2DISADVANTAGES OF T34 [ When compared with Graseby ] WeightSizeBattery lifeWeight; T g, MS16 135g.Approx dimensions; T34 67x169x39mm, MS16 61x166x23Duracell alkaline battery life; T34 approx 2-5 days, Ms16 approx 50 days
3ADVANTAGES OF T34 SINGLE MODEL, THEREFORE NO CONFUSION 3 POINT CONTACT DETECTIONSYRINGE RECOGNITIONAUTOMATIC CALCULATIONLCD AND INSTRUCTIONSPUMP CAN BE CONFIGUREDLOG EVENT MEMORYSUPERIOR RANGE OF ALARMSLog event memory of approx 500 events. Each action, e.g. press stop = an event. Gives 10 pieces info re each even [inc. VI, VTBI, rate, current, occlusion pressure.More about other advantages as go thru presentation.
4Dock / Connection PortAllows technicians to upload and download info. [e.g. add new programs]
5Check Service DateAnnual service mandatory. If more 2/12 over due date for service should not be used and sent to medical electronics.
7T34-Battery fitting and Testing 9 volt alkaline or lithium battery only.Variation in size between different brands (do not force into compartment)Battery TestSwitch the pump onPress INFO keySelect battery life using ↓↑ keys, press YESVerify sufficient battery power for programme.Replace when battery level 35% or belowNo alarm when battery inserted cf Graseby.
8T 34 KeypadINFO; access event log, Set Up (code protected), battery status, keypad lock.UP/DOWN arrow keys- scroll through optionsYES/START key- confirms selection/starts infusion.NO/STOP- step back a screen/stops infusion.FF (forward)-moves actuator forwardBACK-moves actuator backON/OFFFF in stages for safety. Barrel arm must be down to move actuator. No clutch cf Graseby. No ‘boost’Can’t turn off accidently; press stop and then press and hold off.
9InstructionsAide memoire but pump should not be used if person has not received training. Eden Valley Hospice staff [ ] and Palliative Care unit staff at West Cumberland Hospital [ and ask for Pal care Unit] can give advice.
10L.C.D. ScreenFollow instructions on the screen!!
11T34 LCD Screen 4 Line Liquid Crystal Display (LCD) Backlit – activated on any key press (time adjust/ disable)Displays infusion parameters and user instructions
12T34- 3 Point Contact Recognition and Syringe Loading 132Barrel clamp arm- (detects syringe size/width of barrel, secures)Syringe ear/collar sensor (detects secure loading of syringe collar)Plunger sensor (detects secure loading of syringe plunger)Pump should always know what size of syringe e.g. 10 or 20 ml etc. It may occasionally not identify syringe brand if two manufacturers syringes internal dimensions are very similar. But operator can over-rule if pump ‘wrong’ when confirming syringe type/brand.Once size and brand confirmed the pump knows how far back the plunger is and therefore how much fluid volume there is. It is defaulted to run over 24 hrs and therefore can work the hourly rate out. It infuses in mls per hour NOT mm per hour cf Graseby
13Access Codes and Keypad Lock Secure user access codes (2) - prevent misuseAccess codes not provided to local users as it is envisaged that all subcutaneous infusions in palliative care will run over a 24 hour periodKeypad lockPress and hold INFO key to lock, repeat to unlock
14Infusion set up and Programming Draw up prescribed medication and diluent to a minimum volume of 12 millilitres in the syringe. The volume may need to be greater than this in some circumstances.Manually prime the extension set and Saf-t-intima set.DO NOT load syringe, ensure barrel clamp bar is down.Switch the pump on.Screen displays the following …..Pre-Loading…. messageThis screen changes very quickly. Preloading takes actuator back to where it started at beginning of previous infusion; useful if drawing up same volume on consecutive days.when pre-load has finished use the FF or BACK keys to adjust the actuator position if required (forward movement limited + no clutch)
15Syringe Placement Lift the barrel clamp Seat syringe collar/ear and plunger so the back of the collar/ear sits against the back of the central slot (ensure correct placement)Lower barrel clamp armScreen syringe graphic ceases to flash at each point as syringe is correctly seated.If any point continues to flash, check the placement at that point.Need to insert syringe with quite a firm action.
16Syringe Detection and Confirmation confirm syringe size and brand match screen message. Press YES key to confirm or scroll to view closest matches
17Summary Screen and Starting the Pump The summary screen confirms:Volume to be infusedDuration of infusionRate (ml/h)Press YES to confirmPump prompts START INFUSION?Check line is connected to access device or insert cannulae, ensure clamp is off and press YES to start infusionWhat are the indicators that the pump is infusing?
18Running Screen Top line - Infusion Duration remaining is displayed Main line - Infusion rate is displayed in ml/hrBottom line alternates between syringe size/brand and the message <<<< pump delivering (in case keypad LED disabled)Green LED indicator (above ON/OFF key) flashes. (frequency fixed in Change Set up mode/ can be disabled to extend battery life)No audible sound when running, cf Graseby.
19Program Lock If the Program Lock is ON Pre-set duration is locked ( at 24 hours )User cannot change VTBI, volume to be infused. (entire syringe contents will be delivered)User cannot change infusion rate calculated by the pumpInfusion Summary Screen is displayed immediately after syringe confirmationCheck & Confirm Infusion Parameters and Start Infusion
20Recommended Checks During Infusion Check the display- pump is delivering & infusion rate is as programmedPress the INFO key to check -Single press – VTBI & VI (volume infused)Double press- battery life remainingVTBI = volume to be infused and VI = volume infused.
21Alarm Conditions Alarm Possible Cause Action Occlusion or Syringe emptyPt access device blocked, kinked, clamped. Occlusion.Actuator has reached minimum travel positionRemove occlusion and restart.Flush or replace access deviceRelease clampEnd of program, turn pump OFFSyringe DisplacedSyringe has been removed or displacedCheck & Confirm syringe seated correctly and ResumePump UnattendedPump left or no key presses detected for 2 minutesStart infusion, continue programming or switch offNear End15 minutes from end of infusionPrepare to change syringe or switch offEnd ProgramInfusion CompletePump will either default to KVO, await nurse, or alarm, switch pump offLow batteryBattery is almost depleted (30 minutes left)Prepare to change batteryEnd BatteryBattery is depletedChange batteryIf pump not running green flashing light becomes constant red light. Alarms will continue until problem resolved; can be muted by pressing yes/startNear end and low battery are intermittent alarms..
22Troubleshooting Fault Possible Cause Action The pump will not start No battery presentBattery inserted incorrectlyBattery is depleted/very lowPump is faultyFit a batteryRe-align battery terminalsFit a new batteryService requiredInfusion ended early/going too quicklyIncorrect rate setWrong syringe brand confirmed during set upPump faulty or incorrectly calibratedCheck displayed rate against prescription change if necessaryEnsure correct understanding of user/educateService/calibration requiredThe pump has stopped before emptying syringeExhausted batteryFaulty pumpFit new battery, turn pump on, confirm syringe size and brand select to resume infusionReturn for service
23Patient Safety Optional accessories available: Rigid lockbox (with key) for all syringes up to 30mlCarry pouch to protect pump and/or lockboxUse of these accessories protects the syringe pump, syringe and contents from damage and/or tamperingKeys are standard for all boxes.
24Inspection and Maintenance Inspect Box contentsDamageMissing itemsCleaning - damp cloth, weak 10% bleach solution to decontaminate, do not immerse in any fluidIn case of malfunction make a written note of: -Pump serial number (see back of unit)Circumstances (as detailed as possible)screen messages/error codes (press info key to obtain) and notewithdraw pump from use and return toauthorised service engineers for inspection
25McKinley Contact Details & Reference Materials McKinley office Tel:Clinical Support Tel:Tech. Support Tel:Patient Reference Guide (Ref:0504T34PIL)User Pocket reference(Abridged – Program Lock ON) (Ref: 0505T34PRA)(Full – Program Lock Disabled) (Ref:0504T34PRF)T34 Instruction manual (Ref: SM)
26WARNING ! When changing infusion switch the pump OFF. This screen will appear ifthe battery goes flat and isreplaced without the syringe beingremoved or if the syringe contentsare changed and the pump is notswitched off [but just stopped].‘NO for new program’ alwaysdefaults to 24hrs. ‘Yes to resume’protects the prescription i.e. itcontinues at the same rate [volumeand time may change].