Gambro ak 96 manual

The cross-bar holds the segment in place during treatment and it is also easier to thread the blood pump segment through the pump. Blood Line Guide Press lightly on the blood line to place it in one of the grooves of the guide.

Dialyzer Connection Attach the dialyzer end of the arterial blood line firmly to the dialyzer; press and simultaneously turn. Arterial Line Clamp Introduce the blood line into the arterial clamp marked with a red dot by lightly pressing the line into the clamp. Then pull the blood line lightly downwards; the line goes into place when it is lightly pressed at the same time. Arterial Patient Connector Connect the patient end of the arterial blood line to the priming fluid.

Arterial Pressure Connector Attach the arterial pressure transducer protector of the blood line to the arterial pressure connector; press and simultaneously turn.

Check all necessary clamps If the heparin pump is not to be used, especially ensure that the cap at the end of the thin line used for heparin solution, is properly closed. Heparin is to be mixed diluted with the proper solution in a correct syringe used for the purpose. The Heparin pump can be programmed for different syringe sizes , syringes must comply with ISO Consult the authorized technician for information concerning heparin pump presets for the particular machine.

See the following pages continuing point 8 for instructions on how to attach the syringe to the heparin pump and how to set the heparin pump values in the machine.

Check by lightly pulling on the plunger. When doing so, it must be impossible to pull the syringe out of the heparin pump. Prepare a syringe with the desired amount of heparin solution. Attach the syringe to the connection at the end of the thin line coming out just after the blood pump segment pointed out in corresponding figure on the arterial blood line.

Prime the line with the heparin solution to the point where the line ends in the arterial blood line. The luer lock mounting ensures that the syringe is properly connected to the line, see corresponding figure.

Pull out the piston on the heparin pump to end position. To change the position of the piston, press the end of the piston, hold it in and move the holder. When the piston is released the holder cannot move. Insert the syringe in the pump; the plastic collar at the end of the syringe must fit in the groove of the pump, in the corresponding figure.

Push back the piston and insert the plastic plate on the plunger in the groove by the locking wheel, in the figure. Turn the locking wheel upwards until resistance is felt. This is to lock the plastic plate of the plunger in the groove, in the figure. Check that the syringe is properly secured by lightly pulling on the plunger, in the figure. If a bolus dose of heparin solution is to be administered at treatment start, set a bolus volume in ml BOLUS suitable for the patient using the Keypad.

The stop time is the time in minutes at which the heparin pump should stop to run before treatment end. After this the heparin solution will automatically be administered at the set flow rate. Note that the sum of accumulated bolus volume during priming and total accumulated volume since treatment start will be shown below ACC HEP. During machine set-up and priming the heparin pump can be started at any time by pressing the Select key for three seconds until the text Press SELECT 3 seconds to start bolus disappears; the heparin pump immediately starts to run.

However, there is one exception, it is not possible to run the heparin pump when performing recirculation priming. Follow the Instructions For Use for the particular venous blood line being used. The items are pointed out in "set-up" order, starting with the air detector.

A list of details on how to correctly attach the corresponding venous blood line parts, follows on the pages directly after this. Air detector. Air detector Open the cover of the air detector and place the venous drip chamber in it. It may be opened with ease by pressing the middle of the cover at the same time as the cover is being opened.

Compress the venous drip chamber as shown in corresponding figure and push it in to the air detector. Press on the middle of the venous drip chamber, while closing the cover. Adjust the position of the venous drip chamber to a proper position; as low as possible to prevent air from passing into the venous line.

However, it should be possible to adjust the level well above the air detector head. Dialyzer connection Attach the dialyzer end of the venous blood line firmly to the dialyzer; press and simultaneously turn. Venous Line Clamp Introduce the blood line into the venous clamp marked with a blue dot by lightly pressing the line into the clamp.

Priming Detector It is of the utmost importance that the venous blood line is correctly placed in the priming detector for the machine to be able to detect blood after treatment start. Check carefully that the venous blood line has reached end position in the venous line clamp as shown in the corresponding figure. For further information see point 9 "Priming Detector", in Blood Part Component Details" starting on page in part 1. Venous Patient Connector Hook the patient end of the venous blood line to a drain vessel or connect it to a waste bag.

Bear in mind that the placement as high as possible of the drain vessel or waste bag is important to obtain a stable venous pressure above 50 mmHg during the priming procedure. This venous pressure is important for the machine to be able to test the venous pressure measurement function before treatment start. Venous Pressure Connector Attach the venous pressure transducer protector of the blood line to the venous pressure connector; press and simultaneously turn.

Ch" disappears from the Time Display and the bypass path of the Flow Diagram lights up. The Fluid bypass button will start to flash and when pressed, the supply of dialysis fluid will be activated.

The dialysis fluid preparation is complete correct conductivity level has been reached when the bypass path on the Flow Diagram lights up green. If the dialysis fluid tubes are attached to the safety couplings of the machine at that moment, the dialysis fluid will start to circulate in the dialysis fluid tubes.

If the dialysis fluid tubes have been attached to the dialyzer, the dialysis fluid will enter the dialyzer. This is to ensure that correct conductivity is reached when the dialysis fluid enters the dialyzer.

There is a large volume of fluid passing through the dialysis fluid tubes during the flush. An attention alarm text is simultaneously shown on the Information Display. Wait until the attention alarm text has disappeared and the bypass path of the Flow Diagram lights up green before disconnecting the dialysis fluid tubes1.

When the dialysis fluid preparation is complete bypass path lights up green on the Flow Diagram first check that the Fluid bypass button is flashing. If not, press the button to stop the dialysis fluid from circulating in the tubes, before starting the attaching procedure.

Disconnect the outlet dialysis fluid tube from the safety coupling of the machine; press and hold the button on the dialysis fluid tube before removing it from the safety coupling. The newly prepared, fresh dialysis fluid, flows from the machine to the dialyzer via this tube. A small arrow, fixed just below where the tube comes out from the machine, shows the flow direction.

Keep the button on the dialysis fluid tube pressed and hold while attaching it to the dialyzer connector as shown in the corresponding figure. Make sure that it clicks in properly to prevent leakage during treatment.

Disconnect the inlet dialysis fluid tube from the safety coupling of the machine; remove it in the same way as the outlet dialysis fluid tube described in the former point 1 in these instructions.

The spent dialysis fluid flows to the machine from the dialyzer via this tube. General The priming and rinsing procedure of the extracorporeal circuit can be commenced as soon as the Priming button lights up during function check.

Priming can be performed manually or with assistance from the machine. Instructions on handling procedures for both alternatives are described on the following pages. Both alternatives can be preset to be activated at start up by an authorized technician.

The manual priming procedure is default active upon machine delivery. The priming part must always be performed in order to complete the priming procedure. The latter parts, where the handling procedures are the same for both manual and assisted priming, can be used if necessary or requested.

Priming Part Manual Priming When performing manual priming, the operator is in charge of the priming parameter settings, removing air from dialyzer and blood lines and generally monitoring the procedure. Some priming parameter values can however be preset by an authorized technician to facilitate the manual priming procedure; priming volume, blood pump speed, priming UF rate and dialysis fluid flow rate.

Assisted Priming Assisted priming is a modular feature using preset settings to optimize and allow for consistent priming processes. To allow for different combinations of blood lines and dialyzers three different preset combinations of assisted priming can be programmed by an authorized technician and named according to local preference. Assisted priming consists of several phases which can be adjusted, included or excluded.

The blood pump start can be preset to either not consider, or wait for correct dialysis fluid conductivity and temperature. When the blood pump stops automatically the operator is asked to connect the dialysis fluid tubes to the dialyzer and activate the dialysis fluid.

The process stops after the first flush. This makes it possible to do a final flush just before the treatment is initiated. The blood pump runs at the same speed as in the priming process. Extra Priming Part When priming is complete it can be continued by extra priming where an extra priming volume will be added. The extra priming procedure can be used if necessary, for instance just before treatment is initiated or when the extracorporeal circuit needs extra rinsing.

Extra priming parameter values can be preset by an authorized technician to facilitate the procedure, similar to the ones for manual priming. Recirculation Priming Part If requested, priming can be extended by recirculation priming. During this procedure the same priming fluid will recirculate in a closed extracorporeal circuit for a preset period of time. The priming fluid in the circuit will be ultrafiltrated, and needs to be compensated for, by priming fluid connected to the circuit via an infusion line.

The time for how long a period the procedure should last, as well as a recirculation priming UF volume is preset. Based on these two parameters, the machine calculates the recirculation priming UF rate. When recirculation priming UF volume and time have been achieved, the procedure is complete. Recirculation priming can be used to adapt priming and rinsing to the routines of the clinic, or to a specific dialyzer or blood lines.

Recirculation priming parameter values can be preset by an authorized technician to facilitate the procedure; time, recirculation priming UF volume, blood pump speed and dialysis fluid flow rate. Before starting the procedure, the extracorporeal blood circuit must be prepared for recirculation priming in accordance with standard procedure used by the clinic. The patient ends of the arterial and venous blood lines must be connected together to make a closed extracorporeal circuit.

Use a disposable blood line connection designed for this purpose, between the two blood lines. In addition, connect priming fluid via an infusion line in a similar way as when infusions are administered to the extracorporeal blood circuit during treatment.

This is to compensate for the priming fluid being ultrafiltrated from the closed circuit. Check Before Priming Check that the priming fluid and waste bag are properly connected. Remove any obstructing clamps. Check that the venous blood line is correctly placed in the priming detector. See "Venous Blood Line - Attach", point 5, in previous instructions. Check that the pressure transducers of the blood lines have been properly attached to the pressure connectors of the machine.

Follow the instruction for use of the dialyzer. Resume dialysis fluid preparation deactivate concentrate stand-by mode by pressing the Select key for three seconds, as the menu requests. Priming Procedure This menu will be displayed on the Information Display when manual priming is active. Then press the Select key for three seconds to activate manual priming mode.

Check that the Priming button is lit. Press the flashing Blood pump button. If the blood pump segment has been automatically threaded, check for possible kinks.

Prime and de-air the blood lines and the dialyzer. Especially note that the dialyzer should be filled from bottom to top to ensure proper de-airation. The priming overview menu, which gives current information on the most important priming parameters, will be shown on the Information Display.

The total preset priming volume is displayed to the right of the slash. Fill up the level in the venous drip chamber while the blood pump is running using the level adjustment knob anticlockwise direction. Adjust the level so it is well above the air detector head. Note that if the venous drip chamber is not being filled at the beginning of the priming procedure, an attention alarm without buzzer will appear to request the operator to do so.

The Air detector button will start to flash when the venous drip chamber has been filled. This is to request the operator to press it and by doing so, activate the air detector alarm function.

It is not necessary to press the flashing button at this moment, the air detector activation may be moved forward until the extracorporeal circuit is completely de-aired. The activated air detector alarm function is indicated by an unlit button. Attach the dialysis fluid tubes to the dialyzer when "F. Ch" disappears from the Time Display and the bypass path on the Flow Diagram lights up. See "Dialysis Fluid Tubes - Attach", page in part 1 for instructions on how to attach the tubes.

Especially note that if UFD dialysis fluid filter is installed, the dialysis fluid tubes cannot be moved until the bypass path of the Flow Diagram lights up green. Before the correct conductivity level has been reached the fluid flow path will be orange.

When the fluid preparation is finished the bypass path on the Flow Diagram lights up green. Press the flashing Fluid bypass button. The dialysis fluid will now enter the dialyzer when the dialyzer path on the Flow Diagram lights up green.

Establish a stable venous pressure over 50 mmHg until the attention alarm disappears. If this attention alarm is left unattended, unnecessary alarms and technical error will be generated during initiating of treatment.

See "Venous Blood Line - Attach", point 5. Select desired alternative and continue to the corresponding instruction as follows. The menu will change and request the operator to press the flashing Blood pump button when ready for extra priming. The extra priming overview menu, which gives current information on the most important extra priming parameters, will be shown on the Information Display. The total preset priming volume obtained since priming start is displayed to the right of the slash.

When the extra priming volume has been achieved, the blood pump automatically stops and an attention alarm appears. Check priming fluid and waste bag. Continue by following the instructions in "Treatment", page in part 1. The machine will reactivate priming and it is possible to repeat the priming procedure from the start. Recirculation Priming Procedure If requested, extend priming by a recirculation priming procedure where the blood circuit is rinsed using the same priming fluid during the complete procedure.

The menu will change and request the operator to press the flashing Blood pump button when ready for recirculation priming. The recirculation priming overview menu, which gives current information on the most important recirculation priming parameters, will be shown on the Information Display. The total preset recirculation priming UF volume is displayed to the right of the slash.

When the recirculation priming UF volume and time have been achieved, the blood pump automatically stops. Check the priming fluid connected via the infusion line. Prepare the extracorporeal blood circuit for treatment in accordance with standard procedure used by the clinic. Priming Procedure The procedure described below uses the default settings of assisted priming parameters.

This menu will be displayed on the Information Display when assisted priming is active. Then press the Select key for three seconds to activate assisted priming mode. Press the Select key and the menu will change. If the dialysis fluid preparation is complete "F. Ch" disappears from the Time Display and the bypass path on the Flow Diagram lights up the dialysis fluid tubes can be connected to the dialyzer. If the dialysis fluid preparation is not complete, the process can be started with the dialysis fluid tubes connected to the safety couplings.

Press the flashing Blood pump button to start the blood pump and the procedure. Note that the dialyzer should be filled from bottom to top to ensure proper de-airation. The procedure starts with the fill up phase. The blood pump automatically stops before the first flush phase starts and this menu is displayed on the Information Display. The operator is requested to attach the dialysis fluid tubes to the dialyzer if this has not previously been done.

Invert the dialyzer so that the dialyzer will be filled from bottom to top to ensure proper de-airation. Press the flashing Blood pump button to restart the blood pump and to continue the procedure. When the first flush is finished the blood pump automatically stops.

When the second flush is finished the assisted priming procedure is complete and the menu will change. Press the Select key to continue. The patient ends of the. The correct setting of the UF rate is important to avoid backfiltration. Set a minimum UF rate according to the instructions for the specific dialyzer. Once the treatment parameters have been set, the operator should verify that the control and protective systems for conductivity operate with the desired values and that they are in agreement.

Set the UF volume patient weight loss to the required total ultrafiltration volume. Adjust treatment time or UF volume if necessary. Check that the dialysis fluid flow rate is set to the required value. If not manually started, the heparin pump will automatically start when blood is detected in the venous blood line.

If the functions for isolated ultrafiltration, profiling, Diascan or blood pressure measurement are going to be used, or if single needle treatment is going to be performed, see the corresponding chapter in this manual for instructions.

If blood has not been detected in the venous blood line when this connect patient volume has been achieved, an alarm will be generated; Blood is not detected. Check that there is no air in the blood lines and that the level in the venous drip chamber is well above the air detector head. If expansion chambers are used, check that they are filled to the correct levels refer to the instruction for use of the individual blood line.

Manually activate the air detector alarm function by pressing the flashing Air detector button if it has not previously been activated during priming. If the air detector is not activated, it will automatically be activated when the priming detector detects blood. Check that the blood pump has been stopped, if not, press the Blood pump button. Connect the blood lines to the patient as standard procedure.

The connect patient overview menu, which gives current information on the most important parameters during patient connection, will be shown on the Information Display. This preset is to facilitate removal of air from the venous blood line after connecting the venous blood line to the patient. Bear in mind that when this preset is active, the operator is fully responsible for manually clamping the venous blood line and checking it from air whenever necessary during patient connection.

When the priming detector detects blood in the venous blood line, the blood path of the Flow Diagram lights up red and the treatment time starts to count down on the Time Display. When blood has been detected for 20 seconds the blood path of the Flow Diagram will remain lit until treatment end has been confirmed by attention alarm and the machine no longer detects blood in the venous blood line. This is valid even if the venous blood line is removed from the priming detector during treatment i.

The Treatment Overview Menu will start to be displayed and continues to be displayed at all times during treatment when blood is detected. See in "Overview Displays", page in part 1 for details. The Venous Pressure and Arterial Pressure button will be flashing. See "Start the Treatment" in the next following section for information on how to continue. CAUTION Make sure that the blood path of the Flow Diagram lights up, if it does not light up, check that the venous blood line is correctly placed in the priming detector.

If the blood path does not light up, the machine considers the patient not connected and as a consequence the UF system is not controlling the patient ultrafiltration.

If the air detector has not been activated during priming it will not be automatically activated until the priming detector detects blood. Press the flashing Arterial Pressure button to centralize the alarm limits around the current value. Or if desired, set the arterial pressure alarm limits manually using the Keypad. Press the flashing Venous Pressure button to centralize the alarm limits around the current value. Or if desired, set the venous pressure alarm limits manually using the Keypad.

Check that the minimum UF rate is set to the correct value. Adjust if necessary. If the heparin pump is started, this will be running concurrent to the blood pump. If the heparin solution flow rate is set to zero, an attention alarm appears requesting the operator to confirm that the heparin pump is not to be used. If the functions for isolated ultrafiltration, profiling, Diascan, blood pressure measurement or single needle are going to be used, see the corresponding chapter in this manual for instructions on settings.

Set a minimum UF rate according to the instruction for the specific dialyzer. Pressure Alarm Limits Setting Alarm Limit Centralizing Function The machine is equipped with a centralizing function to simplify the correct setting of the alarm limits for arterial and venous pressure and for TMP. The centralizing function means that when the Arterial or Venous pressure buttons are flashing, the buttons are to be pressed.

When pressed, the alarm window will automatically be set around the current value. The size of the alarm limit windows, and where on the pressure scale they are placed, vary for the different parameters and can be preset by an authorized technician.

The default values which the machine is preset with upon delivery, can be read in chapter 9, "Technical Data and Specifications" in part 1. Press the corresponding button and the pressure menu will be shown on the Information Display. Manually adjust the. See "Arterial Pressure Button" and "Venous Pressure Button" in chapter 3 for instructions on manual setting of the alarm limits.

The alarm windows will automatically be widened and the buttons start to flash when the blood flow rate is changed or when the Blood Pump button is pressed. Upon request from the clinic, an authorized technician can preset the high arterial pressure alarm limit to a fixed value. Note that the function of the high arterial pressure alarm limit is in this case deactivated implying that the operator is responsible for monitoring the arterial pressure during treatment. WARNING When the high arterial pressure alarm limit is preset to a fixed value or when the arterial pressure measurement function is not used, there is a risk for air-embolism if the arterial access is accidentally disconnected.

This is especially so when using the machine in combination with a central venous catheter due to possible negative pressure in the catheter. If the TMP alarm limits have not been confirmed within two minutes, an attention appears where the operator is requested to confirm the current settings. For instructions on manual setting of the alarm limits, see "Fluid Path button" in chapter 3.

Go to "Transmembrane Pressure" last in the list. Increase the UF volume, or set the min UF rate to zero. Confirm Treatment End When the remaining treatment time shown on the Time Display equals an attention alarm appears.

Simultaneously, the Time button starts to flash. The TMP alarm limits will automatically be widened. The time shown on the Time Display will continue to count down but will show negative figures.

Confirm treatment end by pressing the Select key. Confirm treatment end by pressing the flashing Time button. If the treatment is to be continued at this point, press the Back key and increase the treatment time SET using the Keypad.

Return The Blood CAUTION During rinse-back procedure, when the blood is returned to the patient, the operator is responsible for monitoring the venous pressure since the supervision of venous needle dislocation is deactivated.

The arterial clamp can be open during rinse-back procedure by preset. This is to facilitate returning all blood in the extracorporeal circuit to the patient.

Bear in mind that if this preset is active, the operator is fully responsible for manually clamping the arterial blood line and checking it for air whenever necessary during rinse back procedure. The menu will change and request the operator to press the flashing Blood pump button when ready for rinse-back.

Clamp the arterial blood line and disconnect it from the patient. The rinse back overview menu, which gives current information on the most important rinse back parameters will be shown on the Information Display. If another rinse-back is started, this value will increase. The total preset rinse-back volume used since rinse-back start is displayed to the right of the slash.

During the rinse-back procedure, the venous clamp automatically opens and closes intermittently while the blood pump is running. The opening and closing rate of the venous clamp can be preset by an authorized technician if the rate is set to zero, the clamping function will be bypassed.

When rinse-back is complete, the blood pump can be stopped in 3 different ways:. Automatically, when blood is no longer detected in the venous blood line. Automatically, when the preset rinse- back volume has been achieved. Manually, when desired, by pressing the Blood Pump button.

If necessary, continue rinse-back by pressing the Select key when corresponding rinse-back type has been selected. The operator will be requested to press the flashing Blood pump button when ready for new, extra or continued rinse-back. Press the flashing Blood pump button to start. Stop the blood pump, if it has not automatically been stopped, when the required amount of blood has been returned to the patient. Clamp the venous blood line.

Confirm Patient Disconnection Check that the arterial and venous blood lines have been completely disconnected from the patient.

Otherwise the negative pressure created by the machine in order to empty the dialyzer may cause a blood flow from the blood compartment to the fluid compartment of the dialyzer. If blood is still detected in the venous blood line the light of the blood path of the Flow Diagram is still red , remove the venous blood line from the priming detector.

The blood path light will then turn off. Invert the dialyzer. Remove the outlet dialysis fluid tube from the dialyzer and attach it to the safety coupling of the machine. The machine will now automatically create negative pressure in the fluid path, which empties the dialyzer of dialysis fluid.

When the dialyzer has been emptied, remove the inlet dialysis fluid tube from the dialyzer and attach it to the safety coupling of the machine as well. Connect the concentrate connector s to the stand-by ports. If the BiCart cartridge has been used, select whether the machine should automatically empty the cartridge or not according to the instructions on the Information Display.

When the BiCart cartridge is empty or directly if manual emptying has been chosen , continue by following the instructions on how to remove the cartridge from the holder. Open the upper latch of the BiCart holder; pull out the latch and lift upwards to its uppermost position. Remove the BiCart cartridge. Close the upper latch by folding it in. Close the lower latch; pull out the latch and fold it in. Check that both the latches of the BiCart holder have been properly closed.

Press the button and start a disinfection program, see handling instructions for each program in chapter 8 "Hygiene and Maintenance" in part 1. Follow the instructions for hygiene and maintenance of the AK 96 dialysis machine in chapter 8 in part 1. Remove the dialyzer and the blood lines, dispose of according to local regulations. Clasp on the arterial blood line just before the pump segment. Pull it out while simultaneously turning the blood pump rotor in an anticlockwise direction.

Make sure that the pins on the blood pump rotor are behind the pulled out segment while turning the rotor. Open the cover of the air detector press on the middle of the cover at the same time as the cover is being opened. Compress the venous drip chamber and then pull it out as shown in the corresponding figures.

It is necessary to call an authorized technician who must replace and clean machine components that may have been contaminated. Hemodialysis - Single Needle Treatment option General. The AK 96 dialysis machine is equipped with a clamp on the arterial side in order to minimize recirculation.

To further minimize recirculation the stroke volume should be maximized. To achieve this the following should be considered: - Make sure a correct blood pump rotor is used. There must be a correct adjustment of the occlusion of the blood pump segment being used. Comments are available on request, concerning the expected recirculation of the blood flow in the extracorporeal circuit, contact your local Gambro representative. Glossary of single needle parameters and key terms The Arterial phase is when the blood pump is running, the arterial line clamp is open and the venous line clamp is closed.

The arterial phase can be controlled by pressure settings. The Venous phase is when the blood pump is not running, the venous line clamp is open and the arterial line clamp is closed. The venous phase is controlled by pressure settings.

The Mean blood flow rate is the effective blood flow rate during the complete cycle, calculated from the arterial blood flow rate. The Stroke volume is the blood volume that passes through the dialyzer during a cycle. The lower the stroke volume the greater the recirculation. Add the following below. Attach an expansion chamber, connecting it between the dialyzer and the venous blood line.

This is in order to reduce the amount of recirculation in the system i. Follow the instructions in "Venous Blood Line - Attach", page in part 1. Add the following instructions on how to attach the expansion chamber. Place the venous expansion chamber in the holder in an upright position inlet and outlet facing downwards.

Make sure that it clicks in properly in the expansion holder. The edge inside the holder should fit into the groove of the expansion chamber as shown in the corresponding figure.

Connect the dialyzer end of the venous blood line to the blood line with the expansion chamber. Connect the blood line with the expansion chamber to the dialyzer. Prime and de-air the blood lines and the dialyzer as described in chapter 4 "Hemodialysis - Double Needle Treatment" in part 1. Tilt the expansion chamber holder backwards until it clicks into position. By doing so the venous expansion chamber will be filled to a suitable level during priming.

Check that the venous expansion chamber has been filled to be level with the groove of the chamber. Make sure to close the clamp at the top of the expansion chamber. Continue to follow the instructions in chapter 4, "Hemodialysis - Double Needle Treatment" starting on page up to "Connect the Patient", page in part 1.

Check that the venous expansion chamber is in an upright position and is filled to a correct level refer to the instructions for use of the individual blood line. Activate the single needle function by pressing the Select key for 3 seconds. It is not the mean blood flow rate for the single needle treatment. The Treatment Overview Menu for single needle treatment will start to be displayed and continues to be displayed at all times during treatment when blood is detected.

The overview differs from the overview when performing double needle treatment, showing parameters of interest when single needle mode is active. The mean blood flow rate is shown on the Treatment Overview Menu for single needle treatment "Overview Displays", see page in part 1 for details. Press the flashing Venous pressure button.

At that moment, the high and low venous pressure alarm limits will automatically be set. If desired, adjust the automatically set venous pressure alarm limits as necessary using the Keypad.

Start by adjusting the high alarm limit. MedWrench is available to help people with specific questions and troubleshooting problems.

Could you please be more specific with the issue that you are having with your instrument, and the MedWrench team will do their best to assist you in solving the issue. This will also help other community members who face similar challenges. Thank you I have a problem with gambro AK96 the conductivity in the first phase get a high value about Toggle Navigation.

Sign in. My Bench Sign out. One moment please My Bench Close. Sign In. Not A Member? Page See page Blood Pressure Alarms See page See page Blood Path Alarms See page Blood Leak Alarm See page Fluid Path Alarms See page Connect Patient Alarm See page Technical Alarm See page At the same time as the Alarm button is being pressed, the buzzer will be simultaneously muted for 2 min.

Page When the Back key is pressed, and the alarm list is displayed on the Information Display, the menu that was previously opened will return. The time for when the alarm was generated is shown to the left on the Information Display. Page Describes which actions that will automatically be taken by the machine due to the alarm. Measures: Describes which actions that are expected from the operator when an alarm appears.

Page The arterial blood line is kinked or clotted between the arterial needle and the arterial pressure measurement point. The position of the arterial needle has changed. Page If necessary, repeat the override procedure. See also "General Alarm Handling", page The operator is responsible for the monitoring during the override time. Page The position of the venous needle has changed. Clotting has occurred in the venous blood line after the venous pressure measurement point; in the blood line, in the venous drip chamber, or in the needle.

Page The venous blood line has separated from the dialyzer. The venous blood line has separated from the venous needle. The position of the venous needle has changed. Clotting before or in the dialyzer. Page The blood lines or the dialyzer has not been properly de-aired during priming.

Air have entered the blood lines e. The arterial needle is dislocated. Page The blood pump has been automatically stopped too long due to machine alarm actions. The operator has left the blood pump in stop position too long. Machine actions: None. Possible cause: Decreased performance of the patient's blood access.

Adjustments to optimize the single needle treatment may have been overlooked. See in the chapter "Hemodialysis - Single Needle Treatment option " starting on page in part 1 for further information. Page The patient's systolic blood pressure is outside the low or high alarm limits set.

Possible cause: Circulatory disturbances in the patient. Inaccurate setting of alarm limits for the particular patient. Page If possible, adjust the alarm limits in accordance with the status of the patient. Page The patient's diastolic blood pressure is outside the low or high alarm limits set. Page The patient's mean blood pressure is outside the low or high alarm limits set.

Page The patient's puls rate is outside the low or high alarm limits set. Page Check cause inlet water supply, power supply and do necessary actions in accordance with this. If necessary, call for an authorized technician or discontinue treatment. The power supply to the heating rods in the machine has been interrupted. Page Check cause concentrates, tubes, connectors and do necessary actions in accordance with this.

Page Machine actions: The blood pump stops. The venous blood line clamp closes. Possible cause: The venous blood line is not properly inserted into the priming detector. Page Diagram lights up red and the treatment time starts to count down on the Time Display.

Page The machine actions differ depending on the kind of technical error. The machine sometimes automatically enters a state which makes it impossible to continue the treatment. Page Technical error during treatment;call the authorized technician. If necessary during treatment, manually return the blood to the patient.

See "Power Failure" on page in part 1 for instructions. Page If the technical error reoccurs, call the authorized technician. The button lights up and the attention alarm text which gives information on what has triggered the attention alarm is displayed in the attention list on the Information Display. Page Min. Buzzer sound: Describes which kind of buzzer sound is used for the attention alarm, see page Mute time: 2 min. Page Check that the changed parameter is correct.

The attention alarm will automatically disappear after it has been displayed. Page Select key and the activated program will be resumed. Alternately, consult an authorized technician. Page Measures: Close the BiCart holder. See "Machine aftercare" on page in part 1 for instructions. Page Machine actions: None. Measures: Check selected concentrate. Page Attach or check BiCart cartridge. Page If this is not the case, clean the priming detector lens. Alternatively call the authorized technician. Page in part 1 for instructions.

Press the Select key when cleaned. If the attention alarm appears again, call an authorized technician. Mute time: Permanently muted buzzer. Page Measures: Press Select key.

The priming phase will start automatically when the blood pump is started. Page Close the blood pump cover. See "Blood Part Component Details" on page in part 1 for instructions. Page 1 for instructions. When properly positioned, press the Select key. Page When the blood pump has been stopped for more than 1 min. Machine actions: None Measures: Start the blood pump. Page Press BPM button to clear the attention alarm. If the attention alarm recurs, call for an authorized technician.

Page When the dwell time in central disinfection has passed. Machine actions: None Measures: Press the Select key to continue. Page The disinfection program is interrupted. Measures: Check the pick-up tube and the disinfectant container. This attention alarm can be removed by preset. Page The period of time between the last performed cleaning and the appearance of the attention alarm can be preset. Page Measures: Check cause, adjust treatment parameters to increase clearance or adjust the alarm limit for clearance.

Page Concentrates" on page in part 1 for instructions. Measures: Connect the selected concentrate to the machine. Page Mute button, but if the attention alarm is left without taking measures, it will reappear the next treatment. Page If this attention alarm appears frequently, discuss preset limits with an authorized technician.

Page Diascan parameter values are the correct ones, adjust if necessary. Restart the Diascan function by pressing the Select key for 3 seconds. If desired, reactivate the single Diascan measurement check. Page Note that the Diascan function is no longer active. The attention alarm automatically disappears after 30 seconds.

Buzzer sound: Soft buzzer. Page Isolated UF phase is complete, without further attention alarms. Page UF activation is made The machine was not able to completely perform the measurement check as the measurement check has been interrupted. If the attention alarm is still generated, consult an authorized technician.

Mute time: 5 min. Page The period of time between the last performed disinfection and the appearance of the attention alarm can be preset.

Page It is not possible to connect the concentrates yet. Page Close the latches of the BiCart holder. It is not possible to connect the BiCart cartridge yet. If attention does not disappear, call for an authorized technician. It is possible when the attention alarm text has disappeared. Page Fluid Bypass button button has been pressed. If the attention alarm does not disappear, the obstruction is internal. Call an authorized technician. Alternately, consult the authorized technician responsible for the machine.

Page Attention alarms in alphabetical order Mute time: 1. Permanently muted buzzer. Buzzer sound: 1. Soft buzzer 2. Supersoft buzzer 3. Restart the disinfection. Page During power failure.

Machine actions: Function check will be delayed until power returns. Measures: Please wait. Page The function check has been prolonged due to internal tests. Machine actions: Function check is restarted and therefore prolonged. Page If the attention alarm reappears, consult an authorized technician. Check also that the correct concentrate has been connected. Page The appearance of the attention alarm can be preset.

Machine actions: A technical alarm is generated. Measures: Consult an authorized technician. Page Machine actions: None Measures: Consult an authorized technician. Page Establish a stable venous pressure over 50 mmHg until the attention alarm disappears. Measures: Check the placement of the yellow disinfectant connector. Page Buzzer is activated 2 min. Measures: Check the placement of the red concentrate connector.

Measures: Check the placement of the blue concentrate connector. Page Check concentrate selection and that the proper concentrate has been connected. Page The machine uses English temporarily as operator language instead of the selected language. Measures: Contact an authorized technician. Page Measures: Check water supply. Page Consider manually discontinuing the treatment, see "Power Failure" on page in part 1 for instructions.

Page in part 1 of the heat disinfection program is complete. Call for an authorized technician. Page WRO H. Measures: Press the Select key. Page 2 min. Buzzer sound: Supersoft buzzer. Page TMP alarm. The appearance of the attention alarm can be preset. Page Check that the cuff is correctly applied to the patient. It could also be that the patient is moving during the measurement check. Measures: Check venous blood line for possible kinks or forgotten clamps. Page Check for kinks or leakage from the cuff and the cuff hose.

Check also that the cuff hose is properly connected to the machine. Page Machine actions: Only the blood unit will run after a power failure. Measures: Mute time: Permanently muted buzzer. Measures: Press the Select key to display the Diascan log list. Page Select key has been pressed. See Recovery from Machine Shut Down" on page in part 1 for further information. If the attention alarm reappears consider discontinuing the treatment.

Page Check that the changed setting is correct. Machine actions: The disinfection program stops.