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What This Guide Helps With
Troubleshoots upstream occlusion or empty-container alarms caused by depleted fluid, closed clamps, tubing restrictions, container position, or administration-set problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Therapy
Do not troubleshoot an unreliable infusion pump while a patient depends on it. Transfer clinically necessary therapy to another verified pump or approved delivery method before extended testing.
Inspect for an actually empty medication container, interruption of critical therapy, leakage, or damaged tubing.
Expected outcome: Therapy continuity is maintained and the pump can be tested safely. If the pump or set is damaged or leaking, remove it from service immediately.
2. Confirm the Exact Report
Verify whether the pump displays an upstream occlusion, empty-container, or similar no-fluid condition.
Determine whether the alarm occurs immediately after starting, near the end of the container, after repositioning, or only with a particular administration set.
Expected outcome: The failure pattern is clearly defined. If the issue cannot be reproduced and the pump completes functional testing normally, troubleshooting can stop.
3. Verify Fluid Is Available
Confirm that the source container contains sufficient fluid and that the tubing inlet remains submerged or properly connected as applicable.
Inspect for a collapsed flexible bag, improperly vented rigid container when applicable, or a source container positioned in a way that prevents normal fluid delivery.
Expected outcome: An adequate fluid source is present and able to supply the pump. If correcting the container condition resolves the alarm, troubleshooting can stop.
4. Check Upstream Clamps and Connections
Trace the administration set from the source container to the pump.
Verify:
- Roller clamps are open where appropriate
- Slide clamps are not engaged
- Spike or connector is fully seated
- Tubing is not pinched
- Stopcocks are correctly positioned
- Filters or accessories are not visibly obstructed
Expected outcome: The entire upstream path is open. If correcting a clamp or connection clears the alarm, troubleshooting can stop.
5. Inspect the Upstream Tubing
Look for kinks, collapsed tubing, twisting, stretching, tubing trapped beneath equipment, or tight bends near the pump.
Pay special attention to tubing passing through pole-mounted accessories.
Expected outcome: Tubing remains open and unrestricted throughout normal positioning. If eliminating a kink resolves the issue, troubleshooting can stop.
6. Verify Administration Set Installation
Unload and reinstall the compatible administration set using approved procedures.
Confirm that the set is routed correctly and not caught, pinched, partially seated, or distorted where it enters the pumping mechanism.
Expected outcome: The set is correctly installed and recognized. If the pump operates normally after proper reloading, troubleshooting can stop.
7. Substitute a Known-Good Set and Fluid Source
When the cause is not obvious, install a known-good compatible administration set and suitable test fluid container.
Do not continue using a suspect disposable during verification.
Expected outcome: The pump runs without an inappropriate upstream or empty-container alarm. If so, the removed administration set or fluid source was the likely cause and troubleshooting can stop.
8. Evaluate Environmental and Positioning Factors
Confirm that ordinary movement of the IV pole, pump, container, or tubing does not create an upstream restriction.
Check whether the fluid container is hanging freely and whether accessories are compressing the tubing.
Expected outcome: Stable operation continues through normal equipment positioning. If correcting positioning resolves the issue, troubleshooting can stop.
9. Perform Final Functional Verification
Using an approved bench setup, verify startup, set recognition, infusion initiation, alarm operation, display function, and stable delivery through a known-good fluid path.
Expected outcome: The pump operates normally without false upstream or empty-container alarms. If all required tests pass, troubleshooting can stop and the pump may be returned to service according to policy.
10. Escalate if the Alarm Persists
If the alarm remains with a full test container, unrestricted tubing, and a known-good compatible set, discontinue external troubleshooting.
Do not adjust internal sensors or enter unauthorized service or calibration functions.
Expected outcome: The pump is identified as requiring service-level evaluation.
If the Problem Persists
External causes such as empty containers, clamps, tubing restrictions, improper loading, and disposable-set problems have been ruled out. Remaining causes may involve sensing, pumping performance, configuration, calibration, or another internal service-level condition.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate manufacturer documentation and approved test equipment
- Repaired, calibrated, or configured only by qualified personnel
Complete appropriate return-to-service testing before clinical use.
Knowing when to stop external troubleshooting and escalate is proper troubleshooting.
Clinical Use Tip
Do not assume an empty-container alarm is false until the source container and entire upstream fluid path have been physically verified.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Nursing reported the Sapphire repeatedly alarmed for upstream occlusion shortly after starting an infusion."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the upstream roller clamp partially closed on the administration set."
Resolution
What action was taken.
Example:
"Opened the clamp, verified unrestricted flow, and completed pump functional testing without recurrence."
Helpful Details to Include (If Known)
- Exact alarm wording
- Fluid remaining in source container
- Container type and position
- Clamp positions
- Upstream tubing condition
- Administration set used
- Known-good set substitution
- Whether the problem followed the disposable
- Alarm behavior during bench testing
- Final device status
Final Thought
Verify the simple fluid-source and tubing conditions first. An upstream alarm often reflects a real restriction outside the pump, and careful verification should precede any assumption of internal failure or escalation.
That is successful troubleshooting.