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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting situations where a BD Alaris infusion pump appears to deliver medication at an incorrect flow rate or does not deliver fluid as expected. Users may report that the infusion is running slower or faster than programmed, the fluid level is not decreasing, or the pump indicates it is infusing but little or no medication is reaching the patient.
Many of these issues are caused by IV set installation problems, flow restrictions, or configuration errors rather than an internal pump failure. This guide focuses on verifying those external causes first.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- If the pump is connected to a patient, transfer the infusion to another functioning pump before beginning troubleshooting.
- Ensure medication delivery is not interrupted during evaluation.
- Never perform troubleshooting that could affect therapy while the device is connected to a patient.
Verify the reported issue
- Confirm what the user observed.
- Determine whether the pump appeared to run but fluid was not moving, the infusion completed too quickly, or the medication bag level did not change as expected.
- Understanding the complaint helps determine where to start.
Confirm the programmed infusion settings
- Check the programmed rate, volume to be infused (VTBI), and infusion mode.
- Incorrect programming (such as a low rate or incorrect units) can make the infusion appear inaccurate.
Inspect the IV set installation in the pump channel
- Open the pump door and confirm the IV tubing is correctly seated in the pumping mechanism.
- Tubing that is misaligned, twisted, or not fully seated can cause inconsistent flow or prevent the pump from moving fluid properly.
Verify the correct IV set type is being used
- Ensure the tubing set is compatible with the Alaris pump and matches the set type configured in the pump.
- Using the wrong tubing set may affect flow accuracy.
Check for kinks, clamps, or restrictions in the IV line
- Inspect the tubing from the IV bag to the distal end.
- Kinks, closed roller clamps, or tight bends can restrict flow and cause inaccurate delivery.
Inspect the drip chamber and fluid source
- Ensure the IV bag contains fluid and the drip chamber is properly primed.
- An empty bag, partially primed line, or collapsed bag can cause the pump to appear to run without delivering fluid.
Check for upstream or downstream occlusions
- Verify that the line is not occluded between the bag and pump (upstream) or between the pump and patient (downstream).
- Even partial occlusions may slow flow without immediately triggering an alarm.
Confirm the pump door is fully closed and latched
- A partially closed door may affect the pumping mechanism and lead to inconsistent delivery.
Run a test infusion using a known-good IV set
- If available, install a new compatible IV set and run a controlled test infusion using a test bag or water source.
- This helps determine whether the issue was related to the original tubing set.
Observe pump operation during the test infusion
- Monitor whether the pump rotor moves smoothly and whether fluid visibly progresses through the tubing.
- Irregular rotor movement or lack of fluid movement may indicate an internal pump mechanism issue.
If the Problem Persists
If the infusion pump continues to deliver inaccurate flow or fails to move fluid after verifying programming, tubing installation, and external restrictions, the issue may be related to an internal pumping mechanism, calibration drift, or sensor failure.
At this point the device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation according to hospital procedures
Knowing when to stop troubleshooting prevents unnecessary risk and ensures the device receives proper evaluation.
Clinical Use Tip
Never troubleshoot an infusion pump while it is actively connected to a patient. If a flow accuracy issue is suspected, the patient should be transferred to another infusion pump before the device is evaluated. Maintaining uninterrupted and accurate medication delivery is critical for patient safety.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Nurse reported infusion running at 50 mL/hr but medication bag level not decreasing and patient not receiving expected volume.”
Cause
What was observed during troubleshooting.
Example:
“IV tubing found partially kinked near pump channel causing restricted flow.”
Resolution
What action was taken.
Example:
“Tubing repositioned and replaced with new compatible IV set. Pump tested and confirmed normal flow.”
Helpful Details to Include (If Known)
- Infusion rate programmed
- VTBI setting
- IV set type used
- Tubing condition (kinks or clamps)
- Alarm messages observed
- Pump door latch status
- Test infusion results
- Final device status
Final Thought
Accurate infusion delivery is critical to patient care, which makes systematic troubleshooting essential. Always begin with programming verification, tubing setup, and simple mechanical checks before suspecting internal failure. When external causes have been ruled out, removing the device from service and documenting findings ensures patient safety and supports effective repair.
That is successful troubleshooting.