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113

LEARNING OBJECTIVES

The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on:

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Hygienic maintenance

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Exterior cleaning

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Heat disinfection

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Heat citric disinfection

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Descaling

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Chemical disinfection

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Integrated Heat disinfection

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Ultrafilter change

HC10139 |

Summary of Contents for AK 98

Page 1: ...AK 98 Machine Introduction Training Material ...

Page 2: ...Introduction Module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapters 2 3 ...

Page 3: ...ingly by an authorized service technician CAUTION The treatment of patients with a weight below 25 kg shall be performed under the full supervision of the physician In these cases additional measures to supervise the patient weight loss as per standard of care for low body weight is recommended Failure to do so could result in serious adverse consequences like hypovolemia and hypotension HC10139 ...

Page 4: ...vider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 5: ... module is to obtain an overview of the AK 98 dialysis machine with special focus on The blood part of the machine The fluid part of the machine The operator s panel Setting of the treatment parameters and activating functions 5 HC10139 ...

Page 6: ... 2 Operator s panel 3 Air detector 4 Venous pressure transducer connector 5 Arterial pressure transducer connector 6 Blood pump 7 Heparin pump 8 Priming detector 9 Arterial blood line clamp 10 Venous blood line clamp 11 Prime bucket not available in all markets 6 2 1 8 6 11 7 4 5 3 10 9 HC10139 ...

Page 7: ...ENTS Blood Part 11 Arm for dialyzer holder 12 Expansion chamber holder 13 Blood pressure monitor BPM 14 Blood line guides 15 Level adjustment knob 16 BPM cuff holder 17 Top tray 18 Infusion stand 11 16 12 15 17 18 13 14 HC10139 ...

Page 8: ...ubes 2 Dialysis fluid tube from machine to dialyzer blue 3 Dialysis fluid tube from dialyzer to machine red 4 Stand by port for red concentrate connector 5 Stand by port for blue concentrate connector 6 Concentrate connector red 7 Concentrate connector blue 1 7 4 5 6 2 3 HC10139 ...

Page 9: ...9 MACHINE EXTERNAL COMPONENTS Fluid Part 1 Pick up tube 2 Pick up tube holder 3 BiCart cartridge holder 4 Blood leak detector 5 Ultrafilter 6 Leakage detector tray 6 1 3 2 4 5 HC10139 ...

Page 10: ...10 MACHINE EXTERNAL COMPONENTS Rear 1 Transportation handle 2 Air filters 3 Inlet water tube 4 Outlet tube drain 5 Citric acid inlet tube 6 Mains connection 7 Fuses 8 Main switch 1 2 6 3 7 5 4 8 HC10139 ...

Page 11: ...11 MACHINE EXTERNAL COMPONENTS Rear 1 Ethernet port 2 USB port 3 External communication port 4 Potential equalisation connection 5 Remote panel contacts 4 5 1 2 3 HC10139 ...

Page 12: ...t The machine has an alarm indication light placed on the top of the operator s panel It can either be a blue yellow or red flashing light depending on the attention or alarm status When there is no information to display the light is off HC10139 ...

Page 13: ...HE OPERATOR S PANEL Hard Buttons Schedule indicator Main switch indicator Mute button Blood pump increase Blood pump start stop button Blood pump decrease On off button Read instructions before use HC10139 ...

Page 14: ...14 THE OPERATOR S PANEL Touch Screen Layout HC10139 ...

Page 15: ...ows the current state of the machine functional check treatment or disinfection The time indictor shows in h mm the remaining time in different machine states The BPM read out field shows the latest reading Pressing it performs a single BPM reading The Diascan button opens the Diascan menu The clearance read out field shows the data from the last performed Diascan monitoring system HC10139 ...

Page 16: ...ent pressure as a numerical value and graphically as the grey pointer The values in white text are the alarm limits beyond these points alarms will be generated Pressing each area when they are not flashing opens the settings boxes where the alarm limits can be adjusted Alarm limits Current values Alarm limits HC10139 ...

Page 17: ... and right arrows Widen both the arterial and venous alarm limits to their widest point Centralize the arterial and venous pressures around the current value Extend the alarm windows for the arterial and venous pressures This functionality will automatically be deactivated as soon as the treatment is finished Move the upper alarm limit up down using the red left and right arrows HC10139 ...

Page 18: ... THE OPERATOR S PANEL Flow Paths Depending on the status of the machine the flow paths are lit in different colors Treatment Bypass Isolated ultrafiltration Incorrect dialysis fluid Function Check HC10139 ...

Page 19: ...t opens the blood menu Accumulated heparin volume delivered in mL Pressing it opens the blood menu Accumulated ultrafiltration volume in L Pressing it opens the fluid menu Ultrafiltration rate in L h Pressing it opens the fluid menu Blood flow rate in mL min Pressing it opens the blood menu HC10139 ...

Page 20: ...ation field If it is an alarm then the alarm tab will be flashing If it is an attention or operator message then the information tab will be flashing The treatment graph tab opens the treatment graphs where key treatment parameters are displayed in a graphical format Alarm tab Information field Information tab Treatment graph tab HC10139 ...

Page 21: ...s The icons that appear on the status information bar are Sodium Bicarbonate and UF profiling Isolated UF Network connection Actual time BPM measurement Diascan Heparin The clock icon indicates that the machine is set for an auto process The BPM alarm off icon tells you that the BPM alarms have not been set The network connection icon is solid white when connected and has a grey outline when not c...

Page 22: ...L Touch Screen Buttons The patient button opens the patient page where information regarding the patient is handled The available functionality will depend on the CIS Clinical Information System in use in the clinic HC10139 ...

Page 23: ... treatment Start the rinse back procedure Select manual or Assisted priming Turns off the Operator s panel Allows the screen to be cleaned If the Operator s panel is pressed or in case of any alarms attentions the Operator s panel is reactivated Opens the service menu The functions button opens the functions page HC10139 ...

Page 24: ...ton opens the disinfection rinse menu where the different disinfection rinse programs can be selected and activated Also the disinfection history tab can be found here as well as e g the ultrafilter data incl confirmation of ultrafilter replacement in the tools tab HC10139 ...

Page 25: ...een Buttons The blood button opens the blood menu which contains the tabs used for setting parameters relating to blood The fluid button opens the fluid menu which contains the tabs used for setting parameters relating to fluid HC10139 ...

Page 26: ...ed by looking at the value in the UF rate treatment overview field The history button opens the treatment history page Here the treatment and alarm history and the treatment graphs are displayed When the fluid bypass button starts to flash the dialysis fluid is ready and in bypass This can be also seen on the fluid flow path HC10139 ...

Page 27: ...ual values are shown on the tab Current menu tab shown in white Other accessible menu tabs are dark blue Press the blue bars to open keypads to change the value Preset syringe type shown in white Not currently available in this phase shown as dimmed Accumulated or actual values shown in white HC10139 ...

Page 28: ...ng treatment time use the overtype method To set 3 45 type in the number 3 then 4 and then 5 The colon is added automatically and the time will be set to 3 45 Value Calculated rate Press cancel to leave the keypad without changing the value Increase Decrease Clear A decimal point is used when setting volumes HC10139 ...

Page 29: ...eters Selectpad Some of the machine parameters can also be set using a selectpad The dark blue bar and check mark show the selected parameter Press OK to confirm a change or cancel to exit To change press one of the light blue bars HC10139 ...

Page 30: ...Baxter AK 98 Diascan and BiCart are trademarks of Baxter International Inc or its subsidiaries End of Introduction Module ...

Page 31: ...Preparation module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapters 4 12 ...

Page 32: ...vider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 33: ...his module is to obtain an overview of the AK 98 dialysis machine with special focus on Attaching the concentrates Attaching the blood lines and heparin syringe Priming the extracorporeal circuit Setting the treatment parameters HC10139 ...

Page 34: ...ly pressing the On Off button The functional check will start the lights of the operator s panel hard buttons the screen the alarm indication light and the buzzer will be tested first The program version will be shown on the start up screen then the treatment screen will be shown Function check will appear in the machine state indicator HC10139 ...

Page 35: ...machine Connect the red concentrate connector to a pick up tube until a click is heard Place the pick up tube into the proper acidic concentrate container Confirm the concentrate combination Press the release buttons Open the upper latch of the BiCart cartridge holder Pull it outwards and upwards Open the lower latch Bring down the upper latch to align the hole with the top port of the BiCart cart...

Page 36: ...pressure transducer connector 9 Heparin pump Make sure the blood pump segment collars are outside the pump housing and that the heparin line is placed on top 3 1 2 4 5 8 9 6 7 NOTE To achieve the correct blood flow ensure that the inner diameter of the blood line pump segment of the blood line used corresponds to the set blood line pump segment diameter on the machine NOTE The connectors of the ar...

Page 37: ...parin Syringe Connect the prepared luer lock syringe to the heparin line Manually prime the heparin solution all the way up to the arterial blood line Press in the end of the piston and move it all the way out to the right hand side HC10139 ...

Page 38: ...ringe into the groove of the pump 2 NOTE To be able to use a syringe with a 13 mm inner diameter a heparin pump adapter must be installed in the heparin pump 3 Insert the plate on the end of the plunger into the groove on the piston 4 Turn the locking wheel upwards until resistance is felt 5 Check the syringe is firmly in place by lightly pulling on the plunger 1 2 3 4 5 HC10139 ...

Page 39: ... to open the blood menu Choose the heparin tab Pressing each of the blue buttons will open a keypad to set the desired value Note that it is possible to set a heparin bolus volume as well as a continuous heparin flow rate To deliver a bolus during priming Preset brand and volume HC10139 ...

Page 40: ...yzer connection 3 Venous line clamp 4 Priming detector 5 Venous patient connector 6 Waste bag Prime bucket 7 Venous pressure transducer connector NOTE The connectors of the venous blood line are blue but the blood lines may differ in appearance 5 6 2 7 4 3 1 HC10139 ...

Page 41: ...hould be moved to the dialyzer fluid ports to prevent spillage Alternatively priming can also be delayed so that it is completed once the machine has reached full conductivity as displayed by the green flow path In this situation the dialysis fluid tubes of the machine can be connected to the dialyzer while remaining in bypass allowing the blood side priming to be started and preventing spillage T...

Page 42: ...he priming procedure By pressing the functions button the functions menu will be opened the preset priming mode is shown here its manual priming It is possible to change to assisted priming using the keypad Once assisted priming has been selected the operator should follow the on screen instructions HC10139 ...

Page 43: ...d in the venous drip chamber should be increased during the priming phase using the adjustment knob The level should be well above the air detector head Once the level is set press the air detector icon in the information field to activate the air detector Priming fluid level HC10139 ...

Page 44: ... enough priming solution to complete the action For recirculation both ends of the blood lines must be connected together using a sterile accessory The priming fluid should be connected to the circuit via an infusion line to compensate for the ultrafiltration that occurs in the dialyzer during the recirculation phase When recirculation is finished or the blood pump is stopped close the clamp on th...

Page 45: ... by mode when 1 The green fluid path is achieved or a preset time thereafter 2 Or when the set priming volume is achieved If concentrate stand by mode has not been preset it can be activated manually by pressing the fluid button and then activating concentrate stand by mode in the fluid flow tab HC10139 ...

Page 46: ...o set the treatment parameters press the time indicator the time menu will open from here both the time and the UF volume can be set using the keypads Check and adjust additional parameters by pressing the blood or fluid buttons to view their menus HC10139 ...

Page 47: ...47 PREPARING THE MACHINE IT Connectivity Confirming patient ID and retrieving the patient prescription from the CIS HC10139 ...

Page 48: ...erator Prescription parameters with no icon are set to the machine default or preset settings Once OK has been pressed in the prescription then the prescription icon will appear in the settings tab All parameters can still be changed by the operator by pressing on their respective blue tabs The patient button has a black check mark when OK has been pressed HC10139 ...

Page 49: ...49 Preparing the machine IT connectivity Setting station ID Using patient ID as a label HC10139 ...

Page 50: ...nation Attach the blood lines and heparin syringe Manual priming Priming Recirculation Concentrate standby mode Set the prescription Time 3 00 UF Volume 1 5 L Fluid flow 600 mls min Heparin Bolus 1 0 ml Flow rate 1 5 mls hr Stop time 30 min 50 HC10139 ...

Page 51: ...Baxter AK 98 BiCart and SoftPac are trademarks of Baxter International Inc or its subsidiaries End of preparation module ...

Page 52: ...Treatment module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapters 4 8 ...

Page 53: ...vider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 54: ...is to get an overview of the AK 98 dialysis machine with special focus on Connecting the patient and starting the treatment Actions during treatment heparin bolus and BPM Pause the treatment End the treatment and rinseback Machine aftercare HC10139 ...

Page 55: ...ct that the machine has been lined and primed in the correct manner Pay special attention to the position of the venous blood line in the priming detector and observe that there are no kinks in the blood lines as well as checking all of the treatment settings have been set to appropriate values for the patient HC10139 ...

Page 56: ...rterial and venous blood lines connected to the patient straight connection The operator should make all the relevant safety checks and then start the blood pump The default blood pump speed is 100mL min The machine is preset by default to stop the blood pump automatically when the priming detector senses the change between the priming solution and the blood HC10139 ...

Page 57: ...ashing blood pump button to restart the blood pump and then use the blood pump up and down buttons to adjust the blood flow Observe that the blood flow path is lit red When ready start the ultrafiltration The alarm arterial and venous pressure alarm limits will automatically be centralized around the actual pressures HC10139 ...

Page 58: ...l bolus of heparin is required by the patient during the treatment this can be delivered by the machine Press the heparin bolus volume settings bar and use the keypad to set to correct volume Once OK has been pressed then the bolus will be delivered HC10139 ...

Page 59: ...s the BPM read out field and the measurement will start To set up automatic blood pressure readings open the setup tab and press the auto mode bar From here the interval time can be set between 5 and 60 minutes press OK to confirm the time and activate to activate the automatic readings HC10139 ...

Page 60: ...s for accessing the BPM alarm limits and history The history tab within the blood pressure menu contains the data from all the blood pressure readings performed during the treatment The set limits tab allows the operator to customize the alarm limits to meet the patients requirements HC10139 ...

Page 61: ...d lines to the patient and press confirm 7 Press the blood pump button and adjust the blood flow 8 Press the ultrafiltration button to resume UF removal When the treatment is paused The blood flow rate is decreased and the arterial and venous pressure alarm windows are widened The elapsed time in pause is displayed and a sound alarm is triggered every 15 minutes Diascan measurements Isolated UF an...

Page 62: ...rm indication light and an attention message After pressing confirm the on screen instructions should be followed If the treatment needs to be finished before the set treatment time has expired then the time needs to be reduced down to 0 00 first This is done by pressing the time indicator and using the keypad to change the time HC10139 ...

Page 63: ...2 Disconnect the arterial line from the access and connect it to the rinse back solution 3 Press the blood pump button to start the blood pump 4 The blood pump will run until either the blood is no longer detected the preset volume is reached or the blood pump is manually stopped by the operator Once the rinse back is completed there is an option to continue the rinse back or disconnect the patien...

Page 64: ...g detector there will be handling instructions on the screen on how to prepare the machine for disinfection The emptying of the dialysis fluid in the dialyzer is initiated by returning the blue dialysis fluid tube to the machine The red concentrate connector should be inserted carefully into the stand by port By following the on screen instructions the BiCart cartridge can be drained by the machin...

Page 65: ...Hands on Straight connection Start treatment Heparin bolus 0 5 ml Single BPM measurement Set the BPM alarm limits Pause treatment End treatment Rinse back Drain dialyzer and BiCart cartridge 65 HC10139 ...

Page 66: ...Baxter AK 98 Diascan and BiCart are trademarks of Baxter International Inc or its subsidiaries End of treatment module ...

Page 67: ...Isolated UF Profiling and Diascan module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapters 6 7 9 ...

Page 68: ...vider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 69: ...RNING OBJECTIVES The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on Isolated ultrafiltration Profiling UF sodium and bicarbonate Diascan monitoring system HC10139 ...

Page 70: ...ation Activation The Isolated UF settings are reached by pressing the fluid button and then isolated UF in the fluid menu Once in the isolated UF menu the time and volume for isolated UF are set and isolated UF is activated HC10139 ...

Page 71: ...ation Once the isolated UF time and volume are set they are automatically added by default to the total treatment time and UF volume When the isolated UF phase is completed the machine will automatically switch into the diffusive phase HC10139 ...

Page 72: ...d UF can be activated at any point during the treatment The time and volume for the new phase must be added to the previous to create a cumulative amount A currently running isolated UF phase can be deactivated at any time as required by the operator Press deactivate in the isolated UF menu HC10139 ...

Page 73: ... Both sodium and bicarbonate concentrations in the dialysis fluid can be profiled They can either be profiled upwards or downwards at a smooth liner rate When deactivating a profile check the set value that the treatment will continue at HC10139 ...

Page 74: ...ree profile types available for ultrafiltration profiling Linear Step Interval Changes to the UF are determined by Total UF volume Treatment time Starting value for the UF rate In step mode number of steps In interval mode number of intervals HC10139 ...

Page 75: ...mooth decreasing profile With step profiles the machine knows the set time and UF volume the operator sets the start UF rate and the number of steps and the machine will calculate the profile With interval profiles the machine knows the set time and UF volume the operator sets the start UF rate and the number of intervals and the machine will calculate the profile HC10139 ...

Page 76: ...ched by pressing the fluid button and then profiling in the fluid menu Choose the desired mode depending on which mode is selected set and OK the other parameters After doing so activate profiling The status bar at the bottom of the screen will show which profiles are running HC10139 ...

Page 77: ...el All of the profiling settings are reached by pressing the fluid button and then profiling in the fluid menu Choose the desired preset model and check that the preset values are appropriate for the patient After doing so activate profiling HC10139 ...

Page 78: ... changes to the treatment time and or the ultrafiltration volume will have an effect on the ultrafiltration rate and change the shape of the profile The original profile in black and changes to the UF volume in grey The original profile in black and changes to the treatment time in grey HC10139 ...

Page 79: ... parameters Clearance K How much blood has been cleaned per unit of time mL min Clearance multiplied by treatment time Kt The volume of the blood that has been cleaned so far in the treatment Clearance multiplied by treatment time and divided by the patients fluid distribution volume Kt V the patient s dialysis dose HC10139 ...

Page 80: ...iascan Monitoring System Measurement Frequency The Diascan monitoring system measurements can take place every 30 or 60 minutes or as a single reading This is done by pressing interval within the setup tab HC10139 ...

Page 81: ... to be entered into the machine This can either be done in the setup tab if the distribution volume is known or through the Watson tab if it needs to be calculated An already calculated distribution volume can be set manually Using the Watson tab the patients data is set to calculate the distribution volume HC10139 ...

Page 82: ...ystem readings Time to target indicates how much more treatment needs to be completed to achieve the set target Kt V It should always be less than the remaining treatment time in order to achieve the target The target Kt V is set here an alarm can also be set to alert the operator if the Kt V will be lower than desired HC10139 ...

Page 83: ...cent reading of the Diascan monitoring system is always displayed in the clearance area alongside the current and forecast Kt V To view the previous clearance rates Kt V actual and forecast and the Qb at the time of the reading press the history tab within the Diascan menu HC10139 ...

Page 84: ...Heparin Bolus 1 5 mls Flow rate 1 0 ml hr Stop time 0 min Isolated UF 0 2 L 10 minutes Na profile deactivate after 10 minutes Start 144 Stop 136 Diascan start after Isolated UF and profiling are finished Interval 30 minutes Watson Kt V target 1 2 Kt V limit 1 0 84 HC10139 ...

Page 85: ...Baxter AK 98 and Diascan are trademarks of Baxter International Inc or its subsidiaries End of Isolated UF Profiling and Diascan module ...

Page 86: ...Troubleshooting module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapter 3 Alarm handbook ...

Page 87: ...vider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 88: ...n overview of the AK 98 dialysis machine with special focus on Troubleshooting UF supervision Fluid leakage Halt button Power failure Manual rinse back Air in venous drip chamber Changing the BiCart cartridge Changing the blood lines and dialyzer HC10139 ...

Page 89: ...upervision The alarm appears when the UF volume measurements are not within the specification of the machine this can happen when The UF control is not calibrated or incorrectly calibrated The UF control does not work correctly The protective system UF sensor does not work correctly HC10139 ...

Page 90: ...ge Alarm Alarm There is one alarm associated with fluid leakage The alarm appears when the machine has detected a fluid leakage during treatment In case of an ultrafilter leakage the detected volume could be an excessive UF volume HC10139 ...

Page 91: ...a reset of the machine this can be done by pressing and holding in the halt button on the rear of the machine This interrupts the power supply to the machine and overrides the battery back up When the button is released the machine will perform a recovery HC10139 ...

Page 92: ...work then the machine will shut down All the settings and the actual values will be kept When the power returns press the On Off button to start the machine The machine will perform a recovery and the treatment will continue from where it stopped However all the treatment parameters must be checked when starting after a recovery Battery connect indicator is lit green if the battery back up has bee...

Page 93: ...The displayed minutes indicate how long the power failure has lasted Machine actions Only the blood unit will run during a power failure Appears When the machine has recovered from power failure Machine actions None Most common all AK 98 are equipped with battery back up In case of battery backup failure HC10139 ...

Page 94: ...ll be made If this is unsuccessful an unconditional or conditional technical alarm will appear Why does an automatic restart occur AK 98 is designed with a safety philosophy that involves a continuous supervision of the computers inside the machine If the system identifies a problem it will generate an automatic restart to restore a fully operational system HC10139 ...

Page 95: ...ilable Connect arterial blood line to the rinse back solution Open the blood pump cover Manually turn the blood pump anti clockwise When returning the blood manually the operator is responsible for visually observing all safety parameters that cannot be monitored by the machine during a power failure for example air detection HC10139 ...

Page 96: ... air detector then alarm 100 Air in venous drip chamber is triggered Check the blood circuit connections are tight Use the timer or confirm icon in the alarm message to restart the blood pump at the same time increase the blood level in the venous chamber using the level adjustment knob Recommended blood level HC10139 ...

Page 97: ...g the BiCart Cartridge If the BiCart cartridge needs to be changed during the treatment follow these steps Remove the empty BiCart cartridge Close the latches and wait for 2 seconds Attach the new BiCart cartridge 2 sec HC10139 ...

Page 98: ...ions button Within new blood circuit there are two options rinse back if this is possible or new blood circuit if it is not possible or desired to rinse back The dialyzer fluid tubes are returned to the machine and then the blood lines can be removed New blood lines and dialyzer are mounted The new circuit is then primed and then the patient can be reconnected HC10139 ...

Page 99: ...an air in venous drip chamber alarm Change the BiCart cartridge Change the blood lines and the dialyzer and continue the treatment End the treatment Simulate a power failure and rinse back the blood manually 99 HC10139 ...

Page 100: ...Baxter AK 98 and BiCart are trademarks of Baxter International Inc or its subsidiaries End of troubleshooting module ...

Page 101: ...Single needle module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapter 5 ...

Page 102: ...ovider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 103: ...NG OBJECTIVES The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on Single needle Lining and priming Terminology Activation Start the treatment End the treatment HC10139 ...

Page 104: ...into the expansion chamber holder until it clicks into position Tilt the expansion chamber holder backwards until it clicks into position Attach the venous dialyzer line to the expansion chamber blood line Attach the expansion chamber dialyzer line to the dialyzer 2 1 3 4 HC10139 ...

Page 105: ...d line The pressure and volume in the circuit increases The Venous phase The arterial blood line is clamped and the blood that entered in the arterial phase is returned to the patient via pressure and gravity Single needle parameters Mean blood flow Is the effective mean blood flow rate during the complete cycle Stroke volume Is the blood volume which passes through the dialyzer during a cycle The...

Page 106: ...l in the expansion chamber is around the groove and return it to the upright position Press the blood button and open the blood menu Press the single needle tab and set a minimum stroke volume limit and then activate single needle The machine is now ready for patient connection HC10139 ...

Page 107: ...nce the treatment has started to 350mmHg high limit and 150mmHg low limit If it is necessary to change the limits press the venous pressure control Alternately the limits can also be changed by in the blood menu low and or high venous pressure limit The stroke volume that can be achieved is determined by the size and position of the venous pressure alarm window and the potential expansion volume p...

Page 108: ...108 SINGLE NEEDLE End the Treatment At the treatment end before rinseback deactivate single needle and proceed according to earlier end the treatment and rinse back instructions HC10139 ...

Page 109: ...Hands on Line and prime the machine Connect the patient Activate single needle Optimize the stroke volume End the treatment Deactivate single needle Rinse back 109 HC10139 ...

Page 110: ...Baxter and AK 98 are trademarks of Baxter International Inc or its subsidiaries End of Single Needle module ...

Page 111: ...Hygienic maintenance module AK 98 Dialysis Machine Reference AK 98 Operator s Manual 3 xx Chapters 10 11 ...

Page 112: ...ovider It does not replace the users responsibility to read and understand the full text of the Operator s manual prior to operating the machine If there are deviations between the actions described here and the instructions contained in the Operator s Manual then the information from the Operator s Manual takes precedence HC10139 ...

Page 113: ...le is to get an overview of the AK 98 dialysis machine with special focus on Hygienic maintenance Exterior cleaning Heat disinfection Heat citric disinfection Descaling Chemical disinfection Integrated Heat disinfection Ultrafilter change HC10139 ...

Page 114: ...propanol 60 or 1 hypochlorite wipe all of the machines exterior surfaces and the top tray In case of cleaning with hypochlorite wipe afterwards with water The pick up tubes need to be flushed inside and out with water between each treatment and then returned to the holder to dry naturally Once a week repeat exactly the same procedure using ethanol 70 instead of water HC10139 ...

Page 115: ...115 HYGIENIC MAINTENANCE Programs There are different programs for cleaning and disinfecting the machine Heat Chemical Rinse HC10139 ...

Page 116: ...alcium and Bicarbonate and or lower concentrations of acetic citric acid in the dialysis fluid as well as higher dialysis fluid flows and or longer dialysis times may require more frequent decalcification than needed for the operating conditions shown in the table below HC10139 ...

Page 117: ...ng At least after every 3rd treatment or at high usage of the equipment at least once per day Run a heat disinfection program together with CleanCart C cartridge or a heat disinfection program with liquid citric acid Decalcification Disinfection At least once every 7th treatment day Cleaning using CleanCart A 1 Run a heat CleanCart A program 2 Run a heat CleanCart C program or a heat disinfection ...

Page 118: ...e of the U9000 Ultrafilter Do not perform more than 8 sodium carbonate e g CleanCart A cartridge based disinfections during the life cycle of the U9000 Ultrafilter Disinfection using sodium carbonate e g CleanCart A cartridge should not be performed before periods when the machine is inactive e g storage over weekend The recommended process of heat disinfection using CleanCart A cartridge should b...

Page 119: ...story To view the disinfection history of the machine press the disinfection button Within the disinfection rinse menu press the history tab This will open the list where the details of the previous disinfection processes can be found HC10139 ...

Page 120: ... cartridge disinfection program press the disinfection button Under the heat tab press heat CleanCart to start the process Wait for the attention message to appear before inserting the CleanCart cartridge into the BiCart cartridge holder Not available on all markets HC10139 ...

Page 121: ...ther a short or a longer heat disinfection with liquid citric acid The citric acid concentration to be used is configurable and in the example below preset to 20 The citric acid inlet tube on the rear of the machine must be placed into the disinfectant solution Citric acid inlet tube HC10139 ...

Page 122: ...IENIC MAINTENANCE Descaling It is possible to initiate a descaling between treatments in order to remove precipitated material 1 Selecting Descaling 2 Confirm and follow the instructions on the screen HC10139 ...

Page 123: ...fection To perform a chemical disinfection press the disinfection button and then the chemical tab Chemical disinfections must take place from the front of the machine Connect the blue concentrate connector to the yellow pick up tube HC10139 ...

Page 124: ...lant CWP During this integrated heat disinfection the machine automatically switches on and receives hot water from the CWP it can also be switched on manually if required The integration between the machine and the CWP allows the water inlet tube to be included into the disinfection process Not available on all markets HC10139 ...

Page 125: ...ed heat disinfection procedure includes the following phases when preset by the service technician Heat disinfection of the AK 98 dialysis machine Low flow heat LFH where all the wet parts of the system between the machine and the WRO 300 H unit are exposed to hot water at a low flow rate Heat disinfection of the WRO 300 H unit Not available on all markets HC10139 ...

Page 126: ...bricate the ultrafilter connections with RO water 5 Insert the new ultrafilter into the holder and push it gently upwards 6 Push the lower latch into position and close the holder until a click is heard 7 Press the disinfection button under the tools tab and confirm the UFD filter replacement 8 After changing the ultrafilter a heat disinfection must be performed before a new treatment HC10139 ...

Page 127: ...Hands on Set an auto schedule for heat disinfections Perform a heat with a CleanCart cartridge Change the U9000 ultrafilter 127 HC10139 ...

Page 128: ...Baxter AK 98 BiCart CleanCart U9000 and WRO 300 H are trademarks of Baxter International Inc or its subsidiaries End of hygienic maintenance module ...

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