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AK 96

Dialysis Machine

Operator's Manual

For use with program version 3.xx

Manufacturer:

Gambro Lundia AB
Box 10101
Magistratsvägen 16
SE-220 10 LUND
Sweden
Phone +46 46 169000
www.gambro.com

Questions or comments about this publication can be directed to your local representative or to the manufacturer.

Order number:

MHCEN12239–12/1

HCEN12239 Revision 12.2010

Program version 3.xx

Содержание AK 96

Страница 1: ...might be different in appearance from the exterior described in this manual If there is a difference this is because you are using a previous version of the machine Whenever this asterix symbol appears in the manual it indicates that it is the previous version of the machine The differences are to be found in chapter 2 and 4 Machine in this manual Previous version of the machine ...

Страница 2: ......

Страница 3: ...ambro Lundia AB Box 10101 Magistratsvägen 16 SE 220 10 LUND Sweden Phone 46 46 169000 www gambro com Questions or comments about this publication can be directed to your local representative or to the manufacturer Order number MHCEN12239 12 10 HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 4: ...Bosnia Herzegovina Bulgaria Benelux Belarus China Cuba Czech Republic Germany Algeria Egypt Spain France Croatia Hungary Italy Kyrgyzstan North Korea Kazakstan Liechtenstein Liberia Latvia Morocco Monaco San Marino Tajikistan Ukraine Uzbekistan Vietnam Serbia and Montenegro Canada Japan Sweden and Australia in the name of Gambro Hospal Schweiz AG Gambro AB and Gambro Lundia AB Diascan is a tradema...

Страница 5: ...g 8 Hygiene and Maintenance 9 Technical Data and Speciﬁcations 10 Major Changes in Operator s Manual Part 2 Instructions for Measurement Functions 11 BPM Blood Pressure Monitor option 12 Diascan option Part 3 Alarm Handbook 13 Alarms 14 Attention Alarms Note Please observe that this part of the Operator s manual for the AK 96 dialysis machine is one out of three To assimilate these instructions th...

Страница 6: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 7: ...this Manual 1 8 Symbols within the User Interface 1 8 Symbols fixed on to the Machine 1 9 General Precautions before use 1 11 Intended Use 1 14 Safety Philosophy 1 15 The Preparation of Dialysis Fluid 1 17 Inlet Water Requirements 1 17 Preparation of the Dialysis Fluid 1 17 UFD Ultrafiltered Dialysis Fluid option 1 17 Ultrafilter Frequency of Change 1 17 List of Concentrates Accessories and Dispos...

Страница 8: ...qently when the manual needs to be changed to a more recent version due to updating of the machine program version the complete manual all three parts needs to be changed at the same time How to ﬁnd what you are looking for To be able to find what you are looking for in this manual first read the brief explanation of how the chapters are structured and intended to be used further on in this sectio...

Страница 9: ...nues with how to attach the dialyzer and the blood lines the priming procedure starting the treatment and setting of parameters It finishes with the discontinuing procedure Chapter 5 Hemodialysis Single Needle Treatment option This chapter contains instructions on how to perform hemodialysis with one needle The chapter is based on chapter 4 Hemodialysis Double Needle Treatment starting on page 4 1...

Страница 10: ... BPM button and the BPM screens and also describes the alarm function The BPM can be used manually if only one measurement check is to be done or at set intervals during treatment Chapter 12 Diascan function option This chapter contains instructions on how to use the Diascan function which measures clearance K and dialysis dose Kt or Kt V The chapter is divided into two parts where the first secti...

Страница 11: ...Caution CAUTION Is used to alert the user operator to take a certain action to protect against a possible hazard which if ignored could have an adverse effect on the patient or the equipment A caution may also be used to alert the user operator not to take a certain action to avoid the potential hazard as above CAUTION Note Note A reminder to the user operator on normal treatment activity and on w...

Страница 12: ...on the AK 96 dialysis machine and has received a Gambro certificate or has gained equivalent knowledge in some other way Machine Whenever the word Machine is used within this manual machine always refers to the AK 96 dialysis machine if no other is written Manual Whenever the word Manual is used within this manual manual always refers to this Operator s Manual for the AK 96 dialysis machine if no ...

Страница 13: ...row appears in figures when something is to be pressed in or pulled out The point where the arrow points to is the pressure pulling point In addition to highlight certain items the details that the describing text in the instructions aims at are highlighted in gray in the corresponding figure The buttons on the operator s panel light up in different situations to guide the operator or to inform of...

Страница 14: ...when there is more important information to be read on the following page there is not enough room for all assembled information on the same page Please continue your reading to obtain the complete information In lists different icons in front of the items show how the lists are to be used 1 A numbered list is to be followed from the beginning to the end This kind of list mostly appears in handlin...

Страница 15: ...ng Symbol Description Alternating current Protective earth ground Warning consult accompanying documents Off power disconnection from the mains On power connection to the mains Type B applied part NIBP type BF applied part defibrillator proof Do not stack Fragile Handle with care HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Before you get started 1 9 ...

Страница 16: ... cause electric shock or burn The label is yellow with a black frame and icon This symbol is a warning label not to tilt the machine through an angle of more than 5 WARNING If a remote operator s panel has been installed ﬂuid bags must be removed from the infusion pole or placed on the top tray when transporting moving the machine WARNING 1 10 AK 96 Operator s Manual Before you get started HCEN122...

Страница 17: ...erator should pay attention to all appropriate alarms and follow the instructions warnings cautions and notes given in this manual It is imperative that the machine has passed the function check before connecting to a patient During installation all calibration checks must be completed before the machine is used for dialysis treatment The AK 96 dialysis machine needs special precautions regarding ...

Страница 18: ...6 dialysis machine and the potential equalization bus bar in the electrical installation Potential equalisation also has to be used when legal requirements of the installation place requires it To minimize the leakage currents from other electrical equipment it is recommended to place such equipment outside the patient area Any equipment within the patient area shall fulﬁl the IEC 60601 1 and IEC ...

Страница 19: ... followed For the authorized technician the Service Manual for the AK 96 dialysis machine is available The Service Manual provides all of the necessary information for installation and safe and required maintenance of the machine It is important that the protective earth in the installation is of high quality For the purpose of protecting the environment the AK 96 dialysis machine must not be disp...

Страница 20: ...irection and supervision of the physician prescribing the treatment Gambro speciﬁcally denies any responsibility for patient education counselling or home care and medical maintenance When the AK 96 dialysis machine is used to produce bicarbonate containing dialysis ﬂuid originating from non liquid concentrates the AK 96 dialysis machine is designed and validated for use with the Gambro BiCart car...

Страница 21: ...amp prevent the dialysis fluid from reaching the dialyzer and alert the operator with sound and light There is a risk that the blood of the patient may be contaminated with bacteria and endotoxins due to transport of undesired substances from the dialysis fluid compartment to the blood compartment of the dialyzer This risk is reduced by using intact dialyzers high inlet water quality high quality ...

Страница 22: ...to detect transparency no blood and non transparency blood before each treatment If the system cannot detect these states it is impossible to start the treatment Air detector The air detector utilizes an ultrasonic sound sensing system in which the transmitter is handled by one microprocessor and the receiver is handled by both microprocessors in the protective system The system is tested pre trea...

Страница 23: ...as the BiCart cartridge It can also be made from an acidic A concentrate and a liquid bicarbonate B concentrate or from an acetate concentrate See Concentrates on page 1 19 in part 1 UFD Ultraﬁltered Dialysis Fluid option The AK 96 dialysis machine can be equipped with a holder in which an ultrafilter can be mounted The ultrafilter purifies the dialysis fluid from possible contamination by bacteri...

Страница 24: ...concentrates accessories or disposables other than those speciﬁed as follows Depending on the circumstances use of concentrates accessories or disposables other than those speciﬁed may also reduce Gambro s warranties for the AK 96 dialysis machine Observe the manufacturer s instructions for use regarding single use of blood lines and dialyzers CAUTION Note The user should make sure to have a curre...

Страница 25: ...eries 8xx series Liquid A concentrate for preparation of bicarbonate dialysis fluid together with BiCart cartridge or with bicarbonate hemodialysis concentrate D 200 Sodium bicarbonate 8 4 3xx series Liquid A and B concentrates for preparation of bicarbonate dialysis fluid Non liquid concentrates Area of use BiCart cartridge Dry bicarbonate concentrate for preparation of bicarbonate dialysis fluid...

Страница 26: ...e especially the Warning text below concerning pediatric blood line set Gambro Blood Tubing System PVC DOA Beta sterilized BL 200 series Arterial and venous blood line set Gambro Accessories C series Hemodialysis accessories C 705 A connection line with an expansion chamber Used in single needle mode WARNING Do not use the pediatric blood lines A 5 128 B4 or V 5 127 X The blood line clamps of the ...

Страница 27: ... e g the maximum UF coefficient and the recommended priming procedure The connectors and the ports of the dialyzer must comply with ISO 8637 and EN 1283 Blood Pressure Measurement Accessories Gambro Cuff Size Adult 23 33 cm Large Adult 31 40 cm Small Adult 17 25 cm Child 12 19 cm Gambro Cuff single hand Size Adult 28 37 cm Large Adult 36 46 cm Small Adult 21 29 cm Gambro Cuff hose 3 0 m Cuff hose ...

Страница 28: ... marks in their own right CSA marking The CSA mark indicates that the AK 96 dialysis machine conforms to the requirements related to safety of medical devices for Canada and that the AK 96 dialysis machine has been evaluated to the applicable CSA standards for use in Canada CCC marking The CCC mark indicates that the AK 96 dialysis machine conforms to the safety requirements for China Compulsory C...

Страница 29: ...rms 2 3 Blood Part Component Details 2 5 The Fluid Part of the Machine 2 16 Fluid Part Component Terms 2 17 Fluid Part Component Details 2 19 The Rear of the Machine 2 28 Rear Component Terms 2 29 Rear Component Details 2 31 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine Description 2 1 ...

Страница 30: ...The Blood Part of the Machine 2 2 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 31: ... Operator s Panel 3 Remote Operator s Panel option 4 Air Detector 5 Venous Pressure Transducer Connector 6 Arterial Pressure Transducer Connector 7 Blood Pump 8 Heparin Pump option 9 Priming Detector 10 Arterial Blood Line Clamp option 11 Potential Equalization Connection 12 Venous Blood Line Clamp 13 Arm for Dialyzer Holder 14 Expansion Chamber Holder 15 BPM Connector option 16 Blood Line Guides ...

Страница 32: ...r s Panel option The operator s panel can be mounted in an external housing This Remote Panel is easy to adjust in different positions The handling procedures are the same as for the usual operator s panel WARNING If a remote operator s panel has been installed ﬂuid bags must be removed from the infusion pole or placed on the top tray when transporting moving the machine WARNING HCEN12239 Revision...

Страница 33: ...the cover is being opened as shown in the corresponding figure The air detector head is designed for a drip chamber with a diameter of 22 mm Instructions on how to attach the venous drip chamber of the venous blood line in the air detector can be read in Venous Blood Line Attach on page 4 28 in part 1 2 6 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 34: ... Line Attach on page 4 28 in part 1 6 Arterial Pressure Transducer Connector The pressure in the arterial blood line just before the blood pump is measured when the arterial pressure transducer of the arterial blood line is attached properly to this connector Instructions on this can be read in Arterial Blood Line Attach on page 4 16 in part 1 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 ...

Страница 35: ...rt 1 If the blood pump cover is opened whilst the blood pump is running it will stop until the cover is closed again During a power failure the pump can be manually operated by turning the pump rotor in an anticlockwise direction using the pump handle The pump cover may be opened with ease by pressing the middle of the cover at the same time as the cover is being opened as shown in the correspondi...

Страница 36: ... handle place the rotor on the pump shaft Then move your fingers from the handle and place them on the rotor as shown in the figure Turn the rotor clockwise slowly and at the same time push slightly until it reaches the bottom position Continue turning until the blood pump handle clicks in HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine Description 2 9 ...

Страница 37: ...e it is of the utmost importance that the venous blood line is correctly placed in the priming detector before treatment is started see Venous Blood Line Attach starting on page 4 28 in part 1 see point 5 for instructions on this Before the priming detector detects blood certain alarms are suppressed to facilitate the priming procedure When blood has been detected the treatment time starts to coun...

Страница 38: ...tral venous catheter is used the conductor must be connected to minimize the risk of electric shock The connection is marked with the symbol for equipotentiality see Symbols fixed on to the Machine starting on page 1 9 in part 1 12 Venous Blood Line Clamp The venous blood line clamp closes the venous blood line in certain alarm situations during treatment It is also of great importance when perfor...

Страница 39: ... clicks into position as shown in the corresponding figure Attach the Dialyzer Holder to the holder arm and lock it into position using the locking screw marked in the corresponding figure on the holder arm 14 Expansion Chamber Holder The holder is principally used for the expansion chamber included on the venous blood line when performing single needle treatment See Preparations on page 5 3 in pa...

Страница 40: ...e Monitor option on page 11 1 in part 2 16 Blood Line Guides The blood lines should always be placed in the guides during treatment for safety reasons 17 Level Adjustment Knob The level in the venous drip chamber can be adjusted by turning the level adjustment knob This is on condition that the venous pressure transducer has been connected to the venous pressure transducer connector Turn the level...

Страница 41: ...documents 19 Infusion Pole The standard infusion pole is intended to be used for hanging up fluid bags The maximum permitted load is 2 kg The height of the infusion pole can be adjusted by first loosening the infusion pole locking screw on the machine whilst holding the pole and then moving the pole upwards or downwards as shown in the corresponding figure before locking it into place 2 14 AK 96 O...

Страница 42: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine Description 2 15 ...

Страница 43: ...The Fluid Part of the Machine 2 16 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 44: ...fety Couplings for the Dialysis Fluid Tubes 2 Machine Outlet Dialysis Fluid Tube from the machine to the dialyzer 3 Machine Inlet Dialysis Fluid Tube to the machine from the dialyzer 4 Parking port marked P for Yellow Disinfectant Connector 5 Disinfection Port for Yellow Disinfectant Connector 6 Yellow Disinfectant Connector 7 Blue Concentrate Connector with White Tube Marking 8 Red Concentrate Co...

Страница 45: ...dialysis fluid tube to the safety coupling press and hold the button on the dialysis fluid tube connector while attaching it to the safety coupling Release the button and simultaneously push the connector into place until it clicks in The small button positioned just below the safety coupling will now be depressed which means that the connector is correctly attached to the machine HCEN12239 Revisi...

Страница 46: ...an be attached to the dialyzer can be read in Dialysis Fluid Tubes Attach on page 4 35 in part 1 3 Machine Inlet Dialysis Fluid Tube The spent dialysis fluid flows to the machine from the dialyzer via this tube A small arrow fixed just below where the tube comes out from the machine shows the flow direction marked in the corresponding figure Remove the inlet dialysis fluid tube in the same way as ...

Страница 47: ...for Yellow Disinfectant Connector The yellow disinfectant connector point 6 in this list is to be connected to this yellow port when a chemical disinfection program is performed This is on condition that the disinfectant used for chemical disinfection program is permanently connected to the inlet line at the back of the machine see The Rear of the Machine on page 2 28 in the next section HCEN12239...

Страница 48: ...nnector is to be connected to the separately attached pick up tube for intake of disinfectants and inserted into the disinfectant container For further information concerning how to run a chemical disinfection program see Chemical Disinfection Program Performing on page 8 27 in part 1 To correctly attach the connector to the port insert the connector into the port and push it into place until it c...

Страница 49: ...connector point 6 in this list 8 Red Concentrate Connector This connector is used for the separately attached pick up tube for acidic concentrate The connector is attached and removed from the port in the same way as the yellow disinfectant connector point 6 in this list 9 Base Plate The plate is designed for placement of concentrate containers during treatment HCEN12239 Revision 12 2010 Program v...

Страница 50: ...oint 6 in this list 11 Pick up Tube Holder The clean pick up tubes can be kept in this holder as shown in the corresponding figure For pick up tube rinsing disinfection instructions see Pick up Tubes on page 8 41 in part 1 for instructions 12 Stand by Port for Red Concentrate Connector The red concentrate connector point 8 in this list must be placed in this port at all times except when used for ...

Страница 51: ...dge a cartridge containing dry bicarbonate powder for treatments It is also used for the CleanCart A or C cartridges containing cleaning A or decalcification C agents for heat disinfection programs with CleanCart cartridge Instructions on how to attach the BiCart cartridge to the holder can be read in Connect Confirm Concentrates page 4 7 in part 1 and how to change it during treatment on page 3 3...

Страница 52: ... corresponding figure Make sure that the sealing ring on the inside of the cover is securely in place when replacing the cover 16 Dialysis Fluid Filter option See in UFD Ultrafiltered Dialysis Fluid option page 1 17 in part 1 for information concerning this option 2 26 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 53: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine Description 2 27 ...

Страница 54: ...The Rear of the Machine 2 28 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 55: ...figure on the previous page A detailed description where each component is described separately sometimes with informative text included follows next in this section 1 Transportation Handle 2 Air Filters 3 Halt Button 4 Battery Connect Indicator green 5 Battery Charge Indicator yellow 6 Outlet Tube 7 Inlet Water Tube 8 Disinfectant Inlet Tube 9 External Communication Port 10 Attachment for Service...

Страница 56: ...pply unit The filter marked is used to protect the inside of the machine from dust 3 Halt Button When this button is pressed the power supply to the machine is interrupted As soon as the button is released the power returns and the machine performs a recovery See Recovery from Machine Shut Down on page 3 29 in part 1 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine D...

Страница 57: ...rked BACH is lit when the mains cable is connected to the mains supply and the main switch is switched on see point 13 further on in this list indicating that the battery charge is ongoing 6 Outlet Tube The spent dialysis fluid flows out from the machine via this tube 2 32 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 58: ...to be removed from the parking port marked P on the front of the machine and placed in the disinfection port when performing chemical disinfection program For further information about how to run a chemical disinfection program see Chemical Disinfection Program Performing on page 8 27 in part 1 9 External Communication Port This port is to be used by the authorized technician It can be used for se...

Страница 59: ...n This connection is used for the mains cable which should always be connected even when the machine is not in use in order for the batteries to be charged Check that the cable locking spring used to prevent the cable from loosening is properly fixed 12 Fuses When necessary these fuses are to be changed by an authorized technician 2 34 AK 96 Operator s Manual Machine Description HCEN12239 Revision...

Страница 60: ...on the Time display even when the machine is not in use This is in order for the batteries to be charged 14 Wheels It is recommended to lock the front wheels especially during treatment for safety reasons HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Machine Description 2 35 ...

Страница 61: ...This page is intentionally left blank 2 36 AK 96 Operator s Manual Machine Description HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 62: ...25 Power Failure 3 27 Battery Back up Operation 3 27 Machine Shut Down 3 28 Return the Blood During Machine Shut Down 3 28 Recovery from Machine Shut Down 3 29 Handling Features 3 30 Concentrate Stand by Mode 3 30 Miscellaneous 3 32 Change of BiCart cartridge during Treatment 3 32 Change of Blood Pump Segments 3 33 Change of Dialyzer and Blood lines during Treatment 3 34 Resume Treatment 3 35 Infu...

Страница 63: ...This page is intentionally left blank 3 2 AK 96 Operator s Manual Operating the Machine HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 64: ...fluid path The blood path on the Flow Diagram lights up red when blood has been detected in the venous blood line The buttons are either function buttons or setting keys The function buttons give access to a variety of functions and parameters Some function buttons only give access to one function This applies when direct access to a function is necessary Other buttons give access to several funct...

Страница 65: ...perators panel as the function buttons are laid out principally according to this rule The Buttons As well as the previously mentioned flow path thinking the function buttons are also placed according to how they are to be used The setting keys are placed within the Keypad next to the Information Display or above and below the Blood Pump button A lit function button means that the function behind ...

Страница 66: ...the Information Display The Blood pump button along with the UF Start Stop button and the Fluid Bypass button are exceptions to those described above as for these functions the operator needs direct access When the Blood pump button is pressed the blood pump will be switched on and off no display The blood flow rate is to be adjusted using the Blood Pump Up Down keys connected to the button When t...

Страница 67: ...shows the remaining treatment time During disinfection programs it shows estimated remaining time for the ongoing program Flow Diagram The Flow Diagram shows the status of the blood flow and the dialysis fluid flow The Blood Path The blood path lights red when the priming detector detects blood 3 6 AK 96 Operator s Manual Operating the Machine HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 68: ... machine will automatically bypass the dialyzer during certain alarm conditions and during self calibration The Dialyzer Path The dialyzer path lights green when dialysis fluid is passing through the dialyzer The Ultrafiltration Path The ultrafiltration path lights yellow during isolated ultrafiltration and in fluid bypass HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Ope...

Страница 69: ...ee page 3 12 The Time Display which is connected to this button is described on page 3 6 Arterial Pressure button see page 3 12 Blood Path button see page 3 13 BPM button see page 3 15 Fluid Bypass button see page 3 15 UF Start Stop button see page 3 15 Fluid Path button see page 3 15 Mute button see page 3 19 Attention button see page 3 19 3 8 AK 96 Operator s Manual Operating the Machine HCEN122...

Страница 70: ...o these buttons is described on page 3 22 The Keypad consists of the Cursor keys the Display Up Down keys the Select key and the Back key See below for page references for each key Right Left Cursor keys see page 3 21 Display Up Down keys see page 3 21 Select key see page 3 20 Back key see page 3 21 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Operating the Machine 3 9 ...

Страница 71: ...f the machine should always be in On position even when the machine is not in use This is in order for the batteries to be charged See Rear Component Details starting on page 2 31 in part 1 see point 13 for further information Note Priming button The Priming button automatically lights up when the machine has been switched on during the function check This indicates that the machine is ready for b...

Страница 72: ...on the Information Display SET LOW low venous pressure alarm limit VEN PRESS current venous pressure SET HIGH high venous pressure alarm limit PA current arterial pressure QB blood flow rate When the Venous Pressure button is pressed in a non alarm situation upper cursors will be placed on both the low and the high venous pressure alarm limits To move the complete alarm window both low and high al...

Страница 73: ...imit PV current venous pressure QB blood flow rate When the Arterial Pressure button is pressed in a non alarm situation upper cursors will be placed on both the low and the high arterial pressure alarm limits To move the complete alarm window both low and high alarm limits will change simultaneously first press the Select key Then move the window on the scale using the Up and Down Display keys Cl...

Страница 74: ...mulated bolus volume during priming and total accumulated volume since treatment start SINGLE NEEDLE current stroke volume Blood Flow From the Blood Path main menu select BLOOD FLOW by using the Keypad to reach the sub menu The following will be shown on the Information Display SET QB set blood flow rate SET LOW set low alarm limit for blood flow rate SEGMENT blood pump segment diameter ACTUAL QB ...

Страница 75: ...tment it will be running continuously irrespective of if the blood pump is running or not Single needle From the Blood Path main menu select SINGLE NEEDLE by using the Keypad to reach the sub menu The following will be shown on the Information Display MIN STROKE displays the low alarm limit for the stroke volume PV LOW low venous pressure alarm limit P VEN current venous pressure PV HIGH high veno...

Страница 76: ...the Fluid Path button to reach the Fluid Path main menu In this menu parameter settings and functions related to dialysis fluid can be set activated The following will be shown on the Information Display UF calculated ultrafiltration rate and profiling type CONC selected concentrate TEMP current dialysis fluid temperature COND current conductivity value DIA FLUID FLOW current dialysis fluid flow r...

Страница 77: ...eight loss ISOL UF refer to chapter 6 Isolated Ultrafiltration in part 1 Concentrates From the Fluid Path main menu select CONC by using the Keypad to reach the sub menu For instructions on connecting and selecting concentrates see Connect Confirm Concentrates page 4 7 in part 1 Temperature From the Fluid Path main menu select TEMP by using the Keypad to reach the sub menu The following will be sh...

Страница 78: ...s fluid flow rate is a preset parameter value which cannot be adjusted by the operator during priming The value can however be set in SET TREATMENT DIA FLUID FLOW during priming but will not be effective until treatment start when the priming detector detects blood in the venous blood line In treatment the operator has access to adjust the value The following will be shown on the Information Displ...

Страница 79: ...nsmembrane pressure alarm limits To move the complete alarm window both low and high alarm limits will change simultaneously first press the Select key Then move the window on the scale using the Up and Down Display keys Close using the Select key To adjust one alarm limit at a time first press the Left or Right Cursor key to select alarm limit Then press the Select key to open the position Change...

Страница 80: ...ton see the initial parts of chapter 14 Attention Alarms in part 3 Alarm button Alarm button see the initial parts of chapter 13 Alarms in part 3 Air Detector button Air Detector button see Air Detector Alarm on page 13 19 in part 3 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Operating the Machine 3 19 ...

Страница 81: ...ood flow rate ACTUAL QB current blood flow rate VEN PRESS current venous pressure ART PRESS current arterial pressure Keypad The Keypad consists of Cursor keys Display Up Down keys Select key and Back key Select key The Select key is used to open and close settings of the menus on the Information Display The operator is requested to use the Select key for instance when activating deactivating func...

Страница 82: ...ers shown on the Information Display The Display Up key increases the value and the Display Down key decreases the value The keys can be used in two ways by briefly pressing one of the keys repeatedly in small steps or if the intension is a faster change of the value by pressing the key pressed in until the proper value is shown The Display Up Down keys are also to be used to scroll up and down wh...

Страница 83: ... the Operator s Panel is pressed The Priming or Treatment Overview Menus will automatically resume 20 seconds after the last time a button was pressed When an alarm is generated and the alarm button is pressed an alarm list containing alarm messages will appear on the Information Display besides other machine alarm actions When an attention alarm is generated and attention button is pressed the at...

Страница 84: ...can be moved within the menu to select another position by using the Cursor keys Display Brace This cursor has a fixed position and displays the value of a parameter The position cannot be entered or moved by the operator Overview Displays The Treatment Overview Menu will start to be displayed and continues to be displayed at all times during treatment when blood is detected Current parameter valu...

Страница 85: ...lood volume since treatment start ACC HEP accumulated infusion volume since treatment start ACC UFV accumulated ultrafiltration volume patient weight loss since treatment start UF RATE current ultrafiltration rate Activated functions are displayed at the bottom of the overview menu in the activity field The first part of the Treatment Overview Menu for single needle treatment differs from the over...

Страница 86: ...atically set current TMP value and the set centralized alarm limits has to be confirmed by the operator via the TMP confirm menu displayed on the Information Display Note that the alarm limits should be set in accordance with the UF rate and dialyzer UF coefficient CAUTION When negative TMP alarm limits are set the operator will not be notiﬁed via alarm or attention alarm that backﬁltration may oc...

Страница 87: ...been too low during a period of time the machine will try to compensate for this by increasing the UF rate but within the UF rate limits 3 26 AK 96 Operator s Manual Operating the Machine HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 88: ...ttention alarm will be displayed Note If the machine has been used on battery back up note that the back up battery will not have full capacity until it has been recharged by the machine Note Override Battery Back up Operation If there is a need to override the battery back up function during power failure press and release the halt button at the rear of the machine The machine will then shut down...

Страница 89: ...arterial blood line and disconnect it from the patient 2 Connect the arterial blood line to the rinse back solution and remove the clamp 3 Open the cover of the blood pump and turn the blood pump manually 4 When the required amount of blood has been returned to the patient clamp the venous blood line and disconnect it from the patient WARNING During manual procedure to return blood to patient in p...

Страница 90: ...ameters after a recovery CAUTION Note If the attention appears there will be no support for the buzzer and no flashing segment on the Time Display during power failure However the settings and accumulated values are stored by the machine When it has been confirmed the machine will not restart automatically The On Off button has to be pressed to recover function The machine will still be able to op...

Страница 91: ...e procedures of the specific clinic There are two presets that can be used separately or in combination 1 Automatic activation of concentrate stand by mode when time is shown on the time display and the bypass path of the Flow Diagram lights up green The time for activation may be straight away when the bypass path lights up green or for a preset amount of time after 2 The time for automatic activ...

Страница 92: ...eactivated press the Select key for 3 seconds when the CONCENTRATE STANDBY MODE is displayed The dialysis fluid will be ready within approximately 2 minutes If dialysis fluid preparation has not been resumed during priming it will automatically be resumed when blood is detected in the priming detector after treatment start Dialysis fluid preparation will also automatically be resumed when concentr...

Страница 93: ...ge This is necessary in order for the machine to automatically prime the new BiCart cartridge Instructions on how to remove the cartridge can be read in Machine aftercare page 4 63 in part 1 Instructions on how to attach the cartridge can be read in Acidic concentrate and BiCart cartridge page 4 9 in part 1 3 32 AK 96 Operator s Manual Operating the Machine HCEN12239 Revision 12 2010 Program versi...

Страница 94: ...he correct blood ﬂow Check with the authorized technician CAUTION The machine has to be in priming mode and the blood pump has to be stopped in order for the diameter of the blood pump segment to be changed 1 Press the Blood Path button 2 Select BLOOD FLOW and SEGMENT using the Keypad 3 Press the Select key to open the parameter adjust using the Display Up Down Keys 4 Make sure to use a correct bl...

Страница 95: ...nlit UF Start Stop button The menu will change and it is possible to select either to immediately disconnect the complete blood circuit from the patient DISCONNECT PATIENT or to return the blood to the patient before disconnecting the blood circuit RINSE BACK Select the appropriate alternative and continue to the corresponding instructions as follows 3 If rinse back RINSE BACK has been selected 3 ...

Страница 96: ...ing that priming mode has been activated 9 Prime and de air the new blood circuit as usual procedure Follow the corresponding instructions starting on page 4 40 for Manual Priming and Rinsing Procedure and on page 4 46 for Assisted Priming and Rinsing Procedure in part 1 Resume Treatment 10 Check adjust the treatment parameters for the continuing treatment see Always Check Adjust page 4 52 in part...

Страница 97: ... an overpressure must be established in the infusion line Normally this is done by using an infusion pump an overpressure cuff or if necessary by manually creating an overpressure Pre blood pump infusions There is also the possibility of connecting the infusion line to the extracorporeal blood circuit pre blood pump i e before the blood pump The corresponding figure shows pre blood pump connection...

Страница 98: ...Procedure 4 40 Check Before Priming 4 40 Priming Procedure 4 40 Extra Priming Procedure 4 44 Recirculation Priming Procedure 4 44 Assisted Priming and Rinsing Procedure 4 46 Check Before Priming 4 46 Priming Procedure 4 46 Extra Priming Procedure 4 50 Recirculation Priming Procedure 4 50 Treatment 4 52 Set Treatment Parameters 4 52 Always Check Adjust 4 52 Connect the Patient 4 53 Start the Treatm...

Страница 99: ...tored with chemical disinfectant this solution must be rinsed out of the system before any treatment can be initiated Note Switch the machine on by pressing the On Off button for three seconds At this moment the buzzer will sound shortly and the computer processor of the machine will count up displayed on the Time display The current program version installed on the machine will be displayed on th...

Страница 100: ...od lines if not done before switching the machine on See Attach Disposables starting on page 4 13 in part 1 It is also possible to start the priming procedure of the blood part See Priming starting on page 4 38 in part 1 Note that if a chemical disinfection program has been performed prior to the function check the function check is prolonged An attention alarm appears to guide the operator in thi...

Страница 101: ...ected to the safety couplings the fluid will circulate within the machine If they are connected to the dialyzer the fluid will enter the dialyzer at that time See Dialysis Fluid Tubes Attach starting on page 4 35 in part 1 for instructions on how to properly attach the dialysis fluid tubes to the dialyzer If desired the concentrates may be connected and the blood lines may be attached before the m...

Страница 102: ...en CAUTION After chemical disinfection procedure a test for residues must have been performed prior to connecting to a patient CAUTION Note After the machine has passed the function check and the bypass path on the Flow Diagram lights up green it is possible to activate concentrate stand by mode in order to save concentrates before patient connection See information in Concentrate Stand by Mode on...

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Страница 104: ...ductivity cells must be checked with conductivity and the air detector must be checked with fluid in the chamber When the function check is finished the treatment time appears on the time display During the conductivity test in function check it is not possible to change between Bicarbonate and Acetate mode If the conductivity check during function check was performed in Acetate mode it is not pos...

Страница 105: ...ctions Acidic concentrate and BiCart cartridge see next page for instructions Acidic concentrate and liquid bicarbonate concentrate see page 4 11 in part 1 for instructions Acetate concentrate see page 4 12 in part 1 for instructions For details about the following mentioned machine components see corresponding information in Fluid Part Component Details starting on page 2 19 in part 1 4 8 AK 96 O...

Страница 106: ...per acidic concentrate container the blue concentrate connector must remain in the stand by port If SoftPac container for acidic concentrate is being used connect the red concentrate connector to the particular connector used for SoftPac containers and insert it into the SoftPac container 2 Attach BiCart cartridge 2 a Open the upper latch of the BiCart holder pull out the latch and lift upwards to...

Страница 107: ...Confirm concentrates The confirm concentrate menus will automatically appear when the red concentrate connector is removed from the stand by port 3 a Select BICARBONATE using the Keypad 3 b Confirm that the connected concentrates correspond with the displayed concentrate alternative on the Information Display using the Select key Note that at any time after confirming the concentrates it is possib...

Страница 108: ...f the machine compress the connector before pulling the connector out 2 b Attach the connector to a concentrate pick up tube insert the connector into the pick up tube port and push it into place until it clicks in Make sure that it clicks in properly to prevent air leakage during treatment 2 c Put the pick up tube into the proper liquid bicarbonate concentrate container 3 Confirm concentrates The...

Страница 109: ...emain in the stand by port 2 Confirm concentrates The confirm concentrate menus will automatically appear when the blue concentrate connector is removed from the stand by port 2 a Select ACETATE using the Keypad 2 b Confirm that the connected concentrates correspond with the displayed concentrate alternative on the Information Display using the Select key Note that at any time after confirming the...

Страница 110: ...yzer and the blood lines When attaching the blood lines always ensure that all connections are properly secured and that no part of the blood lines have been kinked If the heparin pump is not to be used especially ensure that the cap at the end of the thin line used for heparin solution is properly closed CAUTION Note Since tests of the blood pumps and the clamps are included in the function check...

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Страница 112: ...y pushing it into the holder until it clicks in If necessary squeeze the spring clip as shown in the corresponding figure to place the dialyzer in the holder HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 15 ...

Страница 113: ...ons For Use for the particular arterial blood line being used In addition especially observe the following items The items are pointed out in set up order starting with the blood pump A list of details on how to correctly attach the corresponding arterial blood line parts follows on the pages directly after this 4 16 AK 96 Operator s Manual Double Needle Treatment HCEN12239 Revision 12 2010 Progra...

Страница 114: ...nector 7 Arterial Pressure Transducer Connector 8 Heparin Pump option If desired more information concerning the following mentioned components can be read in the list Blood Part Component Details on page 2 6 in part 1 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment Arterial Blood Line Attach 4 17 ...

Страница 115: ...ependent on when the pump segment has been placed over the blood pump rotor If it is manually threaded the operator threads the segment through the blood pump during the arterial blood line set up Instructions on both alternatives follow after this If automatically threaded Place the blood pump segment over the blood pump rotor as shown in the corresponding figure While keeping the segment in plac...

Страница 116: ...e blood pump rotor in an anti clockwise direction This is to hold the segment collar outside the pump housing while threading it Continue turning the blood pump rotor in an anti clockwise direction while holding the segment to thread the segment through the blood pump The pins on the blood pump rotor pointed out as in the figure hold the segment in place 4 20 AK 96 Operator s Manual Double Needle ...

Страница 117: ...ing It is recommended to use a blood line with a plastic cross bar between the segment collars pointed out as in the figure The cross bar holds the segment in place during treatment and it is also easier to thread the blood pump segment through the pump HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 21 ...

Страница 118: ...onnection Attach the dialyzer end of the arterial blood line firmly to the dialyzer press and simultaneously turn 4 Blood Line Guide Press lightly on the blood line to place it in one of the grooves of the guide 4 22 AK 96 Operator s Manual Double Needle Treatment HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 119: ... goes into place when it is lightly pressed at the same time 6 Arterial Patient Connector Connect the patient end of the arterial blood line to the priming fluid Follow the manufacturer s instructions for use for type of priming fluid to be used for the particular dialyzer and blood lines HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 23 ...

Страница 120: ... the proper solution in a correct syringe used for the purpose The Heparin pump can be programmed for different syringe sizes syringes must comply with ISO 7886 2 Consult the authorized technician for information concerning heparin pump presets for the particular machine Make sure that chosen syringe type matches displayed syringe type in the HEPARIN MENU if not call authorized service technician ...

Страница 121: ...solution 8 b Attach the syringe to the connection at the end of the thin line coming out just after the blood pump segment pointed out in corresponding figure on the arterial blood line 8 c Prime the line with the heparin solution to the point where the line ends in the arterial blood line The luer lock mounting ensures that the syringe is properly connected to the line see corresponding figure 8 ...

Страница 122: ...f the plunger in the groove in the figure 8 i Check that the syringe is properly secured by lightly pulling on the plunger in the figure 8 j Press the Blood Path button the BLOOD PATH MENU will be displayed on the Information Display 8 k Select HEPARIN using the Keypad the HEPARIN MENU will be displayed 8 l If a bolus dose of heparin solution is to be administered at treatment start set a bolus vo...

Страница 123: ...start will be shown below ACC HEP To stop the heparin pump from running during treatment set FLOW RATE to zero and bolus volume BOLUS to zero The heparin pump will run concurrent to the blood pump in double needle treatment In single needle treatment it will be running continuously irrespective of if the blood pump is running or not During machine set up and priming the heparin pump can be started...

Страница 124: ...ons For Use for the particular venous blood line being used In addition especially observe the following items The items are pointed out in set up order starting with the air detector A list of details on how to correctly attach the corresponding venous blood line parts follows on the pages directly after this 4 28 AK 96 Operator s Manual Double Needle Treatment HCEN12239 Revision 12 2010 Program ...

Страница 125: ...ient Connector 7 Venous Pressure Transducer Connector If desired more information concerning the following mentioned components can be read in the list Blood Part Component Details on page 2 6 in part 1 Venous Blood Line Attach HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 29 ...

Страница 126: ...e middle of the cover at the same time as the cover is being opened Compress the venous drip chamber as shown in corresponding figure and push it in to the air detector Press on the middle of the venous drip chamber while closing the cover HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 31 ...

Страница 127: ...be possible to adjust the level well above the air detector head 2 Dialyzer connection Attach the dialyzer end of the venous blood line firmly to the dialyzer press and simultaneously turn 3 Blood Line Guide Press lightly on the blood line to place it in one of the grooves of the guide 4 32 AK 96 Operator s Manual Double Needle Treatment HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 128: ...ortance that the venous blood line is correctly placed in the priming detector for the machine to be able to detect blood after treatment start Check carefully that the venous blood line has reached end position in the venous line clamp as shown in the corresponding figure For further information see point 9 Priming Detector in Blood Part Component Details starting on page 2 5 in part 1 HCEN12239 ...

Страница 129: ...ve 50 mmHg during the priming procedure This venous pressure is important for the machine to be able to test the venous pressure measurement function before treatment start 7 Venous Pressure Connector Attach the venous pressure transducer protector of the blood line to the venous pressure connector press and simultaneously turn Check all necessary clamps 4 34 AK 96 Operator s Manual Double Needle ...

Страница 130: ...er the dialyzer Note If the optional Dialysis Fluid Filter UFD has been installed the dialysis fluid tubes must remain connected to the safety couplings until the bypass path of the Flow Diagram lights up green The machine performs a flush of the flow path where the ultrafilter is placed after F Ch has disappeared from the Time Display This is to ensure that correct conductivity is reached when th...

Страница 131: ... removing it from the safety coupling The newly prepared fresh dialysis fluid flows from the machine to the dialyzer via this tube A small arrow fixed just below where the tube comes out from the machine shows the flow direction 2 Keep the button on the dialysis fluid tube pressed and hold while attaching it to the dialyzer connector as shown in the corresponding figure 3 Release the button and si...

Страница 132: ...fixed just below where the tube comes out from the machine shows the flow direction 5 Keep the button on the dialysis fluid tube pressed and hold while attaching it to the dialyzer connector as shown in the corresponding figure 6 Release the button and simultaneously push the connector into place until it clicks in Make sure that it clicks in properly to prevent leakage during treatment HCEN12239 ...

Страница 133: ... priming procedure The latter parts where the handling procedures are the same for both manual and assisted priming can be used if necessary or requested Priming Part Manual Priming When performing manual priming the operator is in charge of the priming parameter settings removing air from dialyzer and blood lines and generally monitoring the procedure Some priming parameter values can however be ...

Страница 134: ...uit will be ultrafiltrated and needs to be compensated for by priming fluid connected to the circuit via an infusion line The time for how long a period the procedure should last as well as a recirculation priming UF volume is preset Based on these two parameters the machine calculates the recirculation priming UF rate When recirculation priming UF volume and time have been achieved the procedure ...

Страница 135: ... key for three seconds as the menu requests The dialysis fluid will be ready within approximately 2 minutes Always follow the manufacturer s recommendations for the minimum rinsing volume for the blood lines and the dialyzer Note Priming Procedure This menu will be displayed on the Information Display when manual priming is active If the ASSISTED PRIMING SETUP MENU is displayed briefly press the l...

Страница 136: ... will start to flash when the venous drip chamber has been filled This is to request the operator to press it and by doing so activate the air detector alarm function It is not necessary to press the flashing button at this moment the air detector activation may be moved forward until the extracorporeal circuit is completely de aired Additionally if the air detector is not manually activated durin...

Страница 137: ...alarm is left unattended unnecessary alarms and technical error will be generated during initiating of treatment See also Venous Patient Connector in Venous Blood Line Attach previously in this chapter When the priming volume has been achieved the blood pump automatically stops and the PRIMING VOLUME ACHIEVED menu is displayed Check that the venous blood line is correctly placed in the priming det...

Страница 138: ...e function check and the bypass path on the Flow Diagram lights up green it is possible to activate concentrate stand by mode in order to save concentrates before patient connection See information in Concentrate Stand by Mode on page 3 30 in part 1 Note HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 43 ...

Страница 139: ...le to select RECIRCULATION at this moment see the following instructions If the operator wishes to restart priming and at the same time set the priming volume value to zero select NEW PRIMING when the priming volume achieved menu is displayed using the Keypad The machine will reactivate priming and it is possible to repeat the priming procedure from the start Recirculation Priming Procedure If req...

Страница 140: ...sh When the recirculation priming UF volume and time have been achieved the blood pump automatically stops EXTRA RECIRCULATION can be restarted as desired Check the priming fluid connected via the infusion line Note that the values below ACC UF VOLUME will be the accumulated ones since the first recirculating priming procedure Select CONNECT PATIENT using the Keypad when the recirculation priming ...

Страница 141: ...t key for three seconds as the menu requests The dialysis fluid will be ready within approximately 2 minutes Always follow the manufacturer s recommendations for the minimum rinsing volume for the blood lines and the dialyzer Note Priming Procedure The procedure described below uses the default settings of assisted priming parameters Make sure that the preset priming procedure is in accordance wit...

Страница 142: ...alyzer should be filled from bottom to top to ensure proper de airation The procedure starts with the fill up phase ACTIVE PHASE FILLUP will be displayed 5 Fill up the level in the venous drip chamber while the blood pump is running using the level adjustment knob anticlockwise direction Adjust the level so it is well above the air detector head 6 The Air detector button will start to flash when t...

Страница 143: ... has not previously been done See Dialysis Fluid Tubes Attach page 4 35 in part 1 for instructions on how to attach the tubes Invert the dialyzer so that the dialyzer will be filled from bottom to top to ensure proper de airation 8 Press the flashing Fluid bypass button The dialysis fluid will now enter the dialyzer when the dialyzer path on the Flow Diagram lights up green Especially note that th...

Страница 144: ...button to restart the blood pump and to continue the procedure The procedure continues with the second flush phase ACTIVE PHASE SECOND FLUSH is displayed 12 When the second flush is finished the assisted priming procedure is complete and the menu will change 13 Check that the venous blood line is correctly placed in the priming detector See Venous Blood Line Attach point 5 Press the Select key to ...

Страница 145: ...rt is shown The total preset priming volume obtained since priming start is displayed to the right of the slash When the extra priming volume has been achieved the blood pump automatically stops and an attention alarm appears EXTRA PRIMING can be restarted as desired Check priming fluid and waste bag Select CONNECT PATIENT using the Keypad when the extra priming procedure is complete and the menu ...

Страница 146: ...ormation Display The preset recirculation priming UF volume is shown below PRESET UF VOLUME Below ACC UF VOLUME to the left of the slash the current recirculation priming UF volume obtained since recirculation start is shown The total preset recirculation priming UF volume is displayed to the right of the slash When the recirculation priming UF volume and time have been achieved the blood pump aut...

Страница 147: ...t time on the Time Display adjust if necessary Press the Time button adjust SET TIME Set the UF volume patient weight loss to the required total ultrafiltration volume Press the Fluid Path button select UF and set the required value in SET UF Check that the calculated UF rate patient weight loss h is suitable Press the Fluid Path button select UF and check the value in UF RATE Adjust treatment tim...

Страница 148: ...ne once the blood pump has been started If blood has not been detected in the venous blood line when this connect patient volume has been achieved an alarm will be generated Blood is not detected See Connect Patient Alarm Connect Patient Alarm page 13 49 in part 3 for instructions 1 Check that there is no air in the blood lines and that the level in the venous drip chamber is well above the air de...

Страница 149: ...od line Note The blood pump can be automatically stopped when the priming detector detects blood in the venous blood line and the blood path in the Flow Diagram lights up During patient connection when blood has been detected in the venous blood line the venous clamp can be open when the blood pump is stopped manually or automatically This preset is to facilitate removal of air from the venous blo...

Страница 150: ...he machine no longer detects blood in the venous blood line This is valid even if the venous blood line is removed from the priming detector during treatment i e the blood alarms will be kept The Treatment Overview Menu will start to be displayed and continues to be displayed at all times during treatment when blood is detected See in Overview Displays page 3 23 in part 1 for details The Venous Pr...

Страница 151: ...adjust the low alarm limit for blood flow rate in SET LOW as necessary 3 Press the flashing Arterial Pressure button to centralize the alarm limits around the current value Or if desired set the arterial pressure alarm limits manually using the Keypad 4 Press the flashing Venous Pressure button to centralize the alarm limits around the current value Or if desired set the venous pressure alarm limi...

Страница 152: ... simplify the correct setting of the alarm limits for arterial and venous pressure and for TMP The centralizing function means that when the Arterial or Venous pressure buttons are flashing the buttons are to be pressed When pressed the alarm window will automatically be set around the current value For TMP the TRANSMEMBRANE PRESSURE CONFIRM MENU appears where the operator confirms the automatical...

Страница 153: ...pressure in the catheter WARNING TMP When the TRANSMEMBRANE PRESSURE CONFIRM MENU is displayed on the Information Display press the Select key to confirm the settings i e that the current TMP value and the automatically set TMP alarm limits are set in accordance with the current UF rate and the UF coefficient of the dialyzer being used If the TMP alarm limits have not been confirmed within two min...

Страница 154: ...t time is decreased in SET and there is still time left in isolated UF phase an attention alarm will appear Deactivate isolated UF press the Select key for 3 seconds when the isolated UF menu is displayed or set ISOL UF time to zero Note Conﬁrm Treatment End When the remaining treatment time shown on the Time Display equals 0 00 an attention alarm appears Simultaneously the Time button starts to f...

Страница 155: ...e UF volume or set the min UF rate to zero Return The Blood CAUTION During rinse back procedure when the blood is returned to the patient the operator is responsible for monitoring the venous pressure since the supervision of venous needle dislocation is deactivated The arterial clamp can be open during rinse back procedure by preset This is to facilitate returning all blood in the extracorporeal ...

Страница 156: ...own below PRESET VOLUME The current rinse back volume used since rinse back start is shown below ACC VOLUME to the left of the slash If another rinse back is started this value will increase The total preset rinse back volume used since rinse back start is displayed to the right of the slash During the rinse back procedure the venous clamp automatically opens and closes intermittently while the bl...

Страница 157: ...inse back can be repeated as necessary 9 Stop the blood pump if it has not automatically been stopped when the required amount of blood has been returned to the patient Clamp the venous blood line 10 Disconnect the venous blood line from the patient 11 Select patient disconnection DISCONNECT PATIENT using the Keypad Conﬁrm Patient Disconnection 12 Check that the arterial and venous blood lines hav...

Страница 158: ...emove the outlet dialysis fluid tube from the dialyzer and attach it to the safety coupling of the machine The machine will now automatically create negative pressure in the fluid path which empties the dialyzer of dialysis fluid 16 When the dialyzer has been emptied remove the inlet dialysis fluid tube from the dialyzer and attach it to the safety coupling of the machine as well 17 Connect the co...

Страница 159: ... properly closed 20 The Rinse Disinfection button will now be flashing Press the button and start a disinfection program see handling instructions for each program in chapter 8 Hygiene and Maintenance in part 1 Follow the instructions for hygiene and maintenance of the AK 96 dialysis machine in chapter 8 in part 1 21 Remove the dialyzer and the blood lines dispose of according to local regulations...

Страница 160: ...he blood pump rotor are behind the pulled out segment while turning the rotor 21 2 Open the cover of the air detector press on the middle of the cover at the same time as the cover is being opened Compress the venous drip chamber and then pull it out as shown in the corresponding figures HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Double Needle Treatment 4 65 ...

Страница 161: ... i e blood has penetrated the disc ﬁlter there is a risk of contamination of the machine It is necessary to call an authorized technician who must replace and clean machine components that may have been contaminated WARNING 4 66 AK 96 Operator s Manual Double Needle Treatment HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 162: ...s 5 2 Preparations 5 3 Connect the Patient 5 5 Start the Treatment 5 8 Pressure Alarm Limits Setting 5 11 Alarm Limit Centralizing Function 5 11 Arterial Pressure 5 11 Venous Pressure 5 11 TMP 5 12 Discontinuing 5 12 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Single Needle Treatment 5 1 ...

Страница 163: ... in the extracorporeal circuit contact your local Gambro representative Note Glossary of single needle parameters and key terms The Arterial phase is when the blood pump is running the arterial line clamp is open and the venous line clamp is closed The arterial phase can be controlled by pressure settings The Venous phase is when the blood pump is not running the venous line clamp is open and the ...

Страница 164: ...ous Blood Line Attach page 4 28 in part 1 Add the following instructions on how to attach the expansion chamber 1 Place the venous expansion chamber in the holder in an upright position inlet and outlet facing downwards Make sure that it clicks in properly in the expansion holder 2 The edge inside the holder should fit into the groove of the expansion chamber as shown in the corresponding figure 3...

Страница 165: ...n chamber holder backwards until it clicks into position By doing so the venous expansion chamber will be filled to a suitable level during priming 5 b Check that the venous expansion chamber has been filled to be level with the groove of the chamber Make sure to close the clamp at the top of the expansion chamber 5 4 AK 96 Operator s Manual Single Needle Treatment HCEN12239 Revision 12 2010 Progr...

Страница 166: ... Patient Alarm page 13 49 in part 3 for instructions 1 Check that the venous expansion chamber is in an upright position and is filled to a correct level refer to the instructions for use of the individual blood line 2 Check that there is no air in the blood lines and that the level in the venous drip chamber is well above the air detector head 3 Manually activate the air detector alarm function b...

Страница 167: ...nd the blood path in the Flow Diagram lights up During patient connection when blood has been detected in the venous blood line the venous clamp can be open when the blood pump is stopped manually or automatically This preset is to facilitate removal of air from the venous blood line after connecting the venous blood line to the patient Bear in mind that when this preset is active the operator is ...

Страница 168: ... e the blood alarms will be kept The Treatment Overview Menu for single needle treatment will start to be displayed and continues to be displayed at all times during treatment when blood is detected The overview differs from the overview when performing double needle treatment showing parameters of interest when single needle mode is active See in Overview Displays page 3 23 in part 1 for details ...

Страница 169: ...e of the single needle cycle It is not the mean blood flow rate for the single needle treatment The mean blood flow rate is shown on the Treatment Overview Menu for single needle treatment Overview Displays see page 3 23 in part 1 for details 2 If desired press the Blood Path button and open the BLOOD FLOW MENU using the Keypad Check adjust the low alarm limit for the blood flow rate when the bloo...

Страница 170: ...to start ultrafiltration Note especially that at all times whenever necessary during treatment the UF Start Stop button can be pressed flashing in order to decrease the UF rate to minimum UF rate Check that the minimum UF rate is set to the correct value Press the Fluid Path button select UF and check the value in SET MIN UFR Adjust if necessary Note The achieved stroke volume is determined by the...

Страница 171: ...ith the current UF rate and the UF coefficient of the dialyzer being used 8 If the heparin pump is started this will be running continuously irrespective of if the blood pump is running or not If BOLUS has been set this will be administered first After this the heparin solution will be administered at the set flow rate FLOW RATE If the heparin solution flow rate is set to zero an attention alarm a...

Страница 172: ...erial Pressure button and the pressure menu will be shown on the Information Display Manually adjust the alarm limits using the Keypad see Arterial Pressure button in chapter 3 for instructions manual setting of the alarm limits The alarm window will automatically be widened and the button starts to flash when the blood flow rate is changed or when the Blood Pump button is pressed Upon request fro...

Страница 173: ...sting the alarm limits using the Keypad For instructions on manual setting of the alarm limits see Fluid Path button in chapter 3 Go to Transmembrane Pressure last in the list The TMP alarm window will automatically be widened when the UF Start Stop button is pressed CAUTION When negative TMP alarm limits are set the operator will not be notiﬁed via alarm or attention alarm that backﬁltration may ...

Страница 174: ...traﬁltration Contents Isolated UF General 6 2 Isolated UF Performing 6 3 Before Treatment 6 3 During Treatment 6 4 After Treatment 6 5 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Isolated UF 6 1 ...

Страница 175: ...the dialyzer and the blood lines Isolated UF can be used if the amount of excessive fluid to be removed is too large for the specific patient to tolerate during hemodialysis diffusion It can also be used if the patient s condition requires immediate fluid removal The hemodialysis treatment is in this context referred to as the diffusion phase and the isolated UF is referred to as the isolated UF p...

Страница 176: ... Set the time SET TIME for the isolated UF phase 5 Activate isolated UF by pressing the Select Key for 3 seconds Isolated UF will automatically be activated when the UF Start Stop button is being pressed at treatment start Start the treatment according to the instructions in Connect the Patient on page 4 53 and Start the Treatment on page 4 56 in part 1 Note that if the heparin pump is used it wil...

Страница 177: ...afiltration volume SET ISOL UF for the isolated UF phase 4 Set the time SET TIME for the isolated UF phase 5 Activate isolated UF by pressing the Select Key for 3 seconds Isolated UF will now be activated Note that if the heparin pump is used it will run during the complete treatment irrespective of the added isolated UF phase and keep the settings for BOLUS FLOW RATE and STOP LIMIT Activated isol...

Страница 178: ...OL UF and enter the sub menu 3 Set the ultrafiltration volume SET ISOL UF for the isolated UF phase 4 Set the time SET TIME for the isolated UF phase 5 Press the Back key for 3 seconds and the Treatment Overview Menu will resume The Isolated UF settings will be kept When the diffusion phase is complete an attention alarm will appear 6 Check that the previously set values are the correct ones and a...

Страница 179: ... Path button select UF and then ISOL UF to view the menu If necessary isolated UF can be deactivated at any time during the phase by pressing the Select Key for 3 seconds when the isolated UF menu is displayed When the time for the isolated UF phase equals 0 00 the attention alarm TREATMENT TIME EXPIRED appears and the treatment is to be discontinued as usual procedure 6 6 AK 96 Operator s Manual ...

Страница 180: ...Profiling Setting Activation 7 6 Profiling without Preset Model 7 7 Setting and Activating the Model 7 7 Ultrafiltration 7 7 If linear graph 7 8 If step or interval graph 7 8 Sodium 7 8 Bicarbonate 7 8 Profiling with Preset Model 7 10 Selecting and Activating the Model 7 10 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Proﬁling 7 1 ...

Страница 181: ...e set The graph represents a constant change in the sodium and or bicarbonate concentrations in the dialysis fluid throughout the treatment The change is determined by the start and stop values set for each parameter Based on these values the machine will perform a smooth and constant adjustment of the concentrations during the treatment time when profiling has been activated See the following fig...

Страница 182: ... smooth and constant adjustment of the UF rate during the treatment time when profiling has been activated See the following figure Figure 7 2 Decreasing linear graph for UF rate profiling The change of UF rate for the graph in steps is determined by the following settings total UF volume treatment time number of steps in the graph and start UF rate Based on these parameters the machine will perfo...

Страница 183: ...justments of the UF rate at intervals during the treatment time when profiling has been activated See the following figure Figure 7 4 Graph in intervals for UF rate profiling For all the UF rate graphs the operator is requested to readjust the TMP alarm limits during treatment in accordance with the UF rate and the dialyzer UF coefficient 7 4 AK 96 Operator s Manual Proﬁling HCEN12239 Revision 12 ...

Страница 184: ...anged graphs in gray original graph in black Note that if time is changed and the stop value of the new graph reaches the minimum UF rate the slope of the graph will also change Figure 7 5 Change of UF rate linear graph when UF volume has been changed Figure 7 6 Change of UF rate linear graph when time has been changed Note For any UF rate graph always check the UF profiling settings if UF volume ...

Страница 185: ...shown on the Time Display It is possible to manually set a model or just select a preset model Profiles for sodium NA bicarbonate HCO3 and ultrafiltration rate UF can be set adjusted for each model If UF profiling UF is to be used the UF volume for the following treatment has to be set before setting the UF profiling The profiling function for all three profiling parameters can be reached by first...

Страница 186: ...values NA displayed in the PROFILING MENU control values Secondly by checking the set start START and stop STOP values for HCO3 PROFILING protective values press the Back key and compare with the values HCO3 displayed in the PROFILING MENU control values During UF proﬁling the operator must readjust the TMP alarm limits to follow the changing UF rate CAUTION 1 Press the Fluid Path button and selec...

Страница 187: ...ART value for UF rate The stop value STOP value for UF rate will be automatically adjusted in proportion to the start value This is to maintain the previously set UF volume for the following treatment 8 Activate the UF profiling function at this moment by pressing the Select key for 3 seconds Or if desired it is possible to activate the UF profiling function at any time during priming or treatment...

Страница 188: ...as been activated the profiling will be bypassed during the isolated UF phase PROFILING will still be displayed on the Information Display When the isolated UF phase is complete the profiling will automatically be reactivated starting where it was interrupted If sodium or bicarbonate profiling is deactivated during treatment the machine will continue running on the values from the point at which i...

Страница 189: ...values press the Back key and compare with the values NA displayed in the PROFILING MENU control values Secondly by checking the set start START and stop STOP values for HCO3 PROFILING protective values press the Back key and compare with the values HCO3 displayed in the PROFILING MENU control values During UF proﬁling the operator must readjust the TMP alarm limits to follow the changing UF rate ...

Страница 190: ...filing has been activated the profiling will be bypassed during the isolated UF phase PROFILING will still be displayed on the Information Display When the isolated UF phase is complete the profiling will automatically be reactivated starting where it was interrupted If sodium or bicarbonate profiling is deactivated during treatment the machine will continue running on the values from the point at...

Страница 191: ...This page is intentionally left blank 7 12 AK 96 Operator s Manual Proﬁling HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 192: ...grated Heat Disinfection 8 25 Hygiene Chemical Disinfection 8 26 Chemical Disinfection General 8 26 Chemical Disinfectants 8 26 Chemical Disinfection Program Performing 8 27 Filling the machine with chemical disinfectant 8 29 Residual Test after Chemical Disinfection 8 31 Central Chemical Disinfection Performing 8 32 Hygiene Rinse Drain 8 34 Rinse Drain General 8 34 Rinse Drain Program Performing ...

Страница 193: ...rmed according to instructions in this chapter The frequency of disinfection decalcification and cleaning of the machine should be carried out according to recommendations in this chapter The quality of the inlet water entering the machine The quality of the concentrates being used The inlet water tube which preferably should be disinfected by using integrated heat disinfection The arrangement of ...

Страница 194: ...rized technician Glossary of Disinfection Terms Disinfection is removal or reduction of bacteria in the fluid path of the dialysis machine Decalcification is removal of calcium and magnesium carbonate precipitates in the fluid path originating from the bicarbonate dialysis fluid Cleaning is removal of fats proteins and organic material originating from the patient and located mainly in the fluid p...

Страница 195: ...on programs can be displayed by scrolling up and down using the Display Up key and the Display Down key If the disinfection program was successfully performed COMPL is shown to the right on the Information Display The time shown to the left is the time for when the disinfection program was completed If the disinfection program was not successfully performed INCOMP is shown to the right on the Info...

Страница 196: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Hygiene and Maintenance 8 5 ...

Страница 197: ... disinfection program with CleanCart C cartridge or liquid citric acid x x x At least once every seventh treatment day Heat disinfection program in combination with CleanCart A cartridge or a chemical disinfection program with sodium hypochlorite This should be performed directly after a heat disinfection program in combination with CleanCart C cartridge or liquid citric acid x x x When time after...

Страница 198: ...te disinfection program was carried out It is still possible to perform a treatment the attention alarm will disappear when the Priming button lights up during the function check However the attention alarm will reappear the next time the machine is switched on if a disinfection program has still not been completely carried out Note When the machine is planned not to be in use If the machine is pl...

Страница 199: ...t None None High High Peracetic acid 0 01 to 0 15 Low3 None None High Citric acid liquid 2 and heat High Low Medium High Sodium hypochlorite 0 5 None None High High Formaldehyde 4 None None None High Glutardialdehyde 2 None None None High Oxalic acid 2 and heat4 Low High None High 3 The manufacturers of disinfectants based on peracetic acid claim that these agents can also be used for decalcificat...

Страница 200: ...isinfection program has the capacity to make viruses inactive The combination of the standard heat disinfection program process 12 cycles and the safe hygienic construction of the fluid path single pass described above provides high safety levels for the patient The standard heat disinfection program is validated by using microbiological challenge tests which gives a 5 log reduction of the followi...

Страница 201: ...eanCart cartridge Note In order to enable the cleaning agents to remove fats proteins etc efficiently cleaning should be carried out after decalcification Note For further details concerning the heat disinfection programs see Disinfection and Cleaning Heat Disinfection on page 9 9 in part 1 Handling instructions of above mentioned heat disinfection programs are described on the following pages in ...

Страница 202: ...aced in the corresponding stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P Procedure Use the Keypad next to the Information Display to select options and to navigate within and between the menus For details concerning the keys included in the Key pad see Keypad in chapter 3 part 1 1 Press the Rinse Disinfection button brie...

Страница 203: ...g 6 If an automatic switch off is required press the On Off button for 3 seconds When the program is complete drain sequence included the Priming button starts to flash not if an automatic switch off has been done 7 Switch the machine off by pressing the On Off button for 3 seconds If a new treatment is to be started directly after the disinfection program press the flashing Priming button briefly...

Страница 204: ...g stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P Procedure Use the Keypad next to the Information Display to select options and to navigate within and between the menus For details concerning the keys included in the Key pad see Keypad in chapter 3 part 1 1 Press the Rinse Disinfection button briefly 2 The RINSE DISINFEC...

Страница 205: ...anCart cartridge to the holder An attention alarm will be generated to notify you when see next point 7 When the attention alarm appears open the latches of the BiCart holder and place the CleanCart cartridge to the holder in a similar way as when you place the BiCart cartridge to the holder Default the cartridge can be left in the holder during the entire program up until next function check is s...

Страница 206: ...am is complete drain sequence included the Priming button starts to flash not if an automatic switch off has been done 10 Switch the machine off by pressing the On Off button for 3 seconds If a new treatment is to be started directly after the disinfection program press the flashing Priming button briefly and PRESS SELECT 3 SECONDS TO START FCH will be displayed Press the Select key for 3 seconds ...

Страница 207: ...aced in the corresponding stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P Procedure Use the Keypad next to the Information Display to select options and to navigate within and between the menus For details concerning the keys included in the Key pad see Keypad in chapter 3 part 1 1 Press the Rinse Disinfection button brie...

Страница 208: ... disinfectant connector to the disinfectant port 7 If the disinfectant connector is still connected to the parking port when the filling phase of the program starts the following attention alarm will be generated Note especially that the disinfectant connector must remain in the disinfectant container disinfectant port and not be moved to the parking port before the chemical disinfectant program i...

Страница 209: ...fection program press the flashing Priming button briefly and PRESS SELECT 3 SECONDS TO START FCH will be displayed Press the Select key for 3 seconds to start a new function check and simultaneously reset previous values to zero 8 18 AK 96 Operator s Manual Hygiene and Maintenance HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 210: ...ogram can be interrupted at any time when the program is running press and hold the Select key for 3 seconds The machine will then interrupt the procedure and finish off with a drain sequence The pick up tubes must be rinsed disinfected separately See Pick up Tubes on page 8 41 for instructions Note Check before starting the procedure That the concentrate connectors are placed in the corresponding...

Страница 211: ...Respond to the text shown on the Information Display on whether to include the WRO or not Use the alternative to include the WRO 7 The process will continue automatically from here When the heat disinfection of the AK 96 dialysis machine and the low flow heat are finished the Priming button will start to flash not if an automatic switch off has been done The WRO will perform a heat disinfection of...

Страница 212: ...ct key for 3 seconds to start a new function check and simultaneously reset previous values to zero Manual start of the Low Flow Heat phase 1 Press the Rinse Disinfection button briefly 2 The RINSE DISINFECTION MENU will be displayed on the Information Display 3 Select HEAT 4 Check that HEAT is displayed as selected program If HEAT is displayed continue to point 4 If not do point 4 a and 4 b befor...

Страница 213: ...ion alarm appears 6 When the low flow heat phase is finished the machine enters drain phase and simultaneously an attention alarm appears Follow the attention alarm request according to the instructions in the Operator s manual for WRO 300 H Then press the Select key to confirm this 8 22 AK 96 Operator s Manual Hygiene and Maintenance HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 214: ...ted to the water supply as well as to power when performing a heat disinfection program with automatic start The drain tube must be connected to the drain Check whenever activated That the dialysis fluid tubes are connected to the safety couplings and that the latches of the BiCart holder are closed That the points in the list Check Before Switching the Machine On in chapter 4 part 1 on page 4 2 a...

Страница 215: ...The Rinse Disinfection button will always be lit when the auto heat function has been activated and the machine is switched on If changes are to be made or the auto heat process shall be inactivated enter the AUTO HEAT MENU as described above The Select key is used to activate and deactivate the auto heat function Should days in the schedule be deactivated the set hours in READY TIME for the inten...

Страница 216: ...omplete the machine is automatically switched off Integrated Heat Disinfection The AK 96 dialysis machine can be programmed to perform integrated heat disinfection In this mode the machine receives hot water from the central water supply system when performing the heat disinfection program The heat disinfection program can be started manually or preferably be programmed to start automatically duri...

Страница 217: ...infectants Chemical disinfectants may be harmful to the materials used in the fluid path of dialysis machines Disinfectants may also contain additives that cause foaming or are difficult to rinse out Solutions based on peracetic acid such as the Dialox and Dialox HP disinfectants sodium hypochlorite and formaldehyde are compatible with the materials in the AK 96 dialysis machine provided that they...

Страница 218: ...re starting the procedure That the dialysis fluid tubes are connected to the safety couplings and that the latches of the BiCart holder are closed That the concentrate connectors are placed in the corresponding stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P CAUTION Before starting the chemical disinfection program make s...

Страница 219: ...ng port to the disinfectant port 7 If the disinfectant connector is still connected to the parking port when the filling phase of the program starts the following attention alarm will be generated Note especially that the disinfectant connector must remain in the disinfectant container disinfectant port and not be moved to the parking port before the program is complete This is due that the chemic...

Страница 220: ...nt follow the instructions in Chemical Disinfection Program Performing on page 8 27 previously in this section from the beginning up to point 7 Continue as follows 7 Press the On Off button during the chemical disinfectant filling phase The machine will continue to run the program for some minutes after the On Off button has been pressed This is to fill up all the tubes and to even out the concent...

Страница 221: ...g to section Residual Test after Chemical Disinfection page 8 31 The machine can be preset to automatically switch off after a complete chemical disinfection program i e when the Priming button is flashing by an authorized technician in the clinic CAUTION After the Chemical disinfection procedure a test for residues must have been performed prior to connecting to a patient CAUTION Note The pick up...

Страница 222: ...k up tubes must be rinsed disinfected separately See Pick up Tubes on page 8 41 for instructions Note Procedure 1 Switch the machine on and let it pass function check with the proper concentrates attached 2 When the green fluid path lights up press the flashing Fluid bypass button in order to let fresh dialysis fluid flow through the dialysis fluid tubes 3 Take the residual test sample from the fl...

Страница 223: ...eck before starting the procedure That the dialysis fluid tubes are connected to the safety couplings and that the latches of the BiCart holder are closed That the concentrate connectors are placed in the corresponding stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P Procedure Use the Keypad next to the Information Display...

Страница 224: ...he rinse drain program is complete and the machine has been drained the Priming button starts to flash 9 The machine can be preset to automatically switch off after a complete chemical disinfection program i e when the Priming button is flashing by an authorized technician CAUTION After the Chemical disinfection procedure a test for residues must have been performed prior to connecting to a patien...

Страница 225: ...aced in the corresponding stand by ports of the machine blue and red and that the yellow disinfectant connector is placed in the parking port marked P Procedure Use the Keypad next to the Information Display to select options and to navigate within and between the menus For details concerning the keys included in the Key pad see Keypad in chapter 3 part 1 1 Press the Rinse Disinfection button brie...

Страница 226: ...Priming button starts to flash not if an automatic switch off has been done 6 Switch the machine off by pressing the On Off button for 3 seconds If a new treatment is to be started directly after the disinfection program press the flashing Priming button briefly and PRESS SELECT 3 SECONDS TO START FCH will be displayed Press the Select key for 3 seconds to start a new function check and simultaneo...

Страница 227: ...Tubes on page 8 41 for instructions Note Check whenever activated That the dialysis fluid tubes are connected to the safety couplings and that the latches of the BiCart holder are closed That the points in the list Check Before Switching the Machine On in chapter 4 part 1 on page 4 2 are fulfilled That the concentrate connectors are placed in the corresponding stand by ports of the machine blue an...

Страница 228: ...ain program i e when the Priming button is flashing by an authorized technician It can also be switched off during the rinse drain program by manually pressing the On Off button while the program is running This will make all of the operator panel lights go out except for the Rinse Disinfection button and the time display When the program is complete the machine automatically switches itself off H...

Страница 229: ...e system Decalciﬁcation Calcium carbonate may deposit in the flow path The requirements for decalcification vary depending on elements as water quality type of concentrate and bicarbonate settings A general guideline for the frequency of decalcification with CleanCart C cartridge or liquid citric acid is described in the introductory part of this chapter Schedule for Hygiene and Maintenance on pag...

Страница 230: ... page 8 39 6 Label the ultrafilter with date for change 7 Perform a Heat disinfection program before the AK 96 dialysis machine is used for treatment after the ultrafilter has been changed Ultraﬁlter replacement reminder If UFD Ultrafilter Dialysis Fluid is installed the operator will be reminded to change ultrafilter The operator will be notified by an attention alarm when a limit has been exceed...

Страница 231: ...SINFECTION MENU and press the Select key Then press the Select key for 3 seconds to confirm All three counters will now begin from zero again To change the limits call for a service technician 8 40 AK 96 Operator s Manual Hygiene and Maintenance HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 232: ...ry Disinfection of the pick up tubes is recommended every to every other week Wipe the outside with 70 ethanol Flush the inside with 70 ethanol Let the pick up tube dry naturally do not wipe dry Blood Pump To remove the blood pump rotor pull out the handle Turn until the blood pump rotor loosens from the pump shaft The blood pump rotor can be cleaned and disinfected in ethanol 70 or isopropanol 60...

Страница 233: ...tened with disinfectant solution Note Make sure that the sealing ring on the inside of the cover is securely in place when replacing the cover Note BPM Cuff Cleaning instructions for the BPM cuff can be read in the package insert leaflet which is enclosed to the cuff upon delivery 8 42 AK 96 Operator s Manual Hygiene and Maintenance HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 234: ...er supply 9 12 Connection of external equipment 9 13 Battery Back up 9 13 Performance and specification Supervisory system 9 14 Blood Pressure Supervision 9 14 Extracorporeal blood loss to the environment 9 14 Air Detection 9 14 Extracorporeal blood loss due to coagulation 9 14 Dialysis fluid preparation 9 15 Ultrafiltration Supervision 9 15 Blood leakage detection 9 15 pH supervision 9 15 Physica...

Страница 235: ...o 500 mmHg post pump pressure pump segment diameter 7 9 mm Flow accuracy 10 ml min or 10 whichever is largest Accumulated blood volume 0 327 liters Volume accuracy 0 6 l treatment time h or 10 Single Needle Single needle is only available if the optional arterial clamp is installed Arterial flow rate 0 and 20 to 500 ml min 150 mmHg pre pump pressure 0 to 500 mmHg post pump pressure pump segment di...

Страница 236: ...all comply with ISO 7886 2 Stop time The heparin pump stops before end of treatment 0 00 to 9 59 h Counter pressure Maximum 400 mmHg Accumulated volume 0 999 9 ml Blood pressure Venous Pressure Operating range 700 to 750 mmHg Alarm limits 10 to 500 mmHg in treatment mode 100 to 500 mmHg in priming mode Accuracy 10 within range 700 to 500 mmHg 5 mmHg or 3 whichever is largest within range 500 to 50...

Страница 237: ...0 mmHg Diastolic pressure range1 40 200 mmHg Low alarm limit 40 200 mmHg 60 mmHg High alarm limit 40 200 mmHg 100 mmHg Mean pressure range1 45 235 mmHg Low alarm limit 45 235 mmHg 75 mmHg High alarm limit 45 235 mmHg 115 mmHg Pulse rate range 40 200 bpm 3 bpm or 2 of reading Low alarm limit 40 200 bpm 40 bpm High alarm limit 40 200 bpm 150 bpm 1 Meets ANSI AAMI SP 10 1992 Mean error 5 mmHg Standar...

Страница 238: ...t 230 V Overheat protection Reg temp 80 C or CondA temp 70 C in treatment software Reg temp 99 C in disinfection software The heater can only be on if there is a flow through the heater The flow is detected by a flow switch Flow rate Dialysis Fluid Flow Rate 300 to 700 ml min in steps of 20 ml min Accuracy 10 or 50 ml min whichever is largest Degassing By use of negative pressure 610 mmHg Adjustab...

Страница 239: ...se back volumes amongst others In addition precise pre and post treatment weight is critical for adequate assessment of the ultrafiltration during the treatment If these measurements are not accurate a discrepancy between the ultrafiltration achieved during the treatment and the changes in body weight will occur Note Volume control Direct electromagnetic measurement of dialysis fluid flow before a...

Страница 240: ...nts with saline Clearance K typical precision 8 1SD Precision has been validated in HD double needle for blood flows 200 to 400 ml min and fluid flows 500 to 700 ml min Cumulated water volume cleared of Kt 0 to 100 l 6 1SD based on 7 measurements Dialysis dose Kt V 0 to 3 Measurement interval 15 30 or 60 minutes HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Technical Data...

Страница 241: ...ine Concentration in machine 0 5 i e diluted 1 19 1 20 Volume Approx 145 ml with UFD approx 153 ml Contact time between treatments 10 minutes Contact time overnight or when not in use Maximum 20 min not intended for overnight disinfection Total time 30 minutes with UFD 50 minutes Time includes 10 min contact time Formaldehyde Program presetable Concentration of disinfectant 37 formaldehyde Concent...

Страница 242: ... heating alternative The default settings are as follows Heat disinfection Total Time min AK 96 Disinfection programs 230 V 115 V Heat 36 40 Heat Citric acid 20 52 57 With UFD Heat CleanCart 50 55 Heat 33 37 Heat Citric acid 20 49 54 Without UFD Heat CleanCart 46 51 Auto heat disinfection Auto heat can be used with or without CleanCart If the auto heat shall be performed with CleanCart must the ca...

Страница 243: ...WRO 300 H will start heat disinfection simultaneously if preset see WRO 300 H Service Manual Note Disinfection and Cleaning Rinse Drain Note Total time for disinfection programs is estimated and may vary Note Rinse Drain 10 min Drain 4 min Disinfection and Cleaning Exterior Cleaning All outside parts of the machine can be cleaned with ethanol 70 or isopropanol 60 9 10 AK 96 Operator s Manual Techn...

Страница 244: ...ct the accuracy of the fluid composition Note Local regulations may require the use of separation devices in the supply and special measures to protect against the possibility of back syphonage from dialysis equipment into the water supply Drain The drain tube outlet must be placed between floor level and maximum 1 2 m above the outlet connection from the fluid monitor An air gap to atmospheric pr...

Страница 245: ...5 W at 115 V Cable 3 conductor cable Length max 3 5 m Ratings 230 250 V AC 13 16A or 110 125 V AC 15 A External fuses For 115 230 V 2 x 12AT for heater Mains plug Earthed plug 250 V AC 10 16 A approved or Hospital grade earthed plug 125 V AC 15 A approved Earth leakage current max 500 μA Patient leakage current max 100 μA AC max 10 μA DC All leakage currents specified are without external equipmen...

Страница 246: ...tem and is therefore responsible that the system complies with the requirements for medical electrical systems Attention is drawn to the fact that local laws take priority over the above mentioned requirements If in doubt consult your local representative or the technical service department Extern alarm Max voltage 24 V AC or DC Max current 100 mA AC or DC RS 232C Max input voltage 15 V DC High le...

Страница 247: ...Extracorporeal blood loss to the environment Detection method Venous pressure supervision Air Detection Detection method Ultrasonic detector placed at the venous drip chamber The detector has a two channel structure and the function of the detector is tested at the function test made by the microcomputers Drip chamber size Diameter 22 mm Sensitivity Bubbles larger than 1 μl will be trapped by the ...

Страница 248: ...ters the machine after the dialyzer Alarm limits 100 to 500 mmHg Accuracy 10 mmHg or 5 whichever is largest within range 500 mmHg Blood leakage detection Detection method Infrared light detector Sensitivity Alarm will be given for 0 3 ml blood hematocrit 32 per minute at 300 700 ml min dialysis fluid flow Time delay for alarm maximum 5 seconds diffusion mode pH supervision pH supervision is only a...

Страница 249: ...pprox 585 mm Depth machine Approx 600 mm Depth stand Approx 620 mm Height Approx 1305 mm without infusion stand Weight Approx 60 kg without options Infusion stand Maximum total load 2 kg 9 16 AK 96 Operator s Manual Technical Data HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 250: ...PP Polypropylene PSU Polysulphone PVDF Polyvinylidene fluoride PTFE Polytetrafluoro ethylene Metals Stainless steel SS2343 Stainless steel SS2353 Stainless steel SS2562 Titanium Platinum Others Carbon Ceramic Steatite 221 Ceramic Aluminum oxide Al2O3 Glass HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Technical Data 9 17 ...

Страница 251: ...ssure 500 to 1060 hPa Electromagnetic environment The AK 96 is intended for use in the electromagnetic environment specified below The customer or the user of the AK 96 should assure that it is used in such an environment Emissions test Compliance Electromagnetic environment guidance RF emissions CISPR 11 Group 1 The AK 96 dialysis machine uses RF energy only for its internal function Therefore it...

Страница 252: ...y input lines IEC 61000 4 11 5 UT 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles 5 UT 95 dip in UT for 5 sec 5 UT 95 dip in UT for 0 5 cycle 40 UT 60 dip in UT for 5 cycles 70 UT 30 dip in UT for 25 cycles 5 UT 95 dip in UT for 5 sec Mains power quality should be that of a typical commercial or hospital environment If the user of the AK 96 dialysis mach...

Страница 253: ...arked with the following symbol Note At 80 MHz and 800 MHz the higher frequency range applies These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Note 2 Field strengths from fixed transmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and F...

Страница 254: ...quency of transmitter m 150kHz 80MHz 80MHz 800MHz 800MHz 2500MHz 0 01 0 11 0 11 0 23 0 1 0 37 0 37 0 74 1 1 2 1 2 2 3 10 3 7 3 7 7 4 100 12 12 23 Rated maximum output power of mobile phone 2W GSM 3G 0 33 For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters m can be estimated using the equation applicable to the frequency of the transmitt...

Страница 255: ... electrical systems IEC 60601 1 2 Electromagnetic compatibility class B IEC 60601 2 30 Particular requirements for the safety of automatic cycling indirect blood pressure monitoring equipment EN 1060 1 Non invasive sphygmomanometers Part 1 General requirements EN 1060 3 Non invasive sphygmomanometers Part 3 Supplementary requirements for electromechanical blood pressure measuring systems 9 22 AK 9...

Страница 256: ...References Assembly Drawings K29000 K29001 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Technical Data 9 23 ...

Страница 257: ...This page is intentionally left blank 9 24 AK 96 Operator s Manual Technical Data HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 258: ...ntents Major Changes between Program Version 2 xx and 3 xx 10 2 Complete Manual 10 2 Chapter 2 part 1 10 2 Chapter 4 part 1 10 2 Chapter 13 Alarm Handbook 10 2 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Major Changes 10 1 ...

Страница 259: ...lue which now cannot be adjusted by the operator during priming yet it is still possible to adjust it during treatment See Fluid Path button page 3 15 in part 1 Chapter 4 part 1 A heparin solution bolus volume can now be administrated using the heparin pump previously called the syringe pump For information of heparin pump setting possibilities see in Blood Part Component Details page 2 5 point 8 ...

Страница 260: ...ocedure has been started the connect patient volume is achieved and no blood has been detected in the venous blood line See in Alarms for information HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Major Changes 10 3 ...

Страница 261: ...ncentrates 1 19 4 8 9 6 profiling 7 2 7 8 9 6 Conductivity 3 17 9 15 12 4 D Decalcification 8 6 8 38 Dialysis fluid filter 1 17 2 26 4 35 Dialysis fluid temperature 9 5 setting 4 52 Dialysis fluid tubes 4 41 4 48 Dialyzer 1 21 4 15 4 22 4 32 remove 4 63 Disc filter 4 66 Disinfectant 8 8 8 26 9 8 Disinfection 8 2 chemical 8 26 9 8 heat 8 9 9 9 Distribution volume 12 5 12 14 Drain tube 2 32 4 2 8 2 ...

Страница 262: ...Treatment time 3 12 3 25 4 52 passed 3 12 U UF activate 6 4 profiling 7 7 UF rate 3 15 3 25 4 52 profiling 7 3 setting 4 52 UF settings 3 25 UF start stop 4 52 4 56 5 9 UF volume 3 16 3 25 4 52 setting 4 52 5 9 Ultrafilter 1 17 1 21 2 26 replace 8 39 Ultrafiltration 4 17 4 29 9 6 V Venous blood line 4 28 Venous clamp 2 11 4 33 Venous drip chamber 4 32 4 41 4 47 4 53 5 5 Venous phase single needle ...

Страница 263: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 264: ...g 8 Hygiene and Maintenance 9 Technical Data and Speciﬁcations 10 Major Changes in Operator s Manual Part 2 Instructions for Measurement Functions 11 BPM Blood Pressure Monitor option 12 Diascan option Part 3 Alarm Handbook 13 Alarms 14 Attention Alarms Note Please observe that this part of the Operator s manual for the AK 96 dialysis machine is one out of three To assimilate these instructions th...

Страница 265: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 266: ...t factors which affect readings 11 4 BPM Log List 11 6 Single Measuring 11 7 Procedure 11 7 Automatic Interval Measuring 11 9 Procedure 11 9 Automatic Continuous Measuring 11 13 Procedure 11 13 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual BPM 11 1 ...

Страница 267: ...Measuring means that the blood pressure measurement checks will be performed at set time intervals These can be set between 5 60 minutes See Automatic Interval Measuring page 11 9 for instructions Automatic Continuous Measuring means that the blood pressure measurement checks will be continuously performed during a time period of five minutes See Automatic Continuous Measuring page 11 13 for instr...

Страница 268: ...ood Part Component Details page 2 5 in part 1 look for BPM Connector in the list The cuff is available in different sizes see Blood Pressure Measurement Accessories page 1 21 in part 1 The cuff and the cuff hose can be ordered from your Gambro representative It is important to use proper cuff size for accurate measurements Use the circumference of the patient s arm to determine cuff size If the bl...

Страница 269: ... the cuff during readings Some arrhythmias may cause pressure fluctuations that make obtaining readings more difficult If difficulty obtaining readings occurs in the presence of arrhythmia blood pressure should periodically be verified by another method Do not apply a blood pressure cuff to a limb with an access e g fistula or graft Do not apply a blood pressure cuff to a limb being monitored with...

Страница 270: ...s or for children with a pediatric cuff and not for infant or neonatal patients The manufacturer advises the user that the information originating from the Blood Pressure Monitor cannot be used alone as unique source of information to induce any therapeutic or pharmacological actions CAUTION HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual BPM 11 5 ...

Страница 271: ...here is need for more than 20 measurements during a treatment the second result will be deleted then the third and so on The first result will be saved regardless of how many measurements are made The values are shown as below TIME shows current time for when the blood pressure measurement check was completed SYS DIA shows systolic diastolic blood pressure MEAN shows mean blood pressure The value ...

Страница 272: ...ake correct actions If the measurement check was successfully performed the cuff pressure will be maximum 30 mmHg above the latest measured systolic blood pressure for following measurement checks Procedure 1 Press the BPM button The BPM MENU will be shown on the Information Display 2 When START has been selected press the Select key to start the measurement check The BPM MENU will remain on the I...

Страница 273: ...ormed This attention is optional and must be preset by a service technician The list starts with the latest measurement at the top See BPM Log List page 11 6 The latest measurement result values will also be displayed on the BPM MENU TIME shows current time for when the blood pressure measurement check was completed SYS DIA shows systolic diastolic blood pressure MEAN shows mean blood pressure The...

Страница 274: ...easurement checks still fail there will be an attention alarm to guide the operator to take correct actions If the measurement check was successfully performed the cuff pressure will be maximum 30 mmHg above the latest measured systolic blood pressure for following measurement checks Procedure 1 Press the BPM button The BPM MENU will be shown on the Information Display 2 Select AUTO using the Keyp...

Страница 275: ...time intervals can be set between 5 60 minutes 5 If desired set high and low alarm limits for systolic diastolic and mean blood pressure as well as pulse rate by first pressing the Back key to go back to the BPM MENU In this menu select ALARM using the Keypad to reach the BPM ALARM MENU 5 a First check or set ALARM to ON using the Keypad 5 b Then select SET LIMITS and the menu will change 11 10 AK...

Страница 276: ... is displayed in P CUFF on the BPM MENU If the measuring process needs to be interrupted when the BPM MENU is open press the Select key to stop the procedure AUTO BPM will be shown at the activity field of the Treatment Overview Menu when automatic BPM measuring has been activated During the ongoing blood pressure measurement check this will be replaced by a flashing BPM label Note especially that...

Страница 277: ...ood pressure The value beside PULSE shows pulse rate To read previous measuring results select LOG using the Keypad to open the BPM LOG LIST See BPM Log List page 11 6 Note After treatment when the cuff is removed from the patient the blood pressure measurement will continue as set when automatic blood pressure measuring has been activated Press the Select key for 3 seconds to deactivate the autom...

Страница 278: ...measurement checks still fail there will be an attention alarm to guide the operator to take correct actions If the measurement check was successfully performed the cuff pressure will be maximum 30 mmHg above the latest measured systolic blood pressure for following measurement checks Procedure 1 Press the BPM button The BPM MENU will be shown on the Information Display 2 Select AUTO using the Key...

Страница 279: ...nute period with continuous measurement checks If alarms are generated they will not appear until the 5 minute period has ended 4 Press the Select key to activate continuous measuring for 5 minutes Blood pressure measurement checks will now be performed continuously for five minutes The current pressure in the blood pressure measurement cuff is displayed in P CUFF on the BPM MENU BPM will be flash...

Страница 280: ... shows current time for when the blood pressure measurement check was completed SYS DIA shows systolic diastolic blood pressure MEAN shows mean blood pressure The value beside PULSE shows pulse rate To read previous measuring results select LOG using the Keypad to open the BPM LOG LIST See BPM Log List page 11 6 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual BPM 11 15 ...

Страница 281: ...This page is intentionally left blank 11 16 AK 96 Operator s Manual BPM HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 282: ...0 Forecast 12 10 Time To Target 12 11 The Setting Menu 12 12 Activation deactivation and measurement mode setting 12 12 Alarm limit for clearance 12 13 Distribution volume 12 14 Distribution volume setting 12 14 Distribution volume calculation and setting using the Watson formula 12 14 Alarm limit for Kt V 12 16 Target for Kt V 12 16 Alarms 12 18 Clearance alarm limit 12 18 Kt V alarm limit 12 19 ...

Страница 283: ...uous measuring of clearance 12 22 Procedure 12 22 Single Kt V and clearance measurement check 12 24 Procedure 12 24 Continuous measuring of Kt V and clearance 12 27 Procedure 12 27 12 2 AK 96 Operator s Manual Diascan HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 284: ...t by the operator for each individual patient can be reached at treatment end If not the operator will be immediately notified during treatment The measurement checks can be performed one at a time when required or continuously at set intervals during treatment If Kt V measurement is required distribution volume VOLUME has to be set before the measurement check takes place The distribution volume ...

Страница 285: ...e conductivity levels in the dialysis fluid before and after the dialyzer in the first phase This is to ensure that the patient s sodium balance remains as neutral as possible When the second phase is complete the conductivity level is returned to the set value and the clearance calculation is performed The calculation is based on the measured difference between the conductivity levels in the firs...

Страница 286: ...res water in the body estimated for the individual patient based on the patient s dry weight The estimation is based on certain formulae used for this purpose chosen by the prescribing physician responsible for the patient The distribution volume has to be set by the machine operator in order for a correct Kt V value to be obtained Forecast in this context is a machine calculated prediction of the...

Страница 287: ...he Diascan function cannot be used in combination with Isolated UF or in combination with UF profiling in steps or intervals In any of these cases the machine will generate an attention alarm telling the operator that the Diascan function is not available During an ongoing Diascan measurement check certain operator s actions will interrupt the measuring process and the machine will automatically r...

Страница 288: ...s changed linear UF profiling activation deactivation is made sodium or bicarbonate profiling activation deactivation is made isolated UF activation is made In any of these cases the measurement check is interrupted The attention alarm is to be confirmed by pressing the Select key and the machine will automatically reschedule measuring as soon as possible Note The blood ﬂow rate and the dialysis ﬂ...

Страница 289: ...mulated Kt are displayed in this menu A Kt forecast value is also displayed If Kt V measurement is desired and a distribution volume has been set the accumulated Kt and the Kt forecast value will be replaced by Kt V values Furthermore if a Kt V target value has been set an estimation of the time needed to reach the target is also displayed in this menu It is also possible to view the 20 last measu...

Страница 290: ...played next to the accumulated Kt value This value shows the Kt value estimated to be obtained when the treatment is complete For further information see Forecast in this section LOG shows the 20 last measurement results Scroll up and down in the list using the Display Up Down keys HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Diascan 12 9 ...

Страница 291: ...eded to reach the desired Kt V target value set by the operator For further information see Time To Target in this section LOG shows the 20 last measurement results Scroll up and down in the list using the Display Up Down keys Forecast Forecast is a calculation of the Kt or Kt V value estimated to be obtained when the treatment is complete If distribution volume VOLUME has been set this Kt V forec...

Страница 292: ... to reach the desired Kt V target value Time to target will be calculated by the machine and will automatically be shown as soon as the first Diascan measurement check has been performed This estimated time can be compared with the treatment time set but there will not be an attention alarm generated to make the operator attentive to any differences HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 293: ... alarm limit for Kt V these settings are also entered here Activation deactivation and measurement mode setting Choose a single measurement check or continuous checks at intervals the intervals are 15 30 or 60 minutes Activate the Diascan function by selecting SINGLE 15 MIN 30 MIN or 60 MIN Deactivate the function by selecting OFF Note If UFD is installed the duration of the Diascan measurement ch...

Страница 294: ...m limit for minimum clearance select K LIMIT and set a proper alarm limit value using the Keypad For further information see Clearance alarm limit page 12 18 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Diascan 12 13 ...

Страница 295: ... on in this section for instructions Distribution volume setting To set a distribution volume select VOLUME and set a proper value using the Keypad 40 l is the default starting point value adjust the value as necessary Distribution volume calculation and setting using the Watson formula It is possible for the machine to carry out a distribution volume calculation displayed in litres using the Wats...

Страница 296: ... to be entered in the same way When all requested parameters have been entered press the Back key and the machine performs the calculation The setting menu will return The distribution volume value in litres calculated by the machine according to the Watson formula will be shown below VOLUME A W in brackets is shown beside the value indicating that the value has been calculated by the machine Note...

Страница 297: ...To set a desired dialysis dose target value Kt V which is to be achieved at treatment end select Kt V TARGET and set a proper value using the keypad The target value for Kt V can be set between OFF and 2 0 When the Kt V target value has been set the machine calculates the time needed to reach the target This time to target TTT will be displayed in the viewing menu as soon as the first Diascan meas...

Страница 298: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Diascan 12 17 ...

Страница 299: ...ue using the Keypad The starting point value is 50 of the current blood flow rate at that time Adjust the value as necessary If the measured clearance value is below the alarm limit set an attention alarm will be generated Check cause adjust treatment parameters to increase clearance or adjust the alarm limit for clearance as above 12 18 AK 96 Operator s Manual Diascan HCEN12239 Revision 12 2010 P...

Страница 300: ...OFF and 1 95 To set the alarm limit for minimum Kt V select Kt V LIMIT and set a proper alarm limit value after the distribution volume VOLUME has been set using the Keypad If the Kt V forecast value estimated at that time to be obtained when the treatment is complete is below the Kt V alarm limit set an attention alarm will be generated Check cause adjust treatment parameters or adjust the alarm ...

Страница 301: ...ect SINGLE using the Display Up key Single measurement is now activated The single clearance measurement check will be performed on an appropriate occasion chosen by the machine The occasion chosen is dependent on when the self calibrations of the machine are to be performed DIASCAN will be shown at the activity field of the Treatment Overview Menu when the function has been activated 12 20 AK 96 ...

Страница 302: ...he measurement result values are also displayed in the Diascan viewing menu When the measurement check has been performed Diascan will automatically be turned to OFF It is possible to repeat the procedure at any time during treatment Note To ensure a correct result a single clearance measurement check should be activated no later than 30 minutes before discontinuing treatment This is to have enoug...

Страница 303: ...r clearance is required select K LIMIT Press the Select key and set a suitable alarm limit value using the Display Up key For further information see Clearance alarm limit page 12 18 The first clearance measurement check in the sequence will be performed on an appropriate occasion chosen by the machine The occasion chosen is dependent on when the self calibrations of the machine are to be performe...

Страница 304: ...the Treatment Overview Menu will be flashing When a measurement check has been performed an attention alarm text without a buzzer will appear on the Information Display Press the Select key to enter the LOG menu The measurement result values are also displayed in the Diascan viewing menu HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Diascan 12 23 ...

Страница 305: ...t DIASCAN 2 Select SET DIASCAN and the setting menu will be displayed 3 When DIASCAN OFF has been selected press the Select key 4 Select SINGLE using the Display Up key Single measurement is now activated 12 24 AK 96 Operator s Manual Diascan HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 306: ... volume has to be properly estimated for the individual patient The calculation of Kt V done in the machine is entirely dependent on the value for the individual patient being the correct one For further information see Glossary of Diascan parameters and key terms page 12 4 The single clearance measurement check will be performed on an appropriate occasion chosen by the machine The occasion chosen...

Страница 307: ... the procedure at any time during treatment Note Changes in treatment parameters above all blood ﬂow rate affect measured clearance K values obtained during treatment and consequently the calculated Kt V result If the Kt V calculation at treatment end is based on few clearance results or only one check that these results are relevant for the complete treatment This is in order to ensure that the K...

Страница 308: ...elect key 4 Select 15 MIN 30 MIN 60 MIN using the Display Up key Continuous measurement of clearance is now activated 5 If an alarm limit for clearance is required select K LIMIT Press the Select key and set a suitable alarm limit value using the Display Up key For further information see Clearance alarm limit page 12 18 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Diasc...

Страница 309: ... key 40 l is the default starting point value Adjust the value as necessary Note that the distribution volume has to be properly estimated for the individual patient The calculation of Kt V done in the machine is entirely dependent on the value for the individual patient being the correct one For further information see Glossary of Diascan parameters and key terms page 12 4 7 To set the alarm limi...

Страница 310: ...ate occasion chosen by the machine The occasion chosen is dependent on when the self calibrations of the machine are to be performed DIASCAN will be shown at the activity field of the Treatment Overview Menu when the function has been activated During the period of time when the measurement check is being performed DIASCAN shown at the activity field of the Treatment Overview Menu will be flashing...

Страница 311: ...tly the calculated Kt V result If the Kt V calculation at treatment end is based on few clearance results or only one check that these results are relevant for the complete treatment This is in order to ensure that the Kt V value is a relevant one Note 12 30 AK 96 Operator s Manual Diascan HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 312: ... 54 5 5 5 6 6 2 12 4 Blood flow rate alarm 4 56 5 8 Blood leak detector 1 16 2 26 8 41 Blood lines 1 20 4 16 4 28 remove 4 63 Blood pump 2 8 4 19 8 41 speed 4 54 5 6 Blood pump segment 3 13 9 2 BPM ranges 9 4 BPM cuff 1 21 8 42 11 2 Buttons list of 3 8 Buzzer sound 4 2 14 2 C Centralizing function 4 57 5 11 Clamp 2 11 4 23 Clearance 9 7 12 4 continuous measuring 12 22 12 27 single measurement 12 2...

Страница 313: ...N Non diffusion time 3 12 P Pediatric blood line 1 20 4 16 4 28 pH 9 15 Physical data 9 16 Pick up tubes 2 24 8 41 Power supply 4 2 9 12 Pressure transducer arterial 4 24 contamination 4 66 venous 4 34 Priming 4 38 extra 4 44 4 50 new 4 44 4 45 4 50 4 51 Priming detector 2 10 4 33 4 55 5 7 Priming UF rate 3 16 4 40 Priming volume 4 41 Pump speed 4 40 4 53 4 54 5 5 5 6 R Recirculation reduction sin...

Страница 314: ...ng 4 52 UF settings 3 25 UF start stop 4 52 4 56 5 9 UF volume 3 16 3 25 4 52 setting 4 52 5 9 Ultrafilter 1 17 1 21 2 26 replace 8 39 Ultrafiltration 4 17 4 29 9 6 V Venous blood line 4 28 Venous clamp 2 11 4 33 Venous drip chamber 4 32 4 41 4 47 4 53 5 5 Venous phase single needle 5 2 Venous pressure 3 11 4 56 9 3 setting 4 56 setting single needle 5 9 Venous pressure single needle 5 8 Venous pr...

Страница 315: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 316: ...g 8 Hygiene and Maintenance 9 Technical Data and Speciﬁcations 10 Major Changes in Operator s Manual Part 2 Instructions for Measurement Functions 11 BPM Blood Pressure Monitor option 12 Diascan option Part 3 Alarm Handbook 13 Alarms 14 Attention Alarms Note Please observe that this part of the Operator s manual for the AK 96 dialysis machine is one out of three To assimilate these instructions th...

Страница 317: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 318: ... 13 9 Venous Pressure Alarms 13 14 Air Detector Alarm 13 19 Low Blood Flow Rate Alarm 13 22 Single Needle Stroke Volume Alarm 13 24 Blood Pressure Alarms 13 26 Blood Leak Alarm 13 34 TMP Alarms 13 37 Temperature Alarms 13 41 Conductivity Alarm 13 45 pH option Alarm 13 47 Connect Patient Alarm 13 49 Technical Alarm 13 51 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms...

Страница 319: ...ghts up displayed alarm texts and page references to the Alarm List for each alarm Button Function Alarm See page 13 9 Arterial Pressure Alarms See page 13 9 See page 13 14 Venous Pressure Alarms See page 13 14 Air Detector Alarm See page 13 19 13 2 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 320: ... 26 See page 13 26 See page 13 26 Blood Pressure Alarms See page 13 26 See page 13 22 Blood Path Alarms See page 13 24 Blood Leak Alarm See page 13 34 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 3 ...

Страница 321: ... page 13 37 See page 13 41 See page 13 41 See page 13 45 Fluid Path Alarms See page 13 47 Connect Patient Alarm See page 13 49 Technical Alarm See page 13 51 13 4 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 322: ... to and the alarm applies for lights up See the description for each alarm in the Alarm List page 13 9 General Alarm Handling Press the flashing Alarm button The button lights up and the alarm text which gives information on what has triggered the alarm is displayed in the alarm list of the Information Display At the same time as the Alarm button is being pressed the buzzer will be simultaneously ...

Страница 323: ... which the alarm applies for In menus where it is possible to manually adjust the alarm limit the value of which the alarm applies for will have an already opened position i e a lower cursor will be present The Mute button can be used to silence the buzzer for 2 minutes at a time The buzzer sounds continuously for all alarms If a new alarm is issued and the first alarm has not been reset or if the...

Страница 324: ...omatically recur The override time can be preset by authorized technician between 5 120 seconds except for the override of the air detector which can be preset 0 15 seconds Alarm History When the Alarm button is pressed for 3 seconds in a non alarm situation a list of the most recently generated alarms will be shown on the Information Display The last generated alarm is shown at the top of the lis...

Страница 325: ... in the Alarms Overview list Alternatively look for the alarm in the Table of Contents first in this chapter Each alarm description in the Alarm List is divided up into the following sections Appears Describes what conditions must be present for an alarm to appear what triggers generates the alarm Possible cause Describes different imaginable reasons for the appearance of the alarm Machine actions...

Страница 326: ...ial pressure is within the set alarm limits again the blood pump automatically starts and the venous blood line clamp opens Possible cause The arterial blood line has separated from the arterial needle The position of the arterial needle has changed Air or infusion fluid have entered the arterial blood line between the arterial needle and the blood pump e g when an infusion is connected to the art...

Страница 327: ...actions in accordance with this If the blood pump intermittently starts and stops consider adjusting the blood flow rate or if necessary manually stop the blood pump using the Blood Pump buttons If possible adjust the arterial pressure high alarm limit using the Key pad After the arterial pressure alarm has been attended to and if the arterial pressure alarm window is set to be wider than the pres...

Страница 328: ...ts again the blood pump automatically starts and the venous blood line clamp opens Possible cause The performance of the patient s vascular blood access is not in accordance with the set blood flow rate The arterial blood line is kinked or clotted between the arterial needle and the arterial pressure measurement point The position of the arterial needle has changed HCEN12239 Revision 12 2010 Progr...

Страница 329: ...starts and stops consider adjusting the blood flow rate or if necessary manually stop the blood pump using the Blood Pump buttons If possible adjust the arterial pressure low alarm limit using the Key pad If necessary override bypass the machine alarm actions by pressing the lit Arterial Pressure button for 3 seconds The blood pump will start up at the set blood flow rate adjust if necessary If th...

Страница 330: ...art to flash Press the flashing button to centralize the alarm limits around the current value WARNING When entering override it is essential to remember that the machine does not monitor that speciﬁc parameter The operator is responsible for the monitoring during the override time WARNING HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 13 ...

Страница 331: ... When the venous pressure is within the set alarm limits again the blood pump automatically starts Possible cause The venous blood line is kinked or clamped The position of the venous needle has changed Clotting has occurred in the venous blood line after the venous pressure measurement point in the blood line in the venous drip chamber or in the needle 13 14 AK 96 Operator s Manual Alarms HCEN122...

Страница 332: ... actions in accordance with this If the blood pump intermittently starts and stops consider adjusting the blood flow rate or if necessary manually stop the blood pump using the Blood Pump buttons If possible adjust the venous pressure high alarm limit using the Key pad After the venous pressure alarm has been attended to and if the venous pressure alarm window is set to be wider than the preset va...

Страница 333: ...n blood is detected When the venous pressure is within the set alarm limits again the blood pump automatically starts and the venous blood line clamp opens Possible cause The venous blood line has separated from the dialyzer The venous blood line has separated from the venous needle The position of the venous needle has changed Clotting before or in the dialyzer 13 16 AK 96 Operator s Manual Alarm...

Страница 334: ...tarts and stops consider adjusting the blood flow rate or if necessary manually stop the blood pump using the Blood Pump buttons If possible adjust the venous pressure low alarm limit using the Key pad If necessary override bypass the machine alarm actions by pressing the lit Venous Pressure button for 3 seconds The blood pump will start up at the set blood flow rate adjust if necessary If the cau...

Страница 335: ... to flash Press the flashing button to centralize the alarm limits around the current value WARNING When entering override it is essential to remember that the machine does not monitor that speciﬁc parameter The operator is responsible for the monitoring during the override time WARNING 13 18 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 336: ... from the dialyzer when blood is detected Possible cause The blood line connections are not properly connected at the arterial needle at the dialyzer The blood lines or the dialyzer has not been properly de aired during priming Air have entered the blood lines e g when an infusion is connected to the blood lines The arterial needle is dislocated HCEN12239 Revision 12 2010 Program version 3 xx AK 9...

Страница 337: ...cessary override bypass the machine alarm actions by pressing the lit Air Detector button for 3 seconds The blood pump will start up at 100 ml min blood flow rate adjust if necessary If the cause of the alarm has not been corrected within the override time the machine alarm actions will automatically recur If necessary repeat the override procedure Especially note that the blood flow rate will rem...

Страница 338: ...ashing button to reset the alarm function WARNING When entering override it is essential to remember that the machine does not monitor that speciﬁc parameter The operator is responsible for the monitoring during the override time WARNING HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 21 ...

Страница 339: ...s None Possible cause The blood flow rate has been decreased for any reason and not been adjusted afterwards The blood pump has been automatically stopped too long due to machine alarm actions The operator has left the blood pump in stop position too long 13 22 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 340: ... detector alarm override previous technical alarm etc If possible increase the blood flow rate to the proper value and the alarm will automatically disappear when the blood flow rate is set above the alarm limit value If necessary adjust the alarm limit value by pressing the Select key to enter the BLOOD FLOW MENU Adjust the alarm limit SET LOW as necessary HCEN12239 Revision 12 2010 Program versi...

Страница 341: ...me STROKE is lower than the set stroke volume SET Machine actions None Possible cause Decreased performance of the patient s blood access Adjustments to optimize the single needle treatment may have been overlooked 13 24 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 342: ...ter the stroke volume The higher the position of the window i e how high in the mmHg scale the window is placed the higher the venous flow When above mentioned measures have been made without expected result adjust the set stroke volume as necessary Press the Select key to open SINGLE NEEDLE and then adjust MIN STROKE using the Keypad See in the chapter Hemodialysis Single Needle Treatment option ...

Страница 343: ...e is outside the low or high alarm limits set Machine actions None Possible cause Circulatory disturbances in the patient Inaccurate setting of alarm limits for the particular patient 13 26 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 344: ...ndard patient checks and take standard measures as whenever the patient has a circulatory disturbance If desired repeat the blood pressure measurement check manually see Single Measuring on page 11 7 in part 2 for instructions If possible adjust the alarm limits in accordance with the status of the patient When the BPM log list is displayed press Back button and navigate to ALARM to adjust the lim...

Страница 345: ...e the low or high alarm limits set Machine actions None Possible cause Circulatory disturbances in the patient Inaccurate setting of alarm limits for the particular patient 13 28 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 346: ...ndard patient checks and take standard measures as whenever the patient has a circulatory disturbance If desired repeat the blood pressure measurement check manually see Single Measuring on page 11 7 in part 2 for instructions If possible adjust the alarm limits in accordance with the status of the patient When the BPM log list is displayed press Back button and navigate to ALARM to adjust the lim...

Страница 347: ...the low or high alarm limits set Machine actions None Possible cause Circulatory disturbances in the patient Inaccurate setting of alarm limits for the particular patient 13 30 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 348: ...ndard patient checks and take standard measures as whenever the patient has a circulatory disturbance If desired repeat the blood pressure measurement check manually see Single Measuring on page 11 7 in part 2 for instructions If possible adjust the alarm limits in accordance with the status of the patient When the BPM log list is displayed press Back button and navigate to ALARM to adjust the lim...

Страница 349: ...ow or high alarm limits set Machine actions None Possible cause Circulatory disturbances in the patient Inaccurate setting of alarm limits for the particular patient 13 32 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 350: ...ndard patient checks and take standard measures as whenever the patient has a circulatory disturbance If desired repeat the blood pressure measurement check manually see Single Measuring on page 11 7 in part 2 for instructions If possible adjust the alarm limits in accordance with the status of the patient When the BPM log list is displayed press Back button and navigate to ALARM to adjust the lim...

Страница 351: ...n rate is set to zero and the dialysis fluid is bypassed from the dialyzer when blood is detected The machine indicates the alarm by a flashing part of the fluid flow path Possible cause A dialyzer leakage resulting in blood flowing from the blood compartment to the dialysis fluid compartment has occurred 13 34 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 352: ...t returning the blood to the patient to continuing treatment without action The blood leak machine alarm actions may be overridden bypassed by pressing the Select key The blood pump will start up at 50 ml min blood flow rate adjust if necessary The blood leak detector will automatically be rinsed with dialysis fluid during the override period If the cause of the alarm has not been corrected within...

Страница 353: ...e alarm function WARNING When entering override it is essential to remember that the machine does not monitor that speciﬁc parameter The operator is responsible for the monitoring during the override time WARNING 13 36 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 354: ... TMP value as well as changed performance of the dialyzer as the treatment proceeds Changes in the machine UF control system can also cause reduced accuracy in measuring the patient s weight loss The following points may cause high TMP alarm changes in the UF control system of the machine the set treatment time has been decreased the set UF volume has been increased clogged dialyzer partly or comp...

Страница 355: ...andard patient checks for incorrect weight loss such as measuring blood pressure If necessary discontinue treatment and call an authorized technician If possible increase the set treatment time decrease the set UF volume or increase the blood flow rate If possible adjust the high TMP alarm limit using the Key pad When the Transmembrane pressure confirm menu is displayed on the Information Display ...

Страница 356: ...ffect the TMP value as well as changed performance of the dialyzer as the treatment proceeds Changes in the machine UF control system can also cause reduced accuracy in measuring the patient s weight loss The following points may cause low TMP alarm changes in the UF control system of the machine the set treatment time has been increased the set UF volume value has been decreased increased blood f...

Страница 357: ...with this Do standard patient checks for incorrect weight loss such as measuring blood pressure If necessary discontinue treatment and call an authorized technician If possible decrease the set treatment time or increase the set UF volume If possible adjust the low TMP alarm limit using the Key pad When the Transmembrane pressure confirm menu is displayed on the Information Display press the Selec...

Страница 358: ...ts again the dialysis fluid automatically enters the dialyzer Possible cause The temperature of the inlet water to the machine is too high The machine has not yet stabilized the dialysis fluid temperature after the function check The machine has not yet stabilized the dialysis fluid temperature after an interruption of the water supply to the machine HCEN12239 Revision 12 2010 Program version 3 xx...

Страница 359: ...and go into the temperature menu using the Keypad The alarm limit setting of which the alarm applies for will be open Check cause inlet water supply power supply and do necessary actions in accordance with this Wait for correct dialysis fluid temperature to be resumed If necessary call for an authorized technician or discontinue treatment 13 42 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 ...

Страница 360: ...e is within the set alarm limits again the dialysis fluid automatically enters the dialyzer Possible cause The machine has not yet stabilized the dialysis fluid temperature after an interruption of the water supply to the machine The power supply to the heating rods in the machine has been interrupted HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 43 ...

Страница 361: ...and go into the temperature menu using the Keypad The alarm limit setting of which the alarm applies for will be open Check cause inlet water supply power supply and do necessary actions in accordance with this Wait for correct dialysis fluid temperature to be resumed If necessary call for an authorized technician or discontinue treatment 13 44 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 ...

Страница 362: ...mpty Air is drawn into the machine instead of concentrate Incorrect concentrate has been connected e g the connected concentrate is not in accordance with the selected concentrate alternative There is an interruption in the concentrate administration to the machine e g the concentrate connector is not properly connected to the pick up tube the BiCart cartridge is not properly attached see Acidic c...

Страница 363: ...ssible to press the lit Fluid Path button select COND and go into the conductivity menu using the Keypad Check cause concentrates tubes connectors and do necessary actions in accordance with this Wait for correct dialysis fluid conductivity to be resumed If necessary call for an authorized technician or discontinue treatment 13 46 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program v...

Страница 364: ...rm limits again the dialysis fluid automatically enters the dialyzer Possible cause The content of the concentrate container does not correspond with the specifications given Incorrect concentrate has been connected Either the acidic container or the bicarbonate container BiCart cartridge is empty when using bicarbonate concentrates HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s ...

Страница 365: ...le to press the lit Fluid Path button select COND and go into the conductivity menu using the Keypad Check cause concentrates tubes connectors and do necessary actions in accordance with this Wait for correct pH of the dialysis fluid to be resumed If necessary call for an authorized technician or discontinue treatment 13 48 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version ...

Страница 366: ...achieved and no blood has been detected in the venous blood line Machine actions The blood pump stops The venous blood line clamp closes Possible cause The venous blood line is not properly inserted into the priming detector HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 49 ...

Страница 367: ...g detector When the priming detector detects blood in the venous blood line the blood path of the Flow Diagram lights up red and the treatment time starts to count down on the Time Display Press the Select key to confirm When done select CONTINUE CONNECT PATIENT and press the Select key 13 50 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 368: ...ctions The machine actions differ depending on the kind of technical error The machine sometimes automatically enters a state which makes it impossible to continue the treatment Possible cause HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 51 ...

Страница 369: ...at the top of the list The arrows on both sides of the text shows where you are in the list The display can show at most three technical errors at the same time Use the Display Down key to view any further possible error codes Technical error during treatment call the authorized technician If necessary during treatment manually return the blood to the patient See Power Failure on page 3 27 in part...

Страница 370: ...will perform a new function check If the technical error reoccurs call the authorized technician WARNING A restart attempt after technical error during treatment may create a potential hazard for the patient WARNING HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Alarms 13 53 ...

Страница 371: ...This page is intentionally left blank 13 54 AK 96 Operator s Manual Alarms HCEN12239 Revision 12 2010 Program version 3 xx ...

Страница 372: ... Alarms General 14 2 Attention Alarm Indication 14 2 General Attention Alarm Handling 14 2 How to find the Attention Alarm 14 4 Attention Alarm List 14 5 HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 1 ...

Страница 373: ...zer sounds There are three kinds of buzzer sounds Soft Supersoft 10 sec 10 sec Continuous General Attention Alarm Handling Press the flashing Attention button The button lights up and the attention alarm text which gives information on what has triggered the attention alarm is displayed in the attention list on the Information Display 14 2 AK 96 Operator s Manual Attention Alarms HCEN12239 Revisio...

Страница 374: ...o silence the buzzer for varying times depending on the attention alarm The mute times for the different alarms are described below for each attention alarm If a new attention alarm is generated and the first attention alarm has not been reset or if there are several attention alarms generated in succession the Attention button will start to flash again or continue to flash when the new attention ...

Страница 375: ...erates an alarm Machine actions Describes actions that will automatically be taken by the machine due to the attention alarm Measures Describes actions expected from the operator when an attention alarm appears Mutetime When the Mute button is pressed the buzzer sound will be muted during the specified period of time Min minutes Buzzer sound Describes which kind of buzzer sound is used for the att...

Страница 376: ...d upon attention alarm request Machine actions The Air detector button will be flashing Measures Press the flashing Air detector button to activate the air detector alarm function Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 5 Attention alarms in alphabetical order ...

Страница 377: ...ures Check the dialysis fluid tubes connections See instructions in Dialysis Fluid Tubes Attach on page 4 35 in part 1 Mute time 2 min Buzzer sound Soft buzzer CAUTION Incorrect weight loss may occur if the machine is left for a longer period with this attention alarm CAUTION 14 6 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabeti...

Страница 378: ... be preset Machine actions The machine has automatically confirmed the change Measures Check that the changed parameter is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Mute time Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 7 Attention alarms in alphabetical order ...

Страница 379: ...the preset value Machine actions None Measures Press the flashing Arterial Pressure button to centralize the alarm limits around the current value Mute time 2 min Buzzer sound Soft buzzer 14 8 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 380: ...een interrupted Measures To be able to continue the activated disinfection or rinse program check that the dialysis fluid tubes are properly attached to the safety couplings of the machine Confirm this by pressing the Select key and the activated program will be resumed Alternately consult an authorized technician Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version ...

Страница 381: ...en interrupted Measures To be able to continue the activated disinfection or rinse program check that the dialysis fluid tubes are properly attached to the safety couplings of the machine Confirm this by pressing the Select key and the activated program will be resumed Alternately consult an authorized technician Mute time 2 min Buzzer sound Soft buzzer 14 10 AK 96 Operator s Manual Attention Alar...

Страница 382: ...ess the Select key to confirm the attention alarm and to be able to start the treatment If the attention alarm is confirmed without changing or recharging the battery the machine will not be able to alarm or restart in case of power failure Mute time Permanently muted buzzer Buzzer sound Soft buzzer during function check No buzzer during disinfectant program HCEN12239 Revision 12 2010 Program vers...

Страница 383: ...er is activated 2 min after the attention alarm is generated Measures Close the BiCart holder See Machine aftercare on page 4 63 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer 14 12 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 384: ...as not been installed Machine actions None Measures Check selected concentrate See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 13 Attention alarms in alphabetical order ...

Страница 385: ...activated 2 min after the attention alarm is generated Measures Attach or check BiCart cartridge See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 14 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 386: ...sures First make sure that the patient has not been connected to the blood lines If this is not the case clean the priming detector lens Alternatively call the authorized technician Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 15 Attention alarms in alphabetical order ...

Страница 387: ...ne clamp closes Measures First make sure that the patient has not been connected to the blood lines If this is not the case clean the priming detector lens Alternatively call the authorized technician Mute time 2 min Buzzer sound Continuous buzzer 14 16 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 388: ...e blood leak detector see Blood Leak Detector on page 8 41 in part 1 for instructions Press the Select key when cleaned If the attention alarm appears again call an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 17 Attention alarms in alphabetical order ...

Страница 389: ... be preset Machine actions The machine has automatically confirmed the change Measures Check that the changed parameter is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Mute time Soft buzzer 14 18 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 390: ... the dialyzer fails Machine actions The blood pump stops Measures Press Select key The priming phase will start automatically when the blood pump is started Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 19 Attention alarms in alphabetical order ...

Страница 391: ...or priming Machine actions The blood pump stops Measures Close the blood pump cover See Blood Part Component Details on page 2 5 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer 14 20 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 392: ...egment is correctly positioned see Arterial Blood Line Attach on page 4 16 in part 1 for instructions When properly positioned press the Select key If the attention alarm appears again call an authorized technician Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 21 Attention alarms in alphabetical order ...

Страница 393: ...s correctly positioned see Arterial Blood Line Attach on page 4 16 in part 1 for instructions When properly positioned press the Select key If the attention alarm appears again call an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 22 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order...

Страница 394: ...ump has been stopped for more than 1 min Machine actions None Measures Start the blood pump Mute time 2 min Buzzer sound Continuous buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 23 Attention alarms in alphabetical order ...

Страница 395: ...ress BPM button to clear the attention alarm If the attention alarm recurs call for an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 24 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 396: ...reset Machine actions The machine has automatically confirmed the change Measures Check that the changed parameter is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 25 Attention alarms in alphabetical order ...

Страница 397: ...entral disinfection has passed Machine actions None Measures Press the Select key to continue Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 26 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 398: ...as been made Machine actions None Measures See Change of Blood Pump Segments on page 3 33 in part 1 and confirm the attention alarm Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 27 Attention alarms in alphabetical order ...

Страница 399: ...s The disinfection program is interrupted Measures Check the pick up tube and the disinfectant container Machine retries the fill up phase Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 28 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 400: ...der and press the Select key See also in the instructions for Heat Disinfection Program with CleanCart cartridge Performing on page8 13 in part 1 This attention alarm can be removed by preset Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 29 Attention alarms in alphabetical order ...

Страница 401: ...erated Measures Open the latches of the BiCart holder and place the CleanCart cartridge in the holder or check that it has been properly attached to the holder See also in the instructions for Heat Disinfection Program with CleanCart cartridge Performing on page 8 13 in part 1 Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 30 AK 96 Operator s Manual Attention Alarms HCEN12239 ...

Страница 402: ... the attention alarm can be cleared by pressing the Select key If the machine is not disinfected after treatment the attention alarm will reappear during the next treatment The period of time between the last performed cleaning and the appearance of the attention alarm can be preset Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Op...

Страница 403: ...ns None Measures Check cause adjust treatment parameters to increase clearance or adjust the alarm limit for clearance Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 32 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 404: ...the concentrates have been connected the function check will automatically continue See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Measures Connect the selected concentrate to the machine Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 33 Attention alarms in alphabetical...

Страница 405: ...n alarm can be cleared by pressing the Select key If the machine is not disinfected after treatment the attention alarm will reappear during the next treatment The period of time between the last performed decalcification and the appearance of the attention alarm can be preset Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 34 AK 96 Operator s Manual Attention Alarms HCEN12239 ...

Страница 406: ...res If possible increase the dialysis fluid flow rate If this is not possible consult an authorized technician It is possible to mute the buzzer by pressing the Mute button but if the attention alarm is left without taking measures it will reappear the next treatment Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual ...

Страница 407: ...ures Wait until the attention alarm has disappeared and the bypass path of the Flow Diagram lights up green before disconnecting the dialysis fluid tubes as there is a high fluid flow through the fluid tubes The period of time for the appearance of the attention alarm is dependent on the dialysis fluid flow rate Mute time Buzzer sound No buzzer 14 36 AK 96 Operator s Manual Attention Alarms HCEN12...

Страница 408: ...lights up green The appearance of the attention alarm can be preset Machine actions None Measures Press the Fluid bypass button to flush the dialysis fluid tubes for 30 seconds Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 37 Attention alarms in alphabetical order ...

Страница 409: ... the patient The Diascan function is not permitted to perform any more measurement checks Turn Diascan function off Contact an authorized technician If this attention alarm appears frequently discuss preset limits with an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 38 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx A...

Страница 410: ...tivated Measures Press the Fluid Path button select DIASCAN and then SET DIASCAN using the Keypad Check that the set Diascan parameter values are the correct ones adjust if necessary Restart the Diascan function by pressing the Select key for 3 seconds Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 39 Attention a...

Страница 411: ...een activated the current Diascan measurement check will automatically be deactivated The Diascan function will continue to be on and the following measurement checks will continue as set Measures Confirm the machine actions by pressing the Select key If desired reactivate the single Diascan measurement check Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 40 AK 96 Operator s Manual...

Страница 412: ...vated Machine actions The Diascan function is not available in combination with UF profiling in steps or intervals The Diascan function will automatically be de activated Measures Note that the Diascan function is no longer active The attention alarm automatically disappears after 30 seconds Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx...

Страница 413: ...nction cannot perform measurement checks during the isolated UF phase Diascan measurement will start automatically when the isolated UF phase is complete Measures Note that the Diascan measuring will automatically be activated and rescheduled when the Isolated UF phase is complete without further attention alarms The attention alarm automatically disappears after 30 seconds Mute time Permanently m...

Страница 414: ...This page is intentionally left blank HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 43 Attention alarms in alphabetical order ...

Страница 415: ...nate conductivity of the dialysis fluid is changed temperature of the dialysis fluid is changed dialysis fluid flow rate is changed UF volume is changed linear UF profiling settings is changed linear UF profiling activation deactivation is made sodium or bicarbonate profiling activation deactiva tion is made isolated UF activation is made The machine was not able to completely perform the measurem...

Страница 416: ...ect key and the machine will automatically reschedule measuring as soon as possible Mute time No buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 45 Attention alarms in alphabetical order ...

Страница 417: ...Attach on page 4 16 in part 1 for information Machine actions None Measures Disconnect the arterial pressure transducer and press Arterial button to confirm If the attention alarm is still generated consult an authorized technician Mute time 5 min Buzzer sound Soft buzzer 14 46 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical...

Страница 418: ...ach on page 4 28 in part 1 for information Machine actions None Measures Disconnect the venous pressure transducer and press Venous button to confirm If the attention alarm is still generated consult an authorized technician Mute time 5 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 47 Attention alarms in alphabetical order ...

Страница 419: ... Press the Mute button The attention alarm disappears automatically when the attention alarm text has been selected in the ATTENTION LIST displayed on the Information Display Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 48 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 420: ... Select key If the machine is not disinfected after treatment the attention alarm will reappear during the next treatment The period of time between the last performed disinfection and the appearance of the attention alarm can be preset Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 49 Att...

Страница 421: ...Machine actions Function check is interrupted Measures Check that the concentrate connectors are properly connected to the stand by ports Check that the disinfectant connector is properly connected to the parking port It is not possible to connect the concentrates yet Mute time 2 min Buzzer sound Soft buzzer 14 50 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version ...

Страница 422: ...s of the BiCart holder are open Machine actions Function check is interrupted Measures Close the latches of the BiCart holder It is not possible to connect the BiCart cartridge yet Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 51 Attention alarms in alphabetical order ...

Страница 423: ...water temperature has not decreased below 45 C within 5 minutes after the high temperature test is started Inlet water temperature has not decreased below 39 C within 5 minutes after the high temperature test is finished If attention does not disappear call for an authorized technician Mute time Permanently muted buzzer Buzzer sound Super soft buzzer 14 52 AK 96 Operator s Manual Attention Alarms ...

Страница 424: ... actions Ongoing chemical valve leakage test Measures Wait for the machine test to be finished to be able to connect the concentrates It is possible when the attention alarm text has disappeared Mute time Buzzer sound No buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 53 Attention alarms in alphabetical order ...

Страница 425: ...has been bypassed the Fluid Bypass button button has been pressed Machine actions None Measures Press the Fluid Bypass button Mute time 2 min Buzzer sound Soft buzzer 14 54 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 426: ...e preset Machine actions The machine has automatically confirmed the change Measures Check that the changed parameter is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 55 Attention alarms in alphabetical order ...

Страница 427: ... is done by pressing the Fluid bypass button If the attention alarm disappears the obstruction is external Check dialysis fluid tubes and dialyzer for possible obstruction If the attention alarm does not disappear the obstruction is internal Call an authorized technician Mute time 2 min Buzzer sound Continuous buzzer 14 56 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program...

Страница 428: ...be sensor test has been interrupted Machine actions None Measures Remove and attach the dialysis fluid tubes from the safety couplings of the machine to restart the test Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 57 Attention alarms in alphabetical order ...

Страница 429: ...nually check that the dialysis fluid tubes are properly attached to the safety couplings of the machine Confirm this by pressing the Select key and the dialysis fluid tube sensor test will be bypassed Alternately consult the authorized technician responsible for the machine Mute time 2 min Buzzer sound Soft buzzer 14 58 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program ve...

Страница 430: ...ube sensor test has been interrupted Machine actions None Measures Remove and attach the dialysis fluid tubes from the safety couplings of the machine to restart the test Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 59 Attention alarms in alphabetical order ...

Страница 431: ...ted to the safety couplings during treatment Buzzer is activated 5 min after attention alarm is generated 3 During assisted priming if the dialysis fluid tubes are still connected to the safety couplings and they are expected to be connected to the dialyzer Machine actions None Measures Move the dialysis fluid tubes from the safety couplings to the dialyzer 14 60 AK 96 Operator s Manual Attention ...

Страница 432: ...min 3 Permanently muted buzzer Buzzer sound 1 Soft buzzer 2 Supersoft buzzer 3 Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 61 Attention alarms in alphabetical order ...

Страница 433: ...ions Function check is interrupted Measures Reconnect the dialysis fluid tubes to the safety couplings If a disinfection or rinse program has been started check that the dialysis fluid tubes are properly connected to the safety couplings Mute time 2 min Buzzer sound Soft buzzer 14 62 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphab...

Страница 434: ...when pressure has decreased Measures Wait until drain is finished Check if the obstruction is external i e the fluid tubes is clamped If equipped with UFD check the UFD filter Restart the disinfection If the attention alarm recurs call for an authorized technician Mute time 5 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 63...

Страница 435: ...ne actions Function check will be delayed until power returns Measures Please wait Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 64 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 436: ...hen the WRO is inaccessible Machine actions None Measures Please wait Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 65 Attention alarms in alphabetical order ...

Страница 437: ...as been prolonged due to internal tests Machine actions Function check is restarted and therefore prolonged Measures Mute time Buzzer sound No buzzer 14 66 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 438: ...t key to confirm that the ongoing disinfection program is insufficient too low temperature Let the machine pass the ongoing program and thereafter start a new heat disinfection program If the attention alarm reappears consult an authorized technician Mute time 2 min Buzzer sound No buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 67 Attention alarm...

Страница 439: ...zer is activated 2 min after attention alarm is generated Measures Press the Select key to confirm that the heparin pump is not going to be used for the treatment Mute time 2 min Buzzer sound Soft buzzer 14 68 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 440: ...eck the syringe and the thin line connected to the syringe for kinks See Heparin Pump in Arterial Blood Line Attach starting on page 4 16 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 69 Attention alarms in alphabetical order ...

Страница 441: ...th button select COND and PROFILING using the Keypad Check that the start and stop values for HCO3 are the correct ones press the Select button to confirm this If not select HCO3 and deactivate profiling Change the values and reactivate profiling as usual procedure See corresponding instructions in chapter 7 Profiling in part 1 Mute time 2 min Buzzer sound No buzzer 14 70 AK 96 Operator s Manual A...

Страница 442: ...properly connected to the pick up tube and the concentrate container see Connect Confirm Concentrates on page 4 7 in part 1 for instructions Check also that the correct concentrate has been connected Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 71 Attention alarms in alphabetical order ...

Страница 443: ...m The appearance of the attention alarm can be preset Machine actions A technical alarm is generated Measures Consult an authorized technician Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 72 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 444: ...tion potassium calcium magnesium will be reduced by 4 20 in the dialysis fluid Measures When this attention alarm appears the operator must consult the attending physician before the attention alarm is confirmed and a treatment is started It will not be possible to start a treatment until the attention alarm is confirmed Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program v...

Страница 445: ...s 58 C Machine actions None Measures Consult an authorized technician The air filter may be filled with dust Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 74 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 446: ...ctions 10 minutes after blood has been detected the treatment will stop if the attention alarm is left unattended Measures Establish a stable venous pressure over 50 mmHg until the attention alarm disappears Mute time 2 min Buzzer sound Continuous buzzer 5 min after blood detection HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 75 Attention alarms in al...

Страница 447: ...o close to present time Machine actions The machine will not be switched off until the time setting has been changed Measures Change the time setting for when the rinse program or heat disinfection program is set to be finished Mute time 2 min Buzzer sound Soft buzzer 14 76 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical ord...

Страница 448: ... Buzzer is activated 2 min after attention alarm is generated Measures Adjust Time SET TIME or UF volume SET UF until the calculated UF rate is lower than the high limit for UF rate Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 77 Attention alarms in alphabetical order ...

Страница 449: ...eck when the chemical valve leakage test is performed the function check will stop If the attention alarm is active during priming or treatment the correct dialysis fluid can not be prepared Measures Check the placement of the yellow disinfectant connector Mute time 2 min Buzzer sound Soft buzzer 14 78 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attenti...

Страница 450: ...hine actions Buzzer is activated 2 min after attention alarm is generated Measures Check the placement of the red concentrate connector Mute time 5 min Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 79 Attention alarms in alphabetical order ...

Страница 451: ... Machine actions Buzzer is activated 2 min after attention alarm is generated Measures Check the placement of the blue concentrate connector Mute time 5 min Buzzer sound Supersoft buzzer 14 80 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 452: ... fluid is bypassed from the dialyzer Measures Check concentrate selection and that the proper concentrate has been connected See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 81 Attention alarms in alphabetical order ...

Страница 453: ...ysis fluid bypasses the dialyzer Measures Check concentrate selection and that the proper concentrate has been connected See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer 14 82 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 454: ... fluid bypasses the dialyzer Measures Check concentrate selection and that the proper concentrate has been connected See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 83 Attention alarms in alphabetical order ...

Страница 455: ...ne actions The dialysis fluid bypasses the dialyzer Measures Check concentrate selection and that the proper concentrate has been connected See Connect Confirm Concentrates on page 4 7 in part 1 for instructions Mute time 2 min Buzzer sound Soft buzzer 14 84 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 456: ... actions The machine uses English temporarily as operator language instead of the selected language Measures Contact an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 85 Attention alarms in alphabetical order ...

Страница 457: ... after attention alarm is generated in priming phase but immediately when attention alarm is generated in disinfection or treatment phase Measures Check water supply Mute time 2 min Buzzer sound Soft buzzer 14 86 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 458: ...e actions None Measures Check cause adjust treatment parameters or adjust the alarm limit for Kt V Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 87 Attention alarms in alphabetical order ...

Страница 459: ...es Confirm by pressing the Select key It is also possible to increase the Kt V target value and the machine will recalculate time to target Mute time Permanently muted buzzer Buzzer sound No buzzer 14 88 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 460: ...cally be stopped Power failure buzzer will appear Measures Consider manually discontinuing the treatment see Power Failure on page 3 27 in part 1 for instructions Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 89 Attention alarms in alphabetical order ...

Страница 461: ...key to continue has not been confirmed within 5 minutes Machine actions The low flow heat phase has automatically been cancelled Measures Press the Select key to confirm the attention alarm The machine now enters drain phase as the circulation phase for information see in Heat Disinfection General on page 8 9 in part 1 of the heat disinfection program is complete Call for an authorized technician ...

Страница 462: ...WRO model which supports low flow heat where the machine receives hot water from the WRO 300 H Machine actions None Measures Press the Select key to confirm Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 91 Attention alarms in alphabetical order ...

Страница 463: ... button select COND and PROFILING using the Keypad Check that the start and stop values for NA are the correct ones press the Select button to confirm this If not select NA and deactivate profiling Change the values and reactivate profiling as usual procedure See corresponding instructions in chapter 7 Profiling in part 1 Mute time 2 min Buzzer sound No buzzer 14 92 AK 96 Operator s Manual Attenti...

Страница 464: ...or obstructions If there are obstructions remove them and press the Select key to confirm the removal Check the UF rate is correct before leaving the machine if not call an authorized technician Mute time 2 min Buzzer sound Soft buzzer CAUTION Incorrect weight loss may occur if the machine is left for a longer period with this attention CAUTION HCEN12239 Revision 12 2010 Program version 3 xx AK 96...

Страница 465: ...ince last change has been exceeded Machine actions None Measures Replace the ultrafilter and confirm that the ultrafilter has been replaced Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 94 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 466: ...ions since last change has been exceeded Machine actions None Measures Replace the ultrafilter and confirm that the ultrafilter has been replaced Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 95 Attention alarms in alphabetical order ...

Страница 467: ...sinfections since last change has been exceeded Machine actions None Measures Replace the ultrafilter and confirm that the ultrafilter has been replaced Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 96 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 468: ... Since the TMP alarm limits have been set below zero there may be backfiltration to the patient without TMP alarm The appearance of the attention alarm can be preset Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 97 Attention alarms in alphabetical order ...

Страница 469: ...n Measures Check that the cuff is correctly applied to the patient It could also be that the patient is moving during the measurement check Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 98 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 470: ...he arterial and venous phases during single needle treatment Machine actions None Measures Check venous blood line for possible kinks or forgotten clamps Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 99 Attention alarms in alphabetical order ...

Страница 471: ...elayed 2 min Measures Check for kinks or leakage from the cuff and the cuff hose Check also that the cuff hose is properly connected to the machine Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 100 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 472: ...isplayed minutes indicate the duration of the power failure Machine actions Only the blood unit will run after a power failure Measures Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 101 Attention alarms in alphabetical order ...

Страница 473: ...measurement check is finished Machine actions None Measures Press Select key to display the BPM log list Mute time No buzzer Buzzer sound No buzzer 14 102 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 474: ...ished Machine actions None Measures Press the Select key to display the Diascan log list Mute time Permanently muted buzzer Buzzer sound No buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 103 Attention alarms in alphabetical order ...

Страница 475: ...e actions None Measures If this attention alarm appears during initiation of the treatment check that the venous blood line is properly inserted into the priming detector Press Select key to confirm Mute time 2 min Buzzer sound Soft buzzer 14 104 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 476: ...heck current set values for the previously activated profiling reactivate Press the Fluid Path button select COND and or UF using the Keypad Check that the start and stop values for the profiling type are the correct ones if not change the values Reactivate the profiling function as usual procedure See corresponding instructions in chapter 7 Profiling in part 1 Mute time 2 min Buzzer sound Soft bu...

Страница 477: ... Press the Select key The Time Display shows reC until the Select key has been pressed See Recovery from Machine Shut Down on page 3 29 in part 1 for further information Mute time 2 min Buzzer sound Soft buzzer 14 106 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 478: ...y pressing the Fluid Path button and selecting DIA FLUID FLOW Adjust SET TREATMENT DIA FLUID FLOW using the Keypad If it is not possible to increase the dialysis fluid flow rate if possible decrease the venous pressure and wait maximum 5 minutes until the dialysis fluid enters the dialyzer again If the attention alarm reappears consider discontinuing the treatment Mute time 5 min Buzzer sound Soft...

Страница 479: ...manually check that the dialysis fluid tubes are properly attached to the safety couplings of the machine Confirm this by pressing the Select key and the dialysis fluid tube sensor test will be bypassed Alternately consult the authorized technician responsible for the machine Mute time 2 min Buzzer sound Soft buzzer 14 108 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program...

Страница 480: ...set Machine actions The machine has automatically confirmed the change Measures Check that the changed setting is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 109 Attention alarms in alphabetical order ...

Страница 481: ...uid tube connectors Machine actions The disinfection program stops Measures Check if the AK 96 dialysis machine is properly connected to the water supply Mute time Permanently muted buzzer Buzzer sound No buzzer 14 110 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 482: ... fluid flow rate Machine actions None Measures If it is possible for the treatment to continue with a lower flow adjust the set value to correspond with the current value the attention alarm will disappear If this is not possible consult an authorized technician Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Atten...

Страница 483: ...start the heat program in the WRO Machine actions None Measures Press the Select key Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 112 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 484: ...start the low flow heat program in the WRO Machine actions None Measures Press the Select key Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 113 Attention alarms in alphabetical order ...

Страница 485: ...t Machine actions The machine has automatically confirmed the change Measures Check that the changed setting is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Buzzer sound Soft buzzer 14 114 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 486: ...urrent value This text will appear at any time during treatment when the blood pump has been started or stopped the ultrafiltration has been activated or deactivated or when changes of treatment time and UF volume have been made Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 115 Attention alarms in alphabetical o...

Страница 487: ...wn to zero and there is still time left in ISOL UF Machine actions None Measures Set ISOL UF time to zero or increase the treatment time Mute time Buzzer sound 14 116 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 488: ...started for the machine to be able to obtain the total UF volume within the set treatment time Start isolated UF or adjust isolated UF time or treatment time Mute time Permanently muted buzzer Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 117 Attention alarms in alphabetical order ...

Страница 489: ...el so it is well above the air detector head When filled the machine finalizes the function check and the set treatment time will appear on the Time Display on condition that bypass path of the Flow Diagram is green For information on the additional activation of the air detector alarm function see in the instructions for the type of priming procedure being used in chapter 4 Mute time Buzzer sound...

Страница 490: ...ion alarm is generated Measures Check the dialyzer too small partly clotted and do necessary actions in accordance with this If possible adjust set Time and or set UF volume until TMP decreases Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 119 Attention alarms in alphabetical order ...

Страница 491: ...ress the Select key to confirm end of treatment See Discontinuing on page 4 59 in part 1 for discontinuing instructions Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 120 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 492: ...t exceeded 50 mmHg during the priming procedure Machine actions The blood pump and the ultrafiltration will be automatically stopped 2 minutes after this attention alarm has been generated Measures Discontinue treatment Contact authorized technician Mute time 2 min Buzzer sound Continuous buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 121 Attenti...

Страница 493: ...Machine actions Buzzer is activated 2 min after attention alarm is generated Measures Adjust Time and or UF volume to allow the machine to calculate a new UF rate Mute time 2 min Buzzer sound Soft buzzer 14 122 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 494: ...Fluid Path button select UF to reach the UF MENU Check that the set minimum UF rate SET MIN UFR is a proper value for the paricular patient If not adjust the value using the Keypad If necessary consider adjusting the set treatment time or UF volume within the limits for the patient s needs and tolerance Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 ...

Страница 495: ... treatment Machine actions Buzzer is activated 2 min after attention alarm is generated Measures Decrease the set minimum UF rate or increase the UF rate by decreasing the treatment time or by increasing the UF volume Mute time 2 min Buzzer sound Soft buzzer 14 124 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 496: ...t and stop values for UF are the correct ones press the Select button to confirm this If not select UF and deactivate profiling Change the values and reactivate profiling as usual procedure See corresponding instructions in chapter 7 Profiling in part 1 Machine continues with set UF rate Measures Mute time 2 min Buzzer sound No buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator ...

Страница 497: ...orrect accordingly Make sure that the venous pressure is decreased by at least 50 mmHg The attention alarm will automatically disappear when the current venous pressure has been decreased If it is not possible to decrease the current venous pressure wait maximum 5 minutes until the dialysis fluid enters the dialyzer again If the attention alarm reappears consider discontinuing the treatment Mute t...

Страница 498: ...r UF has manually been stopped Machine actions None Measures Press UF Start Stop button Mute time 5 min Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 127 Attention alarms in alphabetical order ...

Страница 499: ...Machine actions Buzzer is activated 2 min after attention alarm is generated Measures Press the Select key to confirm no ultrafiltration during treatment Mute time 2 min Buzzer sound Soft buzzer 14 128 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 500: ... preset Machine actions The machine has automatically confirmed the change Measures Check that the changed parameter is correct The attention alarm will automatically disappear after it has been displayed Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 129 Attention alarms in alphabetical order ...

Страница 501: ... set below 10 mmHg Machine actions None Measures Press Venous Pressure button and adjust the alarm limit to a proper value Mute time Permanently muted buzzer Buzzer sound Continuous buzzer 14 130 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 502: ...he preset value Machine actions None Measures Press the flashing Venous Pressure button to centralize the alarm limits around the current value Mute time 2 min Buzzer sound Soft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 131 Attention alarms in alphabetical order ...

Страница 503: ...lush of the flow path where the ultrafilter is placed is performed Measures Wait until the attention alarm has disappeared and the bypass path of the Flow Diagram lights up green before bypassing the dialysis fluid Mute time Permanently muted buzzer Buzzer sound Soft buzzer 14 132 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabeti...

Страница 504: ...and the WRO has stopped Machine actions None Measures Call an authorized technician Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 133 Attention alarms in alphabetical order ...

Страница 505: ...achine actions None Measures Check information on WRO Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer 14 134 AK 96 Operator s Manual Attention Alarms HCEN12239 Revision 12 2010 Program version 3 xx Attention alarms in alphabetical order ...

Страница 506: ...Measures Check that the selected disinfectant matches the disinfectant connected to the machine and press the Select key shortly to repeat fill up phase Mute time Permanently muted buzzer Buzzer sound Supersoft buzzer HCEN12239 Revision 12 2010 Program version 3 xx AK 96 Operator s Manual Attention Alarms 14 135 Attention alarms in alphabetical order ...

Страница 507: ... 54 5 5 5 6 6 2 12 4 Blood flow rate alarm 4 56 5 8 Blood leak detector 1 16 2 26 8 41 Blood lines 1 20 4 16 4 28 remove 4 63 Blood pump 2 8 4 19 8 41 speed 4 54 5 6 Blood pump segment 3 13 9 2 BPM ranges 9 4 BPM cuff 1 21 8 42 11 2 Buttons list of 3 8 Buzzer sound 4 2 14 2 C Centralizing function 4 57 5 11 Clamp 2 11 4 23 Clearance 9 7 12 4 continuous measuring 12 22 12 27 single measurement 12 2...

Страница 508: ...N Non diffusion time 3 12 P Pediatric blood line 1 20 4 16 4 28 pH 9 15 Physical data 9 16 Pick up tubes 2 24 8 41 Power supply 4 2 9 12 Pressure transducer arterial 4 24 contamination 4 66 venous 4 34 Priming 4 38 extra 4 44 4 50 new 4 44 4 45 4 50 4 51 Priming detector 2 10 4 33 4 55 5 7 Priming UF rate 3 16 4 40 Priming volume 4 41 Pump speed 4 40 4 53 4 54 5 5 5 6 R Recirculation reduction sin...

Страница 509: ...ng 4 52 UF settings 3 25 UF start stop 4 52 4 56 5 9 UF volume 3 16 3 25 4 52 setting 4 52 5 9 Ultrafilter 1 17 1 21 2 26 replace 8 39 Ultrafiltration 4 17 4 29 9 6 V Venous blood line 4 28 Venous clamp 2 11 4 33 Venous drip chamber 4 32 4 41 4 47 4 53 5 5 Venous phase single needle 5 2 Venous pressure 3 11 4 56 9 3 setting 4 56 setting single needle 5 9 Venous pressure single needle 5 8 Venous pr...

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