Quick Reference Guide
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RENAL CARE
QUICK REFERENCE GUIDE
Nipro Renal Care is part of Nipro Corporation Japan, a leading global healthcare company established in 1954. With over 28.000 employees worldwide, Nipro serves the Medical Device, Pharmaceutical, and Pharmaceutical Packaging industries. Nipro Renal Care is a global market leader with over 5 decades providing renal solutions for dialysis and dialysis-related treatment. We specialize in developing dialysis machines, water treatment systems, and a comprehensive portfolio of disposable medical equipment. In order to address the needs of patients, healthcare professionals, and procurement managers alike, Nipro Renal Care is driven by innovation and patient safety to offer the highest quality products that optimize time, effort, and costs.
BECAUSE EVERY LIFE DESERVES AFFORDABLE CARE
Nipro Medical Europe : European Headquarters, Blokhuisstraat 42, 2800 Mechelen, Belgium T: +32 (0)15 263 500 | F: +32 (0)15 263 510 | [email protected] | www.nipro-group.com
NIPRO MEDICAL AUSTRIA GMBH : Divischgasse 4, 1210 Wien, AUSTRIA | T: +43 1 532 23 14 | F: +43 1 532 23 14 89 NIPRO EUROPE - EGYPT : Nile City Towers, 22nd Floor, North Tower, Nile City, Towers, Cornich El Nile, 11624 Ramelt Beaulac, Cairo, EGYPT NIPRO MEDICAL FRANCE S.A. : Biopôle Clermont-Limagne, 63360 Saint Beauzire, FRANCE | T: +33 (0)473 33 41 00 | F: +33 (0)473 33 41 09 NIPRO MEDICAL GERMANY GMBH : Kokkolastrasse 5, 40882 Ratingen, GERMANY | T: +49 (0)2102 564 60 81 | F: +49 (0)2102 564 60 90 NIPRO MEDICAL EUROPE NV - ITALY : Centro Direzionale Milanofiori, Strada 1 - Palazzo F1, 20090 Assago (Milano), ITALY | T: +39 (0)2 57 50 00 57 | F: +39 (0)2 57 51 81 11 NIPRO MEDICAL EUROPE NV - NETHERLANDS : Verlengde Poolseweg 16, 4818 CL Breda, NETHERLANDS | T: +31 (0)76 524 50 99 | F: +31 (0)76 524 46 66 NIPRO MEDICAL NIGERIA LTD. : 9 Adelabu Close, Off Toyin Street, 100271 Ikeja, Lagos State, NIGERIA | T: +234 (0)802 706 7065 NIPRO EUROPE - POLAND : Ul. Panska 73, 00-834 Warszawa, POLAND | T: +48 (0)22 31 47 155 | F: +48 (0)22 31 47 152 NIPRO EUROPE - PORTUGAL : Avd. Da Liberdade 249, 1° Andar, 1205-143 Lisboa, PORTUGAL | T: +34 (0)91 878 29 21 | F: +34 (0)91 878 28 40
NIPRO MEDICAL EUROPE - RUSSIAN REPRESENTATIVE OFFICE : 12 Krasnopresnenskaya Nab., Office 1407, entrance 6, 123610 Moscow, RUSSIA | T: +7 (0)495 258 1364 | T: +7 (0)495 258 1365 NIPRO MEDICAL SENEGAL S.U.A.R.L. : 27 Avenue Georges Pompidou, Dakar, SENEGAL NIPRO MEDICAL D.O.O. BEOGRAD : Bastovanska 68a, 11000 Belgrade, SERBIA | T: +381 (0)11 75 15 578 NIPRO MEDICAL SOUTH AFRICA (PTY) LTD : 4B Dwyka Street, Stikland Industria, Cape Town, 7530, SOUTH AFRICA | T: + 27 21 949-2635 | F: +27 21 949-2397 Unit 20&21, Falcon Lane, Lanseria Business Park, Erf 805 Lanseria Corporate Estate, Pelindaba Rd., Lanseria Ext. 26, Gauteng, SOUTH AFRICA | T: + 27 11 431 1114 / 26 | F: +27 11 431 1115 NIPRO MEDICAL EUROPE NV - SPAIN : Poligono Los Frailes n° 93 y 94, Daganzo, 28814 Madrid, SPAIN | T: +34 (0)91 884 5531 | F: +34 (0)91 878 2840 NIPRO MEDIKAL SAĞ.HIZ.TIC.LTD.ŞTI. : Aziziye Mah.Pilot Sok.17/4, 6540 Çankaya-Ankara, TURKEY | T: +90 (0)312 442 21 12 | F: +90 (0)312 442 21 92 NIPRO MEDICAL UK LTD. : 25 Barnes Wallis Road, Segensworth East, Fareham Hampshire PO15 5TT, UNITED KINGDOM | T: +44 148 985 48 30
Nephroflow - Quick Rreference Guide - EN - 21.Nov.18
Please contact your local representative for more information.
D.MED NEPHROFLOW™ RECIRCUL ATION AND ACCESS FLOW MEASURING DEVICE
D.med NephroFlow
™
10. Select the correct tubing set used for the treatment. The last tube set used is indicated on top. If you are using the same set for the present measurement, tap it. If you need to change the type of tubing set, push [Select] and choose the one that applies.
R E C I R C U L AT I O N A N D A C C E S S F L O W M E A S U R I N G D E V I C E
This Quick Reference Guide is intended for D.Med NephroFlow application software versions 1.6.x.x or higher. This document does not replace the official manual provided by the manufacturer. It is a guideline based on experience. For further information, please refer to the D.med NephroFlow Clinical Manual. (Note: x.x stands for updates)
INSTRUCTION FOR MEASURING A PATIENT:
Tubing
Tubing
Nipro Blood Tubing...
Nipro Blood Tubing...
Select
Select
11. Check that the Signal Strength of the sensors is in green. If it is not, please examine the
sensors and/or sensor cable plug on the back of the device (e.g. no air bubbles in the lines) and reconnect.
12. Depending on the protocol you chose, one of the following screens will appear. Access flow Recirculation
1. Attach the sensors to the bloodlines 5-10 cm from the needle connector. (important for temperature linking)
2. Pay attention to the direction of the blood flow!
(red sensor arrow pointing away from patient; blue sensor arrow in direction of patient)
3. Ensure that the sensors have no skin contact and do not touch each other. 4. Confirm that there is no tension on the tubes and that the tubes enter the sensors without bending. (tubing must be straight)
5. Verify that there are no air bubbles inside the blood tube near the sensors. 6.
witch off HDF or any perfusions (except anti-coagulants), as they can influence results. S Do not forget to activate them after the measurements have completed.
Stop the blood pump, close all clamps on bloodlines and needles, wait at least 5 seconds, and push [Correct Offset]. Open the clamps again and start the blood pump. A “Correct Offset” has a big impact on the measurement!
13. After a short while, the status will change from
Status
.
Status
For [Access flow], we recommend a blood flow of 250 ml/min. For [Recirculation], we recommend the same blood flow as standard treatment. Prepare 10 ml of saline solution at maximum room temperature. Follow the instructions on the screen.
7. Now switch on the D.Med NephroFlow device.
8. The first screen will differ, depending on the operation mode (Quick or Normal). If Normal mode is selected, please select your patient first. In Quick mode, this selection is not visible.
Info: a. Normal mode (linked to Patient Database, whereupon measurements can be stored) b. Quick mode (a fast measurement without storing results on the device) NOTE: For detailed information regarding operation mode and patient database/patient selection, please refer to the D.med NephroFlow Clinical Manual.
9. Select the protocol you would like to perform. If you plan to measure [Access flow] and [Recirculation], we recommend performing [Access flow] first. Protocol
REASON: [Access flow] requires switching the lines. By measuring [Access flow] first, followed by Access Flow
Recirculation
[Recirculation], it creates a more logical workflow and decreases the chance of forgetting to switch the lines back.
I MPORTANT: Open the alarm limits on the dialysis machine before injecting saline (e.g. by pushing blood pump +/-). Inject the saline bolus within 3-5 seconds with a constant flow into the venous bubble catcher chamber. Do not move, touch, or manipulate the sensors during measurement after saline injection!
14. After a short moment, the results will appear. If finished, print or export the measurements. If you must perform new measurements on the same patient, start again from step #9. Please check the following after performing any measurement: a. If [Access flow] was performed, please switch back the lines to their normal condition! b. Make sure all modes or alarm limits that you deactivated or opened during the measurement are now active/have returned to normal again!
Advice: • If you perform several measurements successively (one after the other), please wait at least 1 minute between measurements (the previous saline bolus can influence the next measurement and should be diluted). • If possible, the patient should not be lying totally flat in the bed (a semi-recumbent position is preferred). • If you plan to compare the results of a patient over a long period of time, always measure under the same conditions (same blood flow for [Access flow] and [Recirculation]). • The measurement should be completed within the first third of a treatment, before the patient has eaten. • Use a syringe that allows you to give a “linear bolus” with the same flow (e.g. syringe with rubber plunger). • Use physiological saline solution at room temperature.