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07-19-61-244 October 2, 2009

HomeChoice

APD Systems Patient At-Home Guide

20-5

20. Quick Reference

WARNING

If a disposable set is already present in the cycler, CLOSE ALL CLAMPS

before you press

. This prevents fluid from flowing from one bag

to another, or to the patient, when LOAD THE SET appears. The

uncontrolled gravity flow of fluid can result in an increased

intraperitoneal volume (IIPV) situation.

6. Press

when you are

ready to begin.

LOAD THE SET appears.

7. Open the door.

Push the handle up to unlock

and open the door.

Summary of Contents for HomeChoice

Page 1: ...HomeChoice HomeChoice PRO APD Systems Patient At Home Guide Creating a Better World of Care for Renal Patients PATIENT GUIDE COVERS_Update121109 indd 1 12 11 2009 2 26 51 PM...

Page 2: ...The HomeChoice and HomeChoice PRO APD Systems Patient At Home Guide Document Number 07 19 61 244 October 2 2009...

Page 3: ...t At Home Guide October 2 2009 07 19 61 244 Baxter HomeChoice UltraBag MiniCap FlexiCap OptiChoice Dianeal and Extraneal are trademarks of Baxter International Inc Copyright 2009 Baxter Healthcare Cor...

Page 4: ...es General 3 6 3 2 4 Supplies Solutions 3 7 3 2 5 Supplies Disposable Set 3 10 3 2 6 General 3 11 3 3 Cautions 3 14 3 4 Battery Precautions 3 16 4 Indications for Use 4 1 About This Guide 4 1 5 Descri...

Page 5: ...t 7 1 7 2 Set Up the HomeChoice APD System 7 2 7 3 Grounding Instructions 7 4 8 Operating Instructions PRO Card and Modem 8 1 Introduction 8 1 8 2 Using the PRO Card 8 3 8 2 1 Care and Handling of the...

Page 6: ...l Therapy Settings 9 18 9 7 6 Tidal Calculated Settings 9 24 9 7 7 Hi Dose Tidal Therapy Settings 9 25 9 7 8 Hi Dose Tidal Calculated Settings 9 33 9 8 Low Fill Mode 9 34 9 8 1 CCPD IPD Therapy Settin...

Page 7: ...Connect Yourself to the Disposable Set 11 24 12 Operating Instructions Perform Therapy 12 1 Initial Drain 12 1 12 1 1 Menu Options During Initial Drain 12 4 12 2 Fill 12 5 12 2 1 Menu Options During F...

Page 8: ...f Alarms and Procedures 18 1 18 2 Correcting Alarms 18 3 18 2 1 Types of Alarms 18 4 18 3 Alarms 18 5 18 3 1 Check Lines 18 5 18 3 2 Check Lines and Bags 18 9 18 3 3 Check Therapy Setting Value 18 10...

Page 9: ...Disconnect from the System 18 66 18 10 2 Return to Therapy After an Emergency Disconnect 18 67 19 Technical Data 19 1 Physical Specifications 19 1 19 2 Electrical Power Requirements 19 1 19 2 1 Extens...

Page 10: ...able of Contents 19 16 Determining Initial Drain Alarm Volume Settings 19 16 19 17 Determining Tidal Total UF and Last Manual Drain UF Target Volume Settings 19 18 20 Quick Reference 20 1 Prepare for...

Page 11: ...Table of Contents viii HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 12: ...Section 1 Glossary 1 Glossary...

Page 13: ...nt s feeling of fullness sometimes referred to as overfill or overfull This feeling can come from Increased Intraperitoneal Volume IIPV or can come from eating a large meal constipation or abdominal m...

Page 14: ...Drains of each therapy cycle throughout the night Blood Pressure Diastolic The lowest number of your daily blood pressure mmHg when your heart relaxes Blood Pressure Systolic The highest number of you...

Page 15: ...ou sleep Dialysis solution can be left in the peritoneal cavity during the daytime or it can be completely drained before ending the treatment referred to as Nocturnal Intermittent Peritoneal Dialysis...

Page 16: ...se a sugar and other compounds similar to those in the body Disconnect Cap A povidone iodine solution filled cap that is placed over the connectors on the transfer set or the connector on the patient...

Page 17: ...is part of the therapy cycle Effluent The used dialysis solution drained from the body as part of an exchange End Stage Kidney Disease ESKD Kidney failure Requires dialysis or a kidney transplant End...

Page 18: ...therapy that combines conventional nighttime therapies such as CCPD or Tidal with additional daytime exchanges This may help improve the outcome of your dialysis treatment During the Dwell phase of e...

Page 19: ...eal cavity during the day This is also referred to as a Wet Day Low Fill Mode This mode is available only to patients whose Fill volumes are less than 1000 mL These patients typically weigh less than...

Page 20: ...ff This prevents any solution from being delivered to the patient The occluder is located inside the door on the front of the cycler Organizer The blue plastic piece that holds the tubing lines and co...

Page 21: ...neal dialysis can be performed with or without a mechanical device See also Automated Peritoneal Dialysis APD Peritoneal Membrane The layer of tissue that lines your abdominal cavity A membrane can ac...

Page 22: ...is therapy Slow Flow This occurs when the flow rate of solution is very slow Slow Flow can reduce the Dwell Time and decrease the amount of effective dialysis therapy This can be caused by a partial k...

Page 23: ...is solution for the entire course of therapy including the Last Fill Volume Transfer Set Tubing that connects the patient line on the disposable set or UltraBag set to the catheter Ultrafiltration UF...

Page 24: ...only with same type and rating Recovery Recyclable Crossed out wheeled bin Do not dispose of this product as unsorted municipal waste Collect this product separately Use collection and return systems...

Page 25: ...y is recyclable Canadian Standards Association Meets applicable requirements for the U S and Canada Manufacturer Baxter Healthcare Corporation Renal Division McGaw Park IL 60085 U S A Baxter Healthcar...

Page 26: ...tient At Home Guide October 2 2009 07 19 61 244 Stacking limit do not stack more than 5 high Temperature limitation for transport and storage This way up ATTENTION Consult accompanying documents Read...

Page 27: ...Section 2 User Assistance Information 2 User Assistance Information...

Page 28: ...is important Keep this information available at all times 2 1 Personal and Cycler Information 2 2 Numbers to Call for Assistance Name Patient ID Number Cycler Serial Number Cycler Model Number For Ba...

Page 29: ...2 User Assistance Information 2 2 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244 Other Important Information...

Page 30: ...Section 3 Warnings and Cautions 3 Warnings and Cautions...

Page 31: ...e for monitoring the patient s overall condition by trained and qualified personnel 3 2 Warnings READ ALL INSTRUCTIONS BEFORE USING THIS CYCLER 3 2 1 Treatment Use aseptic technique to reduce the chan...

Page 32: ...can cause symptoms and signs of uremia including fluid overload Contact your dialysis center if You did not complete your treatment You skipped your prescribed Last Fill Other conditions occur as ins...

Page 33: ...rease in blood pressure IIPV can occur because of one or more of the following reasons Low Fill Mode is not programmed for patients whose fill volumes are less than 1000 mL These patients typically we...

Page 34: ...amps first This can cause a free flow of fluid from one bag to another and or to the patient during the time when LOAD THE SET is displayed The door is opened during an alarm or System Error without c...

Page 35: ...ition to any fluid left in the peritoneal cavity IIPV could result in a feeling of abdominal discomfort serious injury or death IF IIPV IS SUSPECTED PLEASE DO THE FOLLOWING 1 Press STOP immediately th...

Page 36: ...with Baxter s products will function in a safe and satisfactory manner Steps to perform a Manual Drain Display screen The current FILL phase appears on the display screen 1 Press STOP 2 Press V 3 Pre...

Page 37: ...ESRD including fluid overload 3 2 4 Supplies Solutions Add medication to the solution only as prescribed by a physician Failure to follow proper instructions can result in contamination Adding the wr...

Page 38: ...hat come with the solution Failure to follow the solution labeling instructions can lead to insufficient therapy or patient injury Do not use the dialysis solution if you think you may be allergic to...

Page 39: ...ent from your prescription you may not receive the dialysis therapy you need This may lead to an increase or decrease in the amount of fluid ultrafiltrated during the therapy When performing a Tidal t...

Page 40: ...set can result in an inadequate therapy Check all disposable set connections for a secure fit before beginning your therapy Make sure all clamps on unused fluid lines are closed securely Contaminatio...

Page 41: ...circuit accessible circuit is limited to 60Vrms Using an unapproved modem may increase the risk of electrical shock Do not open the HomeChoice HomeChoice PRO APD System cycler Electrical circuitry ins...

Page 42: ...part of the system Baxter can not ensure that the dialysis products of other manufacturers when connected with Baxter s products function in a safe and satisfactory manner The HomeChoice HomeChoice PR...

Page 43: ...reduce the risk of burns electrocution fire or injury to persons Close supervision is necessary when this product is used by on or near children or those unable to care for themselves Use this product...

Page 44: ...stem does not exceed the extension cord ampere rating Use only heavy duty extension cords rated at 1200 watts 10 amp for 110V systems Use only extension cords less than 12 feet 3 5 meters in length Th...

Page 45: ...ulations please do the following For more information on return recovery or recycling of this product please contact Baxter Technical Assistance at the number listed in 2 2 Numbers to Call for Assista...

Page 46: ...em operation The batteries require no periodic maintenance There is danger of explosion if either battery located within the HomeChoice HomeChoice PRO APD System is incorrectly replaced In case replac...

Page 47: ...Section 4 Indications for Use 4 Indications for Use...

Page 48: ...This Patient At Home Guide provides instructions necessary for the proper operation of the HomeChoice and HomeChoice PRO APD Systems the system This guide is meant to be used with and after your trai...

Page 49: ...4 Indications for Use 4 2 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 50: ...Section 5 Description 5 Description...

Page 51: ...Dialysis APD therapy for pediatric and adult renal patients Their Fill volumes can range from 60 mL to 3000 mL HomeChoice and HomeChoice PRO APD Systems are intended to be operated by Home patients wh...

Page 52: ...odium and bicarbonate in the body This process of cleansing the blood uses the body s own peritoneal membrane as a filter See Figure 5 1 Figure 5 1 Peritoneal Cavity The basic steps of PD are the foll...

Page 53: ...anges are done manually three to five times a day This type of peritoneal dialysis does not use an automatic cycler This method can be used to continue your treatments if you are unable to use your cy...

Page 54: ...lysis by directing the flow of fluid between the solution bags the cassette your peritoneal cavity and your drain option Once you have connected all solution bags and your drain option and have connec...

Page 55: ...toneal cavity to the disposable cassette where it is measured The fluid is then sent to the drain option This process is repeated until the system determines you are empty The system calculates the UF...

Page 56: ...mains locked See 18 9 Power Failure on page 18 62 for complete instructions 5 3 3 Situations When Fluid Lines are Not Controlled There are three 3 situations during the use of the system when the flui...

Page 57: ...ting is correct Audible alarms and signals alert you to check the display screen The cassette with attached fluid lines fits into the system only one way so you always insert it correctly Connections...

Page 58: ...ibed in this guide HomeChoice PRO APD System cycler HomeChoice APD System cycler 5 5 1 The HomeChoice PRO APD System Cycler Figure 5 2 Front and Top of the HomeChoice PRO APD System Cycler 1 Heater Pa...

Page 59: ...3 HomeChoice PRO APD System Back Panel Figure 5 4 HomeChoice PRO APD System Display Screen and Control Panel 1 Power Entry 4 Power Cord 2 J1 Service Port 5 On Off Switch 3 J2 Modem Port 1 Display Scre...

Page 60: ...1 244 5 5 2 The HomeChoice APD System Cycler Figure 5 5 Front and Top of the HomeChoice APD System Cycler 1 Heater Pan 6 Door 2 Silver Heater Sensor Button 7 Handle shown in locked position 3 Bag Stop...

Page 61: ...igure 5 6 HomeChoice APD System Back Panel Figure 5 7 HomeChoice APD System Display Screen and Control Panel 1 Power Entry 3 Power Cord 2 Service Ports 4 On Off Switch 1 Display Screen 4 STOP Button 2...

Page 62: ...button to Start or continue therapy Continue therapy after an alarm sounds Continue therapy after a daytime Dwell Red Press the STOP button to Return to the previous menu Cancel a setting change Stop...

Page 63: ...ion Volume APD Set with Cassette Your dialysis center determines which type of disposable set and connection you use Figure 5 8 and Figure 5 9 show a 4 prong Luer disposable set Figure 5 10 and Figure...

Page 64: ...er Disposable Set Figure 5 8 Luer 4 Prong Disposable Set Figure 5 9 Luer 4 Prong Lines and Connectors 1 Organizer 3 Cassette 2 Effluent Sampling Site 4 Lines 1 Patient Line 4 Heater Line Red Clamp 2 F...

Page 65: ...Disposable Set Figure 5 10 Spike 4 Prong Disposable Set Figure 5 11 Spike 4 Prong Lines and Connectors 1 Organizer 3 Cassette 2 Effluent Sampling Site 4 Lines 1 Patient Line 4 Heater Line Red Clamp 2...

Page 66: ...he data can be transferred between your cycler and your clinician The two systems use the same disposable sets and solutions They perform the same therapies the same way Section 8 Operating Instructio...

Page 67: ...Section 6 Environmental Conditions 6 Environmental Conditions...

Page 68: ...vance of your trip Your solution and disposable sets can be delivered to you at your destination If you are traveling out of the region where you live inquire about any emergency contact information t...

Page 69: ...e October 2 2009 07 19 61 244 To avoid any interruption in your therapy during long trips obtain the needed supplies for at least a full day s manual exchanges CAPD Perform manual exchanges if your cy...

Page 70: ...Section 7 Setup and Check out 7 Setup and Check out...

Page 71: ...ystem the system in your home 7 1 Check out 1 Check the cycler for external damage See 5 5 HomeChoice APD Systems Description on page 5 8 for a description of the system and its components 2 Verify th...

Page 72: ...le should be large enough to hold the cycler and all of the solution bags Make sure a three prong grounded outlet is nearby See 7 3 Grounding Instructions on page 7 4 for warnings concerning the three...

Page 73: ...than normal negative pressure during Drain if the peritoneal membrane is in contact with the catheter This can cause pain discomfort or in extreme cases peritoneal membrane damage WARNING Place the so...

Page 74: ...outlet that is properly installed with a verified ground Please contact your dialysis center for any questions concerning the outlet When the HomeChoice HomeChoice PRO APD System is used on a 120V ci...

Page 75: ...Section 8 Operating Instructions PRO Card and Modem 8 PRO Card and Modem...

Page 76: ...center to automatically set up your therapy The PRO Card also records information about each treatment The PRO Card holds at least two months of treatment information This feature provides information...

Page 77: ...Systems Patient At Home Guide October 2 2009 07 19 61 244 Figure 8 1 PRO Card Port Figure 8 2 HomeChoice PRO APD System Back Panel 1 PRO Card Port 2 Indicator Light 1 Power Entry 4 Power Cord 2 J1 Ser...

Page 78: ...and durable It is designed to be carried to and from your dialysis center visits It must remain inserted in the HomeChoice PRO APD System at all other times Please follow these guidelines for handlin...

Page 79: ...must verify that you have the correct card The following steps help you to confirm your name and patient ID Steps to confirm your PRO Card Display screen 1 With the cycler power OFF insert the PRO Car...

Page 80: ...e PRO Card in the device to collect treatment information You must report this to your dialysis center and verify your therapy settings manually before proceeding with treatment Press GO to proceed to...

Page 81: ...Low Fill Mode only 10 Press ENTER This setting appears in Low Fill Mode only 11 Press ENTER HomeChoice PRO APD System then calculates and briefly displays CYCLES and DWELL TIME PROGRAM ACCEPTED then a...

Page 82: ...enter your data Basic steps for entering data Display screen 1 Press ENTER when the data entry prompt appears The zero setting is replaced with the previous day s data The digits blink Digits blink 2...

Page 83: ...tolic and diastolic numbers of your daily blood pressure Night Concentration 1 This is the concentration of the primary solution bag placed on the heater pan Available concentrations are 4 25 2 5 and...

Page 84: ...repeated for each manual exchange The n is a number from one to five to indicate the manual exchange for the data entered Exchange Time n This is the time of day AM PM format that the nth manual exch...

Page 85: ...er you are usually asked to bring the PRO Card with you Follow the steps below to remove your PRO Card hNOTE The PRO Card must remain in the HomeChoice PRO APD System until your next visit to your dia...

Page 86: ...reader inside the cycler If there is a problem with the PRO Card or the card reader the following messages can appear 8 3 1 No PRO Card Display Message Indicator Light Flashing Yellow Cause The PRO C...

Page 87: ...To Correct 1 Call your dialysis center to verify that your PRO Card is disabled 2 Press GO to proceed to PRESS GO TO START Display Message Indicator Light Yellow Cause The PRO Card is full of treatmen...

Page 88: ...START The program on your system is not changed You must verify your therapy settings manually with your dialysis center before you proceed with treatment Future treatment information can be lost if...

Page 89: ...that were provided with your modem for modem operation Follow the steps below to install your modem h NOTE The modem must be Class II and approved to IEC EN CSA UL 60950 1 with a TNV 1 circuit accessi...

Page 90: ...and Modem 2 Plug the data cable into the J2 Port as shown 3 Unplug the telephone line from the wall jack 4 Plug the double connector into the wall jack 5 Plug the telephone line and modem line into th...

Page 91: ...rmation is initiated by the dialysis center The center will then request that you put the HomeChoice PRO APD System in the MODEM CONNECT mode Follow the steps below to test your modem connection 7 Tur...

Page 92: ...the telephone if necessary and allow the dialysis center to call back with their modem The HomeChoice PRO APD System automatically answers An error message MODEM ERROR n appears if a problem occurs Ca...

Page 93: ...8 Operating Instructions PRO Card and Modem 8 18 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 94: ...Section 9 Operating Instructions Change Program 9 Change Program...

Page 95: ...ogram your system with your PRO Card see Section 8 Operating Instructions PRO Card and Modem 9 2 About Your System s Settings Your physician prescribes your treatment and system settings You view your...

Page 96: ...e Instructions Please have your dialysis nurse check the appropriate box below The Nurse s Menu has not been changed and the factory default settings are being used The Nurse s Menu has been adjusted...

Page 97: ...regions when a replacement cycler swap is delivered by Baxter it is not programmed with your therapy settings Your dialysis center is responsible for knowing and entering your therapy settings Positi...

Page 98: ...Your dialysis center determines if you can change your therapy settings If you are not allowed to change your settings the display screen will say REVIEW PROGRAM instead of CHANGE PROGRAM See 9 6 The...

Page 99: ...4 Press ENTER to change the setting if needed The option or value blinks 5 Press U and V to change the value 6 Press ENTER to save the new value Blinking stops 7 Press V to display THERAPY TIME NITE T...

Page 100: ...by following Steps 4 6 17 Press V to display DAY FILL VOL Day Fill Volume This setting only appears for Hi Dose therapies 18 Make changes if needed by following Steps 4 6 19 Press V to display TIDAL...

Page 101: ...CLE 24 PRESS GO TO START appears on the display screen after the calculated settings You are now ready to press GO to begin the setup for your therapy OR If you do change the value for Last Fill Volum...

Page 102: ...THERAPY type There are four Therapy types available as shown in Table 9 2 See Terms Used in This Guide in Section 1 Glossary for the definitions of APD CCPD IPD Tidal Hi Dose CCPD and Hi Dose Tidal T...

Page 103: ...dard Fill Mode Setting Description Total Volume Total Volume of solution used for the therapy Includes the total Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum s...

Page 104: ...g of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able to c...

Page 105: ...g is 3000 mL Default setting is 0 mL Setting increments 10 in the 100 to 500 mL range 50 in the 500 to 1000 mL range 100 in the 1000 to 3000 mL range Dextrose default setting or The Last Fill Volume c...

Page 106: ...u press STOP after you have completed reviewing your therapy settings Table 9 4 Definitions for CCPD IPD Calculated Settings Setting Description Cycles Total number of cycles at night not including th...

Page 107: ...solution used for the therapy Includes the total Day Fill Volume and Night Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is...

Page 108: ...for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able to communicate essential information to their caregiver during treatm...

Page 109: ...Exceeding this volume can result in an increased intraperitoneal volume IIPV situation IIPV could result in a feeling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms...

Page 110: ...is 3000 mL Default setting is 0 mL Setting increments 10 in the 100 to 500 mL range 50 in the 500 to 1000 mL range 100 in the 1000 to 3000 mL range Dextrose default setting or The Last Fill Volume can...

Page 111: ...u press STOP after you have completed reviewing your therapy settings Table 9 6 Definitions for Hi Dose CCPD Calculated Settings Settings Description Cycles Total number of cycles at night not includi...

Page 112: ...a high number of cycles IIPV could result in a feeling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to moni...

Page 113: ...ycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000 mL range 100 in the 2000 to 5000 mL range 500 in...

Page 114: ...ms for those patients not able to communicate essential information to their caregiver during treatment Fill Volume Volume of solution used for each cycle based on your prescription Minimum setting is...

Page 115: ...ssential information to their caregiver during treatment Total UF Total ultrafiltration UF expected for the therapy The system calculates the UF Per Cycle The UF Per Cycle plus the Tidal Volume is the...

Page 116: ...on for your Tidal therapy that is different from the solution used in your previous therapy you may need to adjust your Total UF based on the concentration of the new solution Contact your dialysis ce...

Page 117: ...s setting does not appear if LAST FILL VOL 0 This setting only appears if you use Last Fill Full Drains Every The frequency of Full Drains during Tidal therapy Only appears if MODE STANDARD and TIDL F...

Page 118: ...ur therapy settings Table 9 8 Definitions for Tidal Calculated Settings Setting Description Cycles Total number of cycles at night not including the Last Fill This parameter is calculated by the syste...

Page 119: ...number of cycles IIPV could result in a feeling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for...

Page 120: ...Fill Volume and Night Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000 mL ra...

Page 121: ...ose patients not able to communicate essential information to their caregiver during treatment Day Fill Volume Volume of solution for each daytime exchange based on your prescription This setting only...

Page 122: ...g of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able to c...

Page 123: ...ing each cycle This is expressed as a percentage of the initial Fill Volume Minimum setting is 5 Maximum setting is 95 Default setting is 5 Setting increment is 5 h NOTE When the Therapy type is chang...

Page 124: ...ntial information to their caregiver during treatment Night UF Total ultrafiltration UF expected for the therapy The system calculates the UF Per Cycle The UF Per Cycle plus the Tidal Volume is the am...

Page 125: ...or your Tidal therapy that is different from the solution used in your previous therapy you may need to adjust your Total UF based on the concentration of the new solution Contact your dialysis center...

Page 126: ...tting does not appear if LAST FILL VOL 0 This setting only appears if you use Last Fill Full Drains Every The frequency of Full Drains during Tidal therapy Only appears if MODE STANDARD and TIDL FULL...

Page 127: ...herapy settings Table 9 10 Definitions for Hi Dose Tidal Calculated Settings Setting Description Cycles Total number of cycles at night not including the Last Fill This parameter is calculated by the...

Page 128: ...LOW DRAIN VOLUME and CAUTION NEGATIVE UF alarms These alarms can not be bypassed to prevent an increased intraperitoneal volume IIPV situation in Low Fill Mode The Negative UF Limit should not be rai...

Page 129: ...therapy Includes the total Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000...

Page 130: ...eeling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able...

Page 131: ...tting is 1000 mL Default setting is 0 mL Setting increments 1 in the 60 to 100 mL range 10 in the 100 to 500 mL range 50 in the 500 to 1000 mL range Dextrose default setting or The Last Fill Volume ca...

Page 132: ...u press STOP after you have completed reviewing your therapy settings Table 9 12 Definitions for CCPD IPD Calculated Settings Setting Description Cycles Total number of cycles at night not including t...

Page 133: ...NEGATIVE UF alarms These alarms can not be bypassed to prevent an increased intraperitoneal volume IIPV situation in Low Fill Mode The Negative UF Limit should not be raised above 50 and the Minimum...

Page 134: ...l Volume and Night Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000 mL range...

Page 135: ...ptoms for those patients not able to communicate essential information to their caregiver during treatment Day Fill Volume Volume of solution for each daytime exchange based on your prescription This...

Page 136: ...ling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able t...

Page 137: ...ing is 1000 mL Default setting is 0 mL Setting increments 1 in the 60 to 100 mL range 10 in the 100 to 500 mL range 50 in the 500 to 1000 mL range Dextrose default setting or The Last Fill Volume can...

Page 138: ...u press STOP after you have completed reviewing your therapy settings Table 9 14 Definitions for Hi Dose CCPD Calculated Settings Setting Description Cycles Total number of cycles at night not includi...

Page 139: ...tons during successive Tidal Dwell cycles can lead to a gradual increase in intraperitoneal volume IPV An increased intraperitoneal volume IIPV situation can result for patients with a low Fill Volume...

Page 140: ...egative UF Limit should not be raised above 50 and the Minimum Drain Volume should not be lowered below 85 the default values It is required that the Low Recirculation Volume Set be used with Low Fill...

Page 141: ...cles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000 mL range 100 in the 2000 to 20000 mL range 500 in...

Page 142: ...a feeling of abdominal discomfort serious injury or death See page 18 58 for IIPV symptoms or if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not...

Page 143: ...lled during each cycle This is expressed as a percentage of the initial Fill Volume Minimum setting is 5 Maximum setting is 95 Default setting is 5 Setting increment is 5 h NOTE When the Therapy type...

Page 144: ...ssential information to their caregiver during treatment Total UF Total ultrafiltration UF expected for the therapy The system calculates the UF Per Cycle The UF Per Cycle plus the Tidal Volume is the...

Page 145: ...olution for your Tidal therapy that is different from the solution used in your previous therapy you may need to adjust your Total UF based on the concentration of the new solution Contact your dialys...

Page 146: ...ll Drains is enabled in the Nurse s Menu by your nurse Minimum setting is 1 Maximum setting is 99 Default setting is 1 Setting increment is 1 h NOTE The Full Drains Every setting always defaults to 1...

Page 147: ...therapy settings Table 9 16 Definitions for Tidal Calculated Settings Setting Description Cycles Total number of cycles at night not including the Last Fill This parameter is calculated by the system...

Page 148: ...ttons during successive Tidal Dwell cycles can lead to a gradual increase in intraperitoneal volume IPV An increased intraperitoneal volume IIPV situation can result for patients with a low Fill Volum...

Page 149: ...he Negative UF Limit should not be raised above 50 and the Minimum Drain Volume should not be lowered below 85 the default values It is required that the Low Recirculation Volume Set be used with Low...

Page 150: ...l Volume and Night Fill Volume for all cycles and the Last Fill Volume Minimum setting is 200 mL Maximum setting is 80000 mL Default setting is 200 mL Setting increments 50 in the 200 to 2000 mL range...

Page 151: ...ose patients not able to communicate essential information to their caregiver during treatment Day Fill Volume Volume of solution for each daytime exchange This parameter appears only when the Number...

Page 152: ...those patients not able to communicate essential information to their caregiver during treatment Night Fill Volume Volume of solution used for each cycle based on your prescription Minimum setting is...

Page 153: ...tial information to their caregiver during treatment Night UF Total ultrafiltration UF expected for the therapy The system calculates the UF Per Cycle The UF Per Cycle plus the Tidal Volume is the amo...

Page 154: ...ion for your Tidal therapy that is different from the solution used in your previous therapy you may need to adjust your Total UF based on the concentration of the new solution Contact your dialysis c...

Page 155: ...rains is enabled in the Nurse s Menu by your nurse Minimum setting is 1 Maximum setting is 99 Default setting is 1 Setting increment is 1 h NOTE The Full Drains Every setting always defaults to 1 when...

Page 156: ...herapy settings Table 9 18 Definitions for Hi Dose Tidal Calculated Settings Setting Description Cycles Total number of cycles at night not including the Last Fill This parameter is calculated by the...

Page 157: ...Section 10 Operating Instructions Make Adjustments 10 Make Adjustments...

Page 158: ...Adjust Loudness Auto Dim Set Clock Set Date I Drain Time Low Fill Mode only I Drain Alarm Comfort Control Last Manual Drain UF Target and Alarm 10 1 1 Changing Settings The settings for these options...

Page 159: ...DJUST BRIGHTNESS appears 4 If you do not want to change this setting press V to see the next option 5 Press ENTER to select the setting you want to change The option or value blinks 6 Press U and V to...

Page 160: ...DJUST BRIGHTNESS is the first option 3 Press ENTER The display screen blinks The display screen blinks 4 Press U or V The brightness of the display screen will change as you press U or V 5 Press ENTER...

Page 161: ...ss V until ADJUST LOUDNESS appears 3 Press ENTER The display screen blinks The display screen blinks 4 Press U or V The loudness of the beep will change as you press U or V 5 Press ENTER to save the n...

Page 162: ...to change the Auto Dim option hNOTE AUTO DIM will not operate when the display screen is showing the current time or estimated treatment end time Steps to set Auto Dim Display screen 1 Press ENTER to...

Page 163: ...U or V to change the hour 5 Press ENTER to save the hour The minute digits then blink The minutes blink 6 Press U or V to change the minutes 7 Press ENTER to save the minutes AM PM then blinks AM PM...

Page 164: ...the day 5 Press ENTER to save the new day The month then blinks The month blinks 6 Press U or V to change the month 7 Press ENTER to save the new month The year then blinks The year blinks 8 Press U...

Page 165: ...Display screen 1 Press ENTER to access the MAKE ADJUSTMENTS menu 2 Press V until I DRAIN TIME appears 3 Press ENTER The digits blink The digits blink 4 Press U or V to change the minutes 30 minutes i...

Page 166: ...incomplete Initial Drain followed by a full Fill This can result in an increased intraperitoneal volume IIPV situation See Table 10 1 on page 10 11 for the recommended starting points when determinin...

Page 167: ...of the Last Fill Volume WARNING Patients whose Fill volumes are less than 1000 mL may normally drain slowly These patients typically weigh less than 44 lbs 20 kg Use of the Low Fill Mode minimizes th...

Page 168: ...HomeChoice APD System moves on to Fill when a No Flow condition occurs Baxter recommends that this setting not be used since there is no Minimum Drain Volume requirement A LOW DRAIN VOLUME alarm is po...

Page 169: ...ars 3 Press ENTER The volume digits blink The volume blinks 4 Press U or V to change the setting 5 Press ENTER to save the new Initial Drain Alarm volume The blinking stops Blinking stops 6 Press V to...

Page 170: ...s ENTER to access the MAKE ADJUSTMENTS menu 2 Press V until COMFORT CONTROL appears 3 Press ENTER The temperature digits blink The temperature blinks 4 Press U or Vto change the temperature 5 Press EN...

Page 171: ...tion you may want to change position before the Last Fill is performed by the system Follow the steps below to set Last Manual Drain hNOTE If a LAST MANUAL DRAIN is set to YES a UF Target and a UF Ala...

Page 172: ...py see 19 17 Determining Tidal Total UF and Last Manual Drain UF Target Volume Settings on page 19 18 If the accumulated UF for the therapy including nighttime UF and Hi Dose UF is below the UF Target...

Page 173: ...n and initiate a Manual Drain Steps to set UF Target Display screen If LAST MANUAL DRAIN is set to YES 1 Press V to display the UF TARGET screen 2 Press ENTER The volume digits blink The volume blinks...

Page 174: ...Section 11 Operating Instructions Prepare for Therapy 11 Prepare for Therapy...

Page 175: ...her all the supplies necessary for your dialysis treatment Figure 11 1 Supplies 1 Solution Bags 2 Disposable Set Luer shown Standard set for Fill volumes above 1000 mL Low Recirculation Volume set for...

Page 176: ...s length increases the recirculation volume and reduces therapy effectiveness WARNING Do not use a Patient Line Extension Set if tip protectors are not in place If the tip protectors are not secure po...

Page 177: ...inadequate therapy or contamination of the fluid lines Contamination of any portion of the fluid or fluid path can result in peritonitis Contact Baxter or your dialysis center to report any problems...

Page 178: ...to prepare your solution bags Steps to prepare solution bags 1 Check each solution bag Remove the overpouch protective wrapping and check the following The solution is clear The solution matches the p...

Page 179: ...n throughout the treatment hNOTE Please read Section 3 Warnings and Cautions before you turn on your HomeChoice or HomeChoice PRO APD System the system Steps to turn on the system 1 Plug the power cor...

Page 180: ...for several seconds h NOTE If the display performs differently than stated in Steps 4 5 and 6 contact Baxter Technical Assistance h NOTE If your dialysis center is using the HomeChoice PRO APD System...

Page 181: ...the previous menu Table 11 1 Options Available at Startup Option Description Start Setup Shows that the system is ready for you to begin preparing for your treatment Change Program OR Review Program...

Page 182: ...evious menu If this value is lower than usual or negative temporarily increase your I Drain Alarm setting when Verify I Drain is displayed prior to the start of the Initial Drain This ensures a comple...

Page 183: ...odem Connect Press ENTER to begin a modem data transfer See 8 4 Install the Modem Option on page 8 14 for details Current Time Shows the current time See 10 2 4 Set Clock on page 10 6 if you need to c...

Page 184: ...to your peritoneal cavity This can result in shoulder and abdominal pain This can also result in an increased intraperitoneal volume IIPV situation if you had fluid in your peritoneal cavity prior to...

Page 185: ...flexible surfaces of the cassette for obvious signs of damage including cuts tears or punctures Ensure the tip protectors on the ends of the tubing are on and unbroken If damage is found obtain a new...

Page 186: ...ill Volume is less than 1000 mL and you are not using the Low Fill Mode If this occurs call your dialysis center to see if your treatment should be performed in the Low Fill Mode Otherwise if you are...

Page 187: ...yourself only when CONNECT YOURSELF appears on the display screen 7 Press down the handle to close and lock the door h NOTE Do not open the door until ending therapy 8 Place the organizer a Place the...

Page 188: ...prevents non sterile fluid from flowing backwards up the drain line Non sterile fluid can contaminate the fluid path resulting in peritonitis Steps to attach a drain option 1 Attach your drain option...

Page 189: ...G If you use a Last Fill with a different solution the line with the BLUE clamp must be connected to the Last Fill solution bag If the solution concentration is incorrect or the wrong solution is conn...

Page 190: ...or disinfect your hands thoroughly WARNING Do not use a Patient Line Extension with the Low Recirculation Set Using an extension with this set increases the recirculation volume and reduces therapy ef...

Page 191: ...ny unused lines in the organizer with clamps closed 7 Review your connections to make sure that a The line with the RED clamp is connected to the solution bag on the heater pan b The solution bag on t...

Page 192: ...until CONNECT YOURSELF appears on the display screen WARNING Failure to open the clamp on the patient line after connecting the solution bags will prevent the patient line from being primed This can...

Page 193: ...taken to monitor for IIPV symptoms for those patients not able to communicate essential information to their caregiver during treatment WARNING Do not use a Patient Line Extension with the Low Recircu...

Page 194: ...ates between CONNECT YOURSELF and CHECK PATIENT LINE 5 Verify that the patient line is properly primed 6 Before you wash your hands and connect yourself a Make sure fluid is present near the connector...

Page 195: ...pen Verify that the end of the patient line or the end of the Patient Extension Line when an extension is used is placed in the left slot in the blue organizer Before connecting yourself Verify that t...

Page 196: ...le set is already present in the system after a power failure CLOSE ALL CLAMPS before you press GO to start your therapy This prevents flow of fluid from one bag to another and or to the patient durin...

Page 197: ...rime the patient line 1 Press STOP when the display screen alternates between CONNECT YOURSELF and CHECK PATIENT LINE 2 Press V until REPRIME PATIENT LINE appears 3 Press ENTER 4 Verify that the patie...

Page 198: ...ur dialysis center when handling lines and solution bags to reduce the possibility of infection Always put on a face mask and wash and dry or disinfect your hands thoroughly Steps to connect yourself...

Page 199: ...nsfer set to the patient line a Remove pull ring from patient line connector b Remove cap from transfer set and immediately connect to the patient line connector 6 Open the transfer set 7 Press GO to...

Page 200: ...11 Operating Instructions Prepare for Therapy 11 26 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 201: ...Section 12 Operating Instructions Perform Therapy 12 Perform Therapy...

Page 202: ...ty hNOTE Change position if the Drain stops and you believe that you are not empty Fluid may have pocketed near your catheter and changing positions can assist draining WARNING Do not replace empty so...

Page 203: ...fluid left in the peritoneal cavity can result in an increased intraperitoneal volume IIPV situation later in your therapy Change your position or sit up to aid draining completely during the Initial...

Page 204: ...you normally have a dry day Baxter recommends it be set to a value greater than zero 0 If your patient line is greater than 12 feet 3 6 meters in length set the I Drain Alarm to at least 30 mL This i...

Page 205: ...view each option 2 Press ENTER to select an option 3 Press STOP to return to the previous menu Table 12 1 Options Available During Initial Drain Option Description Drain Volume Initial Drain Volume u...

Page 206: ...TER to select an option 3 Press STOP to return to the previous menu WARNING IIPV could result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects...

Page 207: ...al therapy UF updated after each Drain is completed Press ENTER to review cycle by cycle information Press STOP to return to the previous menu Average Dwell Time Average actual Dwell Time for your tre...

Page 208: ...the bloodstream through the peritoneal membrane and into the dialysis solution It is during the Dwell phase that the cycler pulls fluid from the supply bags to replenish the heater bag and warm the s...

Page 209: ...y UF updated after each Drain is completed Press ENTER to review cycle by cycle information Press STOP to return to the previous menu Average Dwell Time Average actual Dwell Time for your treatment Pr...

Page 210: ...neal cavity and result in an increased intraperitoneal volume IIPV situation IIPV could result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects...

Page 211: ...apy UF updated after each Drain is completed Press ENTER to review cycle by cycle information Press STOP to return to the previous menu Average Dwell Time Average actual Dwell Time for your treatment...

Page 212: ...your therapy STOPPED and the current phase appears on your display screen 12 5 1 Menu Options When STOP is Pressed This sample screen shows that STOP was pressed during the Fill phase Table 12 5 lists...

Page 213: ...REVIEW PROGRAM appears if the program is locked See Section 9 Operating Instructions Change Program for instructions Make Adjustments If you want to adjust system settings See Section 10 Operating Ins...

Page 214: ...may help to improve the quality of your dialysis treatment Flexible length daytime Dwells based on your needs and daytime schedule During the Dwell phase of a daytime exchange you can disconnect from...

Page 215: ...eritoneal Volume IIPV on page 18 58 if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those patients not able to communicate essential information to their caregive...

Page 216: ...12 6 Options Available During Day Dwell Option Description Day Dwell Time The amount of time elapsed during the daytime Dwell Continue Therapy Connect Yourself Press GO twice to drain the Day Fill and...

Page 217: ...Press STOP to return to the previous menu Review Program Allows you to review the programmed treatment Current Time Current time hNOTE If you bypass a Hi Dose daytime exchange the solution volume from...

Page 218: ...ime is reached See 12 7 2 Reconnect and Continue Treatment on page 12 20 h NOTE Do not press V or GO during the last Day Dwell until you are ready to begin your nighttime treatment 5 Press GO The syst...

Page 219: ...nect yourself during Hi Dose Dwell Steps to disconnect during Hi Dose Dwell 1 Close your transfer set 2 Close the clamp on the patient line WARNING Follow aseptic technique taught by your dialysis cen...

Page 220: ...er set from the patient line of the disposable set 6 Place the patient line back on the organizer 7 Immediately place the MiniCap disconnect cap on the transfer set Tighten the MiniCap until fully sec...

Page 221: ...prepare the room for reconnect h NOTE Do not press V or GO during the last Day Dwell until you are ready to begin your night treatment 3 Press V 4 Press GO The system reminds you to connect yourself...

Page 222: ...ap from the transfer set connector 8 Immediately connect the patient line connector to the transfer set 9 Open the patient line clamp 10 Open the transfer set 11 Press GO The system automatically begi...

Page 223: ...12 Operating Instructions Perform Therapy 12 22 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 224: ...Section 13 Operating Instructions End Therapy 13 End Therapy...

Page 225: ...ter if you had an incomplete treatment skipped the prescribed Last Fill or in other situations as instructed by your clinician Multiple incomplete or skipped treatments can cause reduced Dwell or Ther...

Page 226: ...the TOTAL UF for the therapy h NOTE A low or negative Total UF at the end of a therapy may indicate your last Drain was incomplete and too much fluid may still remain in your peritoneal cavity Make su...

Page 227: ...n result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP immediately then press V and initi...

Page 228: ...you have not viewed this information the system will beep and display the Lost Dwell Time 10 Press V Press ENTER to select MANUAL DRAIN 11 Press V Press ENTER to review the 20 most recent alarms Pres...

Page 229: ...the patient has IIPV during a treatment press STOP immediately then press V and initiate a Manual Drain The Manual Drain procedure is located in 18 5 Manual Drain Procedure on page 18 53 See 18 8 Inc...

Page 230: ...w aseptic technique taught by your dialysis center when handling lines and solution bags to reduce the possibility of infection Always put on a face mask and wash and dry or disinfect your hands thoro...

Page 231: ...e disposable set 4 Place the patient line back on the organizer 5 Immediately place the MiniCap disconnect cap on the transfer set 6 Tighten the MiniCap until fully secured WARNING Do NOT press GO aga...

Page 232: ...bag to another and or to the patient Uncontrolled gravity flow of fluid can result in an increased intraperitoneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort serious i...

Page 233: ...tween CLOSE ALL CLAMPS and DISCONNECT YOURSELF The occluder behind door retracts for 2 minutes 30 seconds for Low Fill Mode to allow removal of the cassette 2 Lift the latch up to unlock and open door...

Page 234: ...uring End of Therapy Table 13 1 lists the options you can select during END OF THERAPY 1 Press V to view each option 2 Press ENTER to select an option 3 Press STOP to return to the previous menu 5 Pre...

Page 235: ...A lower than usual or negative Total UF at the end of a therapy may indicate that your last Drain was incomplete The Last Manual Drain option should be turned ON and a UF Target programmed with a val...

Page 236: ...lculated at the beginning of therapy This message displays automatically if Lost Dwell is 30 minutes or greater and you have not viewed this information Manual Drain Press ENTER to select Alarm Log Pr...

Page 237: ...Section 14 Operating Instructions Effluent Sampling 14 Effluent Sampling...

Page 238: ...ampling 14 1 Introduction An effluent sample is a small amount of solution that has been drained from the peritoneal cavity during your regular drain Your dialysis nurse will tell you how often you sh...

Page 239: ...e WARNING Follow aseptic technique taught by your dialysis center when handling lines and solution bags to reduce the possibility of infection Always put on a face mask and wash and dry or disinfect y...

Page 240: ...s Effluent Sampling 4 Prepare the sampling site Make sure the clamp is closed on the sampling line 5 Remove the cap from the effluent sample bag Save the cap to recap the connectors 6 Remove the cap f...

Page 241: ...t Home Guide October 2 2009 07 19 61 244 7 Connect the effluent sample bag and position the bag below the level of the drain line 8 After draining for 2 or 3 minutes open the clamps 9 When the effluen...

Page 242: ...me Guide 14 5 14 Operating Instructions Effluent Sampling 10 Disconnect the effluent sample bag from the drain line and recap the connectors hNOTE Follow your dialysis nurse s instructions for handlin...

Page 243: ...14 Operating Instructions Effluent Sampling 14 6 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 244: ...Section 15 Cleaning 15 Cleaning...

Page 245: ...iseptic containing alcohol to the disposable set or to the cassette interface inside the door of the cycler Using these products can cause the cassette to develop cracks CAUTION Do not use chemical cl...

Page 246: ...or other AC power source before cleaning the system Failure to do so can cause an electric shock Steps to clean the cycler 1 Turn the cycler off 2 Unplug the cycler from the power source 3 Use a smal...

Page 247: ...umbers to Call for Assistance on page 2 1 IMPORTANT Return this cycler to your dialysis center or to Baxter by calling Baxter Technical Assistance Steps to prepare the cycler for return 1 Put on prote...

Page 248: ...15 Cleaning 15 4 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 249: ...Section 16 Maintenance 16 Maintenance...

Page 250: ...1 Maintenance A regular maintenance schedule is not needed The HomeChoice HomeChoice PRO APD System monitors itself It will notify you if service is needed The battery pack is automatically checked a...

Page 251: ...16 Maintenance 16 2 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 252: ...Section 17 Storage 17 Storage...

Page 253: ...500 m 17 2 Battery If the cycler is not used for more than 12 months the battery pack must be removed This must be done by a qualified Baxter service representative See 2 2 Numbers to Call for Assist...

Page 254: ...17 Storage 17 2 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 255: ...Section 18 Troubleshooting 18 Troubleshooting...

Page 256: ...alphabetical list of alarm messages and special procedures contained in this section hNOTE Alarms pertaining to the PRO Card are described in 8 3 Display Messages on page 8 11 Alarm Messages Page Cau...

Page 257: ...18 11 Load a New Set 18 12 Load New Set Bags 18 12 Low UF 18 13 Low Drain Volume 18 15 Machine Tilted 18 20 Refill Not Finished 18 11 Reload the Set 18 26 Slow Flow Drain 18 19 Slow Flow Heater 18 19...

Page 258: ...monitors the internal system Whenever the system finds an issue it will Sound an alarm Stop moving solution in some circumstances Display the type of alarm Record the issue on the PRO Card if applicab...

Page 259: ...e alarm continues the system beeps 6 times then continues therapy After an Auto Restart Alarm occurs twice the alarm becomes a Manual Restart Alarm Manual Restart These alarms must be corrected by fol...

Page 260: ...e fluid or fluid path can result in peritonitis If a bag becomes disconnected during your therapy follow the End Therapy Early procedure Discard the disposable set and all solution bags at the end of...

Page 261: ...bags 2 Correct the issue you found You do not need to press any buttons OR If the alarm becomes a Manual Restart Alarm 1 Press STOP to mute the alarm 2 Check the line referenced on the display screen...

Page 262: ...n shoulder and abdominal pain This can also result in an increased intraperitoneal volume IIPV situation if you had fluid in your peritoneal cavity prior to the Initial Drain IIPV can result in a feel...

Page 263: ...n the clamp until after you press ENTER 4 When the Manual Drain ends STOPPED FILL appears 5 Press GO to resume Fill Cause 3 CHECK HEATER LINE appears at start of FILL 1 only The pump chambers are not...

Page 264: ...itis If a bag becomes disconnected during your therapy follow the End Therapy Early procedure Discard the disposable set and all solution bags at the end of therapy See 18 6 End Therapy Early Procedur...

Page 265: ...g a HomeChoice HomeChoice PRO APD System for the first time this alarm occurs to remind you to program your therapy This is a Manual Restart Alarm To Correct 1 Press STOP to mute the alarm The display...

Page 266: ...ing a treatment press STOP immediately then press V and initiate a Manual Drain The Manual Drain procedure is located in 18 5 Manual Drain Procedure on page 18 53 See 18 8 Increased Intraperitoneal Vo...

Page 267: ...een shows BYPASS 4 Press ENTER to select BYPASS You have bypassed the alarm or phase and moved to the next phase in your therapy LOAD A NEW SET Display Message Cause The disposable set has failed test...

Page 268: ...y then press V and initiate a Manual Drain The Manual Drain procedure is located in 18 5 Manual Drain Procedure on page 18 53 See 18 8 Increased Intraperitoneal Volume IIPV on page 18 58 if IIPV is su...

Page 269: ...er to learn when it is safe to bypass To bypass the alarm see Steps to bypass LOW UF alarm below Initiate a Manual Drain Steps to bypass LOW UF alarm Display screen 1 Press STOP alternates with 2 Pres...

Page 270: ...ort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP immediately then press V and initiate a Manual Drain The Manual Drain proced...

Page 271: ...position to try to drain more fluid 2 Check for kinks in your patient line 3 Correct the problem you found You do not need to press any buttons OR If the alarm becomes a Manual Restart Alarm 1 Press S...

Page 272: ...ed in 18 5 Manual Drain Procedure on page 18 53 See 18 8 Increased Intraperitoneal Volume IIPV on page 18 58 if IIPV is suspected Additional care should be taken to monitor for IIPV symptoms for those...

Page 273: ...inician instructs you to do so Contact your dialysis center to learn when it is safe to bypass You have bypassed the LOW DRAIN VOLUME alarm The next FILL begins h NOTE Do NOT bypass if you have a Nega...

Page 274: ...rm To Correct 1 Check the line shown in the display for Kinks Closed clamps Fibrin blockage Disconnected solution bags Empty solution bags 2 Correct the problem you found You do not need to press any...

Page 275: ...cycler is tilted If this alarm occurs during therapy it is a Auto Restart Alarm To Correct 1 Make sure that the system is on a flat surface and is not tilted OR If the alarm becomes a Manual Restart...

Page 276: ...r bag is being heated The message clears 5 five minutes after the heater bag temperature reaches 33 C The message can also appear for an extended period if the heater bag is not in full contact with t...

Page 277: ...te a Manual Drain The Manual Drain procedure is located in 18 5 Manual Drain Procedure on page 18 53 See 18 8 Increased Intraperitoneal Volume IIPV on page 18 58 if IIPV is suspected Additional care s...

Page 278: ...rm can be bypassed only once See 18 4 Bypass Procedures on page 18 37 Steps to check Total UF Display screen 1 Press STOP 2 Press V 3 Press V 4 Press V 5 Check your TOTAL UF 6 Select one of the follow...

Page 279: ...t you are empty The system considers your volume zero 0 and delivers your entire prescribed Fill Volume CHECK YOUR POSITION Message Display Cause 1 Your position is more than one foot 12 inches above...

Page 280: ...n cause air to be delivered to your peritoneal cavity This can result in shoulder and abdominal pain This can also result in an increased intraperitoneal volume IIPV situation if you had fluid in your...

Page 281: ...om one bag to another and or to the patient Uncontrolled gravity flow of fluid can result in an increased intraperitoneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort ser...

Page 282: ...le causes This is a Manual Restart Alarm To Correct 1 Press STOP to mute the alarm 2 CLOSE ALL CLAMPS 3 Open the door 4 Remove the cassette 5 Lift the cassette to drain fluid if it is full 6 Reload th...

Page 283: ...if RELOAD SET 201 occurs and fluid flows from the patient line Non sterile air in the peritoneal cavity can cause peritonitis Air in the peritoneal cavity can cause abdominal and or shoulder pain 201...

Page 284: ...either the current cycle or over the course of several cycles The allowable volume can be set between 0 zero and 5000 mL This is a Manual Restart Alarm To Correct 1 Press STOP to mute the alarm 2 Pres...

Page 285: ...u have permanently changed the Initial Drain Alarm setting for this therapy and all future therapy sessions Cause 2 The I Drain Alarm setting is lower than expected To Correct Cause 2 1 Press STOP and...

Page 286: ...er and or to the patient Uncontrolled gravity flow of fluid can result in an increased intraperitoneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort serious injury or deat...

Page 287: ...nclamped unused supply lines if the tip protector has been disrupted Use of Dummy Tummy during training To Correct 1 Press STOP to mute the alarm 2 Write down the System Error number and treatment pha...

Page 288: ...increased intraperitoneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a...

Page 289: ...er Technical Assistance at the number listed in 2 2 Numbers to Call for Assistance on page 2 1 4 Follow the instructions from Baxter Technical Assistance Your next steps will vary as shown in Table 18...

Page 290: ...the bag heater off is raising the solution bag temperature too high to deliver safe fluids to you To Correct 1 Press the power switch OFF 2 Allow the system to cool for 10 to 20 minutes Bags containi...

Page 291: ...ycler if it is in direct sunlight Opening windows in the room Turning on a window fan and directing the flow toward the cycler Turning on an air conditioner if one is available The use of an empty hea...

Page 292: ...l Drain IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP immediately then pr...

Page 293: ...h NOTE The Manual Drain can facilitate obtaining a complete Initial Drain If a Manual Drain ends due to Slow No Flow the system will revert to STOPPED DRAIN without alarming OR a Press V until MANUAL...

Page 294: ...ring the Initial Drain IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP imme...

Page 295: ...o bypass h NOTE When a Manual Drain ends due to low or No Flow conditions LOW DRAIN VOLUME alternates with INITIAL DRAIN on the display screen alternates with OR a Press ENTER to bypass the I Drain Al...

Page 296: ...cavity and result in an increased intraperitoneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the p...

Page 297: ...is shown 5 Press V 6 Press ENTER The next FILL will begin It will be a full Fill if no alarm occurred OR If the volume drained is less than your Minimum Drain Volume a DRAIN NOT FINISHED alarm appear...

Page 298: ...toneal volume IIPV situation IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STO...

Page 299: ...racted from your Fill Volume Your next Fill is reduced by this difference If this alarm occurs during Initial Drain DRAIN VOLUME ML does not appear 3 Press V The Initial Drain Volume I DRAIN VOL from...

Page 300: ...on IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP immediately then press V...

Page 301: ...in a greater potential for IIPV Press GO to resume Drain IIPV can result in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV...

Page 302: ...ess ENTER to bypass The next FILL begins Your full Fill Volume is delivered If you pressed ENTER and the increase in negative UF exceeds your Negative UF Limit a CAUTION NEGATIVE UF alarm occurs See 1...

Page 303: ...e Drain Press STOP to stop the Drain when no alarm is present Bypass the Drain phase See 18 4 3 Bypass Drain Phase on page 18 41 A DRAIN NOT FINISHED alarm occurs if you have not met your minimum Drai...

Page 304: ...lt in a feeling of abdominal discomfort serious injury or death If any patient or patient caregiver suspects the patient has IIPV during a treatment press STOP immediately then press V and initiate a...

Page 305: ...med at 20 to 60 in the Low Fill Mode 2 Press V h NOTE The amount that your Drain Volume is short of your prescribed Fill Volume is subtracted from the previous Drain Total UF see below to obtain your...

Page 306: ...ur volume zero 0 and delivers your entire prescribed Fill Volume h NOTE Bypassing a CAUTION NEGATIVE UF alarm will temporarily increase your Minimum Drain Volume percentage to 100 of your prescribed F...

Page 307: ...m can not be bypassed To return to Fill follow the steps below Steps to return to Fill Display screen 1 Press STOP alternates with 2 Press GO appears briefly then 3 Press STOP 4 Press V 5 Press ENTER...

Page 308: ...tient has IIPV during a treatment follow the Manual Drain procedure below See 18 8 Increased Intraperitoneal Volume IIPV on page 18 58 for more information Additional care should be taken to monitor f...

Page 309: ...is shown in the menu at the beginning of your next therapy See 11 4 Menu Options at Startup on page 11 7 Fluid drained during all other Manual Drains is included as part of the Total UF for the thera...

Page 310: ...nning of your next therapy If a VERIFY I DRAIN ML prompt appears press STOP and press U or V to increase your I DRAIN ALARM setting to at least 70 of your current expected peritoneal volume for this t...

Page 311: ...o return to the previous menu 8 Press V Average actual Dwell Time for your therapy 9 Press ENTER to review cycle by cycle information Press STOP to return to the previous menu 10 Press V END THE THERA...

Page 312: ...ay screen 1 Press STOP when the display screen alternates between CONNECT YOURSELF and CHECK PATIENT LINE alternates with 2 Press V until REPRIME PATIENT LINE appears 3 Press ENTER 4 Verify that the p...

Page 313: ...d increase in blood pressure IIPV can occur because of one or more of the following reasons Low Fill Mode is not programmed for patients whose fill volumes are less than 1000 mL These patients typical...

Page 314: ...ps first This can cause a free flow of fluid from one bag to another and or to the patient during the time when LOAD THE SET is displayed The door is opened during an alarm or System Error without clo...

Page 315: ...vity IIPV could result in a feeling of abdominal discomfort serious injury or death IF IIPV IS SUSPECTED PLEASE DO THE FOLLOWING 1 Press STOP immediately then press Vand initiate a Manual Drain The Ma...

Page 316: ...play screen 1 Press STOP 2 Press V 3 Press V 4 Press V 5 Press V 6 Press V 7 Press ENTER The display screen shows the Drain volume The system continues to drain until flow is no longer detected 8 Pres...

Page 317: ...LOSE ALL CLAMPS before you press GO to start your therapy This prevents flow of fluid from one bag to another and or to the patient during the time when LOAD THE SET is displayed Uncontrolled gravity...

Page 318: ...n is pressed for two 2 minutes the display turns off Press any button to activate the display again Table 18 3 Options Available During a Power Failure Option Description Power Failure Alarm and Curre...

Page 319: ...rapy after power is restored If the power is not restored within 30 minutes An alarm occurs after 30 minutes without power Press STOP to mute the alarm Press V to retrieve therapy information If power...

Page 320: ...iods of time only Extended time away from the system during therapy can result in Lost Dwell Time If Lost Dwell is 30 minutes or greater a Lost Dwell message appears when therapy is completed WARNING...

Page 321: ...onnect cap and a new MiniCap disconnect cap b Disconnect the transfer set from the patient line c Place the patient line back in the organizer d Cap off the transfer set with a new MiniCap disconnect...

Page 322: ...nd dry or disinfect your hands thoroughly Steps to return to therapy 1 Using aseptic technique prepare to connect a Remove the FlexiCap disconnect cap from the patient line connector b Remove the Mini...

Page 323: ...18 Troubleshooting 18 68 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244...

Page 324: ...Section 19 Technical Data 19 Technical Data...

Page 325: ...rcent of nominal voltage The duration of any voltage disturbance should be less than 5 milliseconds U S Standard Metric Height 7 0 in 17 8 cm Width 19 5 in 49 5 cm Depth 15 7 in 39 9 cm Weight 27 lbs...

Page 326: ...ay Precision Volumetric 1 mL 1 mL Fluid Temperature Control 37 C setpoint typical Normal Ambient Cold Ambient Hot Ambient 93 2 F to 100 4 F 91 4 F to 98 6 F 95 F to 104 F 34 C to 38 C 33 C to 37 C 35...

Page 327: ...ust be followed when installing and putting the system into service Because the intensity of electromagnetic energy is greatest near the source of a transmitting antenna portable and mobile RF communi...

Page 328: ...approved for use with the HomeChoice HomeChoice PRO APD System and comply with current EMC standards Detachable power cord Modem cable WARNING When servicing the cycler use only replacement components...

Page 329: ...idance RF emissions CISPR 11 Group 1 The HomeChoice HomeChoice PRO APD System uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any inte...

Page 330: ...1 kV differential mode 2 kV common mode Mains power quality should be that of a typical public low voltage power supply network that supplies hospitals or buildings used for commercial or domestic pu...

Page 331: ...ommended separation distance in meters m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey a should be less than the compliance level in each frequency range b...

Page 332: ...um output power of the communications equipment Rated maximum output power of transmitter W Separation distance according to frequency of transmitter m 150 kHz to 80 MHz d 3 5 3 80 MHz to 800 MHz d 3...

Page 333: ...9 8 Audible Alarm Silence Period If the user presses the STOP button to silence an alarm and does not take action to clear the alarm the HomeChoice HomeChoice PRO APD System will reactivate the alarm...

Page 334: ...g The patient line is correctly primed when the fluid level is at or near the connector at the end of the patient line The system can not detect whether the patient line is correctly primed Refer to 1...

Page 335: ...me to zero 0 and move on to the Fill phase If No Flow occurs the system checks to see if the No Flow condition also applies to flow to the patient If the No Flow condition applies to both outflow and...

Page 336: ...nt line is not occluded The next Fill begins at this volume Table 19 5 Drain Logic Options FLOW CONDITION VOLUME OF FLUID DRAINED when Flow Condition Occurs Standard Fill Mode Drain Logic Minimum Drai...

Page 337: ...thresholds than the Low Fill Mode 19 14 Replenish Logic 19 14 1 Scheduled Replenish The system uses the first part of each cycle s Dwell Time to transfer solution from the supply bags to the heater b...

Page 338: ...ining Maximum Fill Volume Table 19 7 on page 19 15 allows you to determine the highest Fill Volume that should be programmed for a given dry weight This information allows you to verify that the enter...

Page 339: ...ounds the Fill Volume Limit for 135 pounds is 2800 mL Use a Fill Volume Limit of 3000 mL if your weight is 145 pounds or greater Table 19 7 Determining Maximum Fill Volume Weight Fill Volume Limit Wei...

Page 340: ...column with the desired percentage to find the corresponding Initial Drain Alarm volume setting EXAMPLE If your Last Fill Volume is 2000 mL and you desire a limit that is 85 of the Last Fill Volume y...

Page 341: ...00 1100 1100 1200 1300 1400 1400 260 180 200 210 220 230 250 1600 1100 1200 1300 1400 1400 1500 280 200 210 220 240 250 270 1700 1200 1300 1400 1400 1500 1600 300 210 230 240 260 270 290 1800 1300 140...

Page 342: ...ad across to the column with the desired Total UF volume percentage to find the recommended Total UF volume setting EXAMPLE 1 If your expected Total UF volume for the therapy is 1300 mL and you desire...

Page 343: ...200 200 220 150 170 180 190 200 210 150 150 200 200 200 200 240 170 180 190 200 220 230 150 200 200 200 200 250 260 180 200 210 220 230 250 200 200 200 200 250 250 280 200 210 220 240 250 270 200 200...

Page 344: ...1900 1400 1500 1600 1700 1800 1900 2100 1500 1600 1700 1800 1900 2000 1450 1600 1700 1800 1900 2000 2200 1500 1700 1800 1900 2000 2100 1550 1650 1750 1850 2000 2100 2300 1600 1700 1800 2000 2100 2200...

Page 345: ...Section 20 Quick Reference 20 Quick Reference...

Page 346: ...cedures It should not replace the complete operating instructions contained in the other sections of this guide Read the entire manual before operating the HomeChoice APD System or HomeChoice PRO APD...

Page 347: ...er 2 2009 07 19 61 244 20 1 Prepare for Therapy 1 Gather your supplies 1 Solution Bags 2 Drain Option 3 Disposable Set 4 Disconnect Cap s 5 Face Mask s Patient Line Extension if needed not pictured Ch...

Page 348: ...ialysis fluid WARNING DO NOT use external heating sources i e microwave oven to warm solution bags This can result in overheated solution delivered into your peritoneal cavity 2 Place a solution bag o...

Page 349: ...n peritonitis 4 Prepare the disposable set Open the packaging by grasping the top and pulling down in opposite directions Close all clamps on the disposable set 5 Prepare your drain option For Drain B...

Page 350: ...SE ALL CLAMPS before you press GO This prevents fluid from flowing from one bag to another or to the patient when LOAD THE SET appears The uncontrolled gravity flow of fluid can result in an increased...

Page 351: ...tober 2 2009 07 19 61 244 8 Load the cassette The cassette only fits one way with the lines leading to the right of the cycler Press the handle down to close and lock the door 9 Place the organizer Pl...

Page 352: ...n option Drain Bag close clamp on the short tube to prevent leakage Drain Line Extension remove tip protectors from both ends of drain 11 Attach your drain option 12 Open all drain clamps 13 Press GO...

Page 353: ...is center when handling lines and solution bags to reduce the possibility of infection 14 Put on face mask and wash and dry your hands thoroughly 15 Connect bags Connect the line with the RED clamp to...

Page 354: ...lines connected to solution bags Make sure the patient line is in the left slot of the organizer Open the clamp on the patient line WARNING Failure to open the clamp on the patient line after connecti...

Page 355: ...RSELF and CHECK PATIENT LINE WARNING Verify that the fluid level is at or near the connector at the end of the disposable set patient line Connecting when air is present can result in sterile air bein...

Page 356: ...e 20 11 20 Quick Reference 20 Put on face mask and wash and dry your hands thoroughly 21 Connect yourself Remove the MiniCap from the transfer set Connect the transfer set to the patient line by remov...

Page 357: ...tient At Home Guide October 2 2009 07 19 61 244 22 Press GO Treatment begins with INITIAL DRAIN If you perform a Hi Dose therapy skip to 20 2 Perform a Hi Dose Therapy If you are not performing a Hi D...

Page 358: ...009 HomeChoice APD Systems Patient At Home Guide 20 13 20 Quick Reference 20 2 Perform a Hi Dose Therapy 1 Hi Dose therapy begins when INITIAL DRAIN is complete 2 DAY FILL begins automatically when IN...

Page 359: ...Y DWELL you may choose to disconnect yourself from the cycler 4 If you choose to disconnect yourself Close the transfer set Clamp the patient line Disconnect the transfer set from the patient line Con...

Page 360: ...eChoice APD Systems Patient At Home Guide 20 15 20 Quick Reference 5 Press V to display the elapsed Dwell Time in hours and minutes 6 When you are ready to continue your therapy press V until the disp...

Page 361: ...k Reference 20 16 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244 7 Press GO and the system prompts you to CONNECT YOURSELF 8 Put on face mask and wash and dry your hands thor...

Page 362: ...rence 9 Connect yourself Remove the MiniCap disconnect cap from the transfer set Remove the FlexiCap disconnect cap from the patient line Connect the transfer set to the patient line Open the transfer...

Page 363: ...8 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244 11 When DAY DRAIN 1 is complete the nighttime therapy begins with FILL 1 OR If more than one Hi Dose exchange is programmed t...

Page 364: ...nce 20 3 End Therapy 1 The HomeChoice APD System tells you when your therapy is complete 2 Press V to view the end of therapy summary information 3 Write the following on your treatment record if requ...

Page 365: ...ce 20 20 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244 4 Press GO CLOSE ALL CLAMPS appears on the display screen 5 Close all clamps 6 Put on face mask and wash and dry your...

Page 366: ...2 2009 HomeChoice APD Systems Patient At Home Guide 20 21 20 Quick Reference 7 Open a new MiniCap disconnect cap 8 Disconnect the transfer set from the patient line 9 Connect a MiniCap disconnect cap...

Page 367: ...Home Guide October 2 2009 07 19 61 244 10 Press GO DISCONNECT YOURSELF appears on the display screen 11 Open the door 12 Remove and discard the disposable set 13 Press GO TURN ME OFF appears on the di...

Page 368: ...Index Index...

Page 369: ...F 18 13 machine tilted 18 20 refill not finished 18 11 reload the set 18 27 slow flow drain 18 19 slow flow heater 18 19 slow flow patient 18 19 slow flow supply 18 19 system error 18 34 system error...

Page 370: ...me 9 6 nite fill volume 9 5 nite therapy time 9 5 therapy 9 5 therapy time 9 5 tidal volume 9 6 total UF 9 6 total volume 9 5 Changing settings 8 7 9 5 Check I Drain volume 9 7 Clamp blue 5 14 5 15 11...

Page 371: ...nitial drain volume 1 6 line 5 14 5 15 line extension 11 12 logic 19 11 manual 12 12 18 53 phase 5 5 volume 1 5 Drain line extension 1 5 3 11 11 1 11 14 Drain logic 19 11 Drain option 5 4 11 12 11 14...

Page 372: ...herapy 12 13 12 16 Hi Dose Tidal 1 3 1 6 5 4 9 25 9 54 Home patients 5 1 Humidity operating 6 1 19 2 storage 17 1 19 2 Hydrogen peroxide 3 10 15 1 Hypothermia 1 6 3 9 I I Drain 1 6 I Drain alarm 9 7 1...

Page 373: ...dal volume percent 9 29 9 58 Night UF 9 30 9 59 Nite 1 7 Nite night therapy time 1 7 Nitrous oxide 3 11 19 2 No flow 1 8 19 11 No PRO card 8 11 Number of day exchanges 8 9 Number of day fills 9 13 9 2...

Page 374: ...prime patient line 11 23 18 57 Return cycler to Baxter 15 3 Returning the cycler 3 15 Reviewprogram 11 7 12 4 12 6 12 8 12 10 12 16 Review settings 11 7 S Sanitizing solution 15 3 Scheduled replenish...

Page 375: ...PD 1 11 5 4 Tidal volume 1 11 9 24 9 53 Tidal volume percentage 1 11 9 20 9 49 Tip protectors 3 10 Total UF 1 11 9 21 9 50 12 6 12 8 12 10 12 15 13 11 Total volume 1 11 9 9 TPD 1 11 Training 4 1 8 1 T...

Page 376: ...Index I 8 HomeChoice APD Systems Patient At Home Guide October 2 2009 07 19 61 244 W Warnings 3 1 4 1 Waste 1 12 WEEE 2002 96 EC 3 15 Weight 8 8...

Page 377: ...enal Division McGaw Park IL 60085 U S A 1 888 736 2543 press 4 24 hour Technical Assistance is available for the HomeChoice and HomeChoice PRO APD Systems at 1 800 553 6898 Software version 10 210 PAT...

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