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The GemStar System Certification Program Advancing the Art of Infusion…EVERYWHERE GEMSTAR ® The health information contained herein is provided for informational purposes only. All decisions regarding patient care must be made with a healthcare provider and consider the unique characteristics of each patient.

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The GemStar SystemCertification Program

Advancing the Art of Infusion…EVERYWHERE

GEMSTAR®

The health information contained herein

is provided for informational purposes only.

All decisions regarding patient care must be

made with a healthcare provider and consider

the unique characteristics of each patient.

The GemStar System

GemStar® Certification Program A-1

THE GEMSTAR SYSTEM

The GemStar Pump . . . . . . . . . . . . . . . . . . . . . .A-2

System Components . . . . . . . . . . . . . . . . . . . . . .A-5

GemStar General Infusion Administration Sets . . . . .A-8

Selecting a Power Source . . . . . . . . . . . . . . . . .A-10

Priming the GemStar Set Without a Drip Chamber . . . . . . . . . . . . . . . . . . . . . . .A-14

Priming Pump Sets Without a Drip Chamber Using the [PURGE] Key . . . . . . . . . . . . . . . . . . .A-15

Priming the GemStar Set With a Drip Chamber . . .A-17

Priming Pump Sets With a Drip Chamber Using the [PURGE] Key . . . . . . . . . . . . . . . . . . . . . . .A-19

Priming the GemStar Administration Set . . . . . . . .A-26

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .A-27

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .A-31

Objectives

When you complete this module, you will:

■ Know the functions of the keypad buttons and components of the GemStar;

■ Be familiar with the GemStar’s optional system components (accessories);

■ Be familiar with the GemStar-compatible administration sets;

■ Know how to connect and use the appropriate GemStar power source;

■ Know how to prime the GemStar administration set with or without a drip chamber;

■ Be familiar with the types of GemStar-compatible filter sets; and

■ Know how to load and unload the GemStar cassette.

A-2 GemStar® Certification Program

The GemStar System

The GemStarPump

Indications

Description

GemStar Face

This section provides an overview of the Abbott GemStar infusion pump. The GemStar is designed for hospital or home careuse. It is a single-channel pump that can be programmed for up to seven different types of therapies:■ Pain Management ■ Continuous■ mL/hr Only ■ Intermittent■ Weight Dosed ■ Variable Time■ TPN

The GemStar pump is approved for the following infusion types:■ Intravenous ■ Arterial ■ Subcutaneous ■ Epidural

The GemStar weighs 17 ounces (482 grams) and is 5.5 inches (height) x 3.8 inches (width) x 2 inches (depth). This lightweight design makes the pump transportable, convenient to hold, and easy to set up.

The pump has 23 keys. A single beep sounds when any key is pressed. If an invalid key is pressed, a flutter tone sounds.

The following diagram shows the GemStar face layout:

The GemStar System

GemStar® Certification Program A-3

GemStar Face Controls

Display screen The four-line display:■ Indicates the pump’s status.■ Displays programming selections.■ 16 point font.

[SILENCE] key ■ Temporarily silences the alarm.■ Silences the keypad beeps for 5 minutes, if pressed in a non-alarm state.

[STOP] key Stops infusion.

[START] key Starts infusion.

Power indicator light Indicates the pump is powered by: ■ AC when continuously lit.■ Rechargeable battery pack or docking station when flashing.■ Alkaline batteries when unlit.

[ON/OFF] key Turns the pump on or off.■ Press and hold approximately 2 seconds to turn off.

[BACK-UP] key ■ Provides access to previous screens during programming.■ Acts as an “ESCAPE” key to exit the Help, Change, Options, and

all Histories Menus.

[CHANGE] key ■ Corrects an entry during a programming step.■ Provides access to the Change Menu from the STOP or RUN mode.

[OPTIONS] key Provides access to the Options Menu from the STOP or RUN mode.

and keys ■ Scroll through display messages.■ enters a decimal point in numeric entries.

[YES/ENTER] key ■ Responds “YES” to display questions.■ Accepts entries and advances to the next step during programming.

[NO] key Responds “NO” to display questions.

[HELP] key ■ Provides context-sensitive information during programming steps and alarm conditions.

■ Acts as a “hot key” for shift totals.

[PURGE] key ■ Clears an air-in-line alarm.■ Primes the administration set.

[0] - [9] key ■ Press the number keys to select menu items and to enter numeric values.Note: Some menu items require pressing two number keys to select that item. For example, when selecting a unit of measure for a weight dosed program, themenu may display as:

01 mcg/kg/mg 03 mcg/kg/min02 mcg/kg/hr 04 mg/kg/min

To select mg/kg/min, press [0][4].

A-4 GemStar® Certification Program

The GemStar System

Other parts of the GemStar pump are shown in the following diagram (top, bottom, and side views).

Pump Components

Bolus button Press this button to start a bolus delivery if available in the current program.

Pole clamp track Use to connect to an optional pole clamp.

Cassette eject button Push down on this button to release the cassette.

Power connector Use to connect AC mains adaptor.

Data port Use to connect a printer or computer.connector

Bolus connector Use to connect a bolus cord.

Tubing channel Place the pump set tubing in this channel.

Cassette pocket Load the cassette into this pocket.

Battery pack connector Use to connect the Abbott GemStar Rechargeable Battery Pack.

Battery compartment Install two fresh, disposable AA batteries in this compartment.

TOP BOTTOM SIDE

GemStar® Certification Program A-5

The GemStar System

System Components

The following table describes the GemStar optional system components. All GemStar optional system components are latex-free.

Optional System Components

Category/ Item Description IllustrationList No.

Power Sources

13075-01 Docking Station Plugs into a 90 – 260 VAC Volt mains supply (90 – 260 Volts) to power the GemStar pump while mounted on

an I.V. pole (the unit includes an integral pole mount clamp). During periods of transport, an internal rechargeable battery pack powers the pump for up to 16 hours. When charging, the LED illuminates yellow. When fully charged, it illuminates green.

13026-01 AC Wall (Mains) 110 VAC Volt mains supply to power the Adapter GemStar. Do not use this power supply with (110 Volts – USA) other products. 6 ft (1.8 m) cord

13072-01 AC Wall (Mains) Tabletop adapter plugs into a 90 – 260 VAC Adapter Volt mains supply to power the GemStar. Do not (90 – 260 Volts – use this power supply with other products.Universal)

13073-01 Rechargeable The rechargeable nickel metal hydride battery Battery Pack powers the GemStar pump during periods of

transport or when use of AC power is not desirable for up to 8 hours. The battery packis recharged using the AC adapter.

A-6 GemStar® Certification Program

The GemStar System

Optional SystemComponents

Optional System Components

Category/ Item Description IllustrationList No.

Lockboxes

13024-01 GemStar 250 mL Locks the GemStar pump and up to a 250 mL Lockbox flexible I.V. container in a plastic enclosure.

The lockbox can be attached to an I.V. pole using the Abbott GemStar pole clamp.

13077-01 GemStar 30 mL Locks the GemStar pump and a 30 mL PCA Vial Lockbox Abbott PCA vial in a plastic enclosure.

The lockbox can be attached to an I.V. pole using the Abbott GemStar pole clamp.

Bolus Cord

13027-01 GemStar Optional Allows bolus requests to be made by a patient Bolus Cord or clinician up to 6 feet (1.8 m) away from

the pump.

Data Cable

13078-01 Serial Printer Connects the GemStar pump to a compatibleData Cable printer or computer to download the event

history, program, or speed protocol information.

40017-01 Seiko DPU-414 Allows printout of GemStar event history.Printer

GemStar® Certification Program A-7

The GemStar System

Optional System Components

Category/ Item Description IllustrationList No.Carrying Cases13594-01 250 mL Abbott Soft-sided carrying case is worn around the

Carrying Case waist for transporting the GemStar pump and up to a 250 mL flexible solution container.

13079-01 500 mL Abbott Soft-sided carrying case worn around the Carrying Case waist or over the shoulder for transporting

the GemStar pump and up to a 500 mL flexible solution container.

13980-01 1000 mL Abbott Soft-sided carrying case worn around the Carrying Case waist or over the shoulder for transporting

the GemStar pump and up to a 1000 mL flexible solution container.

13593-01 3 Liter (3000 mL) Soft-sided bag that carries a 3-liter Abbott Carrying or smaller flexible solution container Case and the GemStar pump with batteries or

battery pack.

Pole Clamps13076-01 Abbott GemStar Attaches the GemStar pump to an I.V.

Pole Clamp pole. The clamp is mounted to the track on the back of the pump. Depress the release button on the clamp to remove the pump.

13022-01 Triple GemStar Pump Attaches three Abbott GemStar Pumps to Pole Clamp an IV pole. The clamp is mounted to the

back of the pumps. Depress the release button to remove the pumps.

13048-01 Gem Connect13049-01

A-8 GemStar® Certification Program

The GemStar System

GemStar General Infusion

Administration Sets

GemStar General Infusion

Administration Sets

The following table describes the available Abbott GemStar general infustion administration sets. All Abbott GemStar generalinfusion administration sets are latex-free.

GemStar General Infusion Administration Sets

Category/ Description Nominal Drops/mL Approximate Tubing CaseList No. Length Priming Capacity I.D. SizePrimary Sets13042-01 GemStar 150 mL Burette 110" (279 cm) 60 10.0 mL 0.054" 24

Pump Set with small bore 0.100"reduced priming volume 0.120"tubing, convertible piercing 0.146"pin, upper slide clamp, air filter slide clamp, prepierced reseal injection site, burette, drip chamber, CAIR® clamp, upper prepierced reseal injection site, lower slide clamp, and Secure Lock male adapter.

13030-01 GemStar HEMA II Y-Type 110" (279 cm) 15 43.0 mL 0.100" 24Blood Pump Set with 0.120"piercing pins, upper CAIR clamps, drip chamber, 210 micron blood filter chamber, lower CAIR clamp, prepierced reseal injection site, and Secure Lock male adapter.

13014-01 GemStar Primary Piggyback 110" (279 cm) 15 16.0 mL 0.100" 24Pump Set with convertible piercingpin, filter vent cover and dripchamber, slide clamp, backcheckvalve, upper prepierced reseal Y-injection site, CAIR clamp,lower prepierced reseal Y-injectionsite, and Secure Lock male adapter.

13043-01 GemStar Primary Pump Set 110" (279 cm) 15 27.0 mL 0.100" 24with convertible piercing pin, prepierced Y-sites, integral 0.22 micron filter, airfilter assembly, slide clamp, and Secure Lock male adapter.

GemStar General Infusion Administration Sets

Category/ Description Nominal Drops/mL Approximate Tubing CaseList No. Length Priming Capacity I.D. SizePrimary Sets13013-01 GemStar Non-Phthalate 96" (244 cm) — 4.4 mL 0.054" 24

Administration Set with nonvented piercing pin, 1.2 micron filter, slide clamp, prepierced reseal Y-injection site, and Secure Lock male adapter.

13012-01 GemStar Pump Set with 96" (244 cm) — 4.4 mL 0.054" 24nonvented piercing pin, 0.2 micron filter, slide clamp, prepierced reseal Y-injection site, and Secure Lock male adapter.

13015-01 GemStar Pump Set with 96" (244 cm) — 3.0 mL 0.043" 24orange polyethylene-lined light-resistant tubing, nonvented piercing pin, prepierced reseal Y-injection site, slide clamp, and Secure Lock male adapter.

13046-01 GemStar Pump Set with 96" (244 cm) — 4.6 mL 0.054" 24nonvented piercing pin, slide clamp, and Secure Lock male adapter.

GemStar® Certification Program A-9

The GemStar System

The GemStar pump may be powered by:■ A docking station (16 hours) ■ GemStar AC adapter■ A GemStar battery pack ■ 6 ft. cord■ Two disposable AA alkaline or lithium batteries ■ 14 ft. cord

Connecting the Abbott GemStar AC Mains Adaptor

Connect the cord of the AC mains adaptor to the connector labeled “3 VDC” on the bottom of the pump.

Plug the AC mains adaptor into a standard wall outlet.

CAUTION: ALWAYS connect to a grounded AC mains power source when using the AC mains adaptor. USE ONLY ACmains adaptors specifically labeled for use with the Abbott GemStar Pump.

When removing the cord from the bottom of the pump, firmly grasp the connector and pull straight out. DO NOTtwist or bend the cord or connector.

NOTE: The green LED on the pump remains lit when connected to AC mains.

A-10 GemStar® Certification Program

The GemStar System

Selecting aPower Source

Install two disposable AA batteries by performing the steps listed in the following table.

Installing Disposable Batteries

Flip up the tab of the battery door on the bottom of the pump.

Hold onto the tab and turn the battery door to the left (counterclockwise) until it is released from the battery compartment.

Pull the door free and remove any existing batteries.

Install two fresh, disposable AA batteries into the battery compartment. Make sure the batteries are inserted as shown.

Return the battery door to the battery compartment.

Turn the battery door to the right (clock-wise). Make sure the battery door is secured under the slot.

Flip down the tab of the battery door to lock in place.

CAUTION: When using batteries to power the pump:

■ Both batteries should always be replaced with fresh, disposable AA alkaline or lithium batteries when a battery change is required.

■ Use of rechargeable batteries in the battery compartment is NOT recommended due to unpredictable performance characteristics.

12

3

4

7

6

5

The GemStar System

GemStar® Certification Program A-11

Installing Batteries

Connecting the Battery Pack

To connect the battery pack:

Line up the connectors on the top of the battery pack with the holes on the bottom of the pump.

Snap the battery pack into place.

Disconnecting the Battery Pack

To release the battery pack:

Press the release button on the battery pack.

Remove the battery pack from the pump.

NOTE: When the pump is connected to the batterypack, the pump’s green LED flashes and the battery pack light is off.

When the pump is connected to the battery pack at power-on, the pump displays USINGEXT BATT.

Recharging the Battery Pack

To recharge the battery pack:

Plug the pin connector of the AC mains adaptor into the port on the bottom of the battery pack.

Plug the AC mains adaptor into a standard wall outlet.

Leave the battery pack connected to the AC mains adaptor for at least 8 hours to completely recharge the battery pack

2

1

A-12 GemStar® Certification Program

The GemStar System

Connecting the Battery Pack

Disconnecting the Battery Pack

Recharging the Battery Pack

2

CAUTION: When removing the cord from the bottom of the pump, firmly grasp the connector and pull straightout. DO NOT twist or bend the cord or connector.

NOTE: The battery pack light is yellow while the battery pack is charging. When the batterypack is fully charged, the battery pack light is green.

Connecting the Pump to the Docking Station

Mount the docking station to the I.V. pole and tighten the knob.

Line up the connectors on the bottom of the pump with the connectors on the docking station.

Slide the pump into the docking station until it snaps into place.

Connect the docking station to AC mains power.

NOTE: The docking station light is yellow while the docking station is charging. When the docking station is fully charged, the light is green.

Disconnecting the Pump from the Docking Station

To remove the pump:

Press the release button on the top of the docking station.

Slide the pump out.

GemStar® Certification Program A-13

The GemStar System

To prime the GemStar administration set without a drip chamber, perform the steps in the following table:

Priming Pump Sets Without a Drip Chamber

Push down on the flow stop to close the cassette.

Hold the container with the administration port toward the ceiling and insert the piercing pin.

Push down on the flow stop to open (priming position) the cassette.

Invert the cassette approximately 45°.

While holding the rotated cassette, squeeze or roll the container to remove air from the container and cassette.

Return the cassette to the upright position. Continue priming until fluid fills the tubing.

Push down on the flow stop to close the cassette.

Load the cassette.

A-14 GemStar® Certification Program

The GemStar System

Priming the GemStarSet Without a Drip

Chamber

The GemStar System

GemStar® Certification Program A-15

Connect the pump set to the patient-access device.

WARNING:

■ Failure to use the anti-siphon valve may result in unrestricted flow.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

■ When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Priming Pump Sets Without a Drip Chamber Using the PURGE Key

Push down on the flow stop to close the cassette.

Hold the container with the administration port toward the ceiling and insert the piercing pin.

Priming Pump SetsWithout a DripChamber Using the PURGE Key

Load the cassette.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

Program desired therapy.

Press [PURGE].

The pump displays PRIME THE SET? Press [YES/ENTER].

While holding the container with the port toward the ceiling, press and hold [PURGE]. Continue using the [PURGE]key until fluid fills the tubing. Make sure all air is removed from the container, cassette, and tubing

NOTE: Purge rate is 250 mL/hr. The pump purges for up to 2 minutes each time you pressand hold [PURGE].

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

■ When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Connect the pump set to the patient-access device.

A-16 GemStar® Certification Program

The GemStar System

PURGE HELP

Priming Pump Sets With a Drip Chamber

Push down on the flow stop to close the cassette.

Insert the piercing pin into the container. Suspend the container on an I.V. Pole.

Squeeze the drip chamber until filled halfway.

Push down on the flow stop to open (priming position) the cassette.

Make sure the CAIR® (roller) clamp is open.

Invert the cassette approximately 45°.

While holding the rotated cassette, remove air from the container and cassette.

Return the cassette to the upright position. Continue priming until fluid fills the tubing.

Push down on the flow stop to close the cassette.

The GemStar System

GemStar® Certification Program A-17

Load the cassette.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Connect the pump set to the patient-access device.

A-18 GemStar® Certification Program

The GemStar System

Priming Pump Sets With a Drip Chamber Using the PURGE Key

Push down on the flow stop to close the cassette.

Insert the piercing pin into the container. Suspend the container on an I.V. Pole.

Squeeze the drip chamber until filled halfway.

Make sure the CAIR® (roller) clamp is open.

Load the cassette.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

Program the desired therapy.

Press [Purge].

The GemStar System

GemStar® Certification Program A-19

PURGE HELP

Priming Pump Sets With a DripChamber Using the PURGE Key

The pump displays Prime the Set? Press [YES/ENTER].

Press and hold [PURGE]. Continue using the [PURGE] key until fluid fills the tubing. Make sure all air is removedfrom the container, cassette, and tubing.

NOTE: Purge rate is 250 mL/hr. The pump purges for up to 2 minutes each time you pressand hold [PURGE].

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

■ When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Connect the pump set to the patient-access device.

A-20 GemStar® Certification Program

The GemStar System

Priming Pump Sets Using Pre-filled Vials

If using a pump set with the Y-extension, use the slide clamp to close off the KVO (Keep Vein Open) side of the tubing.

Open the upper and lower slide clamps.

Push down on the flow stop to close the cassette.

Connect the pump set to an Abbott pre-filled vial and injector.

Push down on the flow stop to open (priming position) the cassette.

Hold the vial and set upright (vertically) on a flat surface with the pump set extending from the top. Make sure air is removed from the vial and injector.

Slowly push down on the injector until fluid flows at the distal end of the tubing, which indicates that all air is cleared from the vial, injector, cassette, and tubing.

Push down on the flow stop to close the cassette.

The GemStar System

GemStar® Certification Program A-21

Push down on the flow stop to close the cassette.

Load the cassette.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Connect the pump set to the patient-access device.

CAUTION:

■ Close ALL slide clamps before removing the cassette from the pump.

WARNING: Failure to use the anti-siphon valve may result in unrestricted flow.

A-22 GemStar® Certification Program

The GemStar System

Priming Pump Sets Using Pre-filled Vials

If using a pump set with the Y-adapter, use the slide clamp to close off the KVO (Keep Vein Open) side of the tubing.

Push down on the flow stop to close the cassette.

Connect the pump set to an Abbott 30 mL pre-filled vial and injector.

Push down on the flow stop to open (priming position) the cassette.

Hold the vial and set upright (vertically) on a flat surface with the pump set extending from the top. Make sure air is removed from the vial and injector.

Slowly push down on the injector until fluid flows at the distal end of the tubing, which indicates that all air is cleared from the vial, injector, cassette, and tubing.

Push down on the flow stop to close the cassette.

If the set includes a KVO section, close the slide clamp and prime that section.

Load the cassette.

CAUTION:

■ Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

The GemStar System

GemStar® Certification Program A-23

When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow is observed, DO NOT use the pump set.

Connect the pump set to the patient-access device.

CAUTION:

■ Close ALL slide clamps before removing the cassette from the pump.

WARNING: Failure to use the anti-siphon valve may result in unrestricted flow.

Priming Pump Sets with Extensions

Push down on the flow stop to close the cassette.

Hold the container with the port toward the ceiling and insert the piercing pin.

Push down on the flow stop to open (priming position) the cassette.

Invert the cassette approximately 45º.

A-24 GemStar® Certification Program

The GemStar System

While holding the rotated cassette, squeeze or roll the container to removeair from the container and cassette.

Return the cassette to the upright position. Continue priming until fluid fills the tubing.

Push down on the flow stop to close the cassette.

Connect the extension set to the pump set.

Load the cassette.

CAUTION: Make sure all four cassette latches are clearly visible after the cassette is installed. Refer to Loading the Cassette.

Program the desired therapy.

Press [PURGE].

The pump displays PRIME THE SET? Press [YES/ENTER].

Press and hold [PURGE].

NOTE: Purge rate is 250 mL/hr. The pump purges for up to 2 minutes each time you pressand hold [PURGE].

Continue using the [PURGE] key until fluid fills the tubing. Make sure all air is removed from the container, cassette, and tubing.

CAUTION: When priming is complete, make sure no fluid flows at the distal end of the pump set. If flow isobserved, DO NOT use the pump set.

Connect the pump set to the patient-access device.

The GemStar System

GemStar® Certification Program A-25

PURGE HELP

The GemStar administration set must be primed to eliminate air from the cassette and tubing before loading it into the pump and connecting it to the patient.

WARNING:

■ FAILURE to use the anti-siphon valve may result in unrestricted flow.

■ ALWAYS remove air from the cassette, tubing, and injection site prior to connecting the pump to the patient.

■ ALWAYS disconnect the pump set from the patient prior to priming or purging the pump.

■ ALWAYS arrange tubing, cables, and cords to minimize the risk of patient strangulation or entanglement.

CAUTION:

■ Use only GemStar administration sets with the GemStar pump. Use of unauthorized sets may result in injury tothe patient or damage to the pump.

■ To prevent contamination, use aseptic technique with all fluid-path connections. Remove protective coverings as assembly progresses.

TIP: False occlusion alarms and fluid delivery inconsistencies may occur when pumpingviscous fluids in microbore tubing at rates greater than 500 mL/hr.

A-26 GemStar® Certification Program

The GemStar System

Priming theGemStar

Administration Set

Study Questions1. MATCHING: Match the following GemStar keypad buttons with their functions:

Keypad Button Function

A. [BACK-UP] _______ Temporarily silences the alarm.B. [NO] _______ Acts as a “hot key” for shift totals.C. [OPTIONS] _______ Primes the administration set.D. [HELP] _______ Corrects an entry during a programming step.E. [SILENCE] _______ Enters a decimal point in numeric entries.F. [CHANGE] _______ Provides access to the Options menu from STOP or RUN modes.G. [START] _______ Provides access to previous screens during programming.H. [PURGE] _______ Starts infusion.I. _______ Responds “NO” to display questions.

2. MATCHING: Match the following GemStar components with their functions:

GemStar Component Function

A. Data Port Connector _______ Holds two disposable AA batteries for battery operation.B. Cassette Eject Button _______ Connects the rechargeable battery pack to the pump.C. Bolus Button _______ Holds the cassette.D. Battery Compartment _______ Accommodates the administration set tubing.E. Pole Clamp Track _______ Connects an optional bolus cord to the pump.F. Cassette Pocket _______ Connects a printer or PC to the pump.G. Tubing Channel _______ Releases the cassette from the pump.H. Battery Pack Connector _______ Connects to an optional pole clamp.I. Bolus Connector _______ Initiates a bolus delivery.

3. TRUE/FALSE: Batteries should always be installed in the GemStar pump, regardless of thepower source used.

4. Which of the following is true?A. You should remove air from the cassette, tubing, and injection site prior to connecting the GemStar to the patient.B. You should always disconnect the pump set from the patient prior to priming or purging.C. You should always arrange tubing, cables, and cords to minimize the risk of patient strangulation or entanglement.D. All of the above are true.

5. The GemStar pump is approved for which of the following infusion types? A. IntravenousB. ArterialC. SubcutaneousD. EpiduralE. All of the above

The GemStar System

GemStar® Certification Program A-27

6. The GemStar pump can be powered by all but which of the following?A. Abbott GemStar AC adapterB. Two disposable AA alkaline batteriesC. Abbott GemStar battery packD. A docking stationE. All of these can power the GemStar

7. During periods of transport, an internal rechargeable battery pack powers the pump in thedocking station for up to ___________ hours.A. 2B. 5C. 16D. 120E. Indefinitely

8. The optional ________________ allows bolus requests to be made by a patient or clinician up to 6 feet (1.8 m) away from the pump.A. Serial printer data cableB. Cassette eject buttonC. Bolus buttonD. GemStar bolus cordE. None of the above

9. TRUE/FALSE: Only AC adapters specifically labeled for use with the GemStar pump should be used.

10. To fully recharge the battery pack, leave it plugged into the AC adapter for at least _____ hours.A. 1B. 8C. 18D. 30

11. TRUE/FALSE: Use of rechargeable batteries in the battery compartment is not recommended.

A-28 GemStar® Certification Program

The GemStar System

12. False occlusion alarms and fluid delivery inconsistencies may occur when pumping viscous fluids in microbore tubing at rates greater than _________ .A. 500 mL/hrB. 10 mL/hrC. 4 mL/hrD. 0.5 mL/hr

13. TRUE/FALSE: Failure to use the antisiphon valve may result in unrestricted flow.

14. TRUE/FALSE: Abbott recommends the use of air-eliminating filters when the air-in-line alarm is turned off.

15. When the cassette is released from the pump, the cassette flow stop button automaticallyreverts to the ___________ position.A. OpenB. UnlockedC. LockedD. InvertedE. Closed

The GemStar System

GemStar® Certification Program A-29

1. MATCHING: Match the following GemStar keypad buttons with their functions:A. [BACK-UP] _______ Temporarily silences the alarm.B. [NO] _______ Acts as a hot key for shift totals.C. [OPTIONS] _______ Primes the administration set.D. [HELP] _______ Corrects an entry during a programming step.E. [SILENCE] _______ Enters a decimal point in numeric entries.F. [CHANGE] _______ Provides access to the Options menu from STOP or RUN modes.G. [START] _______ Provides access to previous screens during programming.H. [PURGE] _______ Starts infusion.I. _______ Responds “NO” to display questions.

2. MATCHING: Match the following GemStar components with their functions:A. Data Port Connector _______ Holds two disposable AA batteries for battery operation.B. Cassette Eject Button _______ Connects the rechargeable Battery Pack to the pump.C. Bolus Button _______ Holds the cassette.D. Battery Compartment _______ Accommodates the administration set tubing.E. Pole Clamp Track _______ Connects an optional bolus cord to the pump.F. Cassette Pocket _______ Connects a printer or PC to the pump.G. Tubing Channel _______ Releases the cassette from the pump.H. Battery Pack Connector _______ Connects to an optional pole clamp.I. Bolus Connector _______ Initiates a bolus delivery.

3. TRUE/FALSE: Batteries should always be installed in the GemStar pump, regardless of the power source used. TRUE

4. Which of the following is true?D. All of the above are true

5. The GemStar pump is approved for which of the following infusion types? E. All of the above

6. The GemStar pump can be powered by all but which of the following?B. Two disposable C alkaline batteries

7. During periods of transport, an internal rechargeable battery pack powers the pump in thedocking station for up to ___________ hours.C. 16

EDHFICAGB

DHFGIABEC

The GemStar System

GemStar® Certification Program A-31

Study Answers

8. The optional ________________ allows bolus requests to be made by a patient or clinician up to 6 feet (1.8 m) away from the pump.D. GemStar bolus cord

9. TRUE/FALSE: Only AC adapters specifically labeled for use with the GemStar pump should be used. TRUE

10. To fully recharge the battery pack, leave it plugged into the AC adapter for at least___________ hours.B. 8

11. TRUE/FALSE: Use of rechargeable batteries in the battery compartment is not recommended.TRUE

12. False occlusion alarms and fluid delivery inconsistencies may occur when pumping viscous fluids in microbore tubing at rates greater than ________ .A. 500 mL/hr

13. Failure to use the antisiphon valve may result in unrestricted flow.TRUE

14. TRUE/FALSE: Abbott recommends the use of air-eliminating filters when the air-in-line alarmis turned off.TRUE

15. When the cassette is released from the pump, the cassette flow stop button automaticallyreverts to the ____________ position.E. Closed

A-32 GemStar® Certification Program

The GemStar System

GemStar® Certification Program B-1

GEMSTAR MENU FUNCTIONS—MODULE B

How They Work . . . . . . . . . . . . . . . . . . . . . . . . .B-2

Menu Selections . . . . . . . . . . . . . . . . . . . . . . . . .B-2

Programming Menu . . . . . . . . . . . . . . . . . . . . . .B-3

Change Menu . . . . . . . . . . . . . . . . . . . . . . . . . .B-3

Options Menu . . . . . . . . . . . . . . . . . . . . . . . . . .B-3

Connecting to the Data Port . . . . . . . . . . . . . . . .B-13

Connecting to the Printer . . . . . . . . . . . . . . . . . .B-13

Connecting to a Computer . . . . . . . . . . . . . . . . .B-14

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .B-15

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .B-19

GemStar Menu Functions

Objectives

When you complete this module, you will know how to:

■ Use the Programming, Change, and Options Menus;

■ View histories and shift/volume totals;

■ Lock and unlock GemStar pump functions at one of four lock levels;

■ Change the air-in-line sensitivity, occlusion sensitivity, and sound level;

■ Set the clock;

■ Assign and recall a speed protocol;

■ Change the start time of the next dose; and

■ Connect the GemStar to a printer or PC using the data port.

GemStar Menu Functions

B-2 GemStar® Certification Program

How TheyWork

MenuSelections

The GemStar menu system is designed to prompt the user through programming steps. The menu system displays messages on the screen that require you to enter a number (e.g., 100 for 100 mL) or press the [YES/ENTER], [NO], [STOP], or[START] keys.

TIP: Line 4 of the display screen usually contains instructions.

Each function menu has a list of items which are displayed when the menu is accessed. Menu items may vary dependingon the configuration of the pump.

The three basic menus are:■ Programming Menu ■ Change Menu ■ Options Menu

Accessing the Programming Menu

After power-on, the pump checks its memory for a stored program. Respond to the display message as shown in the following table:

Display Message Condition User Response

The pump displays the Programming Menu Pump memory is clear ■ To enter a new program: Select atherapy from the Programming Menuand enter a new program. Refer to the appropriate therapy chapterfor instructions.

1 Resume Program A program is currently stored ■ To continue the current program, 2 Clr Prog&Shift in pump memory. press [1].3 Clr Prog, Shift and History ■ To reset the current program:

1. Press [1].2. Press [CHANGE] to display

the Change Menu and selectNEW CONTAINER.

■ To enter a new program and clearshift totals: Press [2]. The pumpclears the program and shift totalsfrom memory and enters PROGRAM-MING mode.

■ To enter a new program, clear shifttotals and clear history: Press [3].The pump clears the program, shifttotals, and history from memory andenters PROGRAMMING mode.

GemStar Menu Functions

GemStar® Certification Program B-3

Programing Menu

Change Menu

Options Menu

Programming Menu

The Programming Menu is used to select one of the following therapies (depending on availability):■ mL/hr Only■ Weight Dosed■ Intermittent■ Variable Time■ TPN (Total Parenteral Nutrition)■ Continuous■ Pain Management

Each therapy is numbered on the Programming Menu display. Press the corresponding number on the keypad to select a therapy.

TIP: A menu item does not need to be displayed to be accessed. If you know the numberof the menu item, simply press it.

The Change Menu is used for a number of functions. It is accessed by pressing the [CHANGE] button. The following tablelists the menu items for the Change Menu.

Change Menu

New Container Repeats/resets the current program after a new container is hung.

New Program ■ Deletes the current program.■ Accesses the Programming Menu.

Change Program Allows you to change the current program.

Piggybacking Allows a secondary infusion in continuous and mL/hr.

The Options Menu has a number of functions that are used to tailor specific pump parameters.The menu items and their corresponding functions are listed in the following table.

Options Menu

1 Review Program Displays the current program settings.

2 Histories ■ Displays the history for the last 400 events.■ Provides shift totals.■ Provides container totals.■ Shows configurations.■ Clears history (Bolus History).■ Accesses the Operation Test.

3 Keypad Lock Accesses the locking and unlocking functions to prevent unauthorized changes to an infusion protocol.

4 Pump Settings Changes the air sensor, occlusion sensor, and sound level settings.

5 Set Clock Sets the clock.

GemStar Menu Functions

B-4 GemStar® Certification Program

Histories

6 Print ■ Prints the history event log.■ Prints the bolus history.■ Prints the current program settings.■ Prints the speed protocols (if saved).

7 Speed Protocol Allows up to nine speed protocols to be saved in the pump’s memory.

8 Next Dose Permits changes to the start time of the next intermittent dose. This menu item is available only if an Intermittent therapy has been programmed and the pump is not delivering a dose.

To access the Options Menu, complete the following steps:

Accessing the Options Menu

Press [OPTIONS] from the RUN or STOP mode.

Select the number key that corresponds to the desired function (see Table B-2).

Follow the display prompts for the selected function.

Press [BACK-UP] when you are ready to exit the Options Menu.

TIP: A menu item does not have to be visible on the display to be selected. Item numbers5 through 8 can be selected by pressing the corresponding number without scrollingthrough the display.

TIP: The menu selections may vary depending on the configuration of the pump. Some Options Menu functions are not available in the RUN mode.

TIP: When the pump exits the Options Menu, the display returns to the screen the pumpwas in when the Options Menu was accessed.

One of the items included on the Options Menu is the Histories Menu, which has a number of functions. A history event log is maintained with a date and time stamp of each event during each program. The history can be reviewed or downloaded to a printer or computer. The Histories Menu displays an event history or separately displays:■ Shift totals■ Volume totals – Current container■ Bolus history – 48 hr■ Configuration

The Operation Test can also be accessed from the Histories Menu. The following table lists the functions of the HistoriesMenu and the corresponding display information.

Histories Menu

History ■ Current date and time.

■ Date and time a program was cleared, a new container was selected, or a speed protocol was recalled.

GemStar Menu Functions

GemStar® Certification Program B-5

Bolus History

Keypad Lock

■ History event log of the most recent 400 events.

Shift Totals ■ Time and date when a shift was cleared.

■ Volume infused during the shift.

Volume Totals ■ Amount infused.

■ Volume to be infused (VTBI).

Configuration Configuration allows for pump therapies, dose ranges, lock options and other programmableoptions to be configured to meet facility requirements.

NOTE: Refer to the Abbott GemStar Configuration Guide (List 13000-67) for more information on configuration functions.

Clear History ■ Clears the History Event Log.

Bolus History ■ Current date and time.

■ Number of bolus demands made.

■ Number of boluses delivered.

■ Amount delivered through bolus delivery.

Operation Test ■ Allows you to perform a semi-automated functional pump testing.

TIP: Press [HELP] to quickly display shift totals.

TIP: Press and hold the or arrow key to scroll through the history displays faster.

Bolus History is available only if the current program has a bolus programmed or had a bolus programmed at one time. The Bolus History is maintained in hourly increments for the latest 48 hours and is cleared when:■ A new program is entered.■ A speed protocol is recalled.■ The History is cleared.

Keypad Lock allows the keypad to be set to one of four lock levels. These lock levels are:

■ Therapy Limits access to all but one therapy type.

■ Rate Change Allows user to set range for continuous rate and bolus in Pain Management. (See chart B-6 for detailed information)

■ New Container Permits user to reset the current program using NEW CONTAINER.

■ Full No changes to program allowed.

The Abbott GemStar Pump allows two lock levels at the same time. Therapy Lock can be used with either Full Lock,Container Lock, or Rate Change Lock.

When two lock levels are applied, if a function is available under one lock level but not the other, the more stringent restric-tions apply. The table on the following page lists the functions available for each lock level.

GemStar Menu Functions

B-6 GemStar® Certification Program

When the pump is locked under a particular level, a small lock symbol ( ) appears next to the applied lock level as shownabove. When the pump is in RUN or STOP mode, the lock symbol appears in the lower left corner of the display and thelock level abbreviation appears in the lower right corner.

Clinicians: Refer to Chapter 11 GemStar System Operating Manual, page 115 for detailed instructions

When the keypad is locked at a specific level, some functions are not available. The functions that are available with eachof the four keypad lock levels are listed in the following table:

Abbott GemStar Keypad Lock Level Functions

U=Unlock, T=Therapy Lock, R=Rate Change Lock, N=New Container Lock, F=Full Lock

Function U T R N F Comments

Lock/Unlock Keypad ■ ■ ■ ■ ■ Rate Change Lock is available only if the current program is Pain Management.

Power Pump On or Off ■ ■ ■ ■ ■

Start or Stop Infusion ■ ■ ■ ■ ■

Access Display, Help, Print, ■ ■ ■ ■ ■

and Program Review Functions

Deliver a Bolus ■ ■ ■ ■ ■ If programmed.

Silence an Alarm ■ ■ ■ ■ ■

Select a New Container ■ ■ ■ ■

Purge ■ ■ ■ ■

Change a Program ■ ■ ■ Under Rate Change Lock, only the delivery rateor bolus dose volume can be changed andmust be within the preset values.

Review/Recall Speed Protocol ■ ■ Under Therapy Lock, the recalled protocol mustbe the same type that was programmed whenthe pump was locked.

Assign or Delete Speed ■ ■

Protocol

Set Air Sensitivity, Distal ■ ■

Occlusion Level, Sound Level,and Clock

Clear Shift Totals ■ ■ ■ ■

Program and Deliver a ■ ■

Loading Dose (Outside of Programming Mode)

Enter a New Program ■ ■ Under Therapy Lock, the new program must beof the same type that was programmed whenthe pump was locked.

Piggybacking ■ ■

GemStar Menu Functions

GemStar® Certification Program B-7

Function U T R N F Comments

VTBI Titration ■ ■

Rate Titration ■ ■

Operation Test ■

Clear History ■

Select Another Therapy ■

Remove this section from the manual to prevent unauthorized access to these features.

Locking the Pump

To lock the pump from the RUN or STOP mode:

Press [OPTIONS] to display the Options Menu.

Select KEYPAD LOCK from the Options Menu.

NOTE: If a lock level is already applied to the pump, the Lock Sequence Number must beentered before a second lock level can be applied. Refer to Adding a Second LockLevel on page 118 for more information.

Select the desired lock level. For THERAPY, CONTAINER and FULL Lock, go to step 5.

For RATE CHANGE Lock, set the minimum and maximum programmable ranges for the continuous delivery rate andbolus dose in a Pain Management program.

Tip: Press to toggle between the MIN and MAX values.

■ MIN flashes on the display. Enter the minimum value.■ MAX flashes on the display. Enter the maximum value.■ Press [YES/ENTER] when done.■ Repeat step 4 for bolus dose if available in the current program.

Enter the lock sequence number. Asterisks display as the numbers are entered.

■ For THERAPY Lock, enter [0][0][0][3][1].■ For UNLOCKED, FULL, CONTAINER, and RATE CHANGE lock levels, enter [1][3][0][0][0].

NOTE: Note: Default lock sequence numbers are shown.

Adding a Second Lock Level

Press [OPTIONS] to display the Options Menu.

Select KEYPAD LOCK from the Options Menu.

Enter the Lock Sequence Number.

For RATE CHANGE Lock, set the minimum and maximum programmable ranges for the continuous delivery rate andbolus dose in a Pain Management program.

Tip: Press to toggle between the MIN and MAX values.

GemStar Menu Functions

B-8 GemStar® Certification Program

Pump Settings

Air Sensor

Change Air-in-LineSensitivity

Distal Occlusion Sensitivity

■ MIN flashes on the display. Enter the minimum value.■ MAX flashes on the display. Enter the maximum value.■ Press [YES/ENTER] when done.■ Repeat step 4 for bolus dose if available in the current program.

NOTE: When two lock levels are applied, if a function is available under one lock levelbut not the other, the more stringent restrictions apply.

Enter the lock sequence number. Asterisks display as the numbers are entered.

■ For THERAPY Lock, enter [0][0][0][3][1].■ For UNLOCKED, FULL, CONTAINER, and RATE CHANGE lock levels, enter [1][3][0][0][0].

NOTE: Default lock sequence numbers are shown.

Complete the following steps to unlock the pump:

Unlocking the Pump

Press [OPTIONS] to display the Options Menu.

Select KEYPAD LOCK from the Options Menu.

Select the lock level to be unlocked.

Enter the lock sequence number for that level.

NOTE: If the pump is locked under two levels, each level must be unlocked separately.Unlocking one level has no effect on the other level. For example, if both THERAPY and RATE CHANGE lock levels are applied, the clinician must unlock both the RATE CHANGE and THERAPY locks.

The pump displays the current lock levels. Press [YES/ENTER] to return to the mode the pump was in when[OPTIONS] was pressed.

Program and deliver a clinician activated loading dose

This feature is available only when the keypad is UNLOCKED or when THERAPY is the only lock level. The loading doserate is 125 mL/hr.

From the STOP mode, press [YES/ENTER] immediately followed by [0]. PROGRAM A LOADING DOSE? displays.

Press [YES/ENTER] to continue.

Enter the loading dose. Press [YES/ENTER] when done.

DELIVER THE LOADING DOSE NOW? displays.■ Press [YES/ENTER] to deliver the loading dose. After the loading dose is complete, press [START]

to resume infusion.■ Press [NO] to return to the STOP mode. Press [START] to resume infusion.

NOTE: If [YES/ENTER] is pressed, infusion DOES NOT begin automatically when the clinician activated loading dose is complete. Press [START] to resume infusion afterthe loading dose is complete.

GemStar Menu Functions

GemStar® Certification Program B-9

Air Sensor

Change Air-in-LineSensitivity

If [NO] is pressed, the pump returns to the STOP mode. When [START] is pressed, DELIVER LOADING DOSE NOW? displays again. Press [YES/ENTER] to deliver the loadingdose. Infusion resumes automatically when the loading dose is complete. Press [NO] tocancel the loading dose and resume infusion.

Pump Settings

The Pump Settings Menu allows:■ Air sensor sensitivity to be changed.■ Distal occlusion sensor sensitivity to be changed.■ Audible alarm level (sound level) to be adjusted.

The three air-in-line sensitivity levels are:■ On■ 2 mL■ Off

The air-in-line alarm sounds when the pump detects an air bubble of approximately:■ 0.5 mL when ON is selected, or ■ 2 mL when 2 mL is selected

The alarm does not sound if OFF is selected. Removing power has no effect on the air-in-line alarm setting.

WARNING: An air-eliminating filter should be used to reduce the risk of infusing air when the air-in-line alarm is off.

TIP: The air-in-line alarm may be set during programming for TPN, Pain Management,Continuous, Intermittent, and Variable therapy programs.

TIP: The air-in-line alarm is automatically set to ON (default) in the mL/hr Only andWeight Dosed therapy programs.

To change air-in-line sensitivity, complete the steps in the following table:

Changing Air-in-Line Sensitivity

Select PUMP SETTINGS from the Options Menu. Press Options and select pump settings.

Select AIR SENSOR.

Select the desired air-in-line sensitivity level.

Press [YES/ENTER].

GemStar Menu Functions

B-10 GemStar® Certification Program

Distal Occlusion Sensitivity

Proximal OcclusionSensitivity

Changing the Sound Level

The pump alarm sounds if the distal pressure is greater than the selected occlusion sensor limit. There are three occlusion sensitivity levels: ■ 7 (low) psig■ 12 (medium) psig■ 26 (high) psig (default)

To change the distal occlusion sensitivity, complete the steps in the following table:

Changing the Distal Occlusion Sensitivity

Select PUMP SETTINGS from the Options Menu. Press Options Menu and select pump settings

Select OCCLUSION SENSOR. [OCCL SENSOR]

Select the desired occlusion sensitivity level.

Press [YES/ENTER].

Proximal Occlusion Sensitivity

The GemStar has a proximal occlusion sensor. Proximal occlusion sensitivity is – 4 psig and cannot be changed.

The adjustable range for the sound level is from approximately 65 dB (maximum) to silence (minimum). The pump default is the maximum setting. Change the sound level by completing the steps in the following table:

Changing the Sound Level

Select PUMP SETTINGS from the Options Menu. Press Options Menu and Select pump settings.

Select SOUND LEVEL.

Adjust the sound level using to increase the level and to decrease the level.Press [CHANGE] to restore the sound level to the default setting.

Press [YES/ENTER].

TIP: When the Sound Level function is accessed, the pump sounds intermittent beeps at the current sound level. The bar at the top of the display indicates the currentsound level.

GemStar Menu Functions

GemStar® Certification Program B-11

Setting the Clock

To set the clock, perform the steps in the following table:

Press [STOP] to place pump in STOP mode.

Select SET CLOCK from the Options Menu. Press Options and Select Set Clock.

Select a 12-HOUR or 24-HOUR format.

Use the keys to set the week, day, and month.

Use the number keys to enter the current date and time.

Press [YES/ENTER].

TIP: To review the time from the RUN or STOP modes, press [YES/ENTER] thenimmediately press and hold [1]. The clock displays until [1] is released.

Print Menu

The printer should be connected to the pump before selecting a print function. The Print Menu contains five items. The printer’s functions are explained in the following table:

Print History Prints the current program and History Event Log of the most recent 400 events since thehistory was last cleared.

Print Program Prints the current program.

Print Protocol Prints a specified speed protocol or a complete list of all speed protocols. If a protocol isnot assigned, Not Assigned prints next to the protocol number.

Print Bolus Hx Prints the current program and the bolus history (Hx) for the preceding 48 hours, whenthe current program has a bolus programmed or had a bolus programmed at one time.

Stop Print Cancels the print function. This function is available only if you have selected one of theprint functions above.

WARNING: Be sure to disconnect the pump from the patient BEFORE connecting the pump to a printer or a computer.

NOTE: Abbott recommends using AC power when printing to prevent drain on batteries.

GemStar Menu Functions

B-12 GemStar® Certification Program

Speed Protocol The Speed Protocol feature allows frequently used programs to be stored in the pump’s memory for quick access. As manyas nine programs can be stored. The Speed Protocol Menu has three items:

Speed Protocol Menu

Assign Stores a program in the pump’s memory for later use.

Review/Recall Reviews assigned protocols from the RUN or STOP mode. It also recalls an assigned protocol from the STOP mode.

Delete Deletes protocols from the pump’s memory.

Follow the steps in the following table to assign a speed protocol:

Assign a Speed Protocol

Enter the desired program and review it. (Refer to the appropriate programming module.)

Press Options Menu and Select SPEED PROTOCOL.

Select ASSIGN from the Speed Protocol Menu.

Press the numeric key ([1] to [9]) where the new protocol is to be assigned.

If the selected speed protocol is already assigned, the display reads REPLACE PROTOCOL ASSIGNMENT?Press [YES/ENTER] to replace the protocol or [NO] to keep the existing protocol.

Follow the steps in the following table to review/recall a speed protocol:

Review/Recall a Speed Protocol

Select SPEED PROTOCOL from the Options Menu.

Press Speed Protocol Select REVIEW/RECALL.

Select the desired protocol to review/recall.

Review the program by scrolling down with the key.

When review is complete, press [YES/ENTER].

If the pump is in the STOP mode, select [1] to recall the protocol or [2] to review another protocol.

If the pump is in the RUN mode, it exits the Options Menu.

Next Dose

This function is only available when the current therapy is Intermittent and the pump is not delivering a dose.To set the time for the next dose:

Press [OPTIONS] and select NEXT DOSE.

Use the number keys to enter the start time for the next dose. Press [YES/ENTER] to accept the change and exit OPTIONS.

GemStar Menu Functions

GemStar® Certification Program B-13

Connecting to theData Port

Equipment Required

Configuration Settings

Connecting to thePrinter

Tip: When entering the time in 12-hour format, press or to togglebetween AM and PM.

Follow the steps in the following table to delete a speed protocol:

Delete a Speed Protocol

Select DELETE from the Speed Protocol Menu.

Select the desired protocol to delete.

Press [YES/ENTER] to confirm deletion or [NO] to exit OPTIONS without deleting.

The Data Port may be used to connect the GemStar pump to a Seiko® DPU414 or compatible serial printer to print theOperation Test results or the files available from the Print Menu. The Data Port may also be used to transfer the files to a computer.

WARNING: Be sure to disconnect the pump from the patient BEFORE connecting the pump to a printer or a computer.

You will need the following to use the Data Port:■ Abbott GemStar pump■ Abbott serial printer cable (List 13078-01)■ Seiko DPU414 or compatible serial printer (List 40017-01)■ Serial DB9 female-to-female gender changer*■ Null modem*■ Computer*

*Available from local sources.

Refer to the System Operating Manual for information on configuration settings (List #13000-67).

TIP: A one-time only set-up procedure is required when using a Seiko printer or your PC.Following initial set-up, connecting to either the printer or a PC is simple.

To connect to the printer, perform the steps in the following table:

Connecting to the Printer

Connect the serial printer cable to the printer and to the data port on the bottom of the pump (Figure B-1).

Ensure the printer is online and ready to receive data. Refer to printer documentation for more information.

Ensure paper is loaded in the printer.

Select the desired print function from the Print Menu.

GemStar Menu Functions

B-14 GemStar® Certification Program

Connecting to a Computer

To connect to a computer, perform the steps in the following table (Refer to Figure B-2):

Connecting to a Computer

Connect the serial printer cable to the null modem (A).

Connect the null modem to the serial gender changer (B).

Connect the serial gender changer to the serial port of the computer (C).

Connect the serial printer cable to the data port on the bottom of the pump (D).

Configure the communications software on the computer. Refer to computer documentation for more information.

TIP: After the data transfer is complete, the file may be viewed or printed using any text editor. (Word, NotePad, Windows, or add-on package)

NOTE: For maximum battery life, operate the pump on AC mains when connected to a printer or computer.

WARNING: Disconnect the pump from the patient BEFORE connecting it to a printer or a computer.

CAUTION: Do not connect the GemStar AC mains adapter to a printer.

1. What are the three basic GemStar menus?A. Pain Management MenuB. Programming MenuC. Change MenuD. Options MenuE. B, C, and D

2. TRUE/FALSE: In the space provided, indicate whether the following are true or false.A. Line 4 of the display screen usually contains instructions. _______B. If two lock levels are applied at the same time, the less stringent lock restrictions take precedence._______C. A menu item does not need to be displayed to be accessed. If you know the number, you can simply press

it._____D. The Programming Menu is used to display current program settings. _______E. The air-in-line alarm is automatically set to OFF in the mL/hr and Weight Dosed therapies. _______F. The pump alarm will sound if the distal pressure is greater than the selected occlusion sensor limit. _______G. The occlusion sensitivity is changed via the Options Menu. _______H. The NEXT DOSE option displays only when a Pain Management therapy has been programmed. _______I. The GemStar pump should be disconnected from the patient BEFORE connecting it to a printer or computer.

_______J. Proximal occlusion pressure is -4psig and cannot be changed. _______

3. Which of the following can be displayed via the Histories Menu?A. Shift TotalsB. Volume Totals (Current container)C. Bolus History (48 hour)D. ConfigurationE. All of these can be displayed via the Histories Menu.

4. To scroll through the history displays faster, you can:A. Press and hold the [OPTIONS] key on the keypad.B. Press and hold the [HELP] key on the keypad.C. Press and hold the or keys on the keypad.D. Press and hold the cassette release button on the top of the pump.

5. Which of the following selections on the Histories Menu will show you the time and datewhen a shift was cleared?A. Shift TotalsB. ConfigurationC. Operation TestD. Print

GemStar Menu Functions

GemStar® Certification Program B-15

Study Questions

GemStar Menu Functions

B-16 GemStar® Certification Program

6. The Bolus History is cleared when:A. A new program is entered.B. A speed protocol is recalled.C. The history is cleared.D. All of the above.

7. Which of the following functions are available when the GemStar is in FULL Lock mode?A. [START] or [STOP] infusion.B. [SILENCE] an alarm.C. Deliver a bolus, if programmed.D. Set air-in-line sensitivity.E. None of these functions are available in FULL Lock mode.

8. When the GemStar is locked, which of the following appears in the lower left corner of the display screen?A. The letter “L.”B. The lock letter abbreviation.C. A small lock symbol.D. The lock sequence number for that level.

9. TRUE/FALSE: Assigning a speed protocol stores a program in the pump’s memory for later use.

10. The data port may be used to connect the GemStar to which of the following?A. An optional pole clampB. A PCC. A printerD. A fluid containerE. A and DF. B and CG. None of the above.

11. Which of the following is the highest pressure setting for distal occlusion?A. 7B. 12C. 18D. 26E. None of the above.

12. Which of the following is not one of the three air-in-line sensitivity levels that can be programmed on the GemStar?A. On (0.5mL)B. 5 mLC. OffD. 2 mLE. All of the above air-in-line sensitivity levels can be set depending on the therapy.

13. Which of the following Change Menu items repeats the current program after a new container is hung?A. Review/ResumeB. New ProgramC. New ContainerD. Change ProgramE. Piggybacking

14. Which main menu is used to lock and unlock the pump?A. Change MenuB. Program MenuC. Options MenuD. Operation Test Menu

15. What Options Menu selection allows you to change the air sensor, occlusion sensor, and sound level settings?A. Change MenuB. FUNCTIONC. SPEED PROTOCOLD. NEXT DOSEE. PRINTF. PUMP SETTINGS

GemStar Menu Functions

GemStar® Certification Program B-17

1. What are the three basic GemStar menus?E. B, C, and D

2. TRUE/FALSE: In the space provided, indicate whether the following are true or false.A. Line 4 of the display screen usually contains instructions. TRUEB. If two lock levels are applied at the same time, the less stringent lock restrictions take precedence. FALSEC. A menu item does not need to be displayed to be accessed. If you know the number, you can simply press it. TRUED. The Programming Menu is used to display current program settings. FALSEE. The air-in-line alarm is automatically set to OFF in the mL/hr and Weight Dosed therapies. FALSEF. The pump alarm will sound if the distal pressure is greater than the selected occlusion sensor limit. TRUEG. The occlusion sensitivity is changed via the Options Menu. TRUEH. The NEXT DOSE option displays only when a Pain Management therapy has been programmed. FALSEI. The GemStar pump should be disconnected from the patient BEFORE connecting it to a printer or computer. TRUEJ. Proximal occlusion pressure is -4psig and cannot be changed. TRUE

3. Which of the following can be displayed via the Histories Menu?E. All of these can be displayed via the Histories Menu.

4. To scroll through the history displays faster, you can:C. Press and hold the or keys on the keypad.

5. Which of the following selections on the Histories Menu will show you the time and datewhen a shift was cleared?A. Shift Totals

6. The Bolus History is cleared when:D. All of the above.

7. Which of the following functions are available when the GemStar is in FULL Lock?A, B, C, E

8. When the GemStar is locked, which of the following appears in the lower left corner of the display screen?C. A small lock symbol.

9. TRUE/FALSE: Assigning a speed protocol stores a program in the pump’s memory for later use.TRUE

10. The data port may be used to connect the GemStar to which of the following?F. B and C

11. Which of the following is the highest pressure setting for distal occlusion?D. 26

Study Answers

GemStar Menu Functions

GemStar® Certification Program B-19

12. Which of the following is not one of the three air-in-line sensitivity levels that can be programmed on the GemStar?B. 5 mL

13. Which of the following Change Menu items repeats the current program after a new container is hung?C. New Container

14. Which main menu is used to lock and unlock the pump?C. Options Menu

15. What Options Menu selection allows you to change the air sensor, occlusion sensor, and sound level settings?F. PUMP SETTINGS

GemStar Menu Functions

B-20 GemStar® Certification Program

TPN Program

GemStar® Certification Program C-1

TPN PROGRAM—MODULE C

Programming Tips . . . . . . . . . . . . . . . . . . . . . . .C-2

TPN Therapy Programming . . . . . . . . . . . . . . . . .C-3

TPN Programming Scenario . . . . . . . . . . . . . . . . .C-6

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .C-8

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .C-11

Objectives

When you complete this module, you will know how to:

■ Program and change TPN therapy;

■ Set an auto taper down in a TPN therapy;

■ Record and clear shift totals during TPN therapy; and

■ Hang a new container during TPN therapy.

TPN Program

C-2 GemStar® Certification Program

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Programming Tips

TPN Program

GemStar® Certification Program C-3

TPN TherapyProgramming

Total Parenteral Nutrition (TPN) therapy allows programming of a continuous rate with tapering. Key considerations for TPN therapy include:

■ Rate range is 1 to 1000 mL/hr.

■ Taper Up and Taper Down may be programmed to gradually increase and decrease the rate of delivery at the beginning and end of therapy.

■ Auto Taper Down can be accessed during infusion IF Auto Taper Down was originally programmed.

■ Optional KVO (1.0 – 5.0 mL/hr) may be set during programming.

■ If a number outside of the acceptable program range is entered, an error message displays the minimum or maximum value allowed.

Complete the steps in the following table to program a TPN therapy:

TPN Programming

Select TPN from the Programming Menu.

Select the TPN delivery type.

Enter the total TPN volume (VTBI).

Enter the Taper Up and Taper Down times.

Enter the total time to infuse.

Enter the KVO rate.

Enter the container size (VTBI + KVO), plus some overfill.If the KVO is programmed, you must increase the container size to accommodate the desired KVO volume.

Select the air-in-line sensitivity.

Review the program.

TPN Program

C-4 GemStar® Certification Program

Auto Taper Down

Changing a TPNProgram

The GemStar offers the Auto Taper Down option that is available if a Taper Down time was entered during programming. Itmay be activated when the continuous delivery portion of a TPN with Taper Down protocol is stopped.

Complete the steps in the following table to set Auto Taper Down.

Auto Taper Down

Press [STOP] during TPN delivery.

Press [YES/ENTER] to select Auto Taper Down.

Enter the Auto Taper Down time.Maximum Auto Taper Down time is either 3 hours or two times the remaining volume divided by the continuousdelivery rate, whichever is less.

Make the desired time change or press [YES/ENTER] to accept the current settings.

Return to the RUN mode.

Press [START].

The TPN program has the following parameters that can be changed only before [START] is pressed: ■ TPN volume■ Taper times■ Total TPN time

Parameters that can be changed at any time include:■ KVO rate■ Increase container size only■ Air-in-line sensitivity

Delivery type cannot be changed.

TIP: Auto Taper Down can be used if a patient needs to discontinue TPN therapy unexpectedly. This feature can minimize hypoglycemia.

TPN Program

GemStar® Certification Program C-5

Complete the steps in the following table to change the TPN program:

Changing a TPN Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes or press [YES/ENTER] to accept the current settings.

Review the program.

Press [START].

TIP: The program cannot be changed when the pump is in theFULL or NEW CONTAINER Lock.

TPN Program

C-6 GemStar® Certification Program

TPNProgramming

Scenario

The following is a hypothetical prescription to provide an example of programming a TPN therapy.

TPN With Taper: 2500 mL to infuse I.V. over 12 hours with a Taper Up time of 1 hour and a Taper Down time of 1 hour. KVO to infuse at 1 mL/hr after infusion until patient disconnects. The pharmacy prepares a container of 2550 mL, which includes overfill for priming.

TPN Programming Scenario

2500 mL

3 in 1 TPN

12 hour delivery

1 hour Taper Up, 1 hour Taper Down

1 mL KVO

Select TPN from Programming Menu.

Select the delivery type. Both Up and Down

Enter the total TPN volume. 2500 mL

Enter Taper Up time. 1:00

Enter Taper Down time. 1:00

Enter total time to infuse. 12:00

Enter the KVO rate. 1.0 mL/hr

Confirm the container size. 2550 mL

Select the air-in-line sensitivity. ON

Review the program.

TPN Program

GemStar® Certification Program C-7

Recording andClearing Shift Totals

Starting a NewContainer

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Continuous program. Perform the steps in the following table to record and clear shift totals when using theContinuous program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

NOTE: The program cannot be changed when the pump is in the FULL or CONTAINER Lock.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several seconds andthe amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order of the keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

TPN Program

C-8 GemStar® Certification Program

1. If an incorrect value is entered during programming, press __________ before pressing[YES/ENTER] to reset the value to zero.A. [NO]B. [HELP]C. [CHANGE]D. [BACK-UP]E.

2. TPN therapy allows:A. Delivery of mcg, mg, or mL/hr with selectable KVO option.B. Programming of the delivery rate in mL only.C. Administration of analgesics or anesthetics for patient-controlled analgesia.D. Programming of a delivery rate as a function of body weight.E. None of the above.

3. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]B. [START], [STOP], [CHANGE], [1]C. [1], [STOP], [START], [CHANGE]D. [STOP], [1], [CHANGE], [START]

4. The NEW CONTAINER function is not available when the pump is in:A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD. FULL LockE. CONTAINER Lock

5. Which of the following is NOT TRUE of TPN therapy?A. Optional KVO (1.0 – 5.0 mL/hr) may be set during programming.B. Auto Taper Down cannot be accessed during infusion.C. If a number outside the acceptable program range is entered, an error message displays the minimum or maxi-

mum value allowed.D. The rate range is 1.0 to 1000 mL/hr.E. All of the above are true of TPN therapy.

6. If KVO is programmed during TPN therapy, the ___________ is increased to accommodateKVO delivery.A. Air-in-line sensitivityB. Infusion rateC. Container sizeD. Bolus size

Study Questions

TPN Program

GemStar® Certification Program C-9

7. TRUE/FALSE: In TPN therapy, it is common practice to turn on the air-in-line alarm ratherthan use an air-eliminating filter.

8. Auto Taper Down can be used if a patient needs to discontinue TPN therapy unexpectedly.This feature minimizes:A. ShockB. HypoglycemiaC. HyperglycemiaD. Severe blood pressure changesE. Rate changes

9. Which of the following TPN parameters cannot be changed?A. KVO rateB. TPN volumeC. Taper timesD. Delivery type

TPN Program

GemStar® Certification Program C-11

1. If an incorrect value is entered during programming, press __________ before pressing[YES/ENTER] to reset the value to zero.C. [CHANGE]

2. TPN therapy allows:E. None of the above.

3. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]

4. The NEW CONTAINER function is not available when the pump is in:D. FULL Lock

5. Which of the following is NOT TRUE of TPN therapy?B. Auto Taper Down cannot be accessed during infusion.

6. If KVO is programmed during TPN therapy, the ___________ is increased to accommodateKVO delivery.C. Container size

7. TRUE/FALSE: In TPN therapy, it is common practice to turn on the air-in-line alarm ratherthan use an air-eliminating filter.FALSE

8. Auto Taper Down can be used if a patient needs to discontinue TPN therapy unexpectedly.This feature minimizes: B. Hypoglycemia

9. Which of the following TPN parameters cannot be changed?D. Delivery type

Study Answers

Pain Management Program

GemStar® Certification Program D-1

PAIN MANAGEMENT PROGRAM—MODULE D

Programming Tips . . . . . . . . . . . . . . . . . . . . . . .D-2

Pain Management Therapy Programming . . . . . . . .D-3

Pain Management Programming Scenario . . . . . . .D-7

Study Questions . . . . . . . . . . . . . . . . . . . . . . .D-10

Study Answers . . . . . . . . . . . . . . . . . . . . . . . .D-13

Objectives

When you complete this module, you will know how to:

■ Program and change a Pain Management therapy;

■ Deliver a bolus using the bolus button on top of the device or the optional bolus delivery cord;

■ Program and deliver a clinician activated loading dose; and

■ Record and clear shift totals during Pain Management therapy.

Pain Management Program

D-2 GemStar® Certification Program

Programming Tips Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Key Function Key Function

[0]-[9] Selects menu items and enters Scrolls through program review and numeric values. help messages. The up arrow inserts

a decimal point in a numeric value.The down arrow toggles units of mea-sure when entering concentrations.

Accepts entries or continues when Clears numeric value (reset to zero)done viewing a display. during programming.

Displays information during Returns to a previous display, exits programming and alarm conditions. the Options Menu, and exits the

HELP mode.

Pain Management Program

GemStar® Certification Program D-3

Pain ManagementTherapyProgramming

The Pain Management therapy provides administration of analgesics or anesthetics for patient-controlled analgesia. It allows for:■ Continuous only delivery■ Bolus only delivery■ Continuous + bolus delivery

Key considerations for Pain Management therapy include:■ Rate range 0.1 to 25 mL/hr.■ A loading dose may be set during programming, which can be delivered after programming and priming are complete.

The default loading dose rate is 125 mL/hr.■ The default bolus delivery rate is 125 mL/hr (or equivalent mg/hr or mcg/hr).■ A clinician activated bolus can be given at any time.■ In Continuous + Bolus protocols, you can enter zero for either the continuous rate or the bolus dose when entering or

changing a program. The continuous rate and the bolus dose cannot be zero at the same time.■ If a number outside of the acceptable program range is entered, an error message displays the minimum or maximum

value allowed.■ Priming using [PURGE] is only allowed before [START] is pressed or after one of the following events occur:

– Complete Review of New Program– New Container– Air-in-Line Alarm

TIP: The GemStar will round values to the nearest 0.1 mL. When a value is rounded, four quick beeps will sound and ROUNDING will appear briefly on the display. The rounded value will be displayed. For example, at a concentration of 15 mg/mL,a rate of 5 mg rounds to 4.5 mg.

5 mg = 0.333 mL (Rounds to 0.3 mL)0.3 mL = 4.5 mg

CAUTION: When using pre-filled vials, the system may underdeliver at low flow rates.

NOTE: New Container is allowed only when at least 1/2 of the container volume hasbeen infused or 1 hour has elapsed since starting the infusion.

Pain Management Program

D-4 GemStar® Certification Program

Dose Limit

Hard Limits

Bolus Delivery

Complete the steps in the following table to program a Pain Management therapy:

Pain Management Programming

Select PAIN MANAGEMENT from the Programming Menu.

NOTE: If the pump is configured as a Pain Management pump only, this step will not be displayed.Select the delivery type.

NOTE: If you select Continuous + Bolus, you can change the continuous delivery rate or bolusamount to zero through the Change Menu without reprogramming the pump. Both ofthese cannot be zero at the same time.

Select the unit of measure and concentration, as required.

Program the continuous delivery rate.

Program a loading dose, if ordered.

Program a bolus dose with lockout time and dose limit, if required.

If programmed in units of mcg or mg, mg flashes on the display. Enter the container size in mg or mL.

NOTE: In order to enter the total in mL when programming a concentration, press tomove to the mL line. Enter the mL value when mL flashes on the display.

Select the air-in-line sensitivity.

Review the program.

The 1-Hour or 4-Hour Dose Limit is the maximum volume (continuous + bolus) that may be delivered over the selected period. When the programmed dose limit is reached, continuous delivery stops and a new bolus is not allowed. As the oldest delivery amounts are removed from the Hour Dose Limit record, the pump accepts a bolus request or resumes continuous delivery (if programmed).

If a 1-Hour or 4-Hour Dose Limit is programmed, a bolus in progress will stop when the amount infused reaches the dose limit.

Loading doses are included in the Dose Limit volume, and a Dose Limit could prevent the delivery of a loading dose.

Bolus doses, bolus lockout time, and delivery limits are set during programming. An optional bolus cord is available forpatient bolus requests.

To deliver a bolus, press the bolus button on top of the pump or press the button on the end of the bolus cord. BOLUSDELIVERY will flash on the display when the bolus is delivering. The amount infused accrues as the delivery progresses.

NOTE:■ The pump records the bolus request and delivery amount in the Event and Bolus History Logs.■ The delivered bolus is added to the Total Bolus Amount in the program amounts.■ The pump resets the bolus lockout time; subsequent bolus requests are ignored until the lockout time has elapsed.■ The programmed infusion continues.

Pain Management Program

GemStar® Certification Program D-5

Loading DoseDelivery

TIP: If the bolus delivery does not begin, it may be locked out because:■ The pump is in the bolus lockout period.■ Loading dose delivery is in progress.■ Bolus dose delivery is in progress.■ The bolus per-hour limit has been exceeded.■ The 1-Hour or 4-Hour Dose Limit has been exceeded.

A Loading Dose is set during programming and can be delivered after programming and priming are complete. Loading Doseamounts are included in a 1-Hour or 4-Hour Dose Limit.

The clinician activated loading dose is a feature that is available only when the pump is unlocked or in THERAPY Lock.Complete the steps in the following table to program a clinician activated loading dose.

Program and Deliver a Clinician Activated Loading Dose

From the STOP mode, press [YES/ENTER] immediately followed by [0].The message PROGRAM A LOADING DOSE? appears on the display.

Press [YES/ENTER].

Enter the loading dose.

Press [YES/ENTER].The message DELIVER THE LOADING DOSE NOW? appears on the display.

If [YES/ENTER] is pressed, infusion DOES NOT begin automatically when the clinician activated loading dose is complete.Press [START] to resume infusion after the Loading Dose is complete.

Pain Management Program

D-6 GemStar® Certification Program

Changing a PainManagement

Program

The Pain Management program has several parameters that can be changed including:■ Delivery rate■ Bolus dose■ Container size■ Air-in-line sensitivity■ Dose limit time■ Bolus lock out

Parameters that cannot be changed include:■ Unit of measure■ Delivery type■ Concentration■ Dose limit type

TIP: If the facility uses protocols that vary from Bolus Only to Continuous + Bolus, then the recommended delivery type is Continuous + Bolus. The continuous rate or bolus amount may be set to zero. Both of these cannot be zero at the same time.

Complete the steps in the following table to change the Pain Management program:

Changing a Pain Management Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes. ORPress [YES/ENTER] to accept the current settings.

Review the program.

Press [START].

TIP: The program cannot be changed when the pump is in the FULL Lock or CONTAINER Lock. With a RATE CHANGE Lock, the continuous delivery rate and bolus amount can be changed within the set ranges.

Pain Management Program

GemStar® Certification Program D-7

Recording andClearing Shift Totals

Pain ManagementProgrammingScenario

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Pain Management program. Perform the steps in the following table to record and clear shift totals when usingthe Pain Management program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

The following is a hypothetical prescription to provide an example of programming a Pain Management therapy for ahospital application.

Hospital: A post-op patient has orders for PCA therapy. PCA concentration 1:1 morphine sulfate in a 30 mL prefilled vial.Pain management orders a continuous rate of 1.5 mL/hr with a PCA dose of 1 mL every 8 minutes. 4° lockout 30 mL.

Pain Management Program

Pain Management Programming Scenario

Morphine Sulfate: 30 mg in 30 mL of prefilled vial

Concentration: 1 mg/mL

Continuous Infusion Rate: 1.5 mg/hr

Bolus Dose: 1 mg

Lockout Interval: 8 minutes

Select PAIN MANAGEMENT from Programming Menu. Note: If pump is configured as a Pain Managementpump only, this step will not be displayed.

Select the delivery type. Continuous + bolus

Enter the unit of measure. mg/mL

Select CONCENTRATION. Press [ENTER]. 1 mg/mL

Set the continuous delivery rate. 1.5 mg/hrPress [ENTER].

Program the loading dose. [NO]

Program the bolus dose. 1 mg

Enter the lockout time. 8 minutes

Select a Dose Limit. Dose Limit: Choose 4 hour Limit (1).

Set 4-Hour Limit. 30 mg

Enter the container size. 30 mLPress and enter size when mL flashes.

Select the air-in-line sensitivity. ON (1)Press [ENTER].

Review the program.

Press [START].

Discontinue The Continuous Rate

Press [STOP].

Press [CHANGE].

Select [4] CHANGE PROGRAM.

Set rate to zero by pressing [0] or press [CHANGE].

Press [ENTER].

Review the program.

D-8 GemStar® Certification Program

Pain Management Program

GemStar® Certification Program D-9

Setting the Rate Change Lock Level

To lock in a rate change, press [OPTIONS].Press KEYPAD Lock [3].Press RATE CHANGE Lock [1].Set Rate Range:Minimum (8 mg) Max (12 mg)Press [ENTER].

Set Bolus Range:Minimum (3 mg) Maximum (5 mg)Press [ENTER].

Enter Lock Sequence: 13000

TIP: When the pump is locked, a small lock symbol appears in the lower left corner of the display along with the lock level abbreviation in the lower right corner.

Complete the following steps to unlock the pump:

Unlocking the Pump

Select KEYPAD LOCK from Options Menu.

Select the lock level from the Keypad Lock Menu.

Enter the lock sequence number for that level.

(For UNLOCKED, FULL, NEW CONTAINER, and RATE CHANGE Locks, the lock sequence is 13000.)

Pain Management Program

D-10 GemStar® Certification Program

1. After the pump has been programmed, __________ functions like an “ESCAPE” key to exitthe Options, Help, and Histories menus.A. [YES/ENTER]B. [BACK-UP]C. [SILENCE]D. [HELP]E. [OPTIONS]

2. Pain Management therapy allows:A. Delivery of mcg, mg, or mL/hr with selectable KVO option.B. Programming of the delivery rate in mL only.C. Administration of analgesics or anesthetics for patient-controlled analgesia.D. Programming of a delivery rate as a function of body weight.E. None of the above.

3. Which of the following are types of Pain Management delivery?A. Continuous + Bolus deliveryB. Continuous Only deliveryC. Bolus Only deliveryD. All of the above.

4. Which of the following is NOT TRUE of the Pain Management therapy?A. If a number outside the acceptable program range is entered, an error message displays the minimum and maxi-

mum values allowed.B. Piggybacking is available.C. A clinician activated bolus dose can be given at any time.D. The rate range is 0.1 to 25 mL/hr.E. All of the above are true of Pain Management therapy.

5. The GemStar will round values to the nearest ___________ mL.A. 0.1B. 1.0C. 0.5D. 10

6. TRUE/FALSE: A loading dose may be set during programming. It can be delivered after programming and priming are complete.

7. What is the default bolus delivery rate in a Pain Management therapy?A. 90 mL/hrB. 10 mL/hrC. 125 mL/hrD. 12.5 mL/hrE. 1.0 mL/hr

Study Questions

Pain Management Program

GemStar® Certification Program D-11

8. If you select _____________ , you can change the continuous delivery rate or bolus rate tozero via the Change Menu without reprogramming the pump.A. Continuous onlyB. Bolus onlyC. Continuous + BolusD. Placebo + Bolus

9. TRUE/FALSE: If the pump is configured as a Pain Management pump only, you still mustselect PAIN MANAGEMENT from the Programming Menu.

10. In order to enter the total mL when programming in units of delivery, press ________ tomove to the mL line. Enter the mL value when mL flashes on the display.A.B.C. [CHANGE]D. [OPTIONS]

11. The 1-Hour or 4-Hour Dose Limit is the:A. Minimum volume (continuous + bolus) that may be delivered over the selected period.B. Maximum volume (continuous + bolus) that may be delivered over the selected period.C. Minimum volume (bolus only) that may be delivered over the selected period.D. Maximum volume (continuous only) that may be delivered over the selected period.

12. The pump records a bolus request and delivery amount in the:A. Event and Bolus History LogsB. Shift totalsC. Options MenuD. Program settings

13. If the bolus delivery does not begin, it may be locked out because:A. The pump is in the bolus lockout period.B. Loading dose delivery is in progress.C. Bolus dose delivery is in progress.D. The bolus-per-hour limit has been exceeded.E. The 1-Hour or 4-Hour Dose Limit has been exceeded.F. All of the above.

14. TRUE/FALSE: Loading dose amounts are included in a 1-Hour or 4-Hour Dose Limit.

15. The clinician activated loading dose is a feature that is available only when the pump isunlocked or in ________ Lock.A. KEYPADB. THERAPYC. PROGRAMD. FULLE. NEW CONTAINER

Pain Management Program

D-12 GemStar® Certification Program

16. TRUE/FALSE: Infusion begins automatically when the clinician activated loading dose is complete.

17. When changing a current program, which of the following parameters can be changed in Pain Management?A. Delivery rateB. Bolus doseC. Container sizeD. ConcentrationE. A, B, and CF. All of the above.

18. In the RATE CHANGE Lock level, which of the following can be changed:A. Continuous delivery rateB. Bolus lock outC. Bolus rateD. Container sizeE. A and CF. B and D

19. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using a Pain Management therapy.A. VTBI volumesB. Shift totalsC. Delivery ratesD. Pump settingsE. Options

20. Cleared shift totals are recorded and stored in the ______ where they can be reviewed.A. History Event LogB. Menu LogC. Lincoln LogD. Media Event LogE. None of the above.

21. Which of the following is the correct way to display shift totals:A. Press the [CHANGE] key.B. Press the [HELP] key and press until CLEAR? is displayed.C. Press [ON/OFF].D. Press [OPTIONS] and press until CLEAR? is displayed.

Pain Management Program

GemStar® Certification Program D-13

1. After the pump has been programmed, __________ functions like an “ESCAPE” key to exitthe Options, Help, and Histories menus.B. [BACK-UP]

2. Pain Management therapy allows:C. Administration of analgesics or anesthetics for patient-controlled analgesia.

3. Which of the following are types of Pain Management delivery?D. All of the above.

4. Which of the following is NOT TRUE of the Pain Management therapy?B. Piggybacking is available.

5. The GemStar will round values to the nearest ___________ mL.A. 0.1

6. TRUE/FALSE: A loading dose may be set during programming. It can be delivered after programming and priming are complete.TRUE

7. What is the default bolus delivery rate in a Pain Management therapy?C. 125 mL/hr

8. If you select _____________ , you can change the continuous delivery rate or bolus rate tozero via the Change Menu without reprogramming the pump.C. Continuous + Bolus

9. TRUE/FALSE: If the pump is configured as a Pain Management pump only, you still mustselect PAIN MANAGEMENT from the Programming Menu.FALSE

10. In order to enter the total mL when programming in units of delivery, press ________ tomove to the mL line. Enter the mL value when mL flashes on the display.B.

11. The 1-Hour or 4-Hour Dose Limit is the:B. Maximum volume (continuous + bolus) that may be delivered over the selected period.

12. The pump records a bolus request and delivery amount in the:A. Event and Bolus History Logs

13. If the bolus delivery does not begin, it may be locked out because:F. All of the above

14. TRUE/FALSE: Loading dose amounts are included in a 1-Hour or 4-Hour Dose Limit.FALSE

Study Answers

Pain Management Program

D-14 GemStar® Certification Program

15. The clinician activated loading dose is a feature that is available only when the pump isunlocked or in ________ Lock.B. THERAPY

16. TRUE/FALSE: Infusion begins automatically when the clinician activated loading dose is complete.FALSE

17. When changing a current program, which of the following parameters can be changed in Pain Management?E. A, B, and C

18. In the RATE CHANGE Lock level, which of the following can be changed:E. A and C

19. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using an mL/hr therapy.B. Shift totals

20. Cleared shift totals are recorded and stored in the ______ where they can be reviewed.A. History Event Log

21. Which of the following is the correct way to display shift totals:B. Press the [HELP] key and press until CLEAR? is displayed.

Intermittent Program

GemStar® Certification Program E-1

INTERMITTENT PROGRAM—MODULE E

Programming Tips . . . . . . . . . . . . . . . . . . . . . . . .E-2

Intermittent Therapy Programming . . . . . . . . . . . . .E-2

Intermittent Programming Scenario . . . . . . . . . . . . .E-9

TIPs for Intermittent Programming . . . . . . . . . . . . .E-10

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .E-11

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .E-13

Objectives

When you complete this module, you will know how to:

■ Program and change Intermittent therapy;

■ Record and clear shift totals during Intermittent therapy;

■ Hang a new container during Intermittent therapy; and

■ Program a delayed start time for Intermittent therapy.

Intermittent Program

E-2 GemStar® Certification Program

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Intermittent therapy allows you to program multiple doses at regular intervals. It is desirable for optimal effectiveness of certain therapies such as antibiotics. Key considerations for Intermittent therapy include:

■ The pump can be programmed to deliver the first dose at a later time (delayed start time).■ KVO will deliver prior to the programmed, delayed start time.■ Rate range is 0.1 to 1000 mL/hr.■ If a number outside of the acceptable program range is entered, an error message displays the minimum or maximum

value allowed.■ Optional KVO (0.1 – 5.0 mL/hr) may be set during programming.■ The pump may be disconnected from the patient between dose deliveries. A call-back alarm can be set to alert the

patient or caregiver to reconnect the pump before the next scheduled delivery begins. The pump must remain on for the call-back alarm to function.

■ For delayed start when time is entered, use arrow key to change am/pm.

TIP: Be sure to increase the container size to include the KVO amount before the first dose is delivered and add enough overfill to accommodate priming and purging air.

Programming Tips

Intermittent TherapyProgramming

Intermittent Program

GemStar® Certification Program E-3

Complete the steps in the following table to program an Intermittent therapy:

Intermittent Therapy Programming

Select INTERMITTENT from the Programming Menu.

Enter the dose amount.

Set the infusion time for each dose.

Set the frequency of dose deliveries.

Enter the total number of doses in the container.

Enter the KVO rate.

NOTE: KVO delivers before a delayed start time, between doses, and after the last doseuntil the entire programmed container size is reached.

Enter the desired container size.

NOTE: The pump automatically calculates the minimum container size required to deliver the number of programmed doses and KVO between doses. Add 10 – 15 mL overfill for purging in the event of an air-in-line alarm and priming the pump before the first dose.

Select the air-in-line sensitivity.

Request a call-back alarm or press [NO] if a call-back alarm is not desired.

NOTE: Allow sufficient time for the patient or caregiver to reconnect the pump and to press [START] before the scheduled dose start time.

Confirm the time is correct or press [OPTIONS] to change the clock.

The pump will display the message START NOW? Set a delayed start time or press [YES/ENTER] to set the delivery to begin when the pump enters the RUN mode.

Review the program.

The pump will automatically alarm until you push the Start Key.

Intermittent Program

E-4 GemStar® Certification Program

The pump may be disconnected from the patient between dose deliveries. The call-back alarm can be set to alert thepatient or caregiver to reconnect the pump before the next scheduled delivery begins. At the set time before each dose, the alarm sounds, START flashes on the display, and the alarm LED flashes.

The call-back alarm works only when the pump is on and in the STOP mode. If the call-back alarm has been set, the pump should not be turned off while it is disconnected from the patient.

Complete the steps in the following table to use a delayed start without specifying a start time.

Delayed Start Without Specifying a Start Time

At step 11 in the programming procedure (Table D-2), press [YES/ENTER]. START NOW displays.

Complete the program review.

Turn off the pump.

When the pump is powered on again, complete the program review and press [START] to begin.

TIP: When interruptions occur prior to or during an Intermittent delivery dose, subsequent doses are typically shifted to maintain the desired delivery intervals. In some cases, the delivery times may need to be reprogrammed by selecting NEXT DOSE in the Options Menu.

The Next Dose option allows you to change the start time of the next dose. This function is available only in theIntermittent mode and only when the pump currently is not delivering a dose. To access the Next Dose function, select NEXT DOSE from the Options Menu. Use the number keys to enter the start time for the next dose. Press [YES/ENTER] to accept the change and exit the Options Menu.

TIP: The NEXT DOSE option displays only when an Intermittent therapy has been programmed.

Call-Back Alarm

Delayed Start

Next Dose

Intermittent Program

GemStar® Certification Program E-5

Interruptions in the Intermittent delivery will occur if a start time is missed. Situations that can cause the start time of theIntermittent therapy to be missed, and solutions to take, are as follows:

Situation Solution

The programmed start time is missed. It can be changed by selecting NEXT DOSE from the Options Menu.

The pump remains in the STOP mode and the first Press [START] to begin delivery immediately and dose is missed. all subsequent doses will be shifted.

The pump is programmed with a delayed start time but is Select NEXT DOSE from the Options Menu and change turned off. The pump will skip to the next occurrence of the start time.the programmed start time. For example, if the first dose is programmed to start at 10 a.m. and the pump is turned on at 12 p.m., the pump will wait until the next day.

TIP: If the first dose is missed when the pump is off, the NEXT DOSE function is still available.

Interruptions

Intermittent Program

E-6 GemStar® Certification Program

Dose Interruptions

Figure E-1Normal Intermittent

Delivery

Figure E-2Interruption of

Intermittent Delivery

Figure E-3Interruption of

Intermittent Delivery

The pump will resolve interruptions that occur. The following figure illustrates a normal Intermittent delivery given every fourhours over 12 hours.

If an Intermittent dose is interrupted and the pump is placed in the RUN mode during the on or off cycle of the currentdose, the dose delivery continues from the point where it was interrupted, and all subsequent doses are shifted. The following figure illustrates this.

If an Intermittent dose is interrupted and the pump is placed in the RUN mode after the off cycle of the current dose, the next dose begins delivery and all subsequent doses are shifted, if necessary. The following figure illustrates this.

When the dose is complete, the start time for the next dose displays. To change the start time, access the Options Menuand select NEXT DOSE.

Any missed Intermittent doses, except for the first dose, are added to the end of the delivery schedule.

Intermittent Program

GemStar® Certification Program E-7

The Intermittent program has several parameters that can be changed including:■ Dose amount■ KVO rate■ Container size■ Air-in-line sensitivity■ Call-back alarm

The current time cannot be changed after the [START] key is pressed.

TIP: After the [START] key has been pressed, the start time can only be changed by selecting NEXT DOSE from the Options Menu.

Follow the steps in the table below to change the Intermittent program:

Changing an Intermittent Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes. OR Press [YES/ENTER] to accept the current settings.

Review the program.

Press [START].

TIP: The program cannot be changed when the pump is in the FULL Lock or the NEW CONTAINER Lock.

Changing anIntermittent Program

Intermittent Program

E-8 GemStar® Certification Program

Recording andClearing Shift Totals

Starting a NewContainer

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Intermittent program. Perform the steps in the following table to record and clear shift totals when using the Intermittent program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or an alarm condition.ORPress [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can bereviewed there.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several seconds and the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order of the keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

Intermittent Program

GemStar® Certification Program E-9

IntermittentProgramming Scenario

The following is a hypothetical prescription to provide an example of programming an Intermittent therapy.■ Infuse Nafcillin 2 gm in 50 mL I.V. over 30 minutes every 4 hours. KVO at a rate of 0.4 mL/hr in between doses. ■ The pharmacy prepares a 325 mL container of normal saline containing 6 doses (24-hour supply),

plus overfill for KVO and priming.

Intermittent Programming Scenario

Nafcillin 13 gm in 325 mL

Infuse Nafcillin 50 mL (2 gm) I.V. over 30 minutes every 4 hours

KVO 0.4 mL/hr

6 doses (24 hr supply) per 325 mL bag includes overfill

Select INTERMITTENT from the Programming Menu.

Enter the dose amount. 50 mL

Set the infusion time for each dose. 30 min

Set the frequency of dose deliveries. 400 (4 hrs and 0 min)

Enter the total number of doses in the container. 6

Enter the KVO rate. 0.4 mL/hrNOTE: KVO delivers before a delayed start time, between doses,

and after the last dose until the total container is infused.

Enter the desired container size. 325 mLNOTE: The pump automatically calculates the minimum container

size (308.4 mL) required to deliver the number of programmed doses and KVO between doses. 325 mL includes overfill for priming and purging.

Select the air-in-line sensitivity. 2NOTE: DO NOT press [ENTER] after selecting the air sensitivity.

If [ENTER] is accidentally pressed and a call back alarm is not desired, press [BACK-UP] to return to the beginning of step 9 and press [NO].

Pump displays CALLBACK ALARM? Press [NO].NOTE: If callback alarm is selected, allow enough time for the

patient or caregiver to reconnect the pump to the patient and to press [START] before the scheduled dose start time.

Confirm the time is correct or press [OPTIONS] to change the clock. Press [YES/ENTER].

Set a delayed start time or press [YES/ENTER] to set the delivery to begin when the pump enters the RUN mode.

Review the program.

Intermittent Program

E-10 GemStar® Certification Program

TIPs for IntermittentProgramming

TIP: When interruptions occur prior to or during an Intermittent delivery dose, subsequent doses are typically shifted to maintain the desired delivery intervals. In some cases, the delivery times may need to be reprogrammed by selecting NEXT DOSE in the Options Menu.

TIP: If the first dose is missed when the pump is off, the NEXT DOSE function is still available.

TIP: The start time can be changed prior to infusion by selecting NEXT DOSE from theOptions Menu. Once the [START] key has been pressed, the start time cannot be changed.

TIP: When placed in RUN mode, the pump begins delivery from the time started.

Intermittent Program

GemStar® Certification Program E-11

Study Questions1. Pressing the key during programming:A. Scrolls through multiple display screens.B. Toggles between a.m. and p.m. when in the CLOCK mode.C. Puts in the decimal point.D. All of the above.E. A and B only.

2. The pump automatically calculates the minimum container size required to deliver the numberof programmed doses and the KVO between doses. You should add __________ overfill forpurging in the event of an air-in-line alarm or priming the pump.A. 1 – 5 mLB. 10 – 15 mLC. 50 – 100 mLD. 100 – 150 mL

3. Which of the following is TRUE of the Intermittent therapy?A. Optional KVO (0.1 – 5.0 mL/hr) may be set during programming.B. The pump may be disconnected from the patient between dose deliveries.C. The pump can be programmed to deliver the first dose at a later time (delayed start time).D. The rate range is 0.1 to 1000 mL/hr.E. All of the above are true of Intermittent therapy.

4. TRUE/FALSE: KVO will deliver prior to the programmed, delayed infusion start time.

5. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]B. [START], [STOP], [CHANGE], [1]C. [1], [STOP], [START], [CHANGE]D. [STOP], [1], [CHANGE], [START]

6. The NEW CONTAINER function is not available when the pump is in:A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD FULL LockE. NEW CONTAINER Lock

Intermittent Program

E-12 GemStar® Certification Program

7. The call-back alarm works only when the pump is on and in the:A. START modeB. PLACEBO modeC. PROGRAM modeD. RUN modeE. STOP mode

8. TRUE/FALSE: A call-back alarm will not sound if a KVO has been programmed.

9. Which of the following is NOT a situation that can result in the interruption of an Intermittent therapy start time?A. The pump is on and in the START mode.B. The programmed start time is missed.C. The pump remains in the STOP mode and the first dose is missed.D. The pump is programmed with a delayed start time but is turned off.

10. Which of the following parameters cannot be changed after [START] is pressed in an Intermittent therapy?A. Dose amountB. Container sizeC. Current timeD. Air-in-line sensitivityE. Call-back alarm

11. TRUE/FALSE: After the [START] key has been pressed, the start time can only be changed byselecting NEXT DOSE from the Options Menu.

Intermittent Program

GemStar® Certification Program E-13

1. Pressing the key during programming:C. Puts in the decimal point.

2. The pump automatically calculates the minimum container size required to deliver the numberof programmed doses and the KVO between doses. You should add __________ overfill forpurging in the event of an air-in-line alarm or priming the pump.B. 10 – 15 mL

3. Which of the following is TRUE of the Intermittent therapy?E. All of the above are true of Intermittent therapy.

4. TRUE/FALSE: KVO will deliver prior to the programmed, delayed infusion start time.TRUE

5. A quick and easy way to remember the steps for starting a new container on the GemStar pump is:A. [STOP], [CHANGE], [1], [START]

6. The NEW CONTAINER function is not available when the pump is in:D. FULL Lock

7. The call-back alarm works only when the pump is on and in the:E. STOP mode

8. TRUE/FALSE: A call-back alarm will not sound if a KVO has been programmed.FALSE

9. Which of the following is NOT a situation that can result in the interruption of anIntermittent therapy start time?A. The pump is on and in the START mode.

10. Which of the following parameters cannot be changed after [START] is pressed in anIntermittent therapy?C. Current time

11. TRUE/FALSE: After the [START] key has been pressed, the start time can only be changed by selecting NEXT DOSE from the Options Menu.TRUE

Study Answers

Continuous Program

GemStar® Certification Program F-1

CONTINUOUS PROGRAM—MODULE F

Programming Tips . . . . . . . . . . . . . . . . . . . . . . . .F-2

Continuous Therapy Programming . . . . . . . . . . . . .F-3

Continuous Programming Scenario . . . . . . . . . . . .F-8

Study Questions . . . . . . . . . . . . . . . . . . . . . . . . .F-9

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .F-11

Objectives

When you complete this module, you will know how to:

■ Program and change TPN and Continuous therapy;

■ Perform rate titration during Continuous infusion;

■ Record and clear shift totals during Continuous therapy;

■ Hang a new container during Continuous therapy; and

■ Perform a secondary delivery (piggybacking) during Continuous therapy.

Continuous Program

F-2 GemStar® Certification Program

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Programming Tips

Continuous Program

GemStar® Certification Program F-3

ContinuousTherapyProgramming

Rate Titration

Continuous infusion allows for delivery of mg, mcg, or mL/hr with selectable KVO option. Key considerations for continuous infusion include:

■ Rate range is 0.1 to 1000 mL/hr.

■ The rate can be titrated while the pump is infusing.

■ Optional KVO (0.1 – 5.0 mL/hr) may be set during programming.

■ An optional secondary medication can be delivered with a secondary administration set.

■ If a number outside of the acceptable program range is entered, an error message displays the minimum or maximum value allowed.

Complete the steps in the following table to program a Continuous therapy:

Continuous Therapy Programming

Select CONTINUOUS from the Programming Menu.

Select the unit of measure and the concentration as required.

Enter the rate.

Enter the VTBI.

Enter the KVO rate.KVO runs after the programmed VTBI until the total container is infused.

Enter the container size.If KVO is programmed, the container size is increased to accommodate the KVO delivery. To enter the total in mL when programming a concentration, press to move to the mL line and enter the container size.

Select the air-in-line sensitivity.

Review the program.

The Continuous therapy rate can be titrated while the pump is infusing.

Perform the following steps to titrate the rate during infusion:

Titrating During Infusion

Begin with the pump in RUN mode.

Press the numeric keys corresponding to the new rate.

Press [YES/ENTER] when the new rate flashes on the display.

Press [YES/ENTER] when the new rate is displayed to accept the rate and begin delivery or press [NO] to continuedelivery at the programmed rate.

Continuous Program

F-4 GemStar® Certification Program

Secondary delivery (piggybacking) is available with Continuous infusion. In order to piggyback with the GemStar, ensure the following conditions are met.■ The fluids being administered must be chemically and physically compatible.■ GemStar Primary Piggyback Set with a proximal Y-site backcheck valve and an Abbott Secondary Administration Set

with an extension hook must be used.■ During the infusion, the secondary container must be higher than the primary container.

TIP: After pressing a numeric key, the decimal key or [YES/ENTER] must be pressedwithin approximately five seconds. If a key is not pressed within five seconds, the rate does not change and the delivery continues as originally programmed.

TIP: The piggyback rate and piggyback VTBI display until the secondary container has been delivered. The primary delivery then resumes automatically.

The piggyback infusion amount is NOT added to the primary programmed infusion amount.

Complete the steps in the following table to prepare a piggyback delivery:

Preparation for Piggyback Delivery

Prepare the primary piggyback set with a primary Y-site backcheck valve.

Suspend the primary container from the I.V. pole, using the extension hook. (A)

Prepare the secondary administration set according to package instructions.

Attach a needle or a blunt cannula (as appropriate) and prime the secondary administration set.

Close the secondary clamp and suspend the secondary container from the I.V. pole. (B)

Connect the secondary set to the proximal Y-injection site or proximal port using aseptic technique. (C)

Program piggyback delivery and open the clamp.

In order to distinguish between piggyback and primary delivery, PIGGYBACK appears in the display window and the piggyback VTBI counts down to completion.

TIP: When using a secondary container of 500 mL or greater, ensure the bottom of the secondary container is at least 7 inches above the fluid level in the primary container. Use additional extension hooks if necessary.

Piggybacking

Continuous Program

GemStar® Certification Program F-5

Complete the steps in the following table to program the pump for piggyback delivery:

Programming for Piggyback Delivery

Press [CHANGE] to access the Change Menu.

Select PIGGYBACKING from the Change Menu.

Enter the dose amount for the secondary container.

Enter the infusion time for the secondary container.

Press [YES/ENTER] to begin piggyback delivery.

Primary flow stops until the secondary container empties. Then primary flow automatically resumes. Any remaining secondary fluid will be delivered at the primary rate. The maximum piggyback rate is 300 mL/hr. For secondary ratesabove 300 mL/hr, flow may occur from the primary container.

Complete the steps in the following table to cancel a piggyback delivery:

Canceling a Piggyback Delivery

Press [CHANGE].

Select PIGGYBACKING.

Press [CHANGE] to reset the dose amount to zero.

Press [YES/ENTER] to cancel piggyback delivery.

Complete the steps in the following table to change a piggyback delivery:

Changing a Piggyback Delivery

Press [CHANGE].

Select PIGGYBACKING.

Press [CHANGE] to reset the dose amount to zero.

Enter the new piggyback dose amount and press [YES/ENTER].

Set the infusion time for the secondary container.

Press [YES/ENTER] to begin piggyback delivery.

The amount that has already been delivered must be known. When the piggyback dose amount is changed, the pumpbegins a new VTBI countdown.

Continuous Program

F-6 GemStar® Certification Program

The Continuous program has several parameters that can be changed including:■ Delivery rate■ Container size■ Piggybacking

Complete the steps in the following table to change a Continuous program:

Changing a Continuous Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes or press [YES/ENTER] to accept the current settings.

Press [START].

TIP: The program cannot be changed when the pump is in the FULL or CONTAINER Lock.

Changing a ContinuousProgram

Continuous Program

GemStar® Certification Program F-7

Recording andClearing Shift Totals

Starting a NewContainer

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Continuous program. Perform the steps in the following table to record and clear shift totals when using theContinuous program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

NOTE: The program cannot be changed when the pump is in the FULL or CONTAINER Lock.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 2) from the Change Menu. NEW CONTAINER displays for several secondsand the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order of the keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).

[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

Continuous Program

F-8 GemStar® Certification Program

ContinuousProgramming

Scenario

The following is a hypothetical prescription to provide an example of programming a Continuous therapy.

Continuous Programming Scenario

Delivery rate of 75 mL/hrSelect CONTINUOUS from Programming Menu.

Select the unit of measure. mL (3)

Set the rate. 75 mL/hr

Enter the VTBI. 1000 mL

Set the KVO rate. Press [YES/ENTER].

Enter the KVO rate. 1.0 mL/hr

Enter the container size. 1000 mL

Select the air-in-line sensitivity. 2 mL (2)

Review the program. Press the key.

Piggyback Scenario

A patient is receiving 1000 mL normal saline with 20 mEq of KCL for hydration at 74 mL/hr.

When the piggyback setup is complete, press [CHANGE].

Select PIGGYBACKING (option 5).

Set dose amount. 50 mL

Set infusion time. 30 min

Press [ENTER].

Piggyback begins immediately.

Continuous Program

GemStar® Certification Program F-9

1. If an incorrect value is entered during programming, press __________ before pressing[YES/ENTER] to reset the value to zero.A. [NO]B. [HELP]C. [CHANGE]D. [BACK-UP]E.

2. Continuous therapy allows:A. Delivery of mcg, mg, or mL/hr with selectable KVO option.B. Programming of the delivery rate in mL only.C. Administration of analgesics or anesthetics for patient-controlled analgesia.D. Programming of multiple doses at regular intervals.E. None of the above.

3. Which of the following is TRUE of the Continuous therapy?A. Optional KVO (0.1 – 5.0 mL/hr) may be set during programming.B. Piggybacking is not available.C. The rate can be titrated even while the pump is infusing.D. The rate range is 0.1 to 1000 mL/hr.E. A, C, and D

4. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]B. [START], [STOP], [CHANGE], [1]C. [1], [STOP], [START], [CHANGE]D. [STOP], [1], [CHANGE], [START]

5. The NEW CONTAINER function is not available when the pump is in:A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD. FULL LockE. NEW CONTAINER Lock

6. If KVO is programmed during Continuous therapy, the ______________ is increased toaccommodate KVO delivery.A. Air-in-line sensitivityB. Infusion rateC. Container sizeD. Bolus size

Study Questions

Continuous Program

F-10 GemStar® Certification Program

7. Which of the following conditions must be met in order to perform piggybacking with theContinuous therapy?A. The fluids being administered must be chemically and physically compatible.B. An Abbott GemStar Primary Piggyback set with a proximal Y-site backcheck valve must be used alone.C. The secondary container must be lower than the primary container.D. All of the above.

8. TRUE/FALSE: Mark the following as either true or false.A. Piggybacking will automatically start after the program is entered. _____B. In order to distinguish between piggyback and primary delivery, “PRIMARY” appears in the display window during

secondary delivery and the piggyback VTBI counts down to zero. _____C. The piggyback infusion amount is not added to the primary programmed infusion amount. _____D. During piggybacking, primary flow stops until the secondary container empties, then primary flow automatically

resumes. _____E. The Continuous therapy program can be changed when the pump is in the FULL Lock or NEW CONTAINER Lock. ___

9. Which of the following is NOT a parameter of the Continuous therapy that can be changed? A. Unit of measureB. Delivery rateC. Container sizeD. PiggybackingE. All of the above can be changed.

Continuous Program

GemStar® Certification Program F-11

1. If an incorrect value is entered during programming, press __________ before pressing[YES/ENTER] to reset the value to zero.C. [CHANGE]

2. Continuous therapy allows:A. Delivery of mg/mL, mcg/mL, or mL with selectable KVO option.

3. Which of the following is TRUE of the Continuous therapy?E. A, C, and D

4. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]

5. The NEW CONTAINER function is not available when the pump is in:D. FULL Lock

6. If KVO is programmed during Continuous therapy, the ______________ is increased toaccommodate KVO delivery.C. Container size

7. Which of the following conditions must be met in order to perform piggybacking with theContinuous therapy?A. The fluids being administered must be chemically and physically compatible.

8. TRUE/FALSE: Mark the following as either true or false.A. Piggybacking will automatically start after the program is entered. TRUEB. In order to distinguish between piggyback and primary delivery, “PRIMARY” appears in the display window during

secondary delivery and the piggyback VTBI counts down to zero. FALSEC. The piggyback infusion amount is not added to the primary programmed infusion amount. TRUED. During piggybacking, primary flow stops until the secondary container empties, then primary flow automatically

resumes. TRUEE. The Continuous therapy program can be changed when the pump is in the FULL Lock or NEW CONTAINER Lock. FALSE

9. Which of the following is NOT a parameter of the Continuous therapy that can be changed?A. Unit of measure

Study Answers

Weight Dosed Programs

GemStar® Certification Program G-1

WEIGHT DOSED PROGRAM—MODULE G

Programming Tips . . . . . . . . . . . . . . . . . . . . . . .G-2

Weight Dosed Therapy . . . . . . . . . . . . . . . . . . .G-2

Weight Dosed Programming Scenario . . . . . . . . .G-6

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .G-9

Study Answers . . . . . . . . . . . . . . . . . . . . . . . .G-13

Objectives

When you complete this module, you will know how to:

■ Program and change Weight Dosed therapies on the GemStar pump;

■ Perform rate titration during Weight Dosed infusions;

■ Record and clear shift totals during Weight Dosed infusion; and

■ Hang a new container during Weight Dosed infusion.

Weight Dosed Programs

G-2 GemStar® Certification Program

Programming Tips

Weight DosedTherapy

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Weight Dosed Therapy

Weight Dosed therapy allows programming of a delivery rate as a function of body weight. Key considerations for WeightDosed therapy include:

■ Air-in-line sensitivity is automatically set to ON.

■ The pump automatically delivers KVO after the programmed VTBI has been delivered.

■ KVO automatically delivers at 1 mL/hr if the weight dosed rate is greater than or equal to 1 mL/hr. If the rate is lessthan 1 mL/hr, KVO automatically delivers at the same rate.

■ Rate can be titrated while the pump is infusing.

■ Rate range is 0.1 to 1000 mL/hr.

■ The pump converts and displays the units of delivery as well as the rate in mL/hr.

Therapy Weight Dosed

Unit of Measure ■ mcg/kg/min ■ mg/kg/hr ■ mcg/hr ■ U/min■ mcg/kg/hr ■ mg/min ■ grams/hr ■ U/hr■ mcg/min ■ mL/hr ■ ng/kg/min ■ mU/min■ mg/kg/min ■ mg/hr ■ U/kg/hr ■ mEq/hr

Weight Dosed Programs

GemStar® Certification Program G-3

TIP: When infusing, the device displays units of measure and mL/hr.

Complete the steps in the following table to program a Weight Dosed therapy:

Weight Dosed Programming

Select WEIGHT DOSED from the Programming Menu.

Select the unit of measure.

Enter the patient weight, if required.

Enter the concentration as mg in mL (e.g., 400 mg in 250 mL). Use the key to toggle between mL and mg.■ Enter the value in mg when “mg” is displayed. ■ Enter the value in mL when the “mL” is displayed.■ Press [YES/ENTER] to confirm.

NOTE: Total concentration is always entered as mg in mL, even if mcg is the selectedunit of measure.

Enter the infusion rate.NOTE: The pump automatically displays the mL/hr equivalent even when another unit

of measure is selected.

Enter the VTBI.

Review the program.

Press [START].

NOTE: When the programmed VTBI has completed delivery, KVO delivery begins automatically and the empty container alarm sounds. Auto KVO delivers even while the empty container alarm sounds. Press [SILENCE] to quiet the alarm for two minutes.

The Weight Dosed program has some parameters that can be changed after the programhas been saved:■ Delivery rate■ VTBI■ Patient weight

Once the program has been saved, the following parameters cannot be changed:■ Unit of measure■ Concentration

WARNING: When infusing short-half-life drugs (i.e., those dosed with units of mcg/kg/min) at very low rates (0.8 mL/hr or less) the rate may be too slow for that drug. Consider using a lower drug concentration with thesedrugs so a pump rate above 0.8 mL/hr can be used.

When using a vented drip set, ALWAYS use an air-eliminating filter OR set the air sensitivity to either ON or 2 mL.

Changing a Weight DosedProgram

Weight Dosed Programs

G-4 GemStar® Certification Program

Perform the steps in the following table to change the Weight Dosed program:

Changing a Weight Dosed Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes or press [YES/ENTER] to accept the current settings.

Review the program.

Press [START].

TIP: The program cannot be changed when the pump is in the FULL or NEW CONTAINER Lock.

The Weight Dosed therapy rate can be titrated while the pump is infusing. Perform the following steps to titrate the rateduring infusion.

Titrating During Infusion

Begin with the pump in RUN mode.

Press the numeric keys corresponding to the new rate.

Press [YES/ENTER] when the new rate flashes on the display.

Press [YES/ENTER] when the new rate is displayed to accept the rate and begin delivery, or press [NO] to continue delivery at the programmed rate.

TIP: After pressing a numeric key or the decimal key, [YES/ENTER] must be pressedwithin approximately five seconds. If a key is not pressed within five seconds, the rate does not change and the delivery continues as originally programmed.

Rate Titration

Weight Dosed Programs

GemStar® Certification Program G-5

Recording andClearing Shift Totals

Starting a NewContainer

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Weight Dosed program. Perform the steps in the following table to record and clear shift totals when using theWeight Dosed program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or in an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

Note: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several seconds and the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order ofthe keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

Weight Dosed Programs

G-6 GemStar® Certification Program

The following scenarios are hypothetical prescriptions to provide examples of programming a Weight Dosed therapy.

Weight Dosed Programming Scenario A

■ Dopamine HCL 400 mg in 250 mL of D5W. ■ Infuse dopamine I.V. at a rate of 2.5 mcg/kg/min.

Patient weight: 70 kilograms

Concentration: 400 mg in 250 mL of D5W

VTBI: 250 mL

Rate: 2.5 mcg/kg/min (6.6 mL/hr)

Select WEIGHT DOSED from Programming Menu.

Select the unit of measure. mcg/kg/min

Enter the patient’s weight. 70 kg

Enter the total concentration as mg in mL. 400 mg. Press and enter 250 mL.Press [ENTER].

Enter the infusion rate. 2.5 mcg/kg/min

Enter the VTBI. 250 mL

Review the program.

Start infusion.

Titrate to 5 mcg/kg/min.

Weight DosedProgramming

Scenarios

Weight Dosed Programs

GemStar® Certification Program G-7

Weight Dosed Programming Scenario B

■ NTG 50 mg/250 mL of D5W. ■ Infuse NTG at 10 mcg/min.

Patient weight: 75 kilograms

Concentration: 50 mg in 250 mL of D5W

VTBI: 250 mL

Rate: 10 mcg/kg/min (3 mL/hr)

Select WEIGHT DOSED from Programming Menu.

Select the unit of measure. mcg/min

Enter the patient’s weight. 75 kg

Enter the total concentration as mg in mL. 50 mg. Press and enter 250 mL.Press [ENTER].

Enter the infusion rate. 10 mcg/min

Enter the VTBI. 250 mL

Review the program.

Start infusion.

Titrate to 5 mcg/kg/min.

Weight Dosed Programs

G-8 GemStar® Certification Program

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several seconds and the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order ofthe keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Weight Dosed program. Perform the steps in the following table to record and clear shift totals when using theWeight Dosed program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or in an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

Starting a New Container

Recording and ClearingShift Totals

Weight Dosed Programs

GemStar® Certification Program G-9

1. FILL IN THE BLANKS: When the programmed _______ has completed delivery, KVO deliverybegins automatically and the empty container alarm sounds. Auto KVO delivers even whilethe empty container alarm sounds. Press _________ to quiet the alarm for two minutes.A. KVO; [HELP]B. [HELP]; [SILENCE]C. [SILENCE]; VTBID. VTBI; KVOE. VTBI; [SILENCE]

2. When programming, pressing ________ provides an explanation of the current display message.A. [HELP]B. [CHANGE]C. [YES/ENTER]D. [BACK-UP]E.

3. TRUE/FALSE: If a number outside of the acceptable program range is entered, an error message displays the minimum and maximum values allowed for that value.

4. When titrating during infusion, begin with the pump in the ___________ mode.A. STOPB. HELPC. OPTIONSD. MENUSE. RUN

5. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using an mL/hr Only therapy.A. VTBI volumesB. Shift totalsC. Delivery ratesD. Pump settingsE. Options

6. Cleared shift totals are recorded and stored in the _______________ where they can be reviewed.

A. History Event LogB. Menu LogC. Lincoln LogD. Media Event LogE. None of the above.

Study Questions

Weight Dosed Programs

G-10 GemStar® Certification Program

7. A quick and easy way to remember the steps for starting a new container on the GemStar pump is: A. [STOP], [CHANGE], [2], [START]B. [START], [STOP], [CHANGE], [2]C. [2], [STOP], [START], [CHANGE]D. [STOP], [2], [CHANGE], [START]

8. The NEW CONTAINER function is not available when the pump is in: A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD. FULL LockE. NEW CONTAINER Lock

9. Weight Dosed therapy allows: A. Delivery of mcg, mg, or mL/hr with selectable KVO option.B. Programming of the delivery rate in mL only.C. Administration of analgesics or anesthetics for patient-controlled analgesia.D. Programming of a delivery rate as a function of body weight.E. None of the above.

10. Which of the following is a TRUE statement about Weight Dosed therapy?A. Air-in-line sensitivity is automatically set to ON.B. The pump automatically delivers KVO after the programmed VTBI has been delivered.C. The rate can be titrated even while the pump is infusing.D. The pump converts and displays the units of delivery as well as the rate in mL/hr.E. All of the above are true.

11. TRUE/FALSE: In Weight Dosed therapy, the total concentration is always entered as mg inmL, even if other units of measure are selected.

12. Which of the following Weight Dosed parameters can be changed after the program has been saved?A. Unit of measureB. Delivery rateC. VTBID. Patient weightE. B, C, and D

Weight Dosed Programs

GemStar® Certification Program G-11

13. A Weight Dosed therapy cannot be changed when the pump is in the:A. FULL LockB. THERAPY LockC. RATE CHANGE LockD. NEW CONTAINER LockE. A and BF. A and D

Weight Dosed Programs

GemStar® Certification Program G-13

1. FILL IN THE BLANKS: When the programmed _______ has completed delivery, KVO deliverybegins automatically and the empty container alarm sounds. Auto KVO delivers even whilethe empty container alarm sounds. Press _________ to quiet the alarm for two minutes.E. VTBI; [SILENCE]

2. When programming, pressing ___________ provides an explanation of the current display message.A. [HELP]

3. TRUE/FALSE: If a number outside of the acceptable program range is entered, an error message displays the minimum and maximum values allowed for that value.TRUE

4. When titrating during infusion, begin with the pump in the ___________ mode.E. RUN

5. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using an mL/hr Only therapy.B. Shift totals

6. Cleared shift totals are recorded and stored in the _______________ where they can be reviewed.A. History Event Log

7. A quick and easy way to remember the steps for starting a new container on the GemStar pump is:A. [STOP], [CHANGE], [1], [START]

8. The NEW CONTAINER function is not available when the pump is in: D. FULL Lock

9. Weight Dosed therapy allows: D. Programming of a delivery rate as a function of body weight.

10. Which of the following is a TRUE statement about Weight Dosed therapy?E. All of the above are true.

11. TRUE/FALSE: In Weight Dosed therapy, the total concentration is always entered as mg in mL, even if other units of measure are selected.TRUE

12. Which of the following Weight Dosed parameters can be changed after the program has been saved? E. B, C, and D

13. A Weight Dosed therapy cannot be changed when the pump is in the:F. A and D

Study Answers

mL/hr Only Programs

GemStar® Certification Program H-1

mL/hr ONLY PROGRAM—MODULE H

Programming Tips . . . . . . . . . . . . . . . . . . . . . . .H-2

mL/hr Only Therapy . . . . . . . . . . . . . . . . . . . . . .H-3

mL/hr Only Programming Scenario . . . . . . . . . . . .H-8

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .H-9

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .H-13

Objectives

When you complete this module, you will know how to:

■ Program and change mL/hr Only on the GemStar pump;

■ Perform rate titration during mL/hr Only;

■ Perform a secondary delivery (piggybacking) during mL/hr Only therapy;

■ Record and clear shift totals during mL/hr Only therapy; and

■ Hang a new container during mL/hr Only therapy.

Programming Tips

mL/hr Only Programs

H-2 GemStar® Certification Program

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

mL/hr OnlyTherapy

Rate Titration

mL/hr Only Programs

GemStar® Certification Program H-3

This therapy allows quick programming of delivery rate in milliliters (mL) only.

■ The air sensitivity is automatically set to ON. This setting can be changed through the Options Menu after programming iscomplete. Refer to Air Sensitivity in the GemStar Operators Manual, Chapter 10 Options Menu, on page 105.

■ The pump automatically delivers KVO (Keep Vein Open) after the programmed VTBI (Volume To Be Infused) is complete.■ The rate can be titrated while the pump is infusing.■ An optional secondary container can be “piggybacked” onto the primary container during regular delivery using an Abbott

GemStar Piggyback Pump Set. Refer to Piggybacking in this section for more information.■ A program review is not required and is only available through the Options Menu.

WARNING: When using a vented set, ALWAYS use an air-elevating filter or set the air sensitivityto either on or 2 mL.

Follow the steps in the table below to program a mL/hr Only therapy.

mL/hr Only Programming

Select mL/hr Only from the Programming Menu.

Enter the rate.

Enter the VTBI.

TIP: To change a container:■ Press [STOP].■ Press [CHANGE].■ Select NEW CONTAINER [1].■ Do not reset VTBI.■ Press [START].

The mL/hr Only therapy rate can be titrated while the pump is infusing.

To titrate the rate during infusion, perform the steps in the following table:

Titrating During Infusion

Begin with the pump in RUN mode.

Press the numeric keys corresponding to the new rate.

Press [YES/ENTER] when the new rate flashes on the display.

Press [YES/ENTER] when the new rate is displayed to accept the rate and begin delivery, or press [NO] to continuedelivery at the programmed rate.

TIP: After pressing a numeric key or the decimal key, [YES/ENTER] must be pressedwithin approximately five seconds. If a key is not pressed within five seconds, the rate does not change and the delivery continues as originally programmed.

Secondary delivery (piggybacking) is available with the mL/hr Only therapy. In order to piggyback with the GemStar, the following conditions must be met:■ The fluids being administered must be chemically and physically compatible.■ A GemStar Primary Piggyback Administration Set with a proximal Y-site backcheck valve and a Secondary Piggyback

Administration Set with an extension hook must be used.

Piggybacking

mL/hr Only Programs

H-4 GemStar® Certification Program

■ The secondary container must be higher than the primary container.

TIP: Piggyback will automatically start after the program is entered. Be sure the secondary container is hung prior to programming.

TIP: During piggyback infusion, you are unable to titrate the rate.

The piggyback infusion amount is NOT added to the primary programmed infusion amount. To prepare for piggyback delivery, perform the steps in the following table:

Preparation for Piggyback Delivery

Prepare the primary piggyback set with a primary Y-site backcheck valve.

Suspend the primary container from the I.V. pole, using the extension hook. (A)

Prepare the secondary piggyback set according to package instructions.

Attach a blunt cannula or needle (as appropriate) and prime the secondary piggyback set.

Close the secondary clamp and suspend the secondary container from the I.V. pole. (B)

Connect the secondary set to the upper backcheck Y-injection site using aseptic technique. (C)

Program piggyback delivery and open the clamp.

In order to distinguish between piggyback and primary delivery, PIGGYBACK appears in the display window and the piggyback VTBI counts down to completion.

TIP: The piggyback rate and piggyback VTBI display until the secondary container has been delivered. The primary delivery then resumes automatically.

TIP: When using a secondary container of 500 mL or greater, ensure the bottom of the secondary container is at least 7 inches above the fluid level in the primary container. Use additional extension hooks, if necessary.

Complete the steps in the following table to program the pump for secondary delivery:

Programming for Piggyback Delivery

Press [CHANGE] to access the Change Menu.

Select PIGGYBACKING (option 4).

mL/hr Only Programs

GemStar® Certification Program H-5

Enter the dose amount for the secondary container.

Enter the infusion time for the secondary container.

Press [YES/ENTER] to begin piggyback delivery. Secondary infusion begins immediately.

TIP: Primary flow stops until the secondary container empties, then primary flow automatically resumes. Any remaining secondary fluid will be delivered at the primary rate. The maximum piggyback rate is 300 mL/hr. For secondary rates above 300 mL/hr, flow may occur from the primary container.

Complete the steps in the following table to cancel a piggyback delivery:

Canceling a Piggyback Delivery

Press [CHANGE] to access the Change Menu.

Select PIGGYBACKING (option 4).

Press [CHANGE] to reset the dose amount to zero.

Press [YES/ENTER] to cancel piggyback delivery.

Changing a mL/hrOnly Program

mL/hr Only Programs

H-6 GemStar® Certification Program

Complete the steps in the following table to change a piggyback delivery:

Changing a Piggyback Delivery

Press [CHANGE] to access the Change Menu.

Select PIGGYBACKING (option 4).

Press [CHANGE] to reset the dose amount to zero.

Enter the new piggyback dose amount and press [YES/ENTER].

Set the infusion time for the secondary container.

Press [YES/ENTER] to begin piggyback delivery at the new dose amount.

TIP: When the piggyback dose amount is changed, the pump begins a new VTBI countdown. The amount that has already been delivered must be known.

The mL/hr Only program has several parameters that can be changed including:■ Delivery rate■ Container size■ Piggybacking

Complete the steps in the following table to change the mL/hr Only program:

Changing a mL/hr Only Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes or press [YES/ENTER] to accept the current settings.

Press [START].

Recording andClearing Shift Totals

Starting a NewContainer

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the mL/hr Only program. Perform the steps in the following table to record and clear shift totals when using themL/hr Only program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or in an alarm condition.

OR

Press [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

Note: Amounts cleared are recorded and stored in the History Event Log. They can be reviewed there.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several seconds and the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order ofthe keys pressed:

[STOP].[CHANGE].(NEW CONTAINER) [1].[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

mL/hr Only Programs

GemStar® Certification Program H-7

mL/hr Only Programs

H-8 GemStar® Certification Program

mL/hr OnlyProgramming

Scenario

The following is a hypothetical prescription to provide an example of programming a mL/hr Only therapy.

Give 1000 mL of normal saline over 8 hours (125 mL/hr) for hydration.

mL/hr Only Programming Scenario

1000 mL normal saline

Delivery rate of 125 mL/hr

Select mL/hr Only from the Programming Menu.

Set the rate. 125 mL/hr

Set the VTBI. 1000 mL

Press [START].

Piggyback Scenario

A patient is receiving 1000 mL normal saline at 125 mL/hr and the orders read to infuse 1 g ampicillin in a 50 mLADD-Vantage bag over 30 minutes.

When the piggyback setup is complete, press [CHANGE].

Select PIGGYBACKING (option 4).

Set dose amount. 50 mL

Set infusion time. 30 min

Press [ENTER].

Piggyback begins immediately.

mL/hr Only Programs

GemStar® Certification Program H-9

1. Which of the following are TRUE of the mL/hr Only therapy?A. Air-in-line sensitivity is automatically set to ON.B. The rate can be titrated even while the pump is infusing.C. A program review is not required.D. The display screen shows the VTBI and not the amount infused.E. A, B, and C

2. FILL IN THE BLANKS: When the programmed _______ has completed delivery, KVO deliverybegins automatically and the empty container alarm sounds. Auto KVO delivers even whilethe empty container alarm sounds. Press _________ to quiet the alarm for two minutes.A. KVO; [HELP]B. [HELP]; [SILENCE]C. [SILENCE]; VTBID. VTBI; KVOE. VTBI; [SILENCE]

3. When programming, pressing ________ provides an explanation of the current display message.A. [HELP]B. [CHANGE]C. [YES/ENTER]D. [BACK-UP]E.

4. The rate range in mL/hr Only therapy is: A. 0.1 to 1000 mL/hrB. 0.1 to 100 mL/hrC. 1.0 to 100 mL/hrD. 1.0 to 500 mL/hrE. 1.0 to 1000 mL/hr

5. An optional secondary medication (piggybacking) can be delivered during mL/hr Only therapy using:A. The [HELP] keyB. A primary administration setC. A secondary administration setD. A tertiary administration setE. None of the above.

6. TRUE/FALSE: If a number outside of the acceptable program range is entered, an error message displays the minimum and maximum values allowed for that value.

Study Questions

mL/hr Only Programs

H-10 GemStar® Certification Program

mL/hr Only Programs

7. TRUE/FALSE: When piggyback delivery has been programmed, pressing [YES/ENTER] beginssecondary infusion immediately.

8. When titrating during infusion, begin with the pump in the ___________ mode.A. STOPB. HELPC. OPTIONSD. MENUSE. RUN

9. When titrating, press [YES/ENTER] within approximately _______ seconds of pressing a numeric key or the decimal key. If a key is not pressed within this time, the titrating rate does not change and the delivery continues as originally programmed.A. 2B. 5C. 10D. 30E. None of the above.

10. When using a secondary container of 500 mL or greater during piggybacking, ensure that the bottom of the container is at least _______ inches above the fluid level in the primary container.A. 1B. 4C. 7D. 20E. 36

11. During piggybacking, primary flow ______ until the secondary container empties.A. StartsB. SlowsC. Speeds upD. StopsE. Reverses

mL/hr Only Programs

GemStar® Certification Program H-11

12. During piggybacking, the amount that has already been delivered must be known. When thepiggyback dose amount is changed, the pump begins a new:A. KVO countdownB. TKO countdownC. VTBI countdownD. KVO countupE. VTBI rate

13. Which of the following mL/hr Only therapy parameters can be changed?A. Delivery rateB. Container sizeC. PiggybackingD. All of the above.

14. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using an mL/hr Only therapy.A. VTBI volumesB. Shift totalsC. Delivery ratesD. Pump settingsE. Options

15. Cleared shift totals are recorded and stored in the _______________ where they can be reviewed.

A. History Event LogB. Menu LogC. Lincoln LogD. Media Event LogE. None of the above.

16. A quick and easy way to remember the steps for starting a new container on the GemStar pump is: A. [STOP], [CHANGE], [1], [START]B. [START], [STOP], [CHANGE], [1]C. [1], [STOP], [START], [CHANGE]D. [STOP], [1], [CHANGE], [START]

17. The NEW CONTAINER function is not available when the pump is in: A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD. FULL LockE. NEW CONTAINER Lock

mL/hr Only Programs

GemStar® Certification Program H-13

1. Which of the following are TRUE of the mL/hr Only therapy?E. A, B, and C.

2. FILL IN THE BLANKS: When the programmed _______ has completed delivery, KVO deliverybegins automatically and the empty container alarm sounds. Auto KVO delivers even whilethe empty container alarm sounds. Press _________ to quiet the alarm for two minutes.E. VTBI; [SILENCE]

3. When programming, pressing ___________ provides an explanation of the current display message.A. [HELP]

4. The rate range in mL/hr Only therapy is:A. 0.1 to 1000 mL/hr

5. An optional secondary medication (piggybacking) can be delivered during mL/hr Only therapy using:C. A secondary administration set

6. TRUE/FALSE: If a number outside of the acceptable program range is entered, an error message displays the minimum and maximum values allowed for that value.TRUE

7. TRUE/FALSE: When piggyback delivery has been programmed, pressing [YES/ENTER] beginssecondary infusion immediately.TRUE

8. When titrating during infusion, begin with the pump in the ___________ mode.E. RUN

9. When titrating, press [YES/ENTER] within approximately _______ seconds of pressing a numeric key or the decimal key. If a key is not pressed within this time, the titrating rate does not change and the delivery continues as originally programmed.B. 5

10. When using a secondary container of 500 mL or greater during piggybacking, ensure that thebottom of the container is at least ___________ inches above the fluid level in the primary container.C. 7

11. During piggybacking, primary flow ______ until the secondary container empties.D. Stops

Study Answers

mL/hr Only Programs

H-14 GemStar® Certification Program

12. During piggybacking, the amount that has already been delivered must be known. When thepiggyback dose amount is changed, the pump begins a new:C. VTBI countdown

13. Which of the following mL/hr Only therapy parameters can be changed?D. All of the above.

14. Recording and clearing ___________ are two of the most common interactions you willhave with the GemStar pump when using an mL/hr Only therapy.B. Shift totals

15. Cleared shift totals are recorded and stored in the _______________ where they can be reviewed.A. History Event Log

16. A quick and easy way to remember the steps for starting a new container on the GemStar pump is:A. [STOP], [CHANGE], [2], [START]

17. The NEW CONTAINER function is not available when the pump is in: D. FULL Lock

Variable Time Program

GemStar® Certification Program I-1

VARIABLE TIME PROGRAM—MODULE I

Programming Tips . . . . . . . . . . . . . . . . . . . . . . . .I-2

Variable Time Therapy Programming . . . . . . . . . . .I-3

Variable Time Programming Scenario . . . . . . . . . . .I-6

TIP for Variable Time Programming . . . . . . . . . . . . .I-7

Study Questions . . . . . . . . . . . . . . . . . . . . . . . . .I-8

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . . .I-11

Objectives

When you complete this module, you will know how to:

■ Program and change Variable Time therapy;

■ Record and clear shift totals during Variable Time therapy; and

■ Hang a new container during Variable Time therapy.

Variable Time Program

I-2 GemStar® Certification Program

Many of the functions on the GemStar pump advance you to the next step automatically when [YES/ENTER] is pressed.The number keys are used to enter requested values. Time is entered in hours and minutes (e.g., 1 hour is entered bypressing 100).

The keys that are helpful during programming are listed in the following table:

Programming Tips

[HELP] The [HELP] key: ■ Provides an explanation of the current display message. Pressing [BACK-UP]

exits the HELP mode.■ Acts as a “hot key” for accessing shift totals.■ Displays ranges of values that can be entered on a certain screen.

Pressing the or keys: ■ Scrolls through multiple display screens.■ Toggles between a.m. and p.m. when in CLOCK mode.

Pressing the key inserts a decimal point when entering a numeric value.

[CHANGE] If an incorrect numeric value is entered during programming, press [CHANGE] before pressing [YES/ENTER] to reset the value to zero.

[BACK-UP] In the PROGRAMMING mode, [BACK-UP] functions like a browser, taking you back to a previous screen.

After the pump has been programmed, [BACK-UP] functions like an “ESCAPE” key to exitthe Options, Help, and Histories data screens.

Programming Tips

Variable Time Program

GemStar® Certification Program I-3

Variable Time TherapyProgramming

The Variable Time therapy allows for programming of multiple doses at specified times. Variable Time delivery can dispensemedication in accordance with the body’s naturally occurring metabolic cycles for maximum efficiency.

Key considerations for variable time therapy include:■ There are 24 programmable phases.■ Rate range is 0.1 to 1000 mL/hr.■ Optional KVO (0.1 to 5 mL/hr) may be set during programming.■ The default bolus delivery rate is 400 mL/hr.■ If a number outside of the acceptable program range is entered, an error message displays the minimum or

maximum value allowed.

Perform the steps in the following table to program a Variable Time therapy:

Variable Time Programming

Select VARIABLE TIME from the Programming Menu.

Select the phase type (percentages, rates, or doses).

Enter the unit of delivery.

Change the displayed time (if necessary).

Enter the optional base rate with start and stop time. (The base rate is similar to KVO but can go higher than 5 mL/hr.)

Set the daily amount if programming in percentages.

Enter the information for each phase.■ Up to 24 phases can be programmed.■ If programming in percentages, the total amount of all phases programmed must equal 100%.

Enter the optional bolus dose and its lockout time.

Enter the optional KVO.

Enter the container size.

The pump calculates the minimum container size required to deliver all the phases, base rate, and KVO for a 24-hour period. If delivering the protocol for more than one day, multiply this amount by the number of days of therapy.

NOTE: Increase container size to accommodate bolus deliveries base rate and KVO. Select the air-in-line sensitivity.

Review the program.

The pump will automatically alarm until you push the start key.

NOTE: With Variable Time programming, the pump keeps track of where it is in the program each minute of the entire 24-hour period. For example, if Phase 1 ismissed and the pump is placed in RUN mode in the middle of Phase 2, it startsdelivery according to the program parameters from the middle of Phase 2.

I-4 GemStar® Certification Program

If the Variable Time delivery is interrupted, it will affect the program. The pump needs to be reprogrammed to deliver any portion of an infusion that was missed.

The Variable Time program has several parameters that can be changed: ■ KVO rate■ Container size■ Air-in-line sensitivity■ Bolus dose

Parameters that can be changed only before [START] is pressed include:■ Current time■ Base rate■ Phase amount■ Phase parameters

Parameters that cannot be changed include:■ Unit of measure■ Concentration

Complete the steps in the following table to change the Variable Time program.

Changing a Variable Time Program

Press [STOP] (puts pump in STOP mode).

Press [CHANGE].

Select CHANGE PROGRAM (option 3).

Make the desired changes or press [YES/ENTER] to accept the current settings.

Review the program.

Press [START].

TIP: The program cannot be changed when the pump is in theFULL Lock or NEW CONTAINER Lock.

DeliveryInterruptions

Changing a VariableTime Program

Variable Time Program

Variable Time Program

GemStar® Certification Program I-5

Recording and clearing shift totals are two of the most common interactions you will have with the GemStar pump whenusing the Intermittent program. Perform the steps in the following table to record and clear shift totals when using the Intermittent program.

Recording and Clearing Shift Totals

Press [HELP] (“hot key”) to display shift totals when the pump IS NOT in PROGRAMMING mode or an alarm condition.ORPress [OPTIONS] and select HISTORIES. Then select SHIFT TOTALS from the Histories Menu. The shift totalsappear on the screen.

Use the keys to scroll through the display. When done, the pump displays the message CLEAR TOTALS? YES OR NO.

Press [YES/ENTER] to clear the shift totals or press [NO] to exit the Options Menu without clearing the shift totals.

NOTE: Amounts cleared are recorded and stored in the History Event Log. They can bereviewed there.

An important function of the GemStar pump is continuing a program when a new container is hung. Perform the steps inthe following table to repeat the current program with a new container.

Starting a New Container

From the STOP mode, press [CHANGE] to access the Change Menu.

Select NEW CONTAINER (option 1) from the Change Menu. NEW CONTAINER displays for several secondsand the amount infused clears from the pump’s memory.

Press [START] to begin delivery.

TIP: A quick way to remember starting a new container on the GemStar is the order ofthe keys pressed:

[STOP].[CHANGE].[1] (NEW CONTAINER).[START].

NOTE: The NEW CONTAINER function is not available when the pump is in FULL Lock.

Recording andClearing Shift Totals

Starting a NewContainer

Variable Time Program

I-6 GemStar® Certification Program

Variable TimeProgramming Scenario

The following is a prescription to provide an example of programming a Variable Time (circadian) therapy.■ FUDR 0.5 mg/mL in normal saline. 420 mL to infuse I.V. continuously in 4 phases every day for seven days.■ Daily amount is 60 mL.

Phases

Phase 1 68% of daily dose 3:00 p.m. – 9:00 p.m.

Phase 2 15% of daily dose 9:00 p.m. – 3:00 a.m.

Phase 3 2% of daily dose 3:00 a.m. – 9:00 a.m.

Phase 4 15% of daily dose 9:00 a.m. – 3:00 p.m.

Variable Time Programming Scenario

Infuse FUDR in 4 phases every day over 7 days

Daily dose: 60 mL

Container size: 420 mL

Schedule:

Phase 1: 3:00 p.m. – 9:00 p.m., 68%

Phase 2: 9:00 p.m. – 3:00 a.m., 15%

Phase 3: 3:00 a.m. – 9:00 a.m., 2%

Phase 4: 9:00 a.m. – 3:00 p.m., 15%

Select VARIABLE TIME from the Programming Menu.

Select the phase type (percentages, rates, or doses). [1] for percentages

Select unit of delivery. mL

Accept or change displayed time.

Program a base rate? [NO]

Set daily amount for all phases. 60 mL

Enter the phase information for each phase.Use keys to toggle between a.m. and p.m.Phase 1 Start time: Press 3:00 p.m.Stop time: Press 9:00 p.m.Percentage: 68%

Phase 2 Start time: Press 9:00 p.m.Stop time: Press 3:00 a.m.Percentage: 15%

Variable Time Program

GemStar® Certification Program I-7

Phase 3 Start time: Press 3:00 a.m.Stop time: Press 9:00 a.m.Percentage: 2%

Phase 4Start time: Press 9:00 a.m.Stop time: Press 3:00 p.m.Percentage: 15%

Enter the optional bolus dose, if ordered. [NO]

Enter the optional KVO, if ordered. 0

Enter the container size. Enter 420 mL.

Select the air-in-line sensitivity. 2

Review the program.

TIP: When placed in RUN mode, the pump begins delivery from the time started. TIP for VariableTime Programming

Variable Time Program

I-8 GemStar® Certification Program

Study Questions 1. Pressing the key during programming:A. Scrolls through multiple display screens.B. Toggles between a.m. and p.m. when in the CLOCK mode.C. Puts in the decimal point.D. All of the above.E. A and B only.

2. A quick and easy way to remember the steps for starting a new container on the GemStarpump is:A. [STOP], [CHANGE], [1], [START]B. [START], [STOP], [CHANGE], [1]C. [1], [STOP], [START], [CHANGE]D. [STOP], [1], [CHANGE], [START]

3. The NEW CONTAINER function is not available when the pump is in:A. KEYPAD LockB. LOCKBOX modeC. PROGRAMMING modeD FULL LockE. NEW CONTAINER Lock

4. Which of the following is TRUE of the Variable Time therapy?A. Optional KVO (0.1 – 5.0 mL/hr) may be set during programming.B. There are 24 programmable phases.C. The default bolus delivery rate is 400 mL/hr.D. The rate range is 0.1 to 1000 mL/hr.E. All of the above are true of the Variable Time therapy.

5. In Variable Time therapy, the base rate is similar to KVO, but it can go higher than:A. 5 mL/hrB 21 mL/hrC. 0.5 mL/hrD. 1.0 mL/hr

6. If programming in percentages, the total amount of all phases programmed must equal_________.A. The base rateB. 100%C. 99%D. 10%E. 50%

Variable Time Program

GemStar® Certification Program I-9

7. In Variable Time therapy, the pump calculates the ___________ container size required todeliver all the phases and the base rate for a 24-hour period.A. MinimumB. MaximumC. MedianD. Mean

8. In Variable Time therapy, if delivering the protocol for more than one day, multiply the minimum container size by _____________.A. The number of hoursB. The number of daysC. The number of weeksD. The number of minutes

9. TRUE/FALSE: In Variable Time programming, the pump keeps track of where it is in the program each minute of the entire 24-hour period.

10. TRUE/FALSE: The pump needs to be reprogrammed to deliver any portion of an infusion thatwas missed in Variable Time therapy.

11. Which of the following are Variable Time therapy parameters that can be changed ONLYbefore [START] is pressed?A. KVO rateB. Container sizeC. Air-in-line sensitivityD. Phase amountE. Bolus dose

12. What are two Variable Time therapy parameters that cannot be changed?_______________ _______________

GemStar® Certification Program I-11

Study Answers1. Pressing the key during programming:C. Puts in the decimal point.

2. A quick and easy way to remember the steps for starting a new container on the GemStar pump is:A. [STOP], [CHANGE], [1], [START]

3. The NEW CONTAINER function is not available when the pump is in:D. FULL Lock

4. Which of the following is TRUE of the Variable Time therapy?E. All of the above are true of the Variable Time therapy.

5. In Variable Time therapy, the base rate is similar to KVO, but it can go higher than:A. 5 mL/hr

6. If programming in percentages, the total amount of all phases programmed must equal_________.B. 100%

7. In Variable Time therapy, the pump calculates the ___________ container size required todeliver all the phases and the base rate for a 24-hour period.A. Minimum

8. In Variable Time therapy, if delivering the protocol for more than one day, multiply the minimum container size by _____________.B. The number of days

9. TRUE/FALSE: In Variable Time programming, the pump keeps track of where it is in the program each minute of the entire 24-hour period.TRUE

10. TRUE/FALSE: The pump needs to be reprogrammed to deliver any portion of an infusion thatwas missed in Variable Time therapy.TRUE

11. Which of the following are Variable Time therapy parameters that can be changed ONLYbefore [START] is pressed?D. Phase amount

12. What are two Variable Time therapy parameters that cannot be changed?Unit of measureConcentration

Variable Time Program

Troubleshooting

GemStar® Certification Program J-1

TROUBLESHOOTING—MODULE J

Alarm Messages . . . . . . . . . . . . . . . . . . . . . . . . .J-2

Other Display Messages . . . . . . . . . . . . . . . . . . .J-8

Customer Support . . . . . . . . . . . . . . . . . . . . . . .J-9

Handling and Maintenance . . . . . . . . . . . . . . . .J-10

Quick Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . .J-13

Study Questions . . . . . . . . . . . . . . . . . . . . . . . .J-15

Study Answers . . . . . . . . . . . . . . . . . . . . . . . . .J-17

Objectives

When you complete this module, you will:

■ Know how to interpret GemStar alarm messages and take the appropriate action to correct them;

■ Know how to interpret other display messages and take the appropriate action to correct them;

■ Know how to contact Abbott Laboratories Customer Support for help;

■ Know how to handle and maintain the GemStar pump;

■ Understand the function of the Operation Test;

■ Be aware of the most frequently asked questions about the GemStar pump; and

■ Understand tips for optimal ease of use of the GemStar pump.

Troubleshooting

J-2 GemStar® Certification Program

AlarmMessages

Table J-1Alarm Messages

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

AIR IN LINE N A/V■ Pump automatically enters STOP mode.

Cause/ConditionThe specified volume of air has been detected in the line distal to the cassette while infusing.

RemedyPress [SILENCE] to quiet the alarm for 1 minute.Press [STOP] to clear the alarm. Disconnect the patient from the administration set.Press and hold [PURGE]. NOTE: Purge rate is 250 mL/hr. The pump purges for up

to 2 minutes each time you press and hold [PURGE].Purge volume may be limited in a Pain Management program.

Reconnect the administration set to the patient access pump.Press [START] to begin delivery.

CHANGE BATTERIES N A/V

Cause/ConditionThe pump has entered the STOP mode due to battery voltagebelow acceptable levels.

RemedyMake sure batteries are installed correctly.Replace both disposable batteries with fresh AA disposable batteriesand press [ON/OFF] to restart the pump, OR Connect the pump to the AC power adapter. The pump will automatically power up.After power-on, resume the current program.

Troubleshooting

GemStar® Certification Program J-3

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

CHECK CASSETTE N A/V

Cause/ConditionThe cassette is improperly installed or not installed.

RemedyPress [SILENCE] to quiet the alarm for 1 minute.Press [STOP] to place the pump in the STOP mode.Reinstall the cassette.Press [START] to begin delivery.

CAUTION: Make sure all four cassette latches are clearly visible after the cassette is installed.

NOTE: The pump cannot be powered off during a CHECK CASSETTE alarm (except duringPROGRAMMING mode).

CALL N A/VCALL 1-800-XXX-XXXX (the phone number of the appropriate support contact)Code: NN/MM/NN

Cause/ConditionThe pump has detected a condition that may require service.

RemedyDocument the displayed telephone number and code.Turn off the pump. If the pump does not turn off, disconnect external power and/or remove the batteries.Call the telephone number shown on the display message.

DISTAL OCCLUSION N A/V

Cause/ConditionThe pump has detected sustained distal pressure over the user-selected limit.

RemedyPress [SILENCE] to quiet the alarm for 1 minute.Press [STOP] to place the pump in the STOP mode.Check for sources of distal occlusion:■ Kinked tubing below pump■ Clamped patient access device■ Clogged I.V. filter■ Other obstructionsIf the problem persists, remove and reinstall the cassette.

Troubleshooting

J-4 GemStar® Certification Program

To avoid a bolus infusion after occlusion:■ Press [STOP].■ Close the distal clamp.■ Press the cassette release button to remove the cassette from the pump.■ Open the flow stop.■ Wait 10 seconds.■ Close the flow stop.■ Load the cassette into the pump.■ Open the distal clamp.■ Review the program.

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

Press [START] to begin delivery.

CAUTION: Make sure all four cassette latches are clearly visible after the cassette is installed.

LOW BATTERIES Y A/V

Cause/ConditionThe pump has detected battery voltage below acceptablelevels and the batteries are the primary power source.NOTE: The pump allows the user to clear the LOW BATTERIES

audible and visual alarm. If the condition has not been corrected after 15 minutes, the audible and visual alarms resume.

If the pump is infusing and a LOW BATTERIES alarm occurs, the pumpcontinues for approximately 30 minutes before it can no longer deliverdue to insufficient power.

DISCLAIMER: If an external power source is used, the rate is changed, or the pump is turned on after a LOW BATTERIES alarm and the same batteries are still in the pump, this interval may be different.

RemedyPress [SILENCE] to quiet the alarm for 1 minute.Press [STOP] to place the pump in the STOP mode.Connect the pump to the AC adapter, the rechargeable battery pack, or replace both disposable batteries with fresh AA disposable batteries.Press [START] to begin delivery.

TIP: Press [HELP] for additional information during programming andalarm conditions.

Troubleshooting

GemStar® Certification Program J-5

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

PROXIMAL OCCLUSION N A/V

Cause/ConditionThe pump has detected sustained negative pressure in the proximal line.

RemedyPress [SILENCE] to quiet the alarm for 1 minute.Press [STOP] to place the pump in the STOP mode.Check for sources of proximal occlusion:■ Kinked tubing above pump■ High torque syringe■ Blockage in the container or in the piercing pin■ Empty container■ Other obstructionsIf the problem persists, clamp the distal line and reinstall the cassette. If the alarm still persists, turn off the pump, clamp the distal line, then turn on the pump.Press [START] to begin delivery.

CAUTION: Make sure all four cassette latches are clearly visible after the cassette is installed.

USING BATTERIES Y V

Cause/ConditionThis is a normal response when:■ The pump has been turned on with only batteries as

a power source.

OR

■ The pump has switched to battery power due to a loss of AC power or a reduction of external power below acceptable levels.

RemedyWhen turning on the pump:■ Press [YES/ENTER] to confirm battery-only power source.

When switching from the AC adapter:■ Press [SILENCE] to clear the alarm.

Troubleshooting

J-6 GemStar® Certification Program

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

ALMOST EMPTY Y A/VNOTE: This alert is only available with Pain Management protocols.

Cause/ConditionDelivery will complete in 30 minutes or less.For a Bolus Only program, delivery will complete during the next bolus delivery.

RemedyPress [SILENCE] to quiet the alarm for 10 minutes.

CHECK PRINTER N A/V

Cause/Condition■ The printer has not responded to commands from the pump.

OR■ The printer is not properly connected to the pump.

RemedyPress [SILENCE] to quiet the alarm for 2 minutes.Ensure the printer is properly connected to the pump by checking the following:■ Printer is on and in ONLINE mode.■ Cable is plugged into both the pump and the printer.■ Cable part number and printer settings are correct.If the problem continues, select STOP PRINT from the Print Menu to cancel all print jobs.

EMPTY CONTAINER N A/VNOTE: The pump does not infuse unless Auto KVO is delivering

in a mL/hr Only or Weight Dosed program.

Cause/ConditionThe pump has delivered the programmed container size or the pumphas delivered the programmed VTBI.

RemedyPress [SILENCE] to quiet the alarm for 2 minutes.Press [STOP] to place the pump in the STOP mode.Press [CHANGE].Select NEW CONTAINER to reset and repeat the current program.

Troubleshooting

GemStar® Certification Program J-7

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

END OF INFUSION N A/V

Cause/ConditionThe pump has delivered the entire programmed protocol and KVO will continue to deliver if selected.

RemedyIf no KVO is selected:

Press [SILENCE] to quiet the alarm for 2 minutes.Press [STOP] to place the pump in the STOP mode and clear the alarm.

If KVO is selected:

The pump sounds 5 beeps approximately 15 minutes apart.Press [STOP] to place the pump in STOP mode and clear the alarm.

FLASHING DISPLAY N A/V

Cause/ConditionA nonprogrammed call-back has occurred because the pump has been waiting for more than 3 minutes for a key press on an input or a confirmation display.

RemedyFollow the instructions on the display to clear the alarm.

PROGRAMMING INCOMPLETE N A/V

Cause/ConditionProgramming has not been completed and no keys have beenpressed for more than 3 minutes.

RemedyPress any key to clear the alarm.Complete the program entries.

START N A/V■ START flashes on the display. Other parts of the display

are not affected.

Cause/ConditionA STOP mode call-back has occurred because the programmed pump has remained in the STOP mode for more than 3 minutes.

RemedyPress [SILENCE] to quiet the alarm for 3 minutes.Follow the instructions on the display to clear the alarm.

Troubleshooting

J-8 GemStar® Certification Program

Other DisplayMessages

Alarm Display Is the PumpMessage Infusing? Alarm

Y = Yes N = No A = Audible Alarm V = Visual Alarm

POWER LOSS N A/V

Cause/ConditionThe pump has detected a power failure due to one of the following:■ Batteries have been removed while the pump was on battery source.■ External power has failed or has been disconnected and no batteries

are installed.■ Pump has been powered on with insufficient power source.

RemedyConnect the pump to AC mains adaptor, rechargeable battery pack, OR replace BOTH disposable batteries with fresh AA batteries.Power-on the pump. Review the program if required.Press [START] to begin delivery.

TIP: Press [HELP] for additional information during programming andalarm conditions.

The following table describes other display messages you may see while using the GemStar.

Display Message Cause/Condition Remedy

KEYPAD LOCKED User has attempted to perform a function thathas been locked out.

Unlock the keypad to access thedesired function.

NOT ALLOWED DURING INFUSION; PRESS [STOP]TO HALT DELIVERY

User has attempted to perform a function that is not available in RUN mode.

Press [STOP] to access thedesired function.Press [YES/ENTER]to return to the RUN mode display.

ROUNDING The pump has rounded a numberthat was entered during programming.

Press [YES/ENTER] to accept therounded value and continue to thenext step.

DOSE IN PROGRESS;NEW CONTAINER NOT ALLOWED

User has attempted to access the NEW CONTAINER function when it is not allowed.

Press [STOP]Increase the container size tocomplete the dose.Set NEW CONTAINER throughthe Change Menu.

Troubleshooting

GemStar® Certification Program J-9

CustomerSupport

THIS OPTION NOT AVAILABLE WHILEPROGRAMMING THE DEVICE

User has attempted to access a function that is not available fromthe first programming display.

Press [YES/ENTER]to return to the firstprogramming display.Complete programming.Access the desired function.

CANNOT CHANGE CLOCK WHILETIME-BASED DELIVERY IS INPROGRESS

User has attempted to change theclock during a time-based delivery.

Press [STOP].Clear the program through theChange Menu.Change the clock through theOptions Menu.Reprogram the pump.

PROGRAM EXCEEDS MAX CONTAINERSIZE; CHANGE PROGRAM VALUES

The VTBI + KVO volume resulted in acontainer size greater than theallowed value.

Press [HELP] to display theallowed values.Change the programvalues.

TIP: Press [HELP] for additional information during programming and alarm conditions.

For consultation and technical support contact either an authorized Abbott Laboratories representative or the AbbottCustomer Support hotline (available 24 hours a day).

To return a pump for service, first contact Abbott Customer Support between 7:00 a.m. and 4:00 p.m. Pacific time. Have the pump serial number available.

In the USA Abbott Customer Support 1-800-241-4002

Abbott Laboratories Technical Support Operations755 Jarvis DriveMorgan Hill, CA 95037

Outside the USA Contact your local Abbott Laboratories sales office.

Troubleshooting

J-10 GemStar® Certification Program

Handling andMaintenance

The table below describes some cautions and warnings for handling and maintaining the GemStar.

Handling and Maintenance

If the pump is inadvertently subjected to mishandling, check connections and programmed data to confirm no damagehas occurred. (Refer to the Operation Test section in the Operations Manual.)

ALWAYS fully close the battery door when using disposable batteries.

ALWAYS avoid dropping or hitting the pump. If the pump is dropped or hit, ALWAYS verify programmed data.

Never use sharp objects to program or clean the pump.

Do not damage the silicone seals around the sensor bodies in the cassette pocket.

Never submerge the pump in water or other fluids. If pump becomes wet, dry it with a dry, lint-free cloth and check connections and programmed data.

Do not use compounds containing combinations of isopropyl alcohol and dimethyl benzyl ammonium chloride. These compounds can slowly degrade some of the plastic components.

Do not sterilize by heat, steam, ethylene oxide (ETO), or radiation. Apply disinfectants only to the outside surface of the pump. Do not use abrasive cleaners or materials on the pump. Using abrasive cleaners or cleaning solutions not recommended by Abbott Laboratories Inc. may result in product damage.

Use only the AC adapter or battery pack charger specifically labeled for use with the Abbott GemStar pump to charge thebattery pack. Do not use the battery pack charger with other battery packs.

The Abbott GemStar AC adapter is for use with the GemStar pump or Abbott GemStar battery pack. Do not use theAbbott GemStar AC adapter with other products.

During charging, the battery pack becomes warm. If battery pack becomes hot to the touch, IMMEDIATELY unplug ACadapter and contact Abbott Technical Support at 1-800-241-4002.

Please comply with local disposal and recycling regulations as appropriate for disposable batteries, rechargeable batterypacks, medical electronic components, and pump sets.

Troubleshooting

GemStar® Certification Program J-11

Storage

Cleaning Solutions

Cleaning Process

The GemStar pump must be stored in a cool, dry place. Program and event history are protected in the software memoryfor at least one year when power is removed from the pump. The disposable batteries and the battery pack should beremoved before storing the pump.

Only recommended cleaning solutions should be used to clean the pump. Cleaning solutions will vary in their disinfectingproperties. Therefore product labeling should be reviewed before use. The following cleaning solutions will not adverselyaffect the pump:■ Super Edisonite®

■ Vesphene II se®

■ Manu-Klenz®

■ Formula C™■ Household bleach diluted 1:10 in H2O only

The manufacturers’ recommendations should be followed when using the cleaning solutions. Sharp objects (e.g., pens, pencils, needles, etc.) should never be used to clean the pump.

Establish a routine schedule for cleaning the pump to ensure the case exterior, cassette pocket, and tubing channel are freeof contamination.

Perform the steps in the following table to clean the pump case.

Cleaning the Pump Case

Turn off the pump.

Disconnect the pump from AC power.

Clean exposed surfaces of the pump with a soft, lint-free cloth dampened with the appropriate cleaning solution.

Wipe the solution from the pump surface with a water-moistened, lint-free cloth.

Use a dry, lint-free cloth to dry the pump after cleaning.

Troubleshooting

J-12 GemStar® Certification Program

Cleaning the CassettePocket and Tubing

Channel

Sensor Faces

Operation Test

Complete the steps in the following table to clean the cassette pocket and tubing channel.

Cleaning the Cassette Pocket and Tubing Channel

Remove the cassette, if installed.

Use a cotton swab moistened with an approved cleaning solution to clean the sensor faces, tubing channel, plungertip, and sensor pins.

Dry the sensor faces and tubing channel and ensure that the sensor faces are free of detergent film and/or debris.

The area containing the ultrasonic sensors, located in the cassette pocket, should be cleaned on a regular basis.

CAUTION: Use care not to damage the silicone seals around the sensor bodies.

The Operation Test ensures that the GemStar pump is operating properly. The Operation Test:■ Is recommended every 12 months.■ Requires approximately 15 minutes to complete.■ Includes a number of operations to be performed.

The pump can be configured to indicate when the next Operation Test is scheduled.

NOTE: The Operation Test is discussed in detail in the GemStar Operations Manual. Refer to thatdocument when performing the Operation Test.

Troubleshooting

GemStar® Certification Program J-13

Quick TipsQuick Tips

The GemStar System

TIP: False occlusion alarms and fluid delivery inconsistencies may occur when pumping viscous fluids in microbore tubingat rates greater than 500 mL/hr.

GemStar Menu Functions

TIP: Each item that can be activated is numbered within the function menu display. The items are selected by pressing thecorresponding number on the keypad.

TIP: A menu item does not have to be on display to be selected. When the Options Menu is first accessed, only the first 4items are displayed. Item numbers 5 through 8 can be selected by pressing the corresponding number, with or withoutscrolling through the display.

TIP: The menu selections may vary depending on the configuration of the pump. Some Options Menu functions are notavailable in all modes.

TIP: Use the [BACK-UP] key to exit the Options, Help ,and Histories Menus. The display returns to the mode the pumpwas in when the Options Menu was accessed.

TIP: Press and hold the or key to scroll quickly through the History displays faster.

TIP: When the pump is locked, a small lock symbol appears in the lower left corner of the display. The first letter of thelock level appears in the lower right corner.

TIP: To check the current time from the RUN or STOP modes, press [YES/ENTER], then immediately press and hold [1].The clock displays until [1] is released.

Troubleshooting

J-14 GemStar® Certification Program

Quick Tips (cont.)

Programming the GemStar

TIP: When titrating the rate in mL/hr Only, Weight Dosed, and Continuous therapies, after pressing a numeric key or the decimal key, press [YES/ENTER] within approximately five seconds. If a key is not pressed within five seconds, the ratedoes not change and the delivery continues as originally programmed.

TIP: The piggyback rate and piggyback VTBI display until the secondary container has been delivered. The primary delivery resumes automatically.

TIP: When using a secondary container of 500 mL or greater, ensure the bottom of the secondary container is at least 7 inches above the fluid level in the primary container. Use additional extension hooks if necessary.

TIP: When the piggyback VTBI is changed, the pump begins a new VTBI countdown. Thus, the amount that has alreadybeen delivered must be known.

TIP: The program cannot be changed when the pump is in the FULL Lock or CONTAINER Lock.

TIP: Abbott recommends the use of an air-eliminating filter if the air alarm is turned off.

TIP: Press [HELP] for additional information during programming and alarm conditions. Press [HELP] at any other time toobtain and clear shift information.

Troubleshooting

GemStar® Certification Program J-15

Study Questions1. MATCHING: Match the following ALARM MESSAGES with their Cause/Condition:

Alarm Message Cause/Condition

A. AIR IN LINEB. DISTAL OCCLUSIONC. CHANGE BATTERIESD. LOW BATTERIESE. EMPTY CONTAINERF. CHECK CASSETTEG. CHECK PRINTERH. CALL 1-800-XXX-XXXXI. PROGRAMMING INCOMPLETEJ. START

_____ Programming has not been completed and no keys have been pressed for 3 minutes.

_____ The pump has detected a condition that may require service._____ The pump has detected sustained distal pressure over the user-selected

limit._____ The specified volume of air has been detected in the line distal to the

cassette while infusing._____ The cassette is improperly installed or not installed._____ The pump has entered STOP mode due to battery voltage below

acceptable levels._____ The pump has detected battery voltage below acceptable levels and

the batteries are the primary power source._____ The pump has delivered the programmed container size or the

programmed VTBI and auto KVO is delivering._____ The printer has not responded to commands from the pump or is not

properly connected to the pump._____ A STOP mode call-back has occurred because the pump has remained in

the STOP mode for more than 3 minutes.

2. What is the first step to remedy an EMPTY CONTAINER alarm?A. Press [STOP], [CHANGE], [1], [START].B. Turn off the pump.C. Press [SILENCE] to quiet the alarm for 2 minutes.D. Press [START], [CHANGE], [STOP], [1].E. Change the batteries.

3. Which of the following are false statements?A. Compounds containing combinations of isopropyl alcohol and dimethyl benzyl ammonium chloride cannot be used

with caution to clean the GemStar.B. Always avoid dropping or hitting the GemStar pump.C. Never use sharp objects to program or clean the GemStar.D. During charging, the battery pack will become hot to the touch. This is normal.E. Do not sterilize by heat, steam, ethylene oxide (ETO), or radiation.F. The GemStar should be stored in a warm, dry place.G. The first step in cleaning the cassette pocket and channel is to remove the cassette, if installed.H. The GemStar pump can be configured to indicate when the next Operation Test should be performed.I. The ultrasonic sensors, located in the cassette pocket, should be cleaned once a year, only by a specialist.

1. MATCHING: Match the following ALARM MESSAGES with their Cause/Condition:

Alarm Message Cause/Condition

A. AIR IN LINEB. DISTAL OCCLUSIONC. CHANGE BATTERIESD. LOW BATTERIESE. EMPTY CONTAINERF. CHECK CASSETTEG. CHECK PRINTERH. CALL 1-800-XXX-XXXXI. PROGRAMMING INCOMPLETEJ. START

I Programming has not been completed and no keys have been pressed for 3 minutes.

H The pump has detected a condition that requires Customer Support be contacted.

B The pump has detected sustained distal pressure over the user-selectedlimit.

A The specified volume of air has been detected in the line distal to the cassette while infusing.

F The cassette is improperly installed or not installed. C The pump has entered STOP mode due to battery voltage below

acceptable levels. D The pump has detected battery voltage below acceptable levels and

the batteries are the primary power source. E The pump has delivered the programmed container size or the

programmed VTBI and auto KVO is delivering. G The printer has not responded to commands from the pump or is not

properly connected to the pump. J A STOP mode call-back has occurred because the programmed pump

has remained in the STOP mode for more than 3 minutes.

2. What is the first step to remedy an EMPTY CONTAINER alarm?C. Press [SILENCE] to quiet the alarm for 2 minutes.

3. Which of the following are false statements?D. During charging, the battery pack will become hot to the touch. This is normal.F. The GemStar should be stored in a warm, dry place.I. The ultrasonic sensors, located in the cassette pocket, should be cleaned once a year, only by a specialist.

Troubleshooting

GemStar® Certification Program J-17

Study Answers