GemStar Infusion Pump: Part 2

MD Anderson Cancer Center
Date: March 2013

[ Music ]

>> Hello. When you go home from the hospital or clinic, you will use the GemStar ambulatory infusion pump. In the first GemStar pump video, we covered how to use the pump to complete an infusion that was already started.

In this video, we will cover how to start an infusion yourself and how to stop it when it is complete. You will learn how to connect the IV tubing to the IV fluid bag, load the tubing into the GemStar pump, turn the pump on, prime the IV tubing using the pump, connect the IV to the catheter and start the infusion, end the infusion and release the cassette.

Always remember to wash your hands before you begin. Gather your supplies on a clean work surface. You might want to spread a small clean towel on a tabletop.

Supplies include the backpack or fanny pack, the GemStar pump and batteries, the infusion tubing either with an in-line filter or tubing with a separate filter, an IV fluid bag.

lease note if the IV bag has been refrigerated, it must be taken out one hour before use to return to room temperature. Chlorascrub preps and three syringes, one with heparin and the other two filled with normal saline.

If you have tubing with the built-in filter, it connects directly to the IV fluid bag. If you have tubing with a separate filter, the filter must be placed before connecting to the IV bag.

First, remember to wear gloves. Then follow these steps.

Pick up the filter. Remove the cap. Once the cap is off don't let the open filter end touch anything. Keep hold of the filter; with your other hand, pick up the long tubing and remove the backcheck valve. Hold the valve while you connect the long tubing to the filter. You will use the valve later so keep it clean. Let go of the connected filter and long tube. Look at the thin, short tubing on the other side of the filter. See the cap? Remove that cap and replace it with the backcheck valve. This valve prevents the back flow of blood from the patient. You can discard the cap.

Pick up the end of the long tubing. Remove the spiked cap. Hold the IV bag and remove the cover. See the spike? Push it into the IV bag opening. The bag and tube are now ready to load into the pump. You will now learn to load the IV tubing into the GemStar pump. To load IV tubing into the pump, find the cassette pocket on the side of the pump. Pick up the long tubing and find the cassette. This part will load into the pump at the cassette pocket. Align the cassette to the silver ball on the pump and press firmly until you hear clicks.

Place the tubing along the tubing channel. The IV bag and tube and pump are now all connected and ready.

Your nurse will have programmed your pump before you left the hospital. You simply need to turn it on and start the infusion. To turn on the pump press the on/off button. The pump will go into a self test mode. When the screen says using batteries, press enter to confirm.

Then press one to resume program. This allows the program the nurse entered to activate. Next press change button. Then press one again for new container.

The volume will reset to zero. Although you do not press start yet, you will see "press start" on the screen.

The tube needs to be cleared of air first before the pump is started. This is called priming or purging.

To prime or purge, lay the filter flat on the table; press purge. The pump will ask, prime the set? Press yes.

Press and hold the purge button until you see fluid dripping from the end of the IV tubing.

You may need to repeat the purge steps until you see the fluid drip from the end of the IV tubing. This may take several minutes.

Finally, release your finger from the purge button. The pump will ask "prime complete?" Press yes.

Now you are ready to connect the IV to the IV catheter and start the infusion. Make sure both the catheter and the tubing clamps are open. Clean the tip of the catheter with a Chlorascrub prep.

Flush the catheter line, as instructed, with normal saline syringe before connecting the tubing to the catheter line.

Remove the protective cap from the end of the tubing and connect to the IV catheter.

Press start to begin the infusion.

You will see arrows moving across the bottom of the screen. Follow instructions from part one for monitoring the infusion.

After the infusion is complete and the bag is empty, you will end the infusion.

The pump will beep and the screen will read "empty container" or "dose complete".

Remember to wash your hands. Press the silence or mute button to stop the alarm. Then press the stop button.

To turn the pump off, press and hold the on/off button for at least two seconds. Close the clamps on the IV tubing. Wash your hands again and remember to put on gloves.
Disconnect the tubing from the catheter and flush the catheter with saline followed by heparin as instructed. You should have already taken a heparin flush class as part of your central venous catheter care and demonstrated your ability to perform a heparin flush. If you have not taken the heparin flush class please tell your nurse. This is a requirement before you can use the GemStar pump at home.

Now we will show how to release the cassette. To release the cassette, push down on the large black cassette eject button. The cassette will pop out. You may then remove the cassette. Remove the two AA batteries. Dispose of the empty bag and tubing as instructed.

Depending on what medicine or fluid went through the tubing, disposal may differ. Your nurse will tell you what you need to do.

We have tried to cover everything you need to know about your pump and IV homecare, but there may be a time when you want to call the nurses with a question. They are happy to help you so feel free to call. Because each clinic or location has different hours and different phone numbers please be sure to get that information from your nurse before you go home.

Thanks for your attention to the video. We hope this has been helpful to you in learning how to use the GemStar pump. If you have any questions, please do not hesitate to contact your clinic nurse.