How to administer your medication using a CADD^®-Solis pump

Hi, I'm Helen and I'm going to walk you through how to administer your medication using a CAD Solis pump. 

You'll be using this pump to make sure your medication infuses at the rate ordered by your doctor. 

There are seven steps you'll need to follow, and you can jump to anyone at any time using the chapters below. 

Step 1: Getting started  

Let's start by making sure you're using a clean area at home. You can wash the surface with soap and water or a disinfectant wipe. You can use your sash preparation mat as a clean work surface. Use soap and water or disinfectant wipes after each use to keep your sash mat clean. 

Now go ahead and wash your hands really well for at least 20 seconds. Apply enough liquid soap to cover the entire surface of your hands. Use a nail brush to clean under your nails, if needed. Rinse your hands thoroughly and dry them with a paper towel or clean unused hand towel and use that same towel to turn off the faucet. If you don't have access to soap and water, use an alcohol-based hand sanitizer. 

Making sure you have a clean area and clean hands during every step is really important to help prevent infection. Next, make sure you've got all your supplies ready to go on your sash mat or other clean work surface. 

CADD®-Solis pump four AA batteries, pump tubing, medication bag at room temperature, two prefilled saline syringes, one prefilled heparin syringe, if ordered, alcohol pads, pump carrying pack, if instructed to use.  

You'll want to check your medication and label for the correct patient name, correct medication, correct dose, and that it's not expired. And the solution should be clear, consistent in color, and free of any visible particles. If it's not, call us right away. 

If you will be using a pump carrying pack, make sure there is no air in the medication bag. Most bags will already have the air removed by the pharmacy. Follow instructions provided by your nurse if the air needs to be removed. 

Once all of your supplies are ready, wash your hands again for at least 20 seconds.  

If you touch something other than your supplies after washing your hands, you need to re wash your hands. Or you can use an alcohol-based hand sanitizer. 

Step 2: Preparing your medication  

If your medication was refrigerated, you need to let it warm to room temperature before you move on. And no shortcuts here. It's not safe to ever use hot water or a microwave to warm your medication. OK, on to the pump. First, insert new batteries. Use your finger or a coin and turn the knob on the battery door counterclockwise to open it. Insert new batteries facing in the direction shown in the diagram. Avoid mixing new and used batteries at any point. Then close the battery door and turn the knob clockwise to lock it. 

Do not store the pump for prolonged periods with the batteries installed. Before starting the pump, insert new batteries as instructed.  

Take the administration tubing out of its wrapper and unfold the tubing. Then close the clamp on the tubing. Next, take the blue plastic clip off the bottom of the cassette. Now, without touching the end of the medication bag port with your fingers, remove the tab. 

Then take the white cover off the spike end of the IV tubing and push the spike into the port of the medication bag, twisting as you push it so it reaches the ridge. 

Now turn the pump on by pressing and holding the power switch. When the pump powers on, it performs a self-test. 

Once that is complete, you'll hear six beeps. It's important to make sure the pump is powered on before attaching a new cassette. 

Open the cassette latch and then insert the cassette hooks into the hinges on the bottom of the pump. Push the cassette onto the bottom of the pump until it snaps on. Lift the latch into the closed position. Be careful not to force it, and check that the cassette is lined up evenly with the bottom of the pump. Once the cassette is attached, the pump automatically displays screens that allow you to prime the tubing. 

Your pump has been programmed for you by our Coram clinicians. For your safety, these settings are locked, so you'll just be confirming the settings the same way every time you use it. You will see prime tubing on the screen. If you need to prime the tubing, press YES on the soft key below the word yes on the screen. Make sure that the administration tube is not connected to you. 

Open the clamp, then select Prime on the pump and allow the fluid to reach the end of the tubing. Press Stop priming or if the screen shows, continue priming. Press No Priming will automatically stop after 10 milliliters are primed or after 20 milliliters, if using a high-volume tubing cassette. When priming your tubing, leave the protective cover on the end and hold it over its package or another small clean container to catch any drops. 

It's important to be careful with the end of the tubing, you don't want it to touch anything and become contaminated. Now your pump and tubing are ready to go. 

It's likely you've heard us talk about SASH or SASH to help you remember several of the steps, and we're going to use SASH again today. 

Step 3: Saline flush 

The first part of SASH is the saline, which you'll use to flush your catheter. If you have a double lumen catheter flush as directed by your nurse or pharmacist, hold the saline syringe with the tip pointing up and press firmly on the plunger while the tip cap is still on until you feel a click or see the plunger move. Then loosen the tip cap and gently push the plunger to remove any air. Retighten the cap before placing it back down. 

Use an alcohol pad to clean the injection cap for 15 seconds and let it air dry for 5 seconds. Be careful not to touch the top of the injection cap with your fingers. 

Go ahead and open the clamp on your IV catheter or extension set. Remove the tip cap from the saline syringe, then push the saline syringe onto the injection cap and twist it clockwise until it's secure. The tip of the syringe is sterile, so do not touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one. 

Push the plunger and slowly to flush the catheter with as much saline as instructed. If you don't know how much to use, call us and we'll confirm. Administer your saline flush as instructed by your nurse. This can be done slow and steady or by the pulse method. To use the pulse method, push the plunger, then stop for a second and then push the plunger again. 

When you have flushed all of the saline into the catheter, remove the syringe from the injection cap and discard the syringe as instructed by your nurse. 

One note, if it's hard to push in the plunger during any flush, check to make sure all the clamps are open. And if you have pain, burning or swelling when flushing, stop right away and call us. 

Step 4: Administering your medication 

Now, you're ready to administer your medication. The second part of SASH, scrub the catheter injection cap again with a new alcohol pad for 15 seconds and let it air dry for five seconds. Be careful not to touch the top of the injection cap with your fingers. Take the protective cap off the end of the tubing, being careful not to touch the several end with your fingers. Connect the end of the pump tubing to the catheter injection cap by pushing it in and turning it clockwise until it's secure. 

Open all the clamps on the tubing and then press the start key to start the pump. When start pump appears on the screen, press yes. You'll feel the pump start and the red stopped message in the status bar will change to a green running message. Then infusion is starting now will appear briefly and if for any reason you have to stop an infusion before it finishes, the screen will show infusion was interrupted before completion. Finish interrupted infusion or start from the beginning with new bag. 

You'll want to select Finish to restart the infusion you stopped earlier. You might see an error code during the time you are using the pump. 

Some of these are easy to resolve just by checking the back of the pump for the troubleshooting guide. If you can't figure out how to solve the problem, call us. Now, you can put the bag and pump in the backpack and move around as you like during the infusion. Take a deep breath, you're doing great. 

When it is the scheduled time to change your medication bag, you will repeat steps two, three and four, including preparing your new medication bag, priming your new tubing, and administering a saline flush. Press the stop key to stop the pump. When the screen shows stop pump, press yes. You should see the green running message in the status bar. Change to a red stopped message and pump is stopping will appear briefly. 

Once the pump has stopped you will see stopped appear with red highlighting on the status bar. The amber indicator light will flash and the green indicator light will go off. Make sure the pump has stopped before removing the cassette. Press the power switch. When the power down message appears, press yes and the pump will turn off. Clamp the tubing and disconnect it from your catheter injection cap. Then push down on the cassette latch until the cassette pops off. 

Remove and discard the cassette as directed by your clinician if you will be connecting a new bag of medication. Once you attach the new tubing cassette, the pump will display reset reservoir volume to your prescribed volume in milliliters. Select yes to reset the volume. The pump will display that it is saving. If this is the end of your infusion, proceed to the following steps. 

Step 5: Second saline flush 

Now you do another saline flush the third part of SASH and you'll follow the same steps as earlier. Hold the saline syringe with the tip pointing up and press firmly on the plunger while the tip cap is still on until you feel a click or see the plunger move. Then loosen the tip cap and gently push the plunger to remove any air. Re-tighten the cap before placing it back down. 

Use a new alcohol pad to clean the injection cap for 15 fifteen seconds and let it air dry for five seconds. Be careful not to touch the top of the injection cap with your fingers. Remove the tip cap from the saline syringe, then push the saline syringe onto the injection cap and twist it clockwise until it's secure. The tip of the syringe is sterile, so don't touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one. Push the plunger in slowly or use the pulse method to flush the catheter with as much saline as instructed. If you don't know how much to use, call us and we'll confirm. 

If you were given heparin and told to use it to flush your catheter, continue with these next steps. Otherwise, you can jump right to the final step, which is clean up. 

Step 6: Heparin flush, if ordered.  

The heparin flush is the last part of SASH. Hold the heparin syringe with the tip pointing up and press firmly on the plunger while the tip cap is still on until you feel a click or see the plunger move. Then loosen the tip cap and gently push the plunger to remove any air. Re-tighten the cap before placing it back down. Use a new alcohol pad to clean the injection cap for 15 fifteen seconds and let it air dry for 5 seconds. 

Be careful not to touch the top of the injection cap with your fingers. Remove the tip cap from the heparin syringe. Then, push the heparin syringe onto the injection cap and twist it clockwise until it's secure. The tip of the syringe is sterile, so don't touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one. 

Push the plunger in slowly or use the pulse method to flush the catheter with as much heparin as instructed. If you don't know how much to use, call us and we'll confirm. When you're done, take the syringe off the injection cap and clamp the catheter or extension set.  

Step 7: Cleanup and disposal 

Now your final step is clean up. Go ahead and throw away the used alcohol pads into your trash. You can also throw your used flush syringes into your trash unless your nurse has told you to dispose of them in your sharps container. You can discard your empty medication bag, cassette, and tubing in the trash, Clean your sash mat and put it away for next time. 

This may all seem a bit overwhelming at first, but once you do this a few times, you'll feel more comfortable. And remember, as a Coram patient, our team is here for you 24 hours a day, 7 days a week. 

Thank you for watching.