Secondary (Piggyback) Infusions - CareFusion Alaris GP Directions For Use Manual

Secondary (Piggyback) Infusions

Secondary (or piggyback) Infusion mode is only available if it has been configured.
The application of secondary infusions should be limited to the intermittent therapy of medications which are not sensitive to the total
time required to complete an infusion.
• Typically antibiotics may be infused using a secondary infusion, where the primary infusion is limited to
A
maintenance fluid. If intending to use the secondary infusion facility, the primary infusion should be a
maintenance fluid only and is not indicated for drug therapy.
• The application of secondary infusions for delivery of critical drugs, particularly those with a short half life, is
NOT indicated for use. These drugs should be administered through a dedicated pump channel.
• Dependent upon factors such as fluid viscosity, the secondary infusion rate, head height between the secondary
and primary fluid containers and the use of clamps, flow may occur from the primary fluid container during a
secondary infusion. This could result in drug remaining in the container at the end of the secondary infusion,
delaying its delivery for a period of time which is dependent upon the primary infusion rate. For example,
a secondary infusion of 250ml at 300ml/h could result in approximately 33ml remaining, requiring up to 25
minutes additional time to complete the delivery, assuming a primary infusion rate of 80ml/h (and the use of a
72213N-0006 secondary infusion set and its supplied extension hook). Therefore it is recommended that flow
sensors (if used) are disconnected from the pump during secondary infusions.
• Regular monitoring for unexpected primary flow is recommended. If flow from the primary fluid container is
not desired during secondary infusion and/or the patient is sensitive to fluid balance, the clamp on the primary
infusion set should be closed. Check that no drops fall in the primary drip chamber.
• On completion of the primary infusion the pump will continue at Keep Vein Open rate (KVO) rate.
Setting up a secondary infusion
1. Ensure Primary infusion has been setup in ml/h (rate > 0ml/h).
h
2. Press to put the pump ON HOLD.
d
3. Press to access the OPTIONS screen.
4. Select SECONDARY SETUP, press OK to confirm.
5. Select either ml/h or DRUGS A-Z. Press OK to confirm either
selection.
6. Enter the secondary RATE using the
7. Press OK to confirm.
f
8. Set VTBI using the
section).
9. Press OK to confirm.
10. Review PRIMARY/SECONDARY setup summary.
Typical Secondary infusions
IV Pole
Extension Hook (approx.26cm)
Normally included with the secondary Infusion set. Primary
fluid container must hang lower to allow the secondary
infusion to run and primary infusion to restart on completion
of the secondary infusion.
Primary Fluid Container
Primary Infusion set
e.g. 63420E with an upper Y-Site (SmartSite® Needle-
In-line Clamp
Check Valve
Prevents secondary infusions from flowing back up the
primary Infusion set instead of to the patient.
Ensure primary set has a
A
backcheck valve upstream
from the Y-site.
f
keys.
keys (Refer to 'Setting a VTBI'
Free Valve).
1000DF00546 Issue 5
Alaris™ GP (Guardrails™) Volumetric Pump
11. If correct, press OK to continue, or BACK to adjust VTBI or
RATE of the SECONDARY mode.
b
12. Press to start the infusion in secondary mode. An
ADVISORY screen will be displayed - ENSURE SECONDARY
INFUSION SET OPEN.
13. Press OK to start infusing at the displayed rate.
Setting up a subsequent secondary infusion:
On completion of the secondary VTBI, the pump will automatically
transition to the primary infusion, an audible 'BEEP' will be heard.
h
1. Press to place the primary infusion ON HOLD.
2. Follow instructions 3 to 13 of 'Setting up a secondary infusion' .
2
1
A
Alaris®
GP
23/50
Secondary (Piggyback) Infusions
Secondary Fluid Container
Usually a smaller container e.g.
50ml, 100ml, 200ml or 250ml.
Secondary Infusion Set
e.g. 72213N-0006. Usually shorter
tubing to reach the Y-site on the
primary Infusion set.
In-line Clamp e.g.
roller clamp.
Upper Y-Site (SmartSite®
Needle-Free Valve) on Primary
Infusion Set.
The secondary set connects to
the upper Y-connection on the
primary Infusion set.