Asset Type

Infusion Pump

Manufacturer

BD

Model

Alaris

What This Guide Helps With

This guide assists Clinical Engineering in troubleshooting situations where a BD Alaris infusion pump generates Upstream Occlusion or “Check IV Set” alarms. These alarms indicate that the pump is detecting resistance or lack of fluid flow before the pumping mechanism, typically somewhere between the fluid container and the pump.

Many of these alarms are caused by simple external issues such as closed clamps, kinked tubing, improperly installed administration sets, or empty fluid containers. This guide focuses on identifying those common causes before assuming a device failure.

Step-by-Step Troubleshooting

Ensure Patient Safety First

• If the pump is currently connected to a patient, transfer the infusion to a backup pump or alternate delivery method before troubleshooting.
• Do not continue troubleshooting while the pump is delivering medication to a patient.

Confirm the Alarm Message

• Verify the exact alarm displayed on the pump screen.
• Common related alarms include:
• Upstream Occlusion
• Check IV Set
• Flow Error
• Document the exact alarm wording for the work order.

Check the IV Fluid Container

• Ensure the IV bag or bottle is not empty or nearly empty.
• Low fluid levels can introduce air or reduce pressure in the line, which may trigger upstream flow alarms.

Inspect Roller Clamps and Slide Clamps

• Follow the tubing from the fluid container to the pump and verify that:
• Roller clamps are fully open
• Slide clamps are not partially closed
• Partially closed clamps are a very common cause of upstream occlusion alarms.

Check for Kinks or Pinched Tubing

• Inspect the IV tubing between the fluid container and the pump for:
• Sharp bends
• Kinks
• Tubing caught under equipment
• Compression from bed rails or poles
• Any restriction in the tubing can cause the pump to detect reduced upstream flow.

Verify Proper IV Set Installation

• Open the pump door and verify the IV administration set is installed correctly.
• Check that:
• The tubing is seated correctly in the pumping channel
• The set is aligned with the pump’s guides
• The cassette or tubing segment is not twisted
• Improper loading can affect the pump’s ability to detect flow correctly.

Check the Drip Chamber

• Ensure the drip chamber is:
• Filled to the proper level (usually about half full)
• Not collapsed or overfilled
• A collapsed drip chamber can restrict flow from the fluid container.

Inspect the Spike Connection

• Confirm the IV set spike is fully inserted into the fluid container port.
• Look for:
• Loose spike connections
• Air entering the line
• Damaged ports
• Improper spike placement can reduce fluid flow.

Try a Different IV Set

• If the alarm continues:
• Replace the administration set with a new compatible IV set
• Defective tubing, manufacturing issues, or internal tubing obstructions can cause persistent alarms.

Test with a Known Good Setup

• For verification:
• Connect a new IV set
• Hang a full fluid bag
• Prime the line
• Run the pump briefly off-patient
• If the pump runs normally, the original setup was likely the cause.

If the Problem Persists

If upstream occlusion or “Check IV Set” alarms continue after verifying clamps, tubing, fluid source, and IV set installation, the issue may involve internal pump components such as:

• Pressure sensors
• Pumping mechanism alignment
• Internal flow detection components

At this point the device should be:

• Removed from service
• Labeled Out of Service
• Sent for repair or bench evaluation

Escalating the device for further evaluation after ruling out external causes is appropriate Clinical Engineering troubleshooting.

Clinical Use Tip

Never troubleshoot infusion pump flow issues while the device is actively connected to a patient.

If a pump alarm occurs during therapy:

• Transfer the patient to a backup infusion pump first
• Then evaluate the device safely off-patient.

Maintaining uninterrupted therapy and patient safety must always come first.

Work Order Documentation (CCR Method)

CCR = Complaint, Cause, Resolution

Complaint

What was reported by the clinical staff.

Example:
“Nursing reported repeated ‘Upstream Occlusion / Check IV Set’ alarms during infusion setup.”

Cause

What was observed during troubleshooting.

Example:
“Inspection revealed the roller clamp on the IV tubing was partially closed, restricting flow to the pump.”

Resolution

What action was taken.

Example:
“Opened the roller clamp fully and verified normal infusion operation. Alarm cleared and pump returned to service.”

Helpful Details to Include (If Known)

• Outlet tested (if charging)
• IV set type used
• Bag level at time of alarm
• Clamp position
• Tubing condition (kinks or compression)
• Alarm message displayed
• Test results with new IV set
• Final device status

Final Thought

Upstream occlusion alarms on infusion pumps are commonly caused by simple setup issues such as clamps, tubing kinks, or improperly installed IV sets. Clinical Engineering troubleshooting should always begin with these easily verified external factors before assuming device failure. When the basic causes are ruled out, promptly removing the device from service and documenting findings protects both patient safety and equipment reliability.

That is successful troubleshooting.