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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting ICU Medical GemStar infusion pumps that report occlusion alarms despite a free-flowing line. These alarms often indicate resistance in the fluid path, but in many cases, they are caused by external factors such as tubing kinks, improper cassette installation, sensor misalignment, or infusion setup errors. The guide emphasizes logical external checks before assuming internal component failure.
Step-by-Step Troubleshooting
Verify Tubing and Line Setup
- Ensure tubing is properly primed and free of kinks, twists, or bends.
- Confirm that the tubing size and type match the pump’s requirements.
- Why it matters: Tubing issues are the most common cause of false occlusion alarms.
Check Cassette Installation
- Open and re-seat the cassette, ensuring it locks securely into place.
- Inspect for debris or obstruction in the cassette path.
- Why it matters: Misalignment can create incorrect pressure readings, triggering occlusion alarms.
Inspect Pump Door and Sensors
- Ensure the pump door closes fully and the sensor arms engage properly.
- Clean any visible residue from sensors using a lint-free cloth and approved cleaner.
- Why it matters: Sensors detect line pressure; contamination or misalignment can cause false alarms.
Confirm Flow Rate and Infusion Settings
- Verify the programmed flow rate is within pump specifications.
- Ensure the line is not being pinched externally (e.g., under bedrails or clamps).
Swap Tubing or Cassette
- If available, replace the current tubing set and cassette with a known good set.
- Why it matters: Isolates the problem to the pump versus consumables.
Power Cycle the Pump
- Turn the pump off, wait 10 seconds, then restart.
- Recheck for occlusion alarms without changing the setup.
- Why it matters: Resets pump sensors and clears transient errors.
If the Problem Persists
Common external causes have been ruled out. The issue is likely internal (e.g., pressure sensor or control board malfunction).
Action:
- Remove the pump from service.
- Label it “Out of Service.”
- Send to biomedical repair bench or manufacturer for evaluation.
Clinical Use Tip
- Never troubleshoot occlusion alarms on an active patient.
- Move the patient to another infusion pump if the current pump is alarming.
- Only perform checks when patient safety is ensured.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Pump reports occlusion alarms even though the line is free-flowing.”
Cause
What was observed during troubleshooting.
Example:
“Tubing and cassette properly installed; no kinks or obstructions observed. Pump door and sensors functioning normally. Alarm persists after tubing and cassette swap.”
Resolution
What action was taken.
Example:
“Pump removed from service, labeled Out of Service, and sent to repair bench for internal evaluation.”
Helpful Details to Include
- Outlet and power verified
- Tubing and cassette swapped
- Door and sensor engagement confirmed
- Flow rate settings checked
- Alarm persisted after power cycle
Final Thought
Patient safety and logical troubleshooting are paramount. Begin with the simplest external factors before escalating. Proper documentation ensures traceability and informs future troubleshooting. Knowing when to remove a pump from service is an essential skill for Clinical Engineering.
That is successful troubleshooting.