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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting an ICU Medical Plum 360 infusion pump that is suspected of delivering inaccurate infusion volumes or rates. Symptoms may include:
- Infusion rate alarms not matching programmed rates
- Volume delivered significantly different from expected
- Dose inconsistencies reported by clinical staff
This guide focuses on external and verifiable checks before assuming an internal calibration issue.
Step-by-Step Troubleshooting
Verify Setup and Programming
- Ensure the correct infusion set, cassette, and fluid type are loaded.
- Confirm the pump is programmed correctly (rate, volume, units).
- Incorrect setup can mimic calibration errors.
Check for Kinks or Obstructions
- Inspect the tubing and line for kinks, air bubbles, or occlusions.
- Blockages can cause pressure fluctuations that affect delivery accuracy.
Inspect Cassette Placement and Condition
- Remove and re-seat the cassette to ensure proper alignment.
- Check for wear, cracks, or debris that may interfere with flow.
Check Power Source and Battery Status
- Low battery or unstable power can affect pump performance.
- Confirm the pump is fully charged or connected to AC power.
Perform Manufacturer-Recommended Calibration Check
- If available, run the pump’s self-test or calibration routine following manufacturer guidelines.
- Observe for errors or deviations from standard flow rates.
Use a Test Fluid Run (Optional, if safe)
- With a clean line and safe test fluid, run a measured infusion and verify the output volume.
- Compare delivered volume to programmed volume to assess accuracy.
If the Problem Persists
If the pump continues to deliver inaccurate volumes after all external checks:
- Remove the device from service.
- Label as Out of Service.
- Send for internal calibration check or repair per ICU Medical service procedures.
Knowing when to stop prevents unsafe patient exposure and further device damage.
Clinical Use Tip
- Do not attempt troubleshooting on an active patient.
- Move the patient to another verified pump first.
- Ensure all test runs are done with safe, non-medicated fluid when verifying accuracy.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“Pump delivering infusion rates inconsistent with programmed settings.”
Cause
What was observed during troubleshooting.
Example:
“External inspection revealed proper cassette placement, no tubing kinks, and correct programming. Self-test indicated potential calibration deviation.”
Resolution
What action was taken.
Example:
“Pump removed from service, labeled Out of Service, and sent for calibration verification by vendor. Patient transferred to verified pump.”
Helpful Details to Include
- Self-test or calibration error codes
- Tubing/cassette inspection results
- Measured vs. programmed infusion volumes
- Power source or battery status
- Final device status
Final Thought
Accurate infusion delivery is critical for patient safety. Always start with external checks and documented programming verification before assuming internal calibration failure. Escalating appropriately ensures patient safety and maintains equipment reliability.
That is successful troubleshooting.