1. Setup & Use - Integrated Set
OrthoPAT® System
Setup & Use - Integrated Set
Copyright © 2009, 2011 Haemonetics Corporation. All Rights Reserved. Haemonetics,
OrthoPAT, Cell Saver, cardioPAT, SmartSuction Harmony, and TEG are trademarks or registered
trademarks of Haemonetics Corporation in the USA, other countries, or both.
TRN-PPT IE(AA)
Copyright © 2009 Haemonetics Corporation. All Rights Reserved TRN-PPT US-(AA)
Haemonetics, cardioPAT, Cell Saver, Infonalé, OrthoPAT, SmartSuction Harmony, and TEG are trademarks or registered trademarks of Haemonetics Corporation in the USA, other countries, or both.

2. Welcome to Haemonetics Training for the OrthoPAT® System and Disposables

3. Prerequisites
Before taking this lesson, the following module(s) should have been completed:
Cell Salvage Introduction: Transfusion
OrthoPAT® System and Integrated Disposable

4. Topics IntraOp Setup Transition from IntraOp Mode to PostOp Mode
Transporting OrthoPAT® System OrthoPAT® System and Patient in PostOp Mode
PostOp Only Setup
Transfusing OrthoPAT® Product

5. OrthoPAT System & Integrated Disposable Objectives
Be able to:
Name the steps required to setup the OrthoPAT® System for IntraOp use
Name the steps required to transition the OrthoPAT® System from Intra-Op mode to PostOp mode
Name the steps required to setup the OrthoPAT® System for PostOp use only
Name the steps required to transfuse an OrthoPAT® System product

6. Device and IV Pole Setup

7. Mounting OrthoPAT® System on IV Pole
It is recommended to use a sturdy IV pole that has at least 5 wheels for extra stability
Place OrthoPAT® System on the edge of a stable surface with the IV Pole Clamp facing out

8. Mounting OrthoPAT® System on IV Pole
Completely loosen right-hand wing bolt
Partially loosen left-hand wing bolt until the right-hand wing bolt and right-hand side of IV Pole clamp can hang down

9. Mounting OrthoPAT® System on IV Pole
With the OrthoPAT® System still on the stable surface, move the IV Pole into the space on the back of the device
Raise the right-hand side of the IV Pole Clamp and start the right-hand wing bolt into its threads
Do Not tighten the right-hand side of the IV Pole Clamp, yet!

10. Mounting OrthoPAT® System on IV Pole
Place the left-hand side into the proper mounting grove and tighten left-hand wing bolt
The right-hand wing bolt may now be tightened
Move IV pole and device away from the surface, supporting the device until you are sure it will not slide down the pole

11. Mounting OrthoPAT® System on IV Pole
Finally, place your hand under the OrthoPAT® System and loosen the right-hand wing bolt enough to let it slide down the IV pole
Position the OrthoPAT® System so that the top of the cover is no more than 3 feet (36”) above the ground.
Re-tighten the right-hand wing bolt
The device is ready to use

12. What do you think?
Why is it important to keep the device no higher than 3 feet off of the ground?

13. What do you think?
Why is it important to keep the device no higher than 3 feet off of the ground?
Height from the floor affects PostOp suction. Increased height will reduce suction to the wound

14. IntraOp Setup

15. IntraOp Setup - Loading Integrated Set
Load Integrated Disposable Set as follows

16. IntraOp Setup - Loading Integrated Set
Seat Reservoir
Remove Retainer Ring and seat Dynamic Disk

17. IntraOp Setup - Loading Integrated Set
Load Retainer Ring
Lower header arm and verify it is securely latched

18. Why is it important to verify that the Header arm is securely latched?
What do you think?
Why is it important to verify that the Header arm is securely latched?

19. What do you think?
Why is it important to verify that the Header arm is securely latched?
An unlatched Header Arms is the most common cause of noisy disk’s and rotating seal failure leading to blood spills.

20. IntraOp Setup - Loading Integrated Set
Hang RBC and Waste Bag with labels facing out
Close Cover and ensure there are no pinched tubes

21. IntraOp Setup - Loading Integrated Set
Close all 3 reservoir port clamps*
2 IntraOp Ports
1 PostOp Port

22. IntraOp Setup - IntraOp Use
Plug in and turn power on
Device will now initialize
Connect to regulated wall vacuum or SmartSuction
Harmony® (AABB guidelines suggest –150 mmHg)
Spike 1 liter bag 0.9% Saline for injection

23. What do you think?
If wall suction is being used, what is the proper way to set the Regulator suction level?

24. What do you think?
If wall suction is being used, what is the proper way to set the Regulator suction level?
Close off the tubing between the regulator and OrthoPAT, then set the regulator lever

25. IntraOp Setup - IntraOp Use
Press RUN key to prime Dynamic Disk™ with saline solution (This will take approximately 3 minutes)
Operator may attend to other work until surgeon is ready to hand off IntraOp Suction tubing.

26. IntraOp Setup - IntraOp Use
When Surgeon is ready to begin:
Receive Yellow capped end of the A&A line and drip chamber from the field
Attach Yellow capped end of the A&A line to intra-op reservoir port, and open clamp

27. IntraOp Setup - IntraOp Use
Close the roller clamp, spike the anticoagulant
prime the drip chamber with ACD, CPD or 30,000 IU heparin/1 L bag 0.9% saline for injection
Open the roller clamp to prime reservoir (100–300 mL’s)
Set drip rate to approximately 1 drip per second

28. What do you think?
If vacuum were not turned on when the roller clamp was opened to prime the reservoir, what would happen?

29. What do you think?
If vacuum were not turned on when the roller clamp was opened to prime the reservoir, what would happen?
Anticoagulant would likely run out of the suction tip instead of being drawn into the reservoir.

30. IntraOp Setup - IntraOp Use
Place patient label on reservoir (optional)
Place patient label on RBC bag and note start time
Shed blood can now be aspirated

31. Transition From IntraOP Mode to PostOp Mode

32. PostOp Setup - PostOp Use
When surgery is complete, close anticoagulant roller clamp
Press the Suction key to turn off suction
Close clamp to reservoir port that is being used
Remove IntraOp Suction set and discard according to hospital biohazard policy

33. PostOp Setup - PostOp Use
Receive Yellow-capped end of post-op suction set tubing and attach to post-op reservoir port (Don’t Unclamp Port Yet!)
Press Run key to turn suction back on
When the wound is fully closed, unclamp reservoir port leading to the post-op suction tubing

34. PostOp Setup - PostOp Use
In PostOp mode an internal vacuum system maintains -75 mmHg suction to the wound drain.
If vacuum cannot be maintained at acceptable levels, Suction will be turned off and an alarm will be sounded.
The Suction key light will be turned off until the vacuum issue is resolved and the Suction key is pressed

35. PostOp Setup - PostOp Use
In order to facilitate drainage there is an intermittent vacuum release.
Every 10 minutes the OrthoPAT® System automatically releases vacuum for 30 seconds
Suction key light will remain on during this normal process

36. Transporting OrthoPAT® System and Patient In PostOp Mode

37. Transportation in PostOp Mode Beginning Transport
Ensure a person is designated to assist with movement of the OrthoPAT® System.
Just before beginning transport, unplug OrthoPAT® System
DO NOT TURN OrthoPAT® SYSTEM OFF
Internal battery power will maintain suction and volume accounting for at least ½ hour for transport.
As a precaution it is recommended that the screen volumes be written down prior to transport

38. Transportation in PostOp Mode Arriving at PACU/Ward
Plug in device!
Assure clamps at the reservoir are open to the wound drain line and the other ports are clamped
Assure the 4 appropriate keypad lights are lit: POST-OP, RUN, SUCTION, and PROCESS.
If not, press RUN key

39. What do you think?
If you were a nurse and wanted to know if the device was functioning properly from a distance what could you look for?

40. What do you think?
If you were a nurse and wanted to know if the device was functioning properly from a distance what could you look for?
Look for the 4 display lights! If 4 are not on you know something needs attention.

41. Transportation in PostOp Mode Arriving at PACU/Ward
Finally…
Note RBC bag reinfusion time – reinfuse RBC bag per hospital policies/procedures
Check saline bag and replace if necessary

42. Transfusing OrthoPAT Product (IntraOp or PostOp)

43. Transfusion of OrthoPAT Product
Press PROCESS key to stop processing (Leave suction on)
Close slide clamp on RBC line
Disconnect Luer connection/ bag from set
Cap bag using sterile (Red) cap tethered to bag

44. Transfusion of OrthoPAT Product
Connect replacement bag to processing set
Place patient label on new bag and note start time
Press RUN key to resume processing
Hand off removed RBC bag for reinfusion to patient
Reinfuse according to hospital policy

45. Transfusion of OrthoPAT Product
WARNING: Bag contains air –
DO NOT pressure reinfuse.
Transfuse packed RBC’s using a filter designed to retain particles potentially harmful to the donor-patient.
NOTE: This is a physician/hospital decision
Expiration dates and times for OrthoPAT product should be set in accordance with AABB Standards.

46. How is a blood administration set attached to the RBC bag?
What do you think?
How is a blood administration set attached to the RBC bag?

47. What do you think?
How is a blood administration set attached to the RBC bag?
There are two reinfusion ports on the top of the RBC bag. Remove one of them and spike in the blood administration set.

48. Questions?

49. OrthoPAT® System Setup & use – Integrated Set
Quiz
OrthoPAT® System Setup & use – Integrated Set

50. Quiz Question The top of the cover of the OrthoPAT unit should be
Less than 3 feet above the patient bed
Less than 3 feet from the patient bed
Less than 3 feet above the ground
Less than 3 feet from the wall vacuum
Answer: C

51. Quiz Question
While loading the OrthoPAT, The next step will be to close the OrthoPAT cover. Which steps have been completed?
Select all that apply
Header arm raised and latched
Header arm lowered and latched
Retainer Ring loaded
Retainer Ring removed
RBC and waste bag hung labels out
Set vacuum regulator after opening tubing clamp between the regulator and the OrthoPAT
Answer: B, C, E

52. Quiz Question
An unlatched Header Arm is the most common cause of a noisy disk and rotating seal failure leading to blood spills.
True
False
Answer: A - True

53. Quiz Question
When using wall suction, the proper way to set the Regulator suction level is
Close off the tubing between the regulator and OrthoPAT, then set the regulator lever
Open the tubing between the regulator and OrthoPAT, then set the regulator lever
Do not set the wall vacuum level. OrthoPAT automatically controls the vacuum level
Wall vacuum connections should not be used
Answer: A

54. Quiz Question
On the Display Unit keyboard, which key is pressed to prime the Dynamic Disk™ with saline solution?
INTRAOP
POSTOP
RUN
RETURN
PROCESS
Answer: C

55. Quiz Question
When the surgeon is ready to begin, what is the order of steps listed below?
Prime the drip chamber with ACD, CPD or 30,000 IU heparin/1 L bag 0.9% saline for injection
Close the roller clamp, spike the anticoagulant
Attach Yellow capped end of A&A line to intra-op reservoir port, and open clamp
Open the roller clamp to prime reservoir (100–300 mL)
Set drip rate to approximately 1 drip per second
Answer: C, B, A, D, E

56. Quiz Question
On the Display Unit keyboard, which key is pressed to prime the Dynamic Disk™ with saline solution?
INTRAOP
POSTOP
RUN
RETURN
PROCESS
Answer: C

57. Quiz Question
When the surgeon is ready to begin, what is the order of steps listed below?
Prime the drip chamber with ACD, CPD or 30,000 IU heparin/1 L bag 0.9% saline for injection
Close the roller clamp, spike the anticoagulant
Attach Yellow capped end of A&A line to intra-op reservoir port, and open clamp
Open the roller clamp to prime reservoir (100–300 mL)
Set drip rate to approximately 1 drip per second
Answer: C, B, A, D, E

58. Quiz Question
When surgery is complete, what is the order of steps listed below?
Close anticoagulant roller clamp
Press the Suction key to turn off suction
Close clamp to reservoir port that is being used
Remove IntraOp Suction set and discard according to hospital biohazard policy
Answer: A, B, C, D

59. Quiz Question Which is true about OrthoPAT PostOp use?
An internal vacuum system maintains 75 mm Hg to the wound
Alarm sounds if vacuum is not maintained
Every 10 minutes the OrthoPAT® System automatically releases vacuum for 30 seconds
Suction key light remains on during automatic vacuum release
All of the above are true
Answer: E

60. Quiz Question
To use the OrthoPAT during transport, turn the system off and unplug from the wall.
True
False
Answer: B - False

61. Quiz Question
In the PACU, a convenient way to check if the OrthoPAT is functioning correctly is to
Listen for a beeping sound
Look to see if it is plugged in
Look at the keypad to see if the POST-OP, RUN, SUCTION, and PROCESS keys are lit
Look at the vacuum level
Answer: C

62. Quiz Question
To change the reinfusion bag, what would be the order of the steps listed below?
Connect replacement bag to processing set
Press PROCESS key to stop processing (Leave suction on)
Press RUN key to resume processing
Cap bag using sterile (Red) cap tethered to bag
Disconnect Luer connection/ bag from set
Close slide clamp on RBC line
Answer: B, F, E, D, A, C

63. Quiz Question Which is not true about using the reinfusion bag?
It is recommended that the bag is full before reinfusing
Using pressure on the bag is not recommended as the bag may contain air
Using filter designed to retain particles is recommended when transfusing product back to donor-patient
Transfusion procedures are physician/hospital decisions
Expiration dates and times for OrthoPAT product should be set in accordance with AABB Standards
Answer: A