5008 Brief Operating Guide

Starting system and set-up

1

7

4

2

8 6 3

5

A ‘Alpha’/blood pump clip

F Post-dilution connector

B SafeLine/‘alpha clip’

G Pre-dilution connector

C ONLINE HDF pump

H Blood/air optical detector

D ONLINE Substituate port

I Blood Temperature Monitor (BTM)

E Online Rinse port

Caution

The colour coding of the dialyser couplings may vary from that shown above – please check your local policy/colour coding.

62-FMC-5008-TS-Brief-OpGuide.indd 2

09/09/2016 11:4

1.

Switch on the system 1

2.

Select ‘treatment’ (or ‘disinfection’).

3. Connect concentrate and bibag®, ensure correct concentrate is selected in dialysate menu. T1 test starts automatically. 4. Open the EBM doors 2 and follow on screen instructions for lining – arterial line first, ensu e the sound is generated when inserting the red ‘alpha clip’ A into the line guide. Attach heparin syringe 3 if required. 5. Attach the venous line ensuring the line below the venous bubble catcher is firmly placed in the blood/air detector H groove. 6. Place the SafeLine (sub tubing) into the HDF pump ensure the sound is generated on insertion of the clear plastic ‘alpha clip’ B into the line guide, then connect the arterial line to the SafeLine 4 . 7. Connect the rinse connector 5 to the venous line. 8. On completion of T1 test, insert the substituate connector into the ONLINE Substituate port D and the rinse connector (on the venous line) into the ONLINE Rinse port E . 9. Close the doors and attach the dialyser couplings 6 as instructed. 10. Press the blood pump button on the screen to commence prime. 11. Priming is complete when the prime volume has been reached, the blood pump speed has reduced to 50 ml/min and the operating mode (preparation screen) displays pre-circulation. 12. Enter UF and heparin data, check conductivity and temperature are correct. Ensure correct dialysate is selected (dialysate menu).

62-FMC-5008-TS-Brief-OpGuide.indd 3

09/09/2016 11:4

Caution Transducer Protector (Hydrophobic filter 1. In order to avoid a possible ingress/loss of air and wetting of the transducer protector in case of pressure fluctuations, it is important to ensure that the transducer protector is correctly and tightly connected. 2. If a transducer protector is wetted with priming fluid or blood, it must be replaced immediately. Any fluid that is in the line must not be forced back using a syringe, as this may damage the filter and may lead to contamination of the system. 3. If at any time during treatment, blood has reached the transducer protector, the system must be checked for contamination after completion of the treatment (check windows on white face of transducer protector). A CONTAMINATED SYSTEM MUST BE TAKEN OUT OF SERVICE FOR DECONTAMINATION.

62-FMC-5008-TS-Brief-OpGuide.indd 4

09/09/2016 11:4

Venous bubble catcher and level detector. 1. It is important to ensure that the level detector is clean and dry and that the venous bubble catcher is correctly positioned so that it makes good contact with the level detector. 2. If there is a leakage of fluid f om the Safeline/ arterial patient line connection during preparation it is essential to clean and dry both the venous bubble catcher and the level detector. Failure to do so may result in incorrect reading of blood levels in the venous bubble catcher at any time throughout the treatment.

62-FMC-5008-TS-Brief-OpGuide.indd 5

09/09/2016 11:4

Connecting a Patient

1

7

4

2

8 6 3

5

A ‘Alpha’/blood pump clip

F Post-dilution connector

B SafeLine/‘alpha clip’

G Pre-dilution connector

C ONLINE HDF pump

H Blood/air optical detector

D ONLINE Substituate port

I Blood Temperature Monitor (BTM)

E Online Rinse port

Caution

The colour coding of the dialyser couplings may vary from that shown above – please check your local policy/colour coding.

62-FMC-5008-TS-Brief-OpGuide.indd 6

09/09/2016 11:4

1. When the patient access is prepared and the full prime volume has been reached, stop the prime by pressing the blood pump button on the screen. 2. Message ‘choices’ – ‘continue’ (rinse) or ‘exit’ (rinse) are displayed, press ‘exit’ (rinse). 3. Follow on screen instructions – connect arterial and venous lines to patient access. Connect the SafeLine (sub tubing) to the post or pre-dilution connector F / G . 4. Ensure the Rinse port E is closed, close the EBM doors, open clamps and confirm blood pump start 5. Dialysis commences when blood is sensed by the optical detector H below venous bubble catcher, message ‘start dialysis treatment’ – press OK. 6. Increase blood flow to the p escribed speed 7 . 7. UF starts automatically if data is already set. 8.

Heparin starts automatically.

9. Bolus may be given manually from heparin menu.

62-FMC-5008-TS-Brief-OpGuide.indd 7

09/09/2016 11:4

Reinfusion/Disconnection

1

7

4

2

8 6 3

5

A ‘Alpha’/blood pump clip

F Post-dilution connector

B SafeLine/‘alpha clip’

G Pre-dilution connector

C ONLINE HDF pump

H Blood/air optical detector

D ONLINE Substituate port

I Blood Temperature Monitor (BTM)

E Online Rinse port

Caution

The colour coding of the dialyser couplings may vary from that shown above – please check your local policy/colour coding.

62-FMC-5008-TS-Brief-OpGuide.indd 8

09/09/2016 11:4

1. Press ‘reinfusion’ and follow on screen instructions. 2. Disconnect the SafeLine from the post or pre-dilution connector 8 and attach to the recirculation adapter. 3.

Disconnect arterial line from patient.

4. Once connected press ‘OK’ (only press ‘NaCl’ if you have run out of acid/bicarb and need to use saline to wash back). 5. The blood pump will stop automatically when clear fluid is recognised by the optical detector H . Press ‘continue reinfusion’ if more fluid is equired and manually stop the blood pump. 6. Disconnect the patient then press ‘remove lines’ button on screen. 7.

Drain the dialyser.

8. Remove all blood lines ensuring Substituate port D is firmly closed 9. Replace concentrate suction tube and remove the bibag® when empty. 10. Close EBM doors 2 – machine automatically goes into hot disinfection, or press ‘heat disinfection’ on main screen.

62-FMC-5008-TS-Brief-OpGuide.indd 9

09/09/2016 11:4

5008 Alarm Handling Quick Reference Guide Caution This guide does not replace any information in the manufacturer’s operating manual, which should be read before operating the machine. Additional information and help regarding alarms is available by pressing the question mark (help key) in the alarm warning box on the screen.

62-FMC-5008-TS-Brief-OpGuide.indd 10

09/09/2016 11:4

1. ONLINE Connection error (i) Blood pump section has not fed in properly, or (ii) the clamp has not been released on the arterial line, or (iii) part of the circuit is disconnected. Check all connections and that the clamps have been released (use the info’/? button to provide hints on possible causes). If needed, use the handle on the pump to manually feed the pump section (in clockwise direction).

2. Air detected below the venous bubble catcher Venous bloodline not properly inserted in optical detector, or if during treatment the level in the venous bubble catcher needs to be raised. Check level and raise if necessary using the up arrow in blood system screen.

3. Level dropped in venous bubble catcher Visually check the blood level before choosing the option to raise the level. If the level is correct, check that the venous bubble catcher is in the correct postion in the level detector and that the surfaces of both are clean and dry.

62-FMC-5008-TS-Brief-OpGuide.indd 11

09/09/2016 11:4

4. Extracorporeal Blood Module (EBM) Sensor alarm There is a leakage of 20ml of blood or priming fluid in the extracorporeal blood module. Open the doors and clean the drip tray/sensor. Check all connections to identify the leak.

5. DIASAFE®plus leakage alarm There has been a leakage in the DIASAFE compartment of 50ml of fluid Open the compartment, clean the drip tray and sensor. Check the DIASAFEs have been inserted correctly. Treatment may have to be discontinued. Contact Technicians for assistance.

62-FMC-5008-TS-Brief-OpGuide.indd 12

09/09/2016 11:4

6. Hydraulic leakage (treatment not possible) 70ml of fluid has inte nally leaked in the hydraulics. Discontinue treatment and contact Technicians for assistance. 7. Micro bubble alarm Follow on screen instructions, use operating manual if necessary.

8. Air handling procedure Disconnect patient and re-circulate blood lines following the on-screen instructions. 9. Venous pressure too high – reduce pressure manually Open right hand door, attach 20ml syringe to venous bubble catcher, unclamp and release pressure, alarm should clear automatically.

62-FMC-5008-TS-Brief-OpGuide.indd 13

09/09/2016 11:4

10. Venous pressure measurement incorrect If during prime – remove venous transducer protector and reconnect. Press ‘repeat check’. Most common cause is a flooded venous transducer p otector. Press blood system screen and using down arrow reduce level of fluid in the venous bubble catche . Press ‘re-check’ on the screen. If necessary change venous transducer protector.

11. Arterial pressure measurement incorrect (usually in prime mode) Check arterial pressure dome is correctly inserted. If alarm persists, remove arterial line, check cleanliness of arterial pressure unit. Insert new arterial line if necessary.

62-FMC-5008-TS-Brief-OpGuide.indd 14

09/09/2016 11:4

12. Optical detector does not sense blood The optical sensor is below the venous bubble catcher – either the bloodline is incorrectly inserted in the line guide, or treatment has been discontinued without using the re-infusion programme. Follow on screen instructions.

13. Haemoconcentration warning Caused by a rise in TMP of >60mmhg during HDF or HF. Follow on screen instructions and reduce substitution rate as advised

62-FMC-5008-TS-Brief-OpGuide.indd 15

09/09/2016 11:4

Fresenius Medical Care UK Ltd. · Nunn Brook Road · Huthwaite · Sutton in Ashfield · Notts · NG17 2HU · England · Telephone:+44 (0) 1623 445100 · Fax: +44 (0) 1623 550807 Head Office: Else-K öner-Straße 1 · 61352 Bad Homburg v. d. H. · Germany www.fmc-ag.com

62-FMC-5008-TS-Brief-OpGuide.indd 22

FMC UK 11/09 706

09/09/2016 11:4