Air in line in Plum Pumps

  1. Our facility has just switched from all Baxter infusion pumps to Hospira Plum pumps. Baxter pumps are all I have ever used up to this point but since I am a relatively new RN, that's not saying much. Most all of us are having trouble getting used to the cassette system in general and priming the cassette, but I am having a particular problem with intermittent infusions where we re-use the tubing (reuse for 96 hours) from a previous infusion. It seems as if every time I do this, I have air existing in the tubing above the cassette (I assume from the previous infusion running the bag dry) and the pump beeps a "CASSETTE" error. I open the pump, take the cassette out, flick it, turn it over, mess with the button, and still can't get rid of the air. This takes a lot of time and invariably I still end up changing the whole tubing. There is a backpriming feature on the pump but when we were in-serviced they demonstrated using a syringe on the pump's secondary port to pull out the excess air instead of using the backprime feature. I can't seem to get the syringe concept to pull out the air either.

    Can anyone familiar with this pump give me some guidance so I do this safely and hopefully faster? Thanks.
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  2. 12 Comments

  3. by   danfif
    Alright, here is what I know, besides the fact that Plum pumps can be pesky little devils.

    If you let the bag run dry between infussions you will need to prime the entire line as if you were installing an entire new primary line set. Pull the knob on the back of the cassette out so that your fluid is runniug wide open. Invert the cassette allowing the rectangular chamber to fill first, then turn back upright and fill the round chamber next expelling all of the air out of the cassette, and into the line. Continue bleeding the line until all air is out of the line past the cassette.

    The trick to avoiding this problem is to set your VTBI setting at about 10 ml less than that of the bag, ie; if you are infusing 1000 ml NS, set the VTBI at 990, this way the bag will not run dry, causing you the problems you are having.

    I will say this however, there are times that the darn cassette's just have some problem, and need to be replaced. Otherwise, I find the Plum to be a reliable infussion pump.

    Hope this helps,
    Dan
    Last edit by danfif on Apr 24, '05 : Reason: mis spelling, thank you kitty
  4. by   meownsmile
    We use plum pumps. The key to the backprime feature is to backprime into a syringe barrel, with the plunger removed. Sometimes there is to much pressure from the syringe you connect with the plunger still in the barrel and it wont let it backprime. Try taking it out and just connecting the empty barrel to the cassette, then backpriming any air out of the cassette.
    The backpriming feature is great because you can use the same secondary tubing for numerous infusions of different types by backflushing the remnants of whatever was hung prior into the old bag and then connecting the new infusion (there are things that cant be run behind one another though, check with your pharmacy). Just have to be sure that you backprime the fluid all the way up to the chamber of the secondary line before restarting the infusion (3-4ml).

    If the pump reads "check cassette", open the cassette door, connect a syringe to a lower port, below the pump, take the cassette out of the pump, pull the button on the back of the cassette out to open position first,flip the cassette while you aspirate,to move air past the cassette, this will move the air that is in the cassette below the backprime stage(secondary connection) into the tubing past the cassette. Reinsert the cassette and restart the pump,take the syringe off the lower port and empty what you aspirated then reconnect at the same port. Let the pump run as you monitor the bubbles progress, as it gets closer to the lower port you can aspirate the air as it moves past the port that the syringe is connected to.
    Hope this helps a little.
    Last edit by meownsmile on Apr 24, '05
  5. by   ~Kitty~
    Quote from danfif
    where is what I know
    I too wonder "where is what I know" every day!!!

    Where is what you know?!

    Sorry, couldn't resist. Hee, hee!
    (Maybe I need to go back to bed.)
  6. by   danfif
    Kitty,
    All has been corrected as to "where is what I know" , and I think it is me that needs to go back to bed!
    Take Care,
    Dan
  7. by   ~Kitty~
    Quote from danfif
    All has been corrected as to "where is what I know"
    Oh, no.....I liked it the way it was!
    I think I will try to go back to bed now. Got woke up by phone call. :-/
  8. by   oldnewnurse
    Thank you DANFIF and MEOWNSMILE for the guidance. Two things that you have described (backpriming into a syringe without the plunger and aspirating at a port lower than the cassette after forcing the bubbles down) are things we have never seen tried. Learning new equipment may be challenging but it sure as heck is frustrating as well. I really knew my way around the Baxter pumps so these make me feel as if I have two wrong hands and frequently no brain! Thanks again.
  9. by   rjflyn
    Sounds like a step backwards- I thought they quit making those pumps and all the "new" ones are rebuilt ones. Personally I hate those and every opportunity that has come up to put input in to new pumps I have voiced to avoid them like the plauge.


    Having said that the best way to get the air out is to avoid it in the first place ie dont let a bag run empty ie always set for 5-10% residual in the bag and be at the bedside to give any remainder. If air does get in it becomes a pain like you have noted and in the ED dont have time to fuss with it so I just get new tubing.
    rj
  10. by   SmilingBluEyes
    I use the newer-generation Baxters now. They are ok, but some features I miss.

    I "grew up on " Plums, they were the pumps I used through nursing school and in my first 2 years afterward. All you need to do to remove air is use the "backprime" feature, attaching a 10CC syringe to the piggyback port for the air to back prime into. Voila, problem solved. I miss that feature MOST about Plum Pumps.
  11. by   Super_RN
    I have noticed that when I put a syringe on to backprime, I need to first "break it in". I push and pull the plunger a couple of times before connecting it to the cassette. Usually does the trick for me! Jaime
  12. by   SmilingBluEyes
    Quote from super_rn
    I have noticed that when I put a syringe on to backprime, I need to first "break it in". I push and pull the plunger a couple of times before connecting it to the cassette. Usually does the trick for me! Jaime
    yep I remember doing that.
  13. by   jeepgirl
    I love the plums myself. I always use the backprime feature with a 12 ML leurlock syringe. It's great!
  14. by   jeepgirl
    Quote from super_rn
    I have noticed that when I put a syringe on to backprime, I need to first "break it in". I push and pull the plunger a couple of times before connecting it to the cassette. Usually does the trick for me! Jaime
    Yup, that's common... I always "break the seal" whenever I open up a new syringe.

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