McKinley T34 Syringe Pump Training Aid

DISADVANTAGES OF T34 [ When compared with Graseby ] Weight Size Battery life Weight; T 34 210g, MS16 135g. Approx dimensions; T34 67x169x39mm, MS16 61x166x23 Duracell alkaline battery life; T34 approx 2-5 days, Ms16 approx 50 days

ADVANTAGES OF T34 SINGLE MODEL, THEREFORE NO CONFUSION 3 POINT CONTACT DETECTION SYRINGE RECOGNITION AUTOMATIC CALCULATION LCD AND INSTRUCTIONS PUMP CAN BE CONFIGURED LOG EVENT MEMORY SUPERIOR RANGE OF ALARMS Log event memory of approx 500 events. Each action, e.g. press stop = an event. Gives 10 pieces info re each even [inc. VI, VTBI, rate, current, occlusion pressure. More about other advantages as go thru presentation.

Dock / Connection Port Allows technicians to upload and download info. [e.g. add new programs]

Check Service Date Annual service mandatory. If more 2/12 over due date for service should not be used and sent to medical electronics.

Open Battery Compartment

T34-Battery fitting and Testing 9 volt alkaline or lithium battery only. Variation in size between different brands (do not force into compartment) Battery Test Switch the pump on Press INFO key Select battery life using ↓↑ keys, press YES Verify sufficient battery power for programme. Replace when battery level 35% or below No alarm when battery inserted cf Graseby.

T 34 Keypad INFO; access event log, Set Up (code protected), battery status, keypad lock. UP/DOWN arrow keys- scroll through options YES/START key- confirms selection/starts infusion. NO/STOP- step back a screen/stops infusion. FF (forward)-moves actuator forward BACK-moves actuator back ON/OFF FF in stages for safety. Barrel arm must be down to move actuator. No clutch cf Graseby. No ‘boost’ Can’t turn off accidently; press stop and then press and hold off.

Instructions Aide memoire but pump should not be used if person has not received training. Eden Valley Hospice staff [01228 810801] and Palliative Care unit staff at West Cumberland Hospital [01946 693181 and ask for Pal care Unit] can give advice.

L.C.D. Screen Follow instructions on the screen!!

T34 LCD Screen 4 Line Liquid Crystal Display (LCD) Backlit – activated on any key press (time adjust/ disable) Displays infusion parameters and user instructions

T34- 3 Point Contact Recognition and Syringe Loading 1 3 2 Barrel clamp arm- (detects syringe size/width of barrel, secures) Syringe ear/collar sensor (detects secure loading of syringe collar) Plunger sensor (detects secure loading of syringe plunger) Pump should always know what size of syringe e.g. 10 or 20 ml etc. It may occasionally not identify syringe brand if two manufacturers syringes internal dimensions are very similar. But operator can over-rule if pump ‘wrong’ when confirming syringe type/brand. Once size and brand confirmed the pump knows how far back the plunger is and therefore how much fluid volume there is. It is defaulted to run over 24 hrs and therefore can work the hourly rate out. It infuses in mls per hour NOT mm per hour cf Graseby

Access Codes and Keypad Lock Secure user access codes (2) - prevent misuse Access codes not provided to local users as it is envisaged that all subcutaneous infusions in palliative care will run over a 24 hour period Keypad lock Press and hold INFO key to lock, repeat to unlock

Infusion set up and Programming Draw up prescribed medication and diluent to a minimum volume of 12 millilitres in the syringe. The volume may need to be greater than this in some circumstances. Manually prime the extension set and Saf-t-intima set. DO NOT load syringe, ensure barrel clamp bar is down. Switch the pump on. Screen displays the following …..Pre-Loading…. message This screen changes very quickly. Preloading takes actuator back to where it started at beginning of previous infusion; useful if drawing up same volume on consecutive days. when pre-load has finished use the FF or BACK keys to adjust the actuator position if required (forward movement limited + no clutch)

Syringe Placement Lift the barrel clamp Seat syringe collar/ear and plunger so the back of the collar/ear sits against the back of the central slot (ensure correct placement) Lower barrel clamp arm Screen syringe graphic ceases to flash at each point as syringe is correctly seated. If any point continues to flash, check the placement at that point. Need to insert syringe with quite a firm action.

Syringe Detection and Confirmation confirm syringe size and brand match screen message. Press YES key to confirm or scroll to view closest matches

Summary Screen and Starting the Pump The summary screen confirms: Volume to be infused Duration of infusion Rate (ml/h) Press YES to confirm Pump prompts START INFUSION? Check line is connected to access device or insert cannulae, ensure clamp is off and press YES to start infusion What are the indicators that the pump is infusing?

Running Screen Top line - Infusion Duration remaining is displayed Main line - Infusion rate is displayed in ml/hr Bottom line alternates between syringe size/brand and the message <<<< pump delivering (in case keypad LED disabled) Green LED indicator (above ON/OFF key) flashes. (frequency fixed in Change Set up mode/ can be disabled to extend battery life) No audible sound when running, cf Graseby.

Program Lock If the Program Lock is ON Pre-set duration is locked ( at 24 hours ) User cannot change VTBI, volume to be infused. (entire syringe contents will be delivered) User cannot change infusion rate calculated by the pump Infusion Summary Screen is displayed immediately after syringe confirmation Check & Confirm Infusion Parameters and Start Infusion

Recommended Checks During Infusion Check the display- pump is delivering & infusion rate is as programmed Press the INFO key to check - Single press – VTBI & VI (volume infused) Double press- battery life remaining VTBI = volume to be infused and VI = volume infused.

Alarm Conditions Alarm Possible Cause Action Occlusion or Syringe empty Pt access device blocked, kinked, clamped. Occlusion. Actuator has reached minimum travel position Remove occlusion and restart. Flush or replace access device Release clamp End of program, turn pump OFF Syringe Displaced Syringe has been removed or displaced Check & Confirm syringe seated correctly and Resume Pump Unattended Pump left or no key presses detected for 2 minutes Start infusion, continue programming or switch off Near End 15 minutes from end of infusion Prepare to change syringe or switch off End Program Infusion Complete Pump will either default to KVO, await nurse, or alarm, switch pump off Low battery Battery is almost depleted (30 minutes left) Prepare to change battery End Battery Battery is depleted Change battery If pump not running green flashing light becomes constant red light. Alarms will continue until problem resolved; can be muted by pressing yes/start Near end and low battery are intermittent alarms..

Troubleshooting Fault Possible Cause Action The pump will not start No battery present Battery inserted incorrectly Battery is depleted/very low Pump is faulty Fit a battery Re-align battery terminals Fit a new battery Service required Infusion ended early/going too quickly Incorrect rate set Wrong syringe brand confirmed during set up Pump faulty or incorrectly calibrated Check displayed rate against prescription change if necessary Ensure correct understanding of user/educate Service/calibration required The pump has stopped before emptying syringe Exhausted battery Faulty pump Fit new battery, turn pump on, confirm syringe size and brand select to resume infusion Return for service

Patient Safety Optional accessories available: Rigid lockbox (with key) for all syringes up to 30ml Carry pouch to protect pump and/or lockbox Use of these accessories protects the syringe pump, syringe and contents from damage and/or tampering Keys are standard for all boxes.

Inspection and Maintenance Inspect Box contents Damage Missing items Cleaning - damp cloth, weak 10% bleach solution to decontaminate, do not immerse in any fluid In case of malfunction make a written note of: - Pump serial number (see back of unit) Circumstances (as detailed as possible) screen messages/error codes (press info key to obtain) and note withdraw pump from use and return to authorised service engineers for inspection

McKinley Contact Details & Reference Materials McKinley office Tel: 01253 894646 (info@mckinleymed.co.uk) Clinical Support Tel: 07786 077920 (gmckenzie@mckinleymed.co.uk) Tech. Support Tel: 01253 894729 (service@mckinleymed.co.uk) Patient Reference Guide (Ref:0504T34PIL) User Pocket reference (Abridged – Program Lock ON) (Ref: 0505T34PRA) (Full – Program Lock Disabled) (Ref:0504T34PRF) T34 Instruction manual (Ref: 100-090SM)

WARNING ! When changing infusion switch the pump OFF. This screen will appear if the battery goes flat and is replaced without the syringe being removed or if the syringe contents are changed and the pump is not switched off [but just stopped]. ‘NO for new program’ always defaults to 24hrs. ‘Yes to resume’ protects the prescription i.e. it continues at the same rate [volume and time may change].