Aitecs SEP 10S Plus, SEP 12S Plus, SP 12S Pro syringe pump Operator's Manual

Aitecs SEP 10S Plus, SEP 12S Plus, SP 12S Pro syringe pump Operator's Manual
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The SEP-10S Plus, SEP-12S Plus, and SP-12S Pro syringe pumps are designed to meet the fluid and drug delivery requirements of today’s changing clinical environment. These pumps are indicated for infusion via intravenous (IV), intraarterial (IA), epidural, or subcutaneous routes of administration. Infusion rates are programmable from 0.1 to 1500 ml/h. The pump accepts a wide range, single-use syringes with volumes from 10 to 100 ml, optional – 5 ml.

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Aitecs SEP-10S Plus, SEP-12S Plus, SP-12S Pro Operator's Manual | Manualzz

Operator’s Manual

SEP-10S Plus

SEP-12S Plus

SP-12S Pro

S Y R I N G E I N F U S I O N P U M P S

Prior to using this pump, read this manual carefully to fully understand the pump’s functionality and to ensure safe and proper operation.

Document history

Original issue (BN037047EN): September 2006, firmware version: SPP02.

Revision 1.0 (BN037047EN-P01): November 2006, firmware version: SPP02.

Revision 2.0 (BN037047EN-P02): March 2007, firmware version: SPP03.

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CONTENTS

Document history.........................................................................................................................................................2

CONTENTS ....................................................................................................................................................................3

Compliance ..................................................................................................................................................................6

Material Specifications ................................................................................................................................................7

Hazardous components to be separated at the end of life............................................................................................7

INTRODUCTION ..........................................................................................................................................................8

Overview ......................................................................................................................................................................8

Pump description .........................................................................................................................................................8

Serial Number Description ..........................................................................................................................................8

Items supplied with pump.............................................................................................................................................9

Operational Warnings and Cautions ...........................................................................................................................9

Symbol definition .......................................................................................................................................................10

Warnings....................................................................................................................................................................11

Cautions.....................................................................................................................................................................12

Notes ..........................................................................................................................................................................14

1. PUMP DESCRIPTION ............................................................................................................................................15

Front view of SEP-10S Plus.......................................................................................................................................15

Front view of SEP-12S Plus, SP-12S Pro ..................................................................................................................15

Rear Panel Assembly .................................................................................................................................................16

Keypad indicators reference guide ............................................................................................................................17

Keypad keys reference guide......................................................................................................................................17

2. BASIC OPERATION...............................................................................................................................................18

Switching pump on.....................................................................................................................................................18

Switching pump off.....................................................................................................................................................19

Loading the syringe....................................................................................................................................................19

Syringe removal .........................................................................................................................................................21

Purging ......................................................................................................................................................................21

Recommended Syringes .............................................................................................................................................23

3. PROGRAMMING OF INFUSION PARAMETERS ............................................................................................24

Selecting drug name...................................................................................................................................................24

Selecting dose mode (only in SEP-12S Plus and SP-12S Pro)...................................................................................24

Programming drug concentration (only in SEP-12S Plus and SP-12S Pro) .............................................................25

Programming patient’s weight (only in SEP-12S Plus and SP-12S Pro) ..................................................................25

Programming infusion rate or volume over time .......................................................................................................25

Programming volume to be infused (VTBI) ...............................................................................................................26

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Programming bolus rate ............................................................................................................................................26

Programming bolus dose ...........................................................................................................................................27

Programming occlusion pressure level......................................................................................................................27

4. INFUSION.................................................................................................................................................................28

Starting and stopping infusion ...................................................................................................................................28

Bolus dose injection ...................................................................................................................................................28

Review of programmed parameters ...........................................................................................................................29

Change of programmed parameters ..........................................................................................................................29

Standby mode.............................................................................................................................................................30

Clearing infused drug volume, total infused volume..................................................................................................30

Locking and unlocking keypad...................................................................................................................................31

Viewing date and time................................................................................................................................................31

Turning off/on the display backlight (night mode).....................................................................................................31

5. ADVANCED FEATURES .......................................................................................................................................32

Drug protocols (optional in SEP-12S Plus and SP-12S Pro, unavailable in SEP-10S Plus) ....................................32

Parameters used to configure drug protocol .............................................................................................................32

Creating drug protocol ..............................................................................................................................................32

Modyfing drug protocol .............................................................................................................................................34

Infusion of drug with protocol ...................................................................................................................................34

Drug protocol review.................................................................................................................................................34

6. SETUP MENU ..........................................................................................................................................................35

Pump mode ................................................................................................................................................................35

Event history review (optional)..................................................................................................................................35

Syringe set..................................................................................................................................................................35

Drug set .....................................................................................................................................................................35

Default drug set .........................................................................................................................................................36

Language set ..............................................................................................................................................................36

Date and Time setting ................................................................................................................................................36

Parameter set.............................................................................................................................................................36

7. VISUAL AND AUDIBLE ALARM SIGNALS ......................................................................................................38

8. MAINTENANCE AND STORAGE........................................................................................................................40

Cleaning Overview.....................................................................................................................................................40

Preventive Maintenance.............................................................................................................................................41

Battery Operation Overview ......................................................................................................................................41

Storage.......................................................................................................................................................................41

Test routines...............................................................................................................................................................42

Repair ........................................................................................................................................................................42

9. TECHNICAL SPECIFICATIONS .........................................................................................................................43

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Volumetric Accuracy of the System............................................................................................................................45

Startup Graph Description ........................................................................................................................................45

How Trumpet Curve Graphs are Interpreted.............................................................................................................46

How Trumpet Curves Can Be Used ...........................................................................................................................46

Startup and Trumpet Curves......................................................................................................................................47

Influences of Back Pressure at 5 ml/h........................................................................................................................47

Maximum Infusion Pressure Generated.....................................................................................................................48

Alarm Delay at Occlusion..........................................................................................................................................48

Bolus Volume at Occlusion........................................................................................................................................48

Automatic Bolus volume accuracy.............................................................................................................................48

10. GUIDANCE AND MANUFACTURER'S DECLARATION ON ELECTROMAGNETIC EMISSIONS.....49

Electromagnetic Compatibility Statement..................................................................................................................49

11. DRAWING OF CABLES FOR MULTIFUNCTIONAL CONNECTOR (MFC).............................................55

12. WARRANTY AND SERVICE INFORMATION................................................................................................56

Warranty ....................................................................................................................................................................56

Service Information....................................................................................................................................................56

13. ACCESSORIES ......................................................................................................................................................57

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This symbol represents compliance with the essential requirements according to MDD 93/42/EEC (14 June

1993) of the European Communities concerning medical devices.

Compliance

The pumps comply with IEC 60601-1, IEC 60601-1-2, IEC 60601-2-24 standards.

SEP-10S Plus and SP-12S Pro intended for use in road ambulances comply with EN 1789:1999.

SEP-10S Plus and SP-12S Pro - FDA approved.

The pumps have been manufactured by the company, which has implemented and maintains a Quality

Assurance System meeting the requirements of the standards EN ISO 9001:2000 and EN ISO 13485:2003.

Devices: SEP-10S Plus, SEP-12S Plus, SP-12S Pro (hereinafter – the pump)

Manufacturer: Viltechmeda, 125 Kalvariju Str., 08221 Vilnius, Lithuania.

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Material Specifications

Steel

Stainless Steel

Copper

Aluminium

Bronze

Brass

Polyamide PA6 (PA)

Polycarbonate (PC)

Composition of Polycarbonate and ABS (PC+ABS)

Battery NiMH

Hazardous components to be separated at the end of life

Battery NiMH

Printed circuit boards containing brominated flame retardant

(TBBA 79-94-7) and lead

Electrolyte capacitors

AC power lead

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8

INTRODUCTION

Overview

- The pump is designed to meet the fluid and drug delivery requirements of today’s changing clinical environment.

- The pump is indicated for infusion via intravenous (IV), intraarterial (IA), epidural, or subcutaneous routes of administration.

Infusion rates are programmable from 0.1 to 1500 ml/h.

- The pump accepts wide range, single-use syringes with volumes from 10 to 100 ml, optional – 5 ml.

- The pump can be custom-configured to select key features that meet specific requirements. The selected options can be easily reviewed and the chosen configuration can be changed to meet new or different requirements.

Pump description

Serial Number Description

SEP-10S Plus – General ward syringe pump

SEP-12S Plus – Anaesthesia syringe pump

SP-12S Pro – Universal syringe pump

XXXX yy

year the pump was manufactured sequential number (0001 – 9999)

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Items supplied with pump

1. The pump

2. Operator‘s manual

3. AC power cord

4. Packaging

5. Spare parts: cap B8123009 – 2 pcs.

Additional items supplied with pump to be used in ambulance:

1. The pump with clamp for Draeger bar mounting

2. 12VDC cable

Operational Warnings and Cautions

General

- If a software change occurs and the operation/specification for the device changes, new or additional operating instructions will be issued, if needed.

- Although the pumps have been designed and manufactured to exact specifications, it is not intended to replace trained personnel in the supervision of IV infusions.

- In accordance with the international standard, IEC 60601-1

Medical Electrical Equipment – Part 1: General Requirements for

Safety, the pump is classified as:

• Class II

• Type CF

• IPX4 (splashproof)

• Not suitable for use with flammable anesthetic mixtures with air, oxygen or nitrous oxide

• Continuous operation

- Prior to operating the pump, the user should carefully read this manual to fully understand the functionality and to ensure safe and proper operation.

- This manual has been developed with consideration to the requirements in the International Standard, IEC 60601-2-24

Medical Electrical Equipment – Part 2-24: Particular Requirements for Safety of Infusion Pumps and Controllers. Data presented in the Technical Specifications reflect specific test conditions defined in this standard. Other external factors such as, varying back pressure, temperature, head height, set usage, fluid restrictions, solution viscosity, or combinations of these factors, may result in deviations from the performance data enclosed.

Definitions:

Warning messages indicate a possible hazard which, if not avoided, could result in severe personal injury or death.

Caution messages indicate a problem or unsafe practice which, if not avoided, could result in minor or moderate personal injury, product or property damage.

Note messages provide supplemental information to the accompanying text.

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Symbol definition

RS 232

Attention consult accompanying documents

Protection Class II

IPX4

CF type device (leak currents protection)

Splashing water protected

Complies with MDD 93/42/EEC directive

Nurse call connector (optional)

RS232 interface

Do not dispose of this product as unsorted municipal waste.

Follow local municipal waste ordinances for proper disposal provisions to reduce the environmental impact of waste electrical and electronic equipment (WEEE).

Complies with the directive 95/54/EEC concerning the suppression of radio interference in road ambulances (optional in SEP-10S Plus and SP-

12S Pro).

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Warnings

Possible explosion hazard if used in the presence of flammable

anesthetics.

Always read and follow the instructions which accompany the syringe and extension sets you are using. Carefully follow the instructions for priming the set, as well as the recommended set change interval. Set use should not exceed the label set change interval.

Viltechmeda will assume no responsibility for incidents which may occur if the product is not used in accordance with product

labeling.

The pump has no means to detect air presence in the extension set. The pump operator shall ensure there is no air in the extension set

Do not mount the pump in a vertical position with the syringe pointing upwards as this could lead to an infusion of air which may be in the syringe.

Do not connect the IV extension set to the patient when purging.

This device should be used only with Viltechmeda accessories specified for this device. There are risks associated with using anything other than the recommended accessories with this

device.

The specified accuracy of the syringe pump can only be maintained when recommended syringe and accessories are used.

Inter-connection of several devices into a single infusion system can have substantial influence on the accuracy of the infusion rate, at least for one of these devices. In such situations, the operation of devices using gravitational forces can be unstable or impossible at all.

The syringe should be disposed of in an appropriate manner, considering the nature of the residual fluid that may be contained within, in accordance with the hospital disposal

practices.

Though the factory-supplied configuration settings are suitable for most therapies, the operator and hospital professionals should verify that the pump settings are appropriate for the

clinical application.

Do not use hard or sharp objects on the keypad.

Be sure to PURGE THE SYSTEM OF ALL AIR BEFORE

ADMINISTERING ANY MEDICATION. Failure to follow this normal

infusion procedure could precipitate serious consequences.

Remember that the volume of fluid contained in the connecting tubing is a residual amount and cannot be infused. Allow for this

extra volume of fluid when initially filling the syringe.

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Cautions

12

CAUTION must be employed to assure that the pump is in good working order before putting it into use. If the pump is being operated on battery power alone, ensure

that the battery has been charged as described in this manual.

Verify all program data before pressing START.

Wipe off spills immediately. Do not allow fluid or residues to

remain on the pump.

Caution must be exercised in the selection of drugs intended to be delivered via any infusion pump. If the drug contained in the syringe will be exposed to extreme environmental conditions for prolonged time periods, IT IS IMPORTANT TO SELECT DRUGS

THAT WILL NOT CHANGE PHARMACOLOGICALLY UPON SUCH

EXPOSURE.

Epidural administration of drugs other than those indicated for epidural use could result in serious injury to the patient.

• Epidural administration of anesthetics is limited to short term infusion (not to exceed 96 hours) with indwelling catheters specifically indicated for short term anesthetic epidural drug delivery.

• Epidural administration of analgesics is limited to use with indwelling catheters specifically indicated for either short term or long term analgesic epidural drug delivery.

• To prevent infusion of drugs not indicated for epidural use, do not use IV administration sets incorporating injection sites during epidural delivery.

• Clearly distinguish pumps used for epidural drug delivery from

pumps used for other routes of administration.

As with all medical electronic equipment, care must be exercised to avoid exposing this device to powerful sources of electromagnetic interference. This device design has been tested to current European standards and guidelines for medical devices. The device was not found to be affected adversely by these susceptibility tests and will perform safely. The device’s emissions also were found to be acceptable.

Using the pump near operating equipment which radiate high energy radio frequencies (such as electrosurgical/cauterising equipment, two-way radios, or cellular telephones) may cause false alarm conditions. If this happens, reposition the pump away from the source of interference; or

turn off the pump.

This unit emits a certain level of electromagnetic radiation, which is within the levels specified by IEC 60601-2-24 and IEC 60601-1-

2.

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The RS232 is a standard (optional – SEP-10S Plus) feature on the syringe pump. Connection to the computer while pump is connected to the patient is prohibited.

Accessory equipment connected to the analog and digital interfaces must be certified according to the respective IEC standards (e.g. IEC 950 for data processing equipment and IEC

60601-1 for medical equipment). Furthermore all configurations shall comply with the valid version of the system standard IEC

60601-1-1. Everybody who connects additional equipment to the signal output configures a medical system, and is therefore responsible that the system complies with the requirements of the valid version of the system standard IEC 60601-1-1. If in doubt, consult manufacturer’s service department.

Refer to the Service Manual for further information regarding the

RS232 interface.

The assessment for suitability of any software used in the clinical environment to receive data from syringe pump lies with the user of the equipment.

When infusing through a central line catheter, Viltechmeda

recommends using sets with a Luer lock adaptor.

Follow the cleaning schedule and methods defined under

Chapter 8 Maintenance and Storage, to ensure proper

maintenance of the device.

Do not clean, disinfect, or sterilise any part of the device by autoclaving or with ethylene oxide gas. Doing so may damage the device and void the warranty. Only external parts of the

device should be disinfected.

Do not use the following chemicals on the device, as they will damage the front panel: acetone, acetoaldehyde, ammonia, benzene, hydroxytoluene, methylene chloride, and ozone. Do not use cleaners containing n-alkyl dimethyl ethylbenzyl ammonium chloride unless they appear in the list of recommended cleaners in chapter 8.

When attaching the pump to an IV pole or other

mounting locations, ensure it has been securely clamped.

Ensure device is mounted where main body is easily accessible and syringe can be installed in the loading mechanism without

stretching or kinking the tubing.

To avoid personal injury, ensure that the IV pole is stable and secure. Ensure that the pole is able to support the pump, along

with any other devices, without tipping or falling.

Only use approved and pressure proved syringes with Luer lock

connections and lines in accordance with chapter 2.

It is recommended that the extension lines are changed according to hospital protocols.

It is recommended to minimize number of parameters, types of syringes, drug names and other functions leaving only that

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Notes

necessary for work. It will help to avoid errors in parameters

programming and thereby decrease patient’s risk.

Before initially powering on the device, charge the battery.

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1. PUMP DESCRIPTION

Front view of SEP-10S Plus

1. Display 2. Indicators 3. Keypad

Front view of SEP-12S Plus, SP-12S Pro

1. Display 2. Indicators 3. Keypad 4. Key to select dimensions of parameters

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Rear Panel Assembly

1. Syringe driver arm

2. Slot for inserting the push-button of the syringe plunger

3. Rubber bellows

4. Slot for inserting the finger grips of the syringe barrel

5. Syringe clamp

6. Mounting clamp handle

* - optional in SEP-10S Plus

7. Cap

8. Mounting pole clamp

9. Fuse holder

10. Mains inlet

11. MFC*

12. Audio volume control

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Keypad indicators reference guide

The green BATTERY LED lights when the pump is operating on battery power. Flashing if LOW BATTERY alarm condition occurs.

The green MAINS LED lights when the pump is connected to the AC and battery is charging.

During infusion, three yellow LEDs are sequentially flashing. If the rightmost LED is on permanently – the infusion is stopped.

Keypad keys reference guide

Key to switch the pump on/off; keep it pressed for several seconds in order to switch off.

Key to start/stop the infusion.

Key to move the syringe driver arm rapidly to the left-hand side during syringe insertion or to initiate the Bolus mode; it is also intended for air removal from the extension set after syringe insertion.

Key to move the syringe driver arm to the right-hand side.

Keys to scroll up/down the list of parameters and syringe brands or answer positively or negatively the dialog questions.

Key to select dimensions of parameters when programming

(only in SEP-12S Plus and SP-12S Pro).

Key to program (modify) parameters. Pressing it once more restores previous values.

Key to confirm the selected parameter.

Numerical keys to enter digits of the parameter being programmed.

Key to select additional functions or to review programmed parameters.

Key to cancel the numerical value or the meaning of the parameter or silence the alarm signal. It deletes TOTAL

INFUSED and INFUSED DOSE values and clears the numerical value on display when programming.

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2. BASIC OPERATION

Switching pump on

1. Fasten the pump to the stand by turning the pole clamp handle.

2. Connect the power cord to the corresponding socket on the pump.

3. Secure the power cord to the pump by means of the metal clamp.

4. Connect the power cord into the mains receptacle. The green indicator will light on.

18

5. Switch the pump on by pressing the ON/OFF key.

There are three possible situations: a) the following message is displayed:

Insert SYRINGE into SLOTS!

Insert the syringe filled and with the extension set connected (see

Section - Loading the syringe); or b) the following message is displayed:

Close CLAMP!

Remove air from the extension set and fasten the syringe by means of the clamp (see Section - Loading the syringe); or c) the following message is displayed (if syringe inserted prior to switching the pump on):

Syringe:

XX ml

(syringe brand name)

Confirm syringe size and name (see Section

- Loading the syringe

)

NOTES:

1. If the following message is displayed:

SEP-10S PLUS, SEP-12S PLUS, SP-12S PRO

PUMP MANUAL

NO MAINS!!!

Check power cord

after pressing the ON/OFF key, it means the pump is not connected to the mains. Either connect the pump to the mains or confirm by pressing the C key that the pump will be powered with the internal battery.

2. If the message:

VERY LOW BATTERY

is displayed after pressing the ON/OFF key when the pump is connected to the mains, then switch it off by pressing the ON/OFF key once more and wait for approximately 15 min to allow the internal battery to charge. Then the pump will be prepared for syringe insertion and infusion parameter programming.

The internal battery may be charged permanently because it is protected against overcharging. In order to have the battery fully charged, keep the pump constantly connected to the mains.

Switching pump off

Loading the syringe

The pump is switched off by keeping the ON/OFF key pressed for

3 sec.

1. Lift the syringe clamp to its upper position.

2. Turn the syringe clamp counter-clockwise by 90°.

3. Pressing the key move the syringe driver arm to the right to the distance needed for syringe insertion.

Insert the filled syringe into the pump when the following message is displayed:

Insert SYRINGE into SLOTS!

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20

4. Insert the syringe push-button into the syringe driver arm slot to the depth to ensure minimal distance between the syringe barrel and the pump body.

5. Holding the syringe by hand, keep pressing the BOLUS key until the syringe finger grips will fit into the corresponding pump slot.

6. By pressing the syringe barrel and push-button down, insert fully the syringe finger grips and push-button into corresponding pump slots.

The cylindrical syringe barrel shall lay on the pump body with no gap. Axes of the syringe barrel and its plunger shall be on the same line.

The following message is displayed:

Close CLAMP!

7. Turn the syringe clamp clockwise by 90°.

8. Lower the syringe clamp onto the syringe barrel.

The syringe size sensor determines the syringe size automatically.

The following message is displayed:

Syringe:

XX ml

(syringe brand name)

where: XX – syringe size.

9. If the syringe size and brand are correct, press the ENTER key.

10. Otherwise press the PROG key.

11. Select the required syringe name with the scrolling keys.

12. Confirm the selected syringe name and size selected by pressing the ENTER key.

Use of syringes not pre-programmed or incorrect insertion of the syringe increase patient’s risk.

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Syringe removal

NOTES:

1. When you insert a syringe having a diameter not complying with any syringe installed, the following message is displayed:

ILLEGAL SYRINGE!

Change SYRINGE!

2. When you insert a syringe of different type (brand or size) than used previously, the following message is displayed:

CHECK SYRINGE!

(syringe size and brand)?

If inserted syringe size and brand are the same as displayed, press the YES key or the ENTER key. Otherwise press the PROG key and select different syringe type or check the correctness of syringe insertion.

3. User can minimize syringe list through setup menu in accordance with the chapter 6.

13. Lift the syringe clamp to its upper position.

14. Turn the syringe clamp counter-clockwise by 90°.

15. Remove the syringe.

Purging

Air can be removed from the extension set after syringe is inserted and brand confirmed, before entering the STOP mode (before pressing the YES key when the message

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Total: XXX ml

Ready to run?

is displayed.)

In order to remove air from the extension set press the BOLUS key. The following message is displayed:

PURGE? press BOLUS

The syringe extension set should not be connected to the patient during air removal.

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Recommended Syringes

BD PLASTIPAK

BD PRECISE

5 ml

(optional)

10 ml

20 ml

30 ml

50/60 ml

100 ml

BD PrecisG

BD PERFUSOR

BD USA

MONOJECT (Kendall)

OMNIFIX (BBraun)

PERFUSOR (BBraun)

IVAC

INJECTOMAT (Fresenius)

TERUMO (Europe)

TERUMO (USA)

NIPRO

JMS

KD-JECT III

ELVIONY

√ √

EXELMED

DIMES

√ √

DISPOMED

PolfaBol

PolfaLub

JANPOL

HAYAT PERF

HAYAT 10, 20, 50

MAYBOD YAS

WEIHAI

XINHUA

HONGDA

HUI CHUN

YAZD

POMAT

MEDIZ

SHIFA

INFUJECT

PENTAFERTE

ONCE

MK BG

USC

DISPO VAN

VITTA

ROMSONS

V.MED

NOTE:

The Manufacturer of the pump can change the syringe list, including syringes of new brands or removing the included ones. The list of syringe brands is dependant on the software version of the pump.

Only use approved and pressure proved syringes with Luer lock connections and lines.

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3

3. PROGRAMMING OF INFUSION

PARAMETERS

All parameters can be programmed after syringe is loaded and syringe make confirmed. When all the parameters are programmed and infusion started pump keypad can be locked.

Previously programmed parameters are reviewed using the scrolling up/down keys. It is necessary to confirm all the parameters. To confirm the parameter press the ENTER key or the scrolling up key. Only then the pump will switch to STOP mode.

In order to modify the selected parameter, press the PROG key. Enter the parameter value using the numerical keys and press the ENTER key to confirm it. Using the ml

↔mg, during programming of parameter value, it is possible to select the required measurement unit (only in SEP-12S Plus and SP-12S

Pro).

When the parameter has no numerical value, then select the required message by means of the scroll keys and confirm it by pressing the ENTER key. To cancel newly entered (selected) value and restore previous value press the PROG.

Selecting drug name

1. After syringe is inserted and brand confirmed, press the PROG key.

2. Select the required drug name by the scrolling keys.

3. Press the ENTER key to confirm selected drug name.

NOTES:

1. If you don’t want the drug name to be displayed select

“NONE” from the drug list and press ENTER.

2. You can enter new drug name to the list in accordance with

instruction given in the chapter 6 of this manual.

Selecting dose mode

(only in SEP-12S Plus and SP-12S Pro)

Select the message

Dose mode:

1. Press the PROG key.

2. Select the required infusion rate unit by pressing the ml

↔mg key.

3. Press the Enter key to confirm the selected dose mode.

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NOTE:

Available only if mass units enabled in setup menu.

Programming drug concentration

(only in SEP-12S Plus and SP-12S Pro)

Select the message

Concentration: on the display.

1. Press the PROG key.

2. Select the required drug concentration measurement unit using the ml

↔mg key.

3. Enter the required value of drug concentration using the numerical keypad.

4. Confirm drug concentration by pressing the ENTER key.

NOTES:

1. In order to have drug concentration calculated from entered drug mass and diluent volume, select the message

Calculate concentration?

using the ml

mg key.

Press the YES key. Enter drug mass and diluent volume analogously to concentration programming above.

2. Drug concentration can be programmed only if infusion rate is set in mass units.

3. Drug concentration value can not be set to 0.

Programming patient’s weight

(only in SEP-12S Plus and SP-12S Pro)

Select the message

Patient weight:

on the display.

1. Press the PROG key.

2. Enter the patient weight using the numerical keypad.

3. Press the ENTER key to confirm the selected patient weight.

NOTE:

The programmed patient’s weight shall not exceed the value of

200 kg.

Programming infusion rate or volume over time

Select the message

Infusion rate:

on the display.

1. Press the PROG key.

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2. Enter the required value of infusion rate using the numerical keypad.

3. Press the Enter key to confirm the selected infusion rate.

NOTE:

In order to have infusion rate calculated from entered volume to be infused (VTBI) value and time, press the F key during infusion rate programming (i.e. after pressing the PROG key).

The following message is displayed:

Volume over time?

Press the YES key. Enter VTBI value and Time analogously to infusion rate programming above.

Programming volume to be infused (VTBI)

Select the message

VTBI:

on the display.

1. Press the PROG key.

2. Enter VTBI value using the numerical keypad.

3. Press the ENTER key to confirm VTBI value.

NOTE:

To reset previously entered value and execute the infusion without the preset VTBI, set the VTBI value to 0.

Programming bolus rate

Select the message

BOLUS rate:

on the display.

1. Press the PROG key.

2. Enter the required value of Bolus rate with the numeric keypad.

When Bolus function is not required, the Bolus rate value will be set to zero.

3. Press the ENTER key to confirm the selected Bolus rate.

NOTE:

Bolus rate can be programmed only if BOLUS RATE

PROGRAMMING feature enabled in Setup menu (see chapter 6).

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Programming bolus dose

Select the message

BOLUS dose:

on the display.

1. Press the PROG key.

2. Select the required Bolus dose measurement unit using the ml

↔mg key (only in SEP-12S Plus and SP-12S Pro).

3. Enter the required value of Bolus dose using the numeric keypad.

4. Press the ENTER key to confirm the selected Bolus dose.

NOTE:

When the Bolus rate value is set to zero, the Bolus dose can not be programmed as well.

Programming occlusion pressure level

Occlusion pressure level can only be programmed for 50/60 and

100 ml syringes. For syringes from 5 to 30 ml only HIGH occlusion pressure level is available.

Select the message

Occlusion level:

on the display.

1. Press the PROG key.

2. Select the required occlusion pressure level using the scroll keys.

3. Confirm selected occlusion pressure level by pressing the

ENTER key.

NOTE:

The pump has an anti-bolus function which reduces the pressure in the syringe and the extension set in case of occlusion and at the same time diminishes the volume of unwanted Bolus injected to the patient after removal of the occlusion cause.

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27

4. INFUSION

Starting and stopping infusion

The infusion is started from the STOP mode when the following message is displayed:

Stop ... X.X ml

XX ml/h

(X.X – amount of drug in ml, mg or µg, infused during observation time, i.e. period from the last clearing of this parameter by means of the C key or by switching the pump off; XX – programmed infusion rate.)

1. Press the START/STOP key.

Segments of the indicator begin to flash sequentially.

2. You may review the following parameters using the scroll keys:

(drug name)

XXX ml/h

(XXX– infusion rate);

VTBI: XX ml

TIME: XX:XX.XX

(X – Volume to be infused;

XX:XX.XX – time remaining to the end of VTBI);

Infused: X.X ml

Total: XX ml

(X.X – amount of drug infused during current session;

XX – total infused amount of drug);

3. Press the START/STOP key when you wish to stop the infusion.

Segments of the segment only is left on.

indicator stop flashing and the rightmost

Bolus dose injection

Bolus may be injected during infusion only.

1. Press the BOLUS key.

The following message is displayed:

BOLUS?

Press YES/BOLUS

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NOTE:

While the keypad lock is active bolus injection is prevented. To inject bolus, first unlock the keypad.

2. If you want to inject the programmed Bolus dose, press the YES key.

During Bolus performance the following message is displayed:

BOLUS ...X.X ml

XXX ml/h

(X.X – amount of drug injected in Bolus mode,

XXX – Bolus rate).

3. If you want to inject Bolus manually, press and keep the

BOLUS key depressed. Infusion is performed at the Bolus rate until BOLUS key is released and is accompanied by short beeps.

Review of programmed parameters

Programmed parameters may be reviewed during the infusion or after stopping it.

1. Press the F key.

2. Select the following message by the scrolling keys:

SETTINGS

REVIEW

or

SETTINGS

3. Press the ENTER key.

4. It is possible to review all the programmed parameters by pressing the scroll up key.

5. It is possible to exit REVIEW mode by pressing the C key.

Change of programmed parameters

Programmed parameters may be modified only when the infusion is stopped (Infusion rate can be changed

(Titration) during infusion as well as in the stop mode).

1. Press the F key.

2. Select the following message using the scroll keys:

SETTINGS

3. Press the ENTER key.

4. Select the parameter to be modified by the scroll keys.

5. Press the PROG key.

Enter or select the new value of the parameter (see chapter 3).

6. Confirm the new value of the parameter by pressing the

ENTER key.

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29

NOTES:

1. It is possible to change following parameters:

Infusion rate

Bolus rate

Bolus dose

VTBI

Occlusion pressure level

2. Another way to change parameters in the stop mode is as follows:

Open and close the syringe clamp. When the message

Continue infusion?

is displayed, press the NO key.

3. If keypad locked, first unlock the keypad to change the parameters.

Standby mode

Standby mode can be activated if such feature is enabled in setup menu.

1. Stop the infusion by pressing the START/STOP key.

2. Press the ENTER key.

The following message is displayed:

STANDBY!

Duration: min

3. Enter the pause duration using the numeric keys.

4. Confirm the pause duration by pressing the ENTER key.

The following message is displayed:

STANDBY!

Rest: XX:XX.XX

(X:XX.XX – time remaining to the end of pause).

5. Press the C key to cancel the pause.

Clearing infused drug volume, total infused volume

(available only when infusion is stopped)

1. Select the parameter to be cleared with the scroll keys:

Stop ... X.X ml

XX ml/h

or

Total infused:

X X ml

2. Press the C key.

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The appropriate question is displayed:

CLEAR infused volume?

or

CLEAR total infused volume?

3. Press the YES key, and the corresponding parameter value is cleared.

Locking and unlocking keypad

Keypad lock feature is enabled/disabled through the setup menu.

When keypad lock feature enabled in setup menu:

1. After infusion parameters have been set and the infusion started or following the bolus infusion (or after parameter change) the following message is displayed:

Lock keypad?

Press YES/NO

To enable the keypad lock function press the YES key. Press the

NO key if the keypad lock is not required.

NOTE:

The keypad is locked automatically if none of keys is pressed in response to above message within 10 sec.

2. In order to disable keypad lock (if enabled) first press the F key, when message

Keypad LOCKED!

ENTER to unlock

is displayed, press the ENTER key.

3. In order to enable keypad lock (if disabled) first press the F key, when message

Keypad UNLOCKED!

ENTER to lock

is displayed, press the ENTER key.

Viewing date and time

Date and time can be selected for temporary viewing by means of the F key and scroll keys in STOP mode and during infusion.

Turning off/on the display backlight (night mode)

Display backlight can be turned off/on using the key. When running from the internal battery, display backlight is turned off automatically.

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31

5. ADVANCED FEATURES

Drug protocols

(optional in SEP-12S Plus and SP-12S Pro, unavailable in SEP-10S Plus)

There is a possibility to configure 5 profiles with up to 10 steps each. Profile scheme can be custom configured for various applications, i.e. it is possible to set (or disable if unnecessary) induction dose and pause time after it, program each step rate in different units and duration, set post profile rate. The profile mode can be used for Propofol, Dobutamine, Remifentanil and other drugs infusion requiring special drug administration schemes, using the best hospital practice.

Parameters used to configure drug protocol

- Drug name

- Dose mode (ml/h, mg/h, mg/min, mg/kg/h, mg/kg/min,

µg/h, µg/min, µg/kg/h, µg/kg/min)

- Concentration (mg/ml,

µg/ml)

- Maximum patient weight

- Induction/Loading dose/Initial bolus (mg(

µg)/kg, mg, µg, ml)

- Duration

- Step count (0-10)

- Rate N (ml/h, mg/h, mg/min, mg/kg/h, mg/kg/min,

µg/h,

µg/min, µg/kg/h, µg/kg/min)

- Time N

- Post-profile mode

Creating drug protocol

To create drug name with protocol enter Drug Set (code 147).

Drug name

Press the PROG key, the following message is displayed:

Replace drug name?

Press the YES key to edit selected drug name or the NO key and afterwards the YES key in response to message (to add drug name):

Add drug name?

- Enter the new drug name using keys in accordance with the table shown in chapter 6.

- Having entered required drug name press the F key to place symbol at the end of drug name ( symbol initiates programming of protocol).

- Confirm the new drug name by pressing the ENTER key.

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Dose mode

Press the PROG key. Select the required rate units using the ml

↔mg key and press the ENTER key.

Concentration (available if dose mode in mass units)

Press the PROG key. Select the required units using the ml

↔mg key and enter concentration value using the numerical keypad.

Press the ENTER key to confirm.

MAXIMUM PATIENT WEIGHT (available if dose mode based on patient weight)

Press the PROG key. Enter maximum patient weight using the numerical keypad and press the ENTER key.

Induction/Loading dose/Initial bolus

Press the PROG key. Select the required units using the ml

↔mg key and enter required value using the numerical keypad.

NOTE:

Using the F key during programming it is possible to select the naming of parameter: Induction, Loading dose or Initial Bolus.

Duration

Press the PROG key. Enter the Induction/Loading dose/Initial bolus duration (h:min.sec) using the numerical keypad. Use the

key to skip between hours, minutes and seconds.

NOTES:

1) When duration is disabled (set to 0), Induction/Loading dose/Initial bolus will be infused at the bolus rate.

2) In order to set the pause after Induction/Loading dose/Initial bolus it is necessary to leave profile first step rate 0 and set the step duration conforming to the required pause time (see below 8.

Rate N, Time N).

Step count

Press the PROG key and enter the number of steps using the numerical keypad. Confirm the entered value by pressing the

ENTER key.

Rate N, Time N

Select one by one and program parameters of each step, pressing the PROG key and having entered required value confirm it pressing the ENTER key.

Post profile mode

Press the PROG key, set the post profile rate and press the ENTER key to confirm (set 0 to stop the infusion after profile completion).

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33

NOTES:

1) It is possible to exit drug protocol programming by pressing the

START key and afterwards the YES key. In such case all previous settings are discarded.

2) To review the programmed protocol, select the drug name with

symbol and press the F key. When the message

PROTOCOL review

is indicated, press the ENTER key and review the drug protocol using the scroll keys. Press the C key to exit review mode.

Modyfing drug protocol

Enter Drug set and select the drug name with symbol. Press the

PROG key. Following message will be displayed:

Modify protocol?

Press the YES key to start modifying protocol as described above.

Pressing the NO key allows to add new drug name to library.

Infusion of drug with protocol

Infusion of drug protocol can be started after confirmation of loaded syringe, selection drug name with symbol, setting patient weight (if rate units based on patient weight), programming of bolus rate and/or dose (if enabled in set up menu) and setting the occlusion level.

User is able to change rate and duration of the current step of the drug profile during infusion.

Use the scroll keys to review current parameters during infusion.

NOTES:

1. Having achieved the required therapeutic level it is possible to terminate the profile by pressing the STOP key. The following message will appear:

End Profile?

YES/NO

1.1. Press the YES key. If you press the START key afterwards infusion will be continued with the rate profile was terminated at until syringe is emptied.

1.2. Press the NO key. If you press the START key afterwards infusion will be continued from the point profile was terminated.

2. To stop the Induction/Loading dose/Initial bolus during their delivery and switch to the first step execution, press the STOP key and afterwards the START.

Drug protocol review

To review drug protocol parameters, press the F key (available only having selected and confirmed drug name). The following message will be displayed:

Protocol review

Press the ENTER key. Review the protocol profile parameters using the scroll keys.

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6. SETUP MENU

In order to access optional functions or certain parameters, keep the START key in pressed position and switch the pump on by pressing the ON/OFF key. When short beep is heard, release the

START key, enter appropriate code (see codes below) using the numerical keys. Confirm it by pressing the ENTER key.

List of optional functions may be reviewed using the scroll keys. If displayed name is marked with the asterisk, it means that function is active. To activate an inactive function press the ENTER key, and the asterisk will appear in front of the item name.

To deactivate a function, press the C key. The asterisk shall disappear.

To exit setup menu press the START/STOP key.

Pump mode

(code: 100)

This option is used to set the infusion mode the pump will operate in. Following infusion modes are available: Continuous rate mode,

Easy pump mode.

Event history review (optional)

(code:111)

This option is used to review the event history. Use the scroll keys to review the events. In order to get more detailed information on events use the Event History utility to upload the event history to

PC.

Syringe set

(code: 137)

This option is used to configure the type and size of syringe permitted for use on the pump. Select all possible syringes, which may be used, and disable any that should not be used.

Drug set

(code: 147)

This option allows to compose drug library to be used on the pump. Drug library can comprise up to 30 drug names.

To replace drug name open the drug list and select the drug name to be replaced by the new one. Press the PROG key, the following message is displayed:

Replace drug name?

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35

Default drug set

(code: 157)

Press the YES key to edit selected drug name or the NO key and afterwards the YES key in response to message (to add drug name):

Add drug name?

Key 1

Enter the new drug name using keys in accordance with the table below (e.g. to enter letter Z press the 9 key four times):

2 3 4 5 6 7 8 9 0 . YES NO, C

Character 1 A,B,

C,2

D,E,

F, 3

G,H,

I, 4

J, K,

L, 5

M, N,

O, 6

P,Q,

R, S, 7

T, U,

V, 8

W, X,

Y, Z, 9

0, /, -,

#, %

. Space Backspace

Confirm the new drug name by pressing the ENTER key.

NOTES:

1. Entered character can be reset by means of the C or NO keys.

2. Old drug name can be restored by means of the PROG key until new name is confirmed.

This option restores default (manufacturer‘s) drug set.

Language set

(code: 337)

This option allows the language of the pump to be set.

Date and Time setting

(code: 637)

This option allows to set of date and time.

Parameter set

(code: 237)

Function name

VTBI

Enables/disables programming of volume to be infused

Factory default

*

SEP-10S

Plus

SEP-12S

Plus

SP-12S

Pro

Notes

VOLUME OVER

TIME

INFUSION RATE

LIMIT: XXXX ml/h programming of VTBI over time programming of infusion rate upper limit

MANUAL BOLUS manual bolus infusion

AUTOMATIC BOLUS delivery of preprogrammed bolus volume

BOLUS RATE

PROGRAMMING programming of bolus rate

-

1500 ml/h

*

*

-

1,5

2

2

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BOLUS RATE

LIMIT:XXXX ml/h

40, 80, 120 kPa

30, 60, 90 kPa

RATE: mg (µg)/h

RATE: mg (µg)/kg/h (min)

CALCULATION OF

CONCENTRATION

TOTAL VOLUME

DISPLAY programming of bolus rate upper limit

1500 ml/h programming occlusion pressure level for 50/60 and 100 ml syringes

– “ – programming of infusion rate in mass units

40, 80, 120 kPa

* programming of infusion rate in mg/kg/h;µg/kg/h; mg/kg/min;

µg/kg/min calculation of concentration from entered drug mass and diluent volume displaying of total infused volume

*

-

*

X

X

X

X

X

1

AUTOSAVE

DRUG NAME

DISPLAY

TITRATION

STANDBY saving of settings and total infused volume after switching the pump off display of drug name programming of infusion rate without stopping the infusion programming of standby time

*

*

*

-

KEYPAD LOCK

QUIET MODE

NO MAINS ALARM

AT POWER UP protection of the keypad against accidental or unauthorized usage short beep accompanying any keystroke alarm on condition the pump is powered up while not connected to the mains executing of KOR function

-

-

*

KOR FUNCTION *

√ √ √

KOR RATE:

XX ml/h

DATE and TIME

DISPLAY programming of KOR rate displaying of date and time

-

*

*

– enabled

-

– disabled

X

– available

– unavailable

NOTES:

1.

To modify the value of parameter, press the PROG key, enter the new value using the numerical keypad and confirm it by pressing the ENTER key.

2. These parameters are not displayed when both Manual and Automatic boluses disabled.

3. Parameter is not indicated when KOR FUNCTION disabled.

4. If parameter disabled, default KOR rate is 5.0 ml/h.

5. Does not affect infusion rates set in drug protocols.

1, 3,

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37

7. VISUAL AND AUDIBLE ALARM

SIGNALS

Alarm signals are issued by means of sound, flashing display backlight and corresponding message displayed. Alarm signals are cancelled by pressing the C key. Sound volume can be adjusted with rotary switch (optional) on the bottom of the pump.

Table 1 Troubleshooting Pump Alarm Messages

MESSAGE CAUSE

NO MAINS

Check power cord

The pump has been disconnected from the AC power supply and is operating on internal battery.

CORRECTION

Reconnect the pump to AC power supply or press the

CANCEL key to silence the alarm and continue operation on internal battery.

CHECKING

Connect the mains cable to the pump. Switch on the pump and launch infusion. After few seconds disconnect the mains cable.

LOW BATTERY*

(and BATTERY LED flashing)

Battery charge low.

Connect the pump to AC power supply and charge the internal battery.

Run the pump on battery until alarm signal is generated.

VERY LOW BATTERY

OCCLUSION!!!

OCCLUSION or END

SYRINGE EMPTY!*

Stop X.X ml

KOR XX ml/h**

END OF INFUSION!

KOR XX ml/h**

The internal battery is depleted

Connect the pump to AC power supply.

Run the pump on battery until it is depleted completely.

Pressure in the extension set and the syringe has reached the alarm limit.

The pump ceased its operation due to blockage in the extension set, syringe or drive or if the syringe plunger has reached the end of its travel. It may happen when syringe was not fully filled.

The syringe is empty.

Infusion has been stopped and not resumed within 2 min.

The pump has reached the end of infusion.

Identify and remove the cause of the blockage in the extension set, syringe or drive.

If the cause of stopping is an occlusion, remove the cause of blockage and resume infusion by pressing the

START / STOP key.

When the cause of stopping is the syringe plunger reaching the end of its travel, the syringe shall be replaced.

While infusion is in progress block the extension line and wait until alarm is generated.

Use BD Plastipak 50 ml syringe.

Pull out syringe plunger to the value of 1 ml. Launch the infusion and wait until alarm is generated.

Replace the syringe or turn the pump off.

Resume the infusion or press the CANCEL key to silence the alarm.

Replace the syringe or turn the pump off.

Use BD Plastipak 50 ml syringe.

Pull out syringe plunger to the value of 20 ml. Launch the infusion and wait until syringe is emptied.

In the setup menu switch on the

KOR FUNCTION. Launch the infusion and after few seconds stop it. Wait until alarm is generated.

In the setup menu switch on the

KOR FUNCTION. Set the

Volume limit. Launch the infusion and wait until preset volume limit is infused.

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Table 1 Troubleshooting Pump Alarm Messages-continued

MESSAGE CAUSE CORRECTION

SYRINGE EMPTY!

KOR XX ml/h**

The syringe is empty.

Replace the syringe or turn the pump off.

CHECKING

In the setup menu switch on the

KOR FUNCTION. Launch the infusion and wait until syringe is emptied.

ATTENTION!

2 min INACTIVE!

The pump is left for 2 min without starting the operation.

Press the CANCEL key.

Switch on the pump and wait for 2 min.

STANDBY TIME

ELAPSED

X min. PREALARM!

ILLEGAL SYRINGE!

Change SYRINGE!

The preprogrammed standby time interval elapsed.

The pump is nearing the end of infusion.

Loaded syringe having a diameter not complying with any syringe from the pump syringe library.

Press the CANCEL key.

Press the CANCEL key.

Load the proper syringe.

In the setup menu switch on the

STANDBY function. Launch infusion, and after few seconds stop it. Set standby time to 3 min and wait until it is elapsed.

Use BD Plastipak 50 ml syringe.

Pull out syringe plunger to the value of 20 ml. Launch the infusion and wait until alarm is generated.

Load BD Plastipak 50 ml syringe.

Slowly lift up the syringe barrel clamp until message is indicated on the display.

CLAMP

OPENED!

The syringe barrel clamp has been opened during infusion.

Close the clamp and resume the infusion.

While infusion is in progress lift up the syringe barrel clamp.

PLUNGER

NOT FITTED!

The syringe plunger has been displaced during infusion.

Check the correctness of syringe position.

Load syringe barrel without plunger. Insert fixture between the grippers to keep them in plunger inserted position. Launch infusion and after few seconds pull the fixture out of grippers.

ERROR: XX

(XX-error code)

The pump has detected an internal malfunction.

Remove the pump from service and have the pump checked by qualified personnel.

---------------------

* - Audible signal accompanying these messages is an intermittent one.

** - The purpose of the function KOR (Keep Open Rate) is to continue infusion of very small amount of

drug after the end of infusion.

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39

8. MAINTENANCE AND STORAGE

The pump has to be switched off and must be unplugged from the line for cleaning.

Do not clean, disinfect, or sterilise any part of the device by autoclaving or with ethylene oxide gas. Doing so may damage the device and void the warranty. Only external

parts of the device should be disinfected.

Do not use the following chemicals on the device, as they will damage the front panel: acetone, acetoaldehyde, ammonia, benzene, hydroxytoluene, methylene, chloride, and ozone.

Do not use cleaners containing n-alkyl, dimethyl, ethylbenzyl, ammonium chloride unless they appear in the

list of recommended cleaners overleaf.

Keep the syringe pump clean and dry.

After cleaning, check for the absence of liquid in the mains inlet. The presence of liquid can cause shortening of the contacts. Clean the mains inlet using a dry pad of gauze and only then reconnect the pump to the mains.

Cleaning Overview

The exterior of the device may be cleaned with a soft cloth, sparingly dampened with any of the cleaners listed below. Do not

spray cleaners directly into the syringe mechanism, the area where the power cord enters the device or the interface

connectors. Do not use hard instruments for cleaning. Follow the manufacturer’s dilution instructions for concentrated cleaners.

Always clean/disinfect the device after each use. For a device that has been in an Isolation Area, select those agents from the list below that both clean and disinfect.

While the product design safeguards against fluid spillage, if fluid enters the pump, contact your dealer or manufacturer’s servicing department for assistance. This should be done immediately to minimise any potential difficulties with the solutions pooling and drying on the mechanism.

Recommended cleaners

Before using a cleaner on the pump, it should be tested on a small area beforehand.

- A solution of 3% hydrogen peroxide

- Soapy water

- Ethyl alcohol

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Preventive Maintenance

The table below contains a schedule of basic maintenance tasks that should be performed on the device. If the device cannot be cleaned using the basic methods described earlier or components are missing or damaged, discontinue use and notify the appropriate authorised service personnel.

Check

Perform as required but recommended after every use

Action

Housings

Labels

Power cord

Rear housing accessory

Battery

Clean housing and front panel as recommended in the cleaning instructions in this section.

Check for cracks and large dents.

Clean as recommended in the cleaning instructions. Check for scratches, cuts or obliterated words.

Verify that the power cord is undamaged over the entire length of the cord and the moulded plug.

Verify that there are no loose or missing parts and that connectors and accessories are undamaged.

Recharge by plugging into mains power outlet. Check that the MAINS LED is illuminated during this time.

Perform as required but recommended every 24 months.

Entire device Schedule operational checkout by qualified biomedical personnel or authorised service representative.

Battery Operation Overview

The device can be battery operated in emergency situations and for temporary portable applications. When operating on battery the

Battery LED lights.

Battery Charging

The battery is charging whenever the device is plugged into mains outlet, regardless of whether the device is on or off. If the pump is not used for a long time, the battery should be charged at least once in a 2 months.

In general, the more often a battery is discharged and recharged, the sooner it will need to be replaced. Notify a authorised service person for replacement. Batteries should only be replaced by

authorized service personnel.

Battery Disposal

Battery should be disposed of as outlined by the local country regulation.

Storage

It is recommended that the device remain plugged in during storage to maintain the battery at full charge. Do not store the device with the key ON and the device unplugged.

When unpackaged, ensure the product is stored in a clean and dry

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41

Test routines

Repair

(20-95%, RH, non-condensing) environment to safeguard against prolonged exposure to dust and moisture. In conditions falling outside the Environmental Operating Limits (see the Technical

Specifications Table in chapter 9), Viltechmeda recommends that the device be repackaged in the original shipping materials.

The test routines are designed to allow confirmation of many of pump parameters, functions and calibration without requiring internal inspection. Refer to Service Manual for a complete list of test and calibration procedures.

The right to repair the pump or carry out periodical part replacements is reserved only to the Manufacturer authorised service representative.

The pump as well as its replaceable spare parts shall be disposed of taking local legislation into consideration. Do not send back to the manufacturer. None of the pump’s components does not pose hazard to environment and can be safely disposed of in accordance with hospital protocols.

Table 1 Pump part to be periodically replaced

Part

Number

Part Name

B6640001 Battery

Periodicity of

Replacement*

3–4 years

Criterion for

Replacement

Cordless work time has diminished more than twice

(check at 25 o

C)

B8123009 Cap 3–4 years Damages (cracks, etc.)

* - periodicity of replacement depends mainly on the frequency of use for each part

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9. TECHNICAL SPECIFICATIONS

Description

Component

SEP-10S Plus SEP-12S Plus, SP-12S Pro

Syringe sizes

Infusion rates

Volumetric accuracy

Mechanical accuracy

Volume To Be Infused (VTBI)

10-100 ml of main brands;

5 ml – optional.

0.1 to 99.9 ml/h in 0.1 ml/h steps;

100 to 1500 ml/h in 1 ml/h steps.

Note:

Maximal infusion and Bolus rates:

– 200 ml/h for syringe 5 ml;

– 450 ml/h for syringe 10 ml;

– 750 ml/h for syringe 20 ml;

– 950 ml/h for syringe 30 ml;

– 1500 ml/h for syringes 50/60 ml and 100 ml.

+/- 2% or +/- 0.1 ml/h (the greater of these values) – with approved syringes

+/- 1%

0.1 to 99.9 ml 0.1 ml steps;

100 to 999 ml in 1 ml steps; unlimited volume.

Bolus rates

KOR (Keep Open Rate) rate

KOR volume

Standby time

Volume infused

Occlusion alarm pressure

Concentration

0; 10 to 1500 ml/h in 1 ml/h steps;

0.1 - 10.0 ml/h in 0.1 ml/h steps (or set rate if lower than KOR).

1.0 % of syringe volume.

1 to 999 min in 1min steps.

0.1 to 99999 ml high – 120 kPa ± 25 kPa; medium – 80 kPa ± 20 kPa ; low – 40 kPa ± 15 kPa; or (only for SP-12S Pro) high – 90 kPa ± 20 kPa medium – 60 kPa ± 15 kPa low – 30 kPa ± 15 kPa

Medium and low levels for 50/60 ml and 100 ml syringes only.

____________

0.01 to 9.99 (µg)mg/ml in 0.01

(µg)mg/ml steps;

10.0 to 99.9 (µg)mg/ml in 0.1

(µg)mg/ml steps;

100 to 999 (µg)mg/ml in 1

(µg)mg/ml steps.

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Infusion rate in mass units

____________

0.01 to 9.99 (µg)mg/h,

(µg)mg/kg/h(min) in 0.01 (µg)mg/h,

(µg)mg/kg/h(min) steps;

10.0 to 99.9 (µg)mg/h,

(µg)mg/kg/h(min) in 0.1 (µg)mg/h,

(µg)mg/kg/h(min) steps;

100 to 999 (µg)mg/h,

(µg)mg/kg/h(min) in 1 (µg)mg/h,

(µg)mg/kg/h(min) steps;

Bolus doses

0.1 to 99.9 ml in 0.1 ml steps;

0.1 to 99.9 ml in 0.1 ml steps;

0.01 to 9.99 µg,mg,(µg)mg/kg in 0.01

µg,mg,(µg)mg/kg steps;

10.0 to 99.9 µg,mg,(µg)mg/kg in 0.1

µg,mg,(µg)mg/kg steps;

100 to 999 µg,mg,(µg)mg/kg in 1

µg,mg,(µg)mg/kg steps; no automatic bolus.

Patient weight

__________

0.4 to 99.9 kg in 0.1 kg steps;

100 to 200 kg in 1 kg steps.

Mounting - table top operation

- universal pole clamp

- Draeger bar (optional)

- Mains splitter (optional)

AC power supply

220-230 VAC ±10%, 50/60 Hz, or

115 VAC (optional) ±10%, 50/60 Hz

External DC power supply

Battery:

Battery type

Battery operation

Battery charging time

Power consumption

Fuses

12 VDC

NiMH, 9.6 V / 1300 mAh

8 h @ 5 ml/h

Up to 24 hours to 100% charge

10 VA (max).

Protection against current leakage

Protection against electrical shocks

T80 mA/L250 V (for 220-230 VAC);

T160 mA/L250 V (for 115 VAC).

Type CF equipment

Class II

Protection against splashing liquid

CE

0408

Electrical safety and EMC

IPX4 (splashing water protected)

Council Directive 93/42/EEC (14 June 1993) concerning medical devices

IEC 60601-(1, 1-2, 2-24)

Maximum volume under single fault condition

<0.5 ml

44

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Operating temperature range

Transport and storage temperature

Operating atmospheric pressure

Permissible relative humidity

Memory retention

Event log

Infusion modes

Use in ambulances

Interfaces

Dimensions (WxHxD)

Weight

Transport

+5°C – +40°C

-20°C – +40°C

60 kPa – 106 kPa

20 - 90%, no condensation

For more than 10 years when not powered up. up to 2000 events

Continuous, Profile (optional in SEP-12S Plus, SP-12S Pro)

Optional in SEP-10S Plus and SP-12S Pro

RS 232 (optional in SEP-10S Plus)

Nursecall (optional)

305 x 135 x 195 mm

2.6 kg

In the original packaging

Volumetric Accuracy of the System

The pump, using the appropriate syringe (identified in

Chapter 2), maintains a volumetric accuracy with delivery errors not exceeding ±2% for any one hour period over 72 hours at 5 ml/h.

Note that flow fluctuations can be caused by unusual conditions or combinations of conditions that may involve, but are not limited to, the following: fluid density, positive and negative pressure and the environment. Flow fluctuations are most likely to occur when the conditions mentioned above are exacerbated or when the device is operated in conditions outside of its normal limits.

The accuracy figures as stated are based upon operation at a room temperature of 22°C.

NOTE:

The all data shown is for the BD Plastipak 50 ml syringe with

BALTON, PPI/LL – 120 cm extension set

Startup Graph Description

The Startup Graph was developed in accordance with IEC 60601-

2-24.

The Startup data shown in the graph illustrates the startup performance of the pump during the first 120 minutes of operation with a sampling period of 30 seconds.

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A Startup graph of flow versus time illustrates initial stability with time.

Even with the proper components and set up, the flow of any manufacturer’s pump may be erratic during the 120-minute startup period. Therefore, we have included the startup, or stabilisation data. It should be noted that as the time interval over which accuracy is measured is lengthened, all pumps show considerable improvement in flow accuracy.

Startup Graph Example

How Trumpet Curve Graphs are Interpreted

Trumpet Graph Example

The trumpet curve provides a graphical view of the maximum deviation in flow rate from the programmed delivery rate for specific segments of delivery time. The horizontal axis does not represent elapsed delivery time, but rather acts as a graphical reference for selecting specific observation time intervals. The widest area of the trumpet curve (greatest deviation) reflects the smallest sampling intervals or observation windows. As the sizes of the sampling intervals increase (in minutes), the deviations in flow from the programmed delivery rate are reduced as the deviations are spread out over the longer periods of time. This results in the narrowing of the trumpet curve giving a more realistic representation of the device’s average flow rate accuracy over longer intervals of time.

For example, if you were to look at the maximum and minimum percentage error points corresponding to the 5-minute interval point on the Observation Interval axis, you would be looking at the average flow variance for any 5-minute period throughout the infusion.

Similarly, if you were to look at the 60-minute interval point on the Observation Interval axis, you would be looking at the average flow variance for any 60-minute period throughout the infusion.

How Trumpet Curves Can Be Used

Trumpet curves can be important sources of information for the medical professional who must decide whether a certain infusion pump can be used with a particular drug. For example, when delivering a drug with a short half-life, very small deviations in flow over the course of an infusion would be desirable to ensure that the deviations in plasma level also remained small. The device’s ability to deliver very closely to the programmed rate would ensure that the drug’s efficacy was being maintained. In this example, the medical professional would be wise to select a device whose trumpet curve indicated a small or narrow range of deviations in flow rate.

46

SEP-10S PLUS, SEP-12S PLUS, SP-12S PRO

PUMP MANUAL

Startup and Trumpet Curves

Startup graph. BD Plastipak 50 ml @ 1 ml/h Startup graph. BD Plastipak 50 ml @ 5 ml/h

Trumpet graph. BD Plastipak 50 ml @ 1 ml/h Trumpet graph. BD Plastipak 50 ml @ 5 ml/h

Influences of Back Pressure at 5 ml/h

Startup graph. BD Plastipak 50 ml (+100 mmHg) Startup graph. BD Plastipak 50 ml (-100 mmHg)

Trumpet graph. BD Plastipak 50 ml (+100 mmHg)

Trumpet graph. BD Plastipak 50 ml (-100 mmHg)

SEP-10S PLUS, SEP-12S PLUS, SP-12S PRO

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47

Maximum Infusion Pressure Generated

The maximum infusion pressure prior to alarm activation is 145 kPa.

Alarm Delay at Occlusion

Rate

1 ml/h

Occlusion alarm pressure level

Low

High

Low

High

Time to Alarm activation (max) low – 40 kPa ± 15 kPa; high – 120 kPa ± 25 kPa.

1 h 20 min

2 h

15 min

25 min low – 30 kPa ± 15 kPa; high – 90 kPa ± 20 kPa.

1 h

1 h 40 min

10 min

20 min

5 ml/h

Bolus Volume at Occlusion

Rate Occlusion alarm pressure level Bolus volume (max)

5 ml/h

Low

High

0.3 ml

0.5 ml

Automatic Bolus volume accuracy

The information in the following table represents laboratory testing conducted per Sub-Clause 50.106 of IEC 60601-2-24 Part 2.

Set value

0.1 ml

1 ml

20 ml

Mean

- 0.6 %

+ 0.5 %

+ 0.3 %

Deviation

Maximum positive Maximum negative

+ 2.0 %

+ 1.2 %

+ 1.4 %

- 4.0 %

- 0.2 %

- 0.3 %

48

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10. GUIDANCE AND MANUFACTURER'S

DECLARATION ON ELECTROMAGNETIC

EMISSIONS

Electromagnetic Compatibility Statement

This statement and the information provided in the following tables are required by IEC 60601-1-2:2001. The tables can be used to identify what EMC (electromagnetic compatibility) standards SEP-10S Plus, SEP-12S Plus, SP-12S Pro syringe pumps (hereinafter – Syringe pump) were subjected to, the minimum test level identified in the standard, the level that the pump meets and general guidance on the EMC environment. The pump is intended for use in the electromagnetic environment specified in the following tables. As with most microprocessorbased electronic products, syringe pump creates RF (radio frequency) energy as a side effect of its internal functions.

Precautions should be taken to avoid exposing syringe pump to powerful sources of electromagnetic radiation such as MRI

(magnetic resonance imaging) and ESU (electro-surgical equipment).

Note that portable and mobile communications equipment such as cell phones can affect MEDICAL ELECTRICAL EQUIPMENT such as syringe pump.

The use of ACCESSORIES and cables other than those specified in the Operator’s Manual may result in increased

EMISSIONS or decreased IMMUNITY of syringe pump.

Syringe pump should not be used adjacent to or stacked with other equipment and if adjacent or stacked use is necessary, syringe pump should be observed to verify normal operation in the configuration in which it will be used.

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Table 1 Guidance and manufacturer's declaration - electromagnetic emissions

Syringe pump is intended for use in the electromagnetic environment specified below. The customer or the user of syringe pump should assure that it is used in such an environment.

Emission test

RF emissions

CISPR 11

RF emissions

CISPR 11

Harmonic emissions

IEC 61000-3-2

Voltage fluctuations/flicker emissions

IEC 61000-3-3

Compliance

Group 1

Class B

Class A

Complies

Electromagnetic environment - guidance

Syringe pump uses RF energy only for its internal function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment.

Syringe pump is suitable for use in all establishments including domestic establishments and those directly connected to the public low-voltage power supply network that supplies buildings used for domestic purposes.

Table 2 Guidance and manufacturer's declaration – electromagnetic immunity

Syringe pump is intended for use in the electromagnetic environment specified below. The customer or the user of syringe pump should assure that it is used in such an environment.

Immunity test

Electrostatic discharge (ESD)

IEC 61000-4-2

Electrical fast transient burst

IEC 61000-4-4

Surge

IEC 61000-4-5

IEC 60601 test level

+/- 6 kV contact

+/- 8 kV air

Compliance level

+/- 8 kV contact (1)

+/- 15 kV air (1)

Electromagnetic environment - guidance

Floors should be wood, concrete, or ceramic tile. If the floors are covered with synthetic material, the relative humidity should be at least 30%.

Mains power quality should be that of a typical commercial or hospital environment.

+/- 2 kV for power supply lines

+/- 1kV for input/output lines

+/- 1kV differential mode

+/- 2 kV common mode

+/- 2 kV for power supply lines

+/- 1kV for input/output lines

+/- 1kV differential mode

+/- 2 kV common mode

Mains power quality should be that of a typical commercial or hospital environment.

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Table 2 Guidance and manufacturer's declaration – electromagnetic immunity – continued

Syringe pump is intended for use in the electromagnetic environment specified below. The customer or the user of syringe pump should assure that it is used in such an environment.

Immunity test

IEC 60601 test level

Compliance level

Electromagnetic environment - guidance

Voltage dips, short interruptions and voltage variations on power supply input lines

IEC 61000-4-11

<5% U dip in U cycle

40% U in U

T

T

T

(> 95%

T

) for 0.5

(60% dip

) for 5 cycles

70% U in U

T cycles

T

(30%dip

) for 25

< 5% U

T

(>95% dip in U

T sec

) for 5

<5% U dip in U cycle

T

(> 95%

T

) for 0.5

40% U

T

(60% dip in U

T

) for 5 cycles

70% U in U

T

) for 25 cycles

< 5% U

T

(30%dip

(>95% dip in U

T sec (2)

T

) for 5

Mains power quality should be that of a typical commercial or hospital environment. If the user of the syringe pump requires continued operation during power mains interruptions, it is recommended that the syringe pump be powered from an uninterruptible power supply or a battery.

User should always have battery installed per

Operator’s Manual.

Power frequency

(50/60 Hz) magnetic field

IEC 61000-4-8

3 A/m 3 A/m

400 A/m (1)

Power frequency magnetic characteristic of a typical location in a typical commercial or hospital environment.

The pump functions normally when exposed to power frequency magnetic fields of 400 A/m.

Note 1: Syringe pump was designed to meet the requirements of EN 60601-1-2: 2001 and IEC 60601-2-24: 1998

Note 2: Pump automatically transfers to battery operation if there is a loss of main power.

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Table 3 Guidance and manufacturer's declaration - electromagnetic immunity - for

LIFE-SUPPORTING EQUIPMENT and SYSTEMS

Syringe pump is intended for use in the electromagnetic environment specified below. The customer or the user of syringe pump should assure that it is used in such an environment.

Conducted RF

IEC 61000-4-6

Radiated RF

IEC 61000-4-3

Immunity test IEC 60601 test level

3 Vrms

150 KHz TO 80

MHz outside ISM bands a

10 Vrms

150 kHz to 80 MHz in ISM bands b

10 V/m

80 MHz to 2.5 GHz

Compliance level

3 Vrms

10 Vrms

10 V/m

Electromagnetic environment - guidance

Portable and mobile RF communications equipment should be used no closer to any part of syringe pump, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter.

Recommended separation distance

d=1.17√P d=1.2√P d=1.2√P 80 MHz to 800 MHz d=2.3√P 800 MHz to 2.5 GHz

where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer and d is the recommended separation distance in meters (m).

b

Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey, c

should be less than the compliance level in each frequency range.

d

Interference may occur in the vicinity of equipment marked with the following symbol:

NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. a

The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz;

13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz. b

The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80

MHz to 2.5 GHz are intended to decrease the likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into patient areas. For this reason, an additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in these frequency ranges.

52

Table 3 Guidance and manufacturer's declaration - electromagnetic immunity - for LIFE-

SUPPORTING EQUIPMENT and SYSTEMS – continued

Syringe pump is intended for use in the electromagnetic environment specified below. The customer or the user of syringe pump should assure that it is used in such an environment.

Immunity test IEC 60601 test level

Compliance level

Electromagnetic environment - guidance

c

Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which syringe pump is used exceeds the applicable RF compliance level above, syringe pump should be observed to verify normal operation. If d abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating syringe pump.

Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

Table 4 Recommended separation distances between portable and mobile RF communications equipment and syringe pump - for LIFE - SUPPORTING EQUIPMENT and

SYSTEMS

Syringe pump is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of syringe pump can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and syringe pump as recommended below, according to the maximum output power of the communications equipment.

Rated maximum output power of transmitter

W

150 kHz to 80 MHz outside ISM bands

d=1.17√P

Separation distance according to frequency of transmitter m

150 kHz to 80 MHz in ISM bands

d=1.2√P

80 MHz to 800

MHz

d=1.2√P

800 MHz to 2.5

GHz

d=2.3√P

0.01

0.1

1

10

0.12

0.37

1.17

3.70

0.12

0.38

1.20

3.80

0.12

0.38

1.20

3.80

0.23

0.73

2.30

7.28

100 11.70 12.00 12.00 23.00

For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.

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Table 4 Recommended separation distances between portable and mobile RF communications equipment and syringe pump - for LIFE - SUPPORTING EQUIPMENT and

SYSTEMS – continued

Syringe pump is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of syringe pump can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and syringe pump as recommended below, according to the maximum output power of the communications equipment.

Rated maximum output power of transmitter

W

d=1.17√P

Separation distance according to frequency of transmitter m

150 kHz to 80 MHz outside ISM bands

150 kHz to 80 MHz in ISM bands

d=1.2√P

80 MHz to 800

MHz

d=1.2√P

800 MHz to 2.5

GHz

d=2.3√P

NOTE 1 At 80 MHz and 800 MHz, the separation distance of the higher frequency range applies.

NOTE 2 The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to

6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz.

NOTE 3 An additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz to decrease the likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into patient areas.

NOTE 4 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people.

54

11. DRAWING OF CABLES FOR

MULTIFUNCTIONAL CONNECTOR

(MFC)

*

Connection Data:

Ground (GND)

Normally Closed (NC)

Common (COM)

Normally Open (NO)

NOTE:

Use standard D Type - 9 Pin connectors.

* – the internal batteries are not fully charged when operating from 12VDC. When operating pump from 12 VDC permanently recharge the internal batteries (connect pump to the MAINS) after 1 week of operation.

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55

12. WARRANTY AND SERVICE

INFORMATION

Warranty

The Manufacturer warrants that pump is free from defects in material and workmanship under normal use and service for a period of 12 months after the purchase date.

The Manufacturer or its authorised representative takes obligation to carry out the warranty repair of the pump or to replace the pump with an operational one in case the Manufacturer or its authorised representative determines that the cause of the pump’s failure was related to the manufacturing process.

If the customer finds a defect in the pump during the

Warranty period, he must report it and inform the Manufacturer or its authorised representative within 30 days.

A pump sent for testing, repair or replacement shall be submitted to the Manufacturer or its authorised representative in its original or equivalent packaging. The pump is sent for repair and back at customer expense.

If no defect is found during testing, the Manufacturer or its authorised representative reserves the right to submit the invoice to the customer for the work carried out.

This Warranty is not applicable to pumps with damaged seal or when failure was caused by violations of requirements of this

Operation Manual, by mains voltage non-conformity to the requirements of IEC, by spills of liquids, by mechanical damages caused by shocks or a pump being dropped, by pump damages caused during transportation, or when packaging is damaged.

Service Information

For service and repair contact manufacturer:

Viltechmeda, 125 Kalvariju Str., 08221 Vilnius, Lithuania.

Tel.: (+370 5) 2776 745, 2737 508, 2737 506

Fax: (+370 5) 2763 867

E-mail: [email protected]

Shipping costs for all units returned to Viltechmeda shall be paid for by the customer. The unit must be packed in its original container or in another Viltechmeda approved container that will provide adequate protection during shipment. To ensure prompt return, a Viltechmeda’s authorised dealer must be notified before shipping any unit for repair.

When calling for service, please be prepared to provide model and serial number of the unit. A brief written description of the problem should be attached to the instrument when it is returned for service.

Viltechmeda will not be responsible for unauthorised returns or for units damaged in shipment due to improper packing.

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13. ACCESSORIES

Description Part Number

Headboard/footboard mounting clamp

Clamp for mounting in ambulance cars, required by EN

1789:1999+A1:2003

RS 232 cable

B6302003

B6090003

B6650007

12VDC cable B6650008

Mains splitter MS-04 B2087019

IV stand I-235

Clamp for Draeger bar mounting B6302019-01

Nurse Call cable B6650009

Model:

Serial No:

Delivery date:

Quality inspector:

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57

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Key Features

  • Programmable infusion rates
  • Accepts various syringe sizes
  • Intravenous, intraarterial, epidural, and subcutaneous infusion
  • Customizable configuration
  • Advanced features (drug protocols)
  • Alarm signals
  • Battery operation

Frequently Answers and Questions

What are the infusion rate ranges for these pumps?
The infusion rates are programmable from 0.1 to 1500 ml/h.
What size syringes can be used with these pumps?
The pumps accept single-use syringes with volumes from 10 to 100 ml, optional – 5 ml.
What are the different infusion routes supported by these pumps?
The pumps can be used for intravenous (IV), intraarterial (IA), epidural, or subcutaneous routes of administration.
How do I change the pump's configuration to suit my specific needs?
The pumps can be custom-configured to select key features that meet specific requirements. The selected options can be easily reviewed and the chosen configuration can be changed to meet new or different requirements.
What are some of the advanced features offered by these pumps?
The pumps include advanced features like drug protocols, which allow you to pre-program the infusion parameters for specific drugs.
What kind of alarms do the pumps have?
These pumps are equipped with a variety of visual and audible alarm signals to alert you to potential problems during infusion.

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