Brief Operating Guide - Renal Society of Australasia 5008... · The 5008 Therapy System Brief...

The 5008 Therapy System Brief Operating Guide

0462-FMC-5008-TS-Brief-OpGuide.indd 1 09/09/2016 11:43

Starting system and set-up

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A ‘Alpha’/blood pump clip

B SafeLine/‘alpha clip’

C ONLINE HDF pump

D ONLINE Substituate port

E Online Rinse port

F Post-dilution connector

G Pre-dilution connector

H Blood/air optical detector

I Blood Temperature Monitor (BTM)

Caution

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


1. Switch on the system 1

2. Select ‘treatment’ (or ‘disinfection’).

3. Connect concentrate and bibag®, ensure correct concentrate isselected in dialysate menu. T1 test starts automatically.

4. Open the EBM doors 2 and follow on screen instructions forlining – arterial line first, ensure the sound is generated wheninserting the red ‘alpha clip’ A into the line guide. Attach heparinsyringe 3 if required.

5. Attach the venous line ensuring the line below the venousbubble catcher is firmly placed in the blood/air detectorH groove.

6. Place the SafeLine (sub tubing) into the HDF pump ensurethe sound is generated on insertion of the clear plastic ‘alphaclip’ B into the line guide, then connect the arterial line to theSafeLine 4 .

7. Connect the rinse connector 5 to the venous line.

8. On completion of T1 test, insert the substituate connectorinto 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 theoperating mode (preparation screen) displays pre-circulation.

12. Enter UF and heparin data, check conductivity and temperatureare correct. Ensure correct dialysate is selected (dialysate menu).


CautionTransducer 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.


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 from 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.


Connecting a Patient

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C ONLINE HDF pump


E Online Rinse port





Caution



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 prescribed speed 7 .

7. UF starts automatically if data is already set.

8. Heparin starts automatically.

9. Bolus may be given manually from heparin menu.


Reinfusion/Disconnection

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C ONLINE HDF pump


E Online Rinse port





Caution



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 concentrate/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 required and manually stop the blood pump.

6. Disconnect the patient then press ‘remove lines’ buttonon-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.


5008 Alarm HandlingQuick Reference Guide

CautionThis 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.


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.


4. Extracorporeal Blood Module (EBM) Sensor alarm

There is a leakage 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.

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.


6. Hydraulic leakage (treatment not possible)

Fluid has internally 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.


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 protector. Press blood system screen and using down arrow reduce level of fluid in the venous bubble catcher. 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.


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


Notes


Fresenius Medical Care Australia Pty Ltd

Level 27 · 100 Miller Street · North Sydney · NSW · 2060 ABN 80 067 557 877 · Phone: (61) 2 9466 8000 · Fax: 61) 2 9929 5595

www.fmc-au.com · February 2020 · ATSF 7007 BBK 02/20

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1019-FMC-BVM-PocketGuide.indd 16 04/04/2019 08:02

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Brief Operating Guide - Renal Society of Australasia 5008... · The 5008 Therapy System Brief...

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