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What This Guide Helps With
This guide helps troubleshoot a Downstream occlusion alarm on an ICU Medical CADD-Solis infusion pump. This alarm occurs when the pump detects downstream pressure or restriction in the patient line. The pump may stop medication delivery and issue visual and audible alarms until the occlusion is corrected.
The technical information notes that the downstream occlusion analog sensor trips when tubing inflation corresponds to 18 ± 9 psi. The listed maximum infusion pressure is 27 psi / 1.86 bar.
Step-by-Step Troubleshooting
Ensure Patient Safety First
- Do not continue using the pump on an active patient if medication delivery may be unsafe or interrupted.
- Notify clinical staff immediately if the alarm occurs during active infusion.
- Use a backup pump or alternate medication delivery method if therapy must continue.
- Do not disconnect the patient line until pressure is relieved safely according to facility procedure.
Verify the Reported Alarm
- Confirm the pump display shows Downstream occlusion.
- Ask staff when the alarm occurs: immediately after starting, during infusion, after patient movement, after medication change, or intermittently.
- Check whether the infusion stops when the alarm occurs.
- Confirm the correct administration set, cassette, and tubing are being used.
Check the Tubing and Clamps
- Inspect the tubing from the cassette toward the patient.
- Look for a closed clamp, partially closed clamp, pinched tubing, kink, twist, or tubing caught under equipment.
- Check that the line is not compressed by the bed rail, patient position, blankets, pump door, or transport setup.
- Correct any obvious external tubing restriction before restarting the infusion.
Check for Patient-Line or Catheter Obstruction
- Have clinical staff assess the IV site, catheter, access device, or downstream connection.
- Look for signs of a blocked catheter, positional IV, occluded extension set, or restricted patient access line.
- Do not flush, manipulate, or disconnect patient access unless performed by qualified clinical staff following facility policy.
- Restart the pump only after the downstream obstruction has been corrected.
Check Filters, Connectors, and Accessories
- Inspect downstream filters, needleless connectors, extension sets, stopcocks, and adapters.
- Look for a clogged filter, closed stopcock, incompatible accessory, or high-resistance setup.
- Replace questionable disposable components according to facility procedure.
- Confirm the line is fully open from the cassette to the patient connection before restarting.
Check for High Back Pressure
- Review whether the infusion setup creates excessive downstream resistance.
- Check for small-bore tubing, long extension sets, high-viscosity medication, restrictive filters, or elevated pressure from the patient access site.
- Confirm the setup matches clinical and manufacturer-approved use.
- If the alarm repeats with a normal-looking setup, remove the pump from service for evaluation.
Restart Only After Correction
- Relieve downstream pressure safely before disconnecting any tubing.
- Clear the alarm only after the occlusion or restriction has been corrected.
- Restart the infusion according to facility procedure.
- Observe the pump long enough to confirm the alarm does not immediately return.
If the Problem Persists
If closed clamps, kinked tubing, blocked catheter concerns, clogged filters, high back pressure, patient-line obstruction, and accessory issues have been ruled out, remove the infusion pump from service.
Label the pump Out of Service and send it for repair or bench evaluation. Do not return the pump to clinical use if the Downstream occlusion alarm repeats without a confirmed external cause.
Clinical Use Tip
Never troubleshoot this alarm on an active patient in a way that could delay therapy, disconnect medication delivery unsafely, or expose the patient to pressure release risk. Move the patient to a backup pump or alternate approved delivery method first.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"ICU Medical CADD-Solis infusion pump alarming Downstream occlusion during infusion and stopping delivery."
Cause
What was observed during troubleshooting.
Example:
"Found downstream tubing kinked near patient connection, causing elevated line pressure and repeated occlusion alarm."
Resolution
What action was taken.
Example:
"Tubing restriction corrected by clinical staff, line pressure relieved safely, pump restarted and observed with no repeat Downstream occlusion alarm. Pump returned to service."
Helpful Details to Include (If Known)
- Alarm behavior
- Accessories swapped
- Power behavior
- Environmental factors
- Indicator lights
- Final device status
Final Thought
A Downstream occlusion alarm should be handled as a medication delivery interruption first and an equipment problem second. Start with patient safety, check the external fluid path, confirm the line is open, and escalate the pump only after tubing, catheter, filter, accessory, and back-pressure causes have been ruled out.
That is successful troubleshooting.