What is an Ambulatory Infusion Pump (AIP)?

An Ambulatory Infusion Pump (AIP) is a small battery powered pump that slowly puts medicine, like chemotherapy or antibiotics, into your body. The pump gives you the medicine for the amount of time prescribed by your doctor.

Why do I need an AIP?

You and your health care team have decided that you will get your medicine using an AIP. This lets you get your medicine without having to stay at the hospital overnight and lets you carry on with most of your daily activities.

How do I prepare to get the pump?

You need an intravenous catheter (IV). The type of IV that you get depends on the type of medicine you need and how long you need to get the medicine.

Here is a list of types of IV’s that can be used with the pump:

• PICC line
• Tunneled catheter (Port-A-Cath™)
• Implanted port
• Peripheral IV

Try to wear loose clothing with large sleeves, short sleeves, or no sleeves. A shirt or blouse with buttons at the front will make it easier for the nurse to attach your IV to the pump to receive your medicine.

How do I use the pump?

Your nurse programs the pump so it can deliver your medicine at specific time. Once completed, your nurse connects the pump to your IV and starts the pump. Your nurse will tell you how long you need to wear the pump. During this time you can do your normal activities, but with care.

The hospital may provide you with a carrying case for your pump. You can use a carrying case of your own, like a waist fanny pack or shoulder purse. Put the medicine bag and pump in a bag to protect your own carrying case in case there is a spill.

Your nurse reviews instructions on how to take care of the pump and what to do in case of an emergency. These important instructions are included in this pamphlet for you to review. The pump has several safety features that keep you from accidentally changing the settings. Your nurse will tell you which information is important for you to know.

Keypad Buttons and their Functions

 

To turn OFF and save power when the pump is not being used, or to turn ON return the pump to full power.

 

To start and stop the medicine, and to silence the pump’s alarms.

 

To change from one display screen to the nextension

 

Used by your nurse to program the pump.

 

To increase or decrease a setting, or to scroll up and down through items on a menu.

 

To be used only by a nurse.

 

To be used only by a nurse.

How do I turn the pump on and off?

Do not turn your pump off on your own, unless a nurse has told you to turn off the pump because it is not working properly.

To turn OFF the pump:

1. Press and hold the ‘ON/OFF’ key until 3 sets of bubbles (•••• •••• ••••) appear on the pump screen. You will hear beep with each set of the dots.
2. Let go the ‘ON/OFF’ key after you see a third set of bubbles. The screen will turn blank once the pump is turned off correctly. Please ask your nurse if you have any questions or concerns.

How do I stop and start the pump?

Do not stop your pump unless you need to change the pump batteries or a nurse tells you to stop the pump. Stopping and starting the pump on your own may lead to your medicine being given too early, too late or not at all. Please ask your nurse if you have any questions or concerns.

To stop the pump:

1. Press and hold the ‘STOP/START’ key until 3 sets of dashes (---- ---- ----) shows up on the screen. You will hear a beep with each set of dashes.
2. Let go of the ‘STOP/START’ key after you see a third set of dashes. If the pump is stopped correctly, the word “STOPPED” will appear on screen.

To start the pump:

1. Press and hold the ‘STOP/START’ key until 3 sets of dashes (---- ---- ----) disappear from the screen.
2. Let go of the ‘STOP/START’ key after the last set of dashes has disappeared. The pump will beep several times. If the pump starts correctly, the word “RUN – ResVol” will appear on the screen. You should hear a buzzing-like noise every few minutes when the medication is being given. This means the pump is working properly.

How do I change the batteries?

If “LowBat” or “Battery Depleted” appears on the pump’s display screen you will need to change the batteries.

Use 2 “AA” batteries (like Duracell™ or Energizer™). We will give you 2 spare batteries with the pump when you leave the hospital. Do NOT use rechargeable or heavy-duty batteries because the pump will not work properly with these types of batteries.

Follow these steps to change the battery:

 

1. Stop the pump. The battery compartment is on the back of the pump. Press the lid down and slide the battery cover off.

 

2. Remove the old batteries and replace with new batteries. Make sure to match the negative (-) and positive (+) charge as shown in the picture located inside the battery compartment.

 

3. Place the battery cover at the middle of the battery compartment and then slide it on to close until you hear a click. Make sure there is no gap between the battery cover and the pump itself. If there is gap, remove the battery cover and repeat the step.

4. The pump should turn on right away. You will hear several beeps as the pump turns on. Once completed, the display screen will show “STOPPED”.
5. You must restart the pump as soon as possible after changing the batteries to make sure you are getting the medicine (see how to start and stop the pump).

What should I do if the alarm beeps?

If you hear an alarm from the pump, check the message on the display screen and follow the directions below.

"Error"

There is a problem with the pump. Do not use the pump. Press the ‘STOP/START’ key to silence the alarm and to stop the infusion. Please call the hospital (see who do I call for help?) to ask whether or not you need to come to the hospital right away to replace the pump.

"LowBat" or "Battery Depleted"

The batteries are low. Change the batteries as soon as possible (see how change the batteries).

"High Pressure"

This means that the medicine is not getting through the tubing. There may be a “kink” or twist in the tubing or a clamp might be closed. Check the tubing and make sure that all clamps are open.

"Service due"

Press the ‘STOP/START’ key to silence the alarm. The pump will still work but, you need to come to the hospital to exchange the pump. Please call the hospital (see who do I call for help?) to ask whether or not the pump needs to be replaced right way.

"Air in line detected"

Press the ‘STOP/START’ key to silence the alarm. Call the hospital (see who do I call for help?) and ask for help with your pump.

How do I take care of the pump?

Here are a few safety tips you can follow while you have the pump:

• Keep the pump away from damp and humid areas, such as a bath or sauna.
• Do not place the pump in water and keep it away from any fluid that may spill on it.
• If you drop the pump in water, take it out right away and wipe it dry with a towel.
  
  Please call the hospital (see who do I call for help?). You might need to come to the hospital to replace the pump.
• When bathing or showering keep the pump and your IV dressing dry by covering them with a plastic bag. Place the pump on a chair beside the tub or hang it on a hook outside the shower. Using a handheld showerhead can help keep the pump and IV dressing dry.
• When sleeping, you may place the pump under your pillow. Do not place it on the floor.
• Always check to see that the pump and tubing are near each other. This will stop the tubing from being pulled and coming apart from the IV or pump.

What should I be careful about if I am getting chemotherapy using the pump?

Chemotherapy drugs are dangerous to cancer cells and healthy cells. Your body can take in chemotherapy drugs in 3 ways:

• direct skin contact
• breathing them in
• swallowing them

Here are some safety steps you can take to lower the chances of your family and pets coming in contact with chemotherapy drugs:

• Do NOT remove or disconnect the pump tubing or medicine bag containing chemotherapy. Keep the tubing and bag attached to the pump and return everything to the hospital.
• You and your family members or caregivers should know how to use the items in the chemotherapy spill kit that you got at the start of your treatment. Keep this kit somewhere where you will be able to get it quickly.
• Wear disposable gloves if someone other than yourself is cleaning up your bodily waste (vomit, stool or urine) and when handling soiled linens, a bedpan or urinal, or anything else that may have come in contact with chemotherapy. Wear disposable gloves for up to 2 days after your chemotherapy ends.
• Once your treatment is completely done, do NOT re-use the carrying case that you used to carry the chemotherapy bag and pump during your treatments. It needs to be washed by itself first.
• If you notice that the chemotherapy bag or IV tubing connector is leaking, or if the IV tubing is not connected to the catheter, you or your caregiver must follow the instructions on your chemotherapy spill kit.

What should I do if there is a leak or the IV tubing get disconnected?

1. Put on the plastic gloves, or use a plastic bag if gloves are not available.
2. Close all the clamps on the catheter and IV tubing.
3. Stop the pump (see how to start and stop the pump).
4. Wrap a gauze or tissue around the leaking area and tape.
5. If the IV tubing is completely disconnected, put the medicine bag and IV tubing in a plastic bag. Put the pump in a separate plastic bag to prevent the pump from getting wet or damaged.
6. If the chemotherapy has spilled or dripped onto a surface, put the blue absorbent pad or towel over the spill to soak up the fluid.
7. Put this blue absorbent pad or towel into a plastic bag.
8. Use a cloth that can be thrown away to wash the area with warm soapy water and rinse with clear water 2 times.
9. Put this cloth and everything else that you used to clean the spill into the same plastic bag when you finish washing the surface.
10. Remove the gloves and put them in the plastic bag.
11. Tighten the plastic bag securely.
12. Put this bag into a second bag and tighten it securely.
13. Wash your hands well with warm soapy water.
14. Mark the plastic bag as Chemo Waste, and bring it to the hospital to be thrown away in a special garbage bin.
15. Call the hospital (see who do I call for help?). Tell the person who answers the phone that you have a “chemotherapy spill”. You may need to come to the hospital to replace the chemotherapy bag or tubing.

What should I watch for and call the hospital about?

Take a look at your pump, IV and the medicine bag at least once or twice a day and watch for any of the issues below. Call the hospital right away (see phone numbers under who do I call for help?) if you notice any of the following: :

• Redness, swelling, pus or fluid leakage from or around the IV.
• Long lasting pain or discomfort, numbness or tingling around the IV site, shoulder, chest or jaw.
• The pump does not seem to be working or continues to alarm.
• The amount of fluid in the medicine bag or the plastic cassette does not seem to be getting lower as the day goes on.
• A pocket of air in the tubing, cassette bad or IV bag.
• Blood pooled along the IV site or tubing connection site.
• The IV catheter or needle is coming out from the IV insertion site. Do not push the IV catheter back into place as this can lead to an infection.

Then, follow steps 1 to 4 below:

1. Clamp the IV tubing immediately.
2. Stop the pump by pressing the “STOP/START” button and continue to hold until three sets of dashes (--- --- ---) appear on the display screen.
3. If the pump is stopped correctly, the word “STOPPED” will appear on the screen.
4. Call the hospital (see who do I call for help?) for further instructions.

What should I do with the pump when I am done treatment?

You need to come to Princess Margaret to have your pump removed. In the rare case that you can’t come to the hospital, your health care team can arrange a home care nurse to come to your home to remove the pump.

If a home care nurse or a nurse at another hospital (like the Emergency department) removes your pump, you need to return the pump to Princess Margaret as soon as possible.

You can return the pump:

• In-person
  Put the pump in a plastic bag, then drop it off to:
  • The Systemic Therapy Patient Registration desk, 4th floor
  • The Auto Day Hospital, 14th floor, Room 627 by the Service Elevator
• Purolator courier
  If you live far away, let your nurse know. You may get a prepaid Purolator package that you can use to send the pump back to Princess Margaret.
  
  Once the pump is removed, follow these steps to return the pump:
  1. Wrap the pump with the bubble wrap provided.
  2. Put the wrapped pump into the Purolator bag.
  3. Complete the “Sender” information (see black circles for # 2, 3 and 7).
  4. Call 1 888 SHIP 123 to arrange for pickup.

Who do I call for help?

If you have questions or need help using your pump, please call the unit where your pump was connected or where you are currently being cared for, and ask to speak to the Charge Nurse:

• Chemo Day Unit: 416 946 2000 extension 5109
  • Monday to Friday, 9:00 am to 6:00 pm
  • Saturday 9:00 am to 3:30 pm
• Malignant Hematology Day Unit (MHDU): 416 946 2000 extension 5918
  • Monday to Saturday, 9:00 am to 6 pm
• Auto Day Hospital: 416 946 6555
  • Monday to Sunday, 8:00 am to 6 :00 pm
  • After hours of operation, you will be automatically redirected to 15C
• After Hours of Operation or Holidays: Call 416 946 2000, and ask Locating to speak to the Administrator-On-Site (AOS).

If you are not able to get help from someone at the hospital for any reason, go to your nearest emergency department to get help with the pump. It is important to tell your Princess Margaret health care team as soon as possible for follow-up care.

Please have the following information ready when calling or going to the hospital:

1. Name of medicine on the medicine label
2. Start date of medicine
3. Expected stop date
4. Your doctor’s name
5. Your nurse case manager’s name and phone number

Do you need an interpreter?

Please tell your healthcare provider or phone operator to contact UHN Interpretation and Translation Services. Interpretation is provided free of charge to University Health Network patients.