ambIT

Implant Procedure & Techniques

Overview

The ambIT® external epidural pump is used to infuse medication and/or fluids into patients primarily for pain management. Routes of delivery are generally intravenous, epidural and/or regional.

The Model 8516 percutaneous intraspinal catheter is intended to provide percutaneous access to the intrathecal or epidural space for up to 4 days and is designed for use with the ambIT® epidural pump.

Preparing for the Procedure

  • Before beginning the procedure, you must protect against air infusion. 
  • The infusion solution must be provided in a non-vented, collapsible container.
  • Remove all air from solution container and tubing before use.
  • Infusion with the pump requires the use of one of the following ambIT® pump cassettes:
  • ambIT® PCA Pump Cassette, Filterless, Male Luer, Ref 220267
  • ambIT® PCA Pump Cassette, Filter, Spike, (1.2 micron air-eliminating filter) Ref 220140
  • ambIT® PCA Pump Cassette, Filterless, Spike, Ref 220139

The Procedure

Priming the Cassette

  1. Remove protective cover from bottom of cassette as shown


  2. Connect the solution container to the cassette using aseptic technique
  3. Release all clamps on tubing
  4. Invert the solution container to allow air to be evacuated first before priming the cassette with fluid
  5. Gently squeeze the solution to force fluid and air upward through the tubing and cassette. Continue until the solution has completely filled the tubing and all air bubbles have been removed
  6. After priming, close the fluid path by snapping the cassette bottom disc into the cassette body. This will prevent free flow

Warnings:

  • Do not use a cassette if the outer package is torn, punctured, wet, or damaged
  • Do not touch sterile open ends of the tubing. Use aseptic technique
  • Remove all air from solution container and tubing before use.
  • Be sure all connections are secure before starting the intervention and check fluid path for leaks
  • If filled solution container is not going to be used immediately, clamp the tubing and cap the female luer connector with the protective cap provided to prevent contamination
  • Always verify the cassette bottom disc is snapped closed before attaching cassette to pump

Note: In the event the cassette bottom disc is snapped closed before the priming process is complete, place the cassette on the pump (not attached to patient) and use the Bolus button to complete the priming of the cassette.

To help ensure a successful infusion, please include the following steps:

  1. Before placing the cassette on the pump:
  • Prime the tubing (set aside the protective cover)
  • Press the cassette bottom disc into the cassette body as shown
  • Bend or break away the wings of the protective cover. Place the protective cover back on cassette (insert cassette shaft into octagonal opening)
  • Use protector cover to rotate cassette shaft counterclockwise 3 or 4 times

    Note: The cassette shaft can also be rotated by hand.
  1. Most "MA" alarms can be resolved by pressing the Run/Pause button to silence the alarm and pressing it again to restart the infusion. If the alarm persists, contact the distributor or Sorenson Medical, Inc.
  2. Make sure the patient is instructed on proper use of the pump

Procedure Summary

  1. Place the catheter in the epidural space. Do not trim the catheter
  2. Connect the solution container to the short pump extension tubing
  3. Prime the cassette extension tubing
  4. Snap in the cassette bottom disc and rotate the cassette shaft counter-clockwise
  5. Connect pump extension tubing to the catheter
  6. Secure catheter, extension tubing, and connector, then cover with adhesive-backed dressing
  7. Attach the cassette to the pump
  8. Insert new batteries
  9. Enter Program mode: Press and hold the Run/Pause and the Bolus buttons until the pump beeps
  10. Set the basal infusion rate. Use individual buttons to adjust the values. Hold either button for 2 seconds to enter the values
  11. If you choose to prime the catheter using the pump, set the bolus volume to 0.3 mL. Additional volume can be entered if a therapeutic bolus is desired to follow a priming bolus
    Note: If a bolus volume other than 0.0 mL is selected, the Bolus button will be enabled at the end of the bolus lockout period (maximum lockout of 12 hours), allowing the patient to deliver the programmed bolus volume. If this is not desired, program the bolus volume to 0.0 mL. The catheter will be full when 0.3 mL has been infused
  12. Set the bolus lockout time (if the bolus volume is not set to 0.0 mL).
  13. Set the volume to be infused (the amount in the bag)
  14. Perform a program review: In Pause mode, press and release the Bolus button
  15. Start infusion and administer a bolus: In Pause mode, press the Run/Pause button. To administer a bolus, press the Bolus button (if bolus volume not set to 0.0 mL)
  16. Reprogram the bolus volume to 0.0 mL
  17. Lock the pump (Patient Lockout), if desired