the current therapy
• select a new CCA
• update patient information
Note: The Stop Mode Screen shall only display the Dose label and value if a dose is
programmed.
To stop the infuser using the touchscreen Stop Program button:
1. If the Far Viewing screen is active, touch it to display the Near Viewing screen.
2. On the Near Viewing screen, locate and press Stop Program.
Figure 33: Stop Program Button
3. To resume infusing, press Start Program.
To stop the infuser using the Emergency Stop button:
Note: In an Emergency, use Emergency Stop to stop all channels. Otherwise, use Stop Program
on the touchscreen to stop individual channels.
1. Locate the Emergency Stop button on the front of the infuser. See Figure 30: "Emergency
Stop Button" on page 42.
2. Press and release Emergency Stop. All active programs stop infusing and a high urgency
alarm sounds.
02:30 PM
Press Stop to end infusion. Program button to edit program.
Advanced
DELIVERING PROGRAM
DOPamine
Dose: 5 mcg / kg / min
VTBI: 24.6 mL
Time: 00:04 hh:mm
Volume infused: 0.4 mL
[ 400 mg / 250 mL]
Stop
Program A
Rate: 13.1 mL /hr
Settings Logs Lock
Mode
Piggyback
Program
Bolus
ICU
Alarm
A
DOPamine
13.1 mL / hr
24.6 mL
General Programming Guidelines Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 45
3. Press Start Program on the touchscreen to resume the therapy.
Figure 34: Touchscreen Start Program Button
General Programming Guidelines
If the infuser is powered off before you complete or confirm a program, the partially entered
program is cleared the next time the infuser is powered on. If a change is made to a program
during an infusion but is neither canceled nor confirmed, a Callback alarm activates.
Calculated Values
Calculated values for a given field display on the touchscreen as shown in Figure 35.
Figure 35: Calculated Field Value
A calculated value that either exceeds the current maximum medication delivery rate or the
maximum volumetric rate for the selected CCA activates a warning message.
Invalid Value Handling
Entering a value in a field that exceeds a value limit defined for that field the following occurs:
Press Start to resume infusion. Program button to view or
edit program.
Advanced
STOPPED PROGRAM
Bolus Program
Piggyback
ICU
Start
Program A
A
DOPamine
Emergency Stop button pressed.
Infusion(s) stopped.
Press here to
clear alarm.
EMERGENCY STOP
00:00:09
Rate:
Dose
13. mL /hr
1
5mcg/kg/min
Repeat?
DOPamine
[400 mg / 250 mL]
VTBI
Volume Infused
Time Remaining:
105 mL
0mL
08:00 hh:mm
13.1 mL / hr
105 mL
Rate
100
(Calculated)
500
05:00
VTBI
Time
mL / hr
mL
hh:mm
Next
Options
Clear
46 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations General Programming Guidelines
• activates the Invalid Entry system message
• sounds the Invalid Key tone
• replaces the value with three dashes (“---”)
There are two types of value limits for a field; maximum field length and maximum field amount.
For fields with defined maximum lengths, entering a four-character value in a field with a three-
character limit exceeds the length limit for that field and activates the Invalid Entry system
message.
Entering an amount that exceeds the defined limit activates the Invalid Entry system message
(Figure 36).
Figure 36: Invalid Entry System Message
A field must contain a valid value before exiting. To remove the Invalid Entry system message,
press Clear. Pressing Clear also replaces the three dashes (“---”) in a field with field default
values; either “0” for non-time fields or “--:--” for time fields.
Value Rounding
For calculated values, the infuser truncates the value one digit beyond what the screen can
display, and then rounds off the value. If the therapy is based on either a calculated value or a
rounded value, the infuser delivers the therapy at the stored value. For example, if the stored value
is in hundredths but displays in tenths, the infusion rate has a granularity of hundredths. Stored
information does not change. If a stored value contains more decimal places than can be
displayed, the Infuser rounds the displayed value. The infuser uses the rounding rules based on
one digit beyond what can be displayed.
Note: Calculated interim values retain all decimal places supported by the infuser’s hardware.
Piggyback
Dose
Program
04:34 PM
Infusion
Lidocaine
D
ICU
Settings Logs Lock
Mode
Cancel
Cancel
Cancel
Clear
Cancel
Enter
1 2 3
4 5 6
7 8 9
0
Advanced
Weight
Height
BSA
5
60
0
Invalid value entered. Clear to delete entry. Cancel to exit
without saving change.
0mL/hr
0mL
A
Alarm
---
Bolus
Biomed Mode Chapter 3: Infuser Operations
SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06) 47
Biomed Mode
Biomed mode is used to perform calibrations and diagnostic tests on the SYMBIQ™ Infusion
System. In Biomed mode, a trained and qualified biomedical technician can restore the infuser’s
default factory settings and default drug library, configure device settings, and clear all logs and
viewable data.
CAUTION: Only qualified biomedical technicians should access the infuser’s
Biomed mode.
Note: Biomed mode is password protected.
48 SYMBIQ™ Infusion System Operating Manual 430-10599-001 (MDS DRAFT 04/06)
Chapter 3: Infuser Operations Biomed Mode
NOTES: