Professional Documents
Culture Documents
Therapy
Preparation Setting of treatment parameters
Doppelnadel-
Enter the treatment parameters via the
Switch the machine on.
Therapie
Parameter icon.
Select.
The machine changes to the Preparation
mode. The self-test of the dialysate (DFS) Dialysate
runs automatically.
Doppelnadel-
Ultrafiltration
Therapie
Limit values
Doppelnadel-
Heparin
If necessary, after disinfection, check
whether machine is free from disinfectant. When diskettes / Patient Therapy Cards
Therapie
Use suitable indicator strips. are used, the patient parameters can be
directly read in.
Connect concentrates and bicarbonate.
Check correctness of the patient data
from Patient Therapy Card and confirm.
Doppelnadel-
Insertion of blood line systems. To fill the or
tubing system with NaCl, start the blood Check correctness of the patient data
Therapie
pump with the + button below the monitor. from diskette and confirm.
The blood pump stops automatically after
a preset filling volume.
The following text is shown after a
successfully completed test.
Brief Instructions Standard Dialysis: Double Needle Therapy
confirm.
Touch the Connect patient icon.
Therapie
The appearance of the window is depen- Two short acoustic signals sound and the
dent on the machine configuration. 2x Enter button is illuminated.
Doppelnadel-
and confirm.
Connect both patient connections for
circulation to the saline bag.
The automatic self-test on the blood side To connect the patient, connect the
starts. After completion, the machine arterial line and start the blood pump by
Doppelnadel-
rinse time, the machine automatically connected alarm is triggered and the
switches to stand-by mode (if preset in blood pump stops automatically.
Therapie
(h:min)
the machine configuration). End the alarm with this button.
Therapy
Performing the haemodialysis Sequential therapy (Bergstrm)/UF profile
Doppelnadel-
Start the blood pump and adjust the After touching the icons, the window
blood flow with the + and buttons on
Therapie
UF profile opens.
the monitor.
Deactivate the Bypass. The Bypass button
is now no longer highlighted green. It is possible to select preset UF profiles
(numbered) or to create profiles individu-
Dialysis starts. ally. The desired UF rate can be set by
Doppelnadel-
Call up the treatment parameters with the the % button (100% = average rate) or
Overview icon. by touching/moving a finger over the
Therapie
touch screen. The complete HD time is
divided into 10 time intervals (bars).
Doppelnadel-
the button SEQ. Thereby the bar will be
Therapie
marked yellow. Leave the window by tou-
ching the O.K. icon.
Doppelnadel-
Arterial Bolus
Therapie
If necessary, minimize ultrafiltration with
the MIN-UF icon For the easy and rapid application of
NaCl 0.9% - for example in the case of
or
a decrease of blood pressure - select the
switch to Bypass with the Bypass icon. function Arterial Bolus. This way you
can administer an exactly defined bolus.
The maximum bolus is 250 ml.
Brief Instructions Standard Dialysis: Double Needle Therapy
To start the bolus press the Bolus icon. During reinfusion, empty the bicarbonate
cartridge .
Attend to the instructions on the screen When the venous red sensor detects
and confirm. Then check the height of sufficient saline, the blood pump stops
the venous blood level. automatically.
Start after the completion of therapy by Follow the instructions and confirm.
pressing the Disinfection icon
Disinfection
If the machine is not yet free of
or disinfectant, continue to rinse the
machine and test again.
by selecting this item in the program
selection. If the basic setting has been selected
accordingly, the machine goes directly
to Preparation mode after the end of
disinfection.
Doppelnadel-
Canceling a running disinfection
Therapie
To cancel an already started disinfection,
Start disinfection by pressing the
press the Exit icon
respective icon.
and
Thermal Long chemical Short chemical
The main disinfectant for chemical disin- confirm operation.
Doppelnadel-
fection is preset (usually Citric Acid 50%).
If the machine already contains disinfec-
Therapie
tant, the required compulsory rinsing is
Central Central Central
performed automatically. If this is not the
thermal chemical rinse case, the screen starts Disinfection rinsing
Central disinfection programs include the and a different type of disinfection can be
water inlet/dialyzer outlet hose and selected, for example.
must be timed to coincide with the RO
Doppelnadel-
equipment. Automatic switching off and on
Therapie
End of disinfection
When the Auto switch-off icon is
The following information is displayed activated, the machine is switched off
after disinfection: automatically.
To start the Auto Off and Auto On
Doppelnadel-
functions of the machine, activate the
Auto On icon.
Therapie
Brief Instructions Disinfection
The respective parameters for the next Setting of the time for a possible Night
disinfection are set via the fields Time, action (the machine is switched off after
Type of Disinfection, Disinfectant and disinfection)
Date.
or
The settings are accepted with the
Day action (the machine remains on after
Activate field.
disinfection).
The Auto Off function is automatically
activated by confirmation with this
Doppelnadel-
machine to "Off"!
Disinfection error list for the ongoing disinfection
Therapie
Preparation Set-up
Online Therapy
Use suitable indicator strips. line. Pay attention to the correct flow
direction.
HDF/HF
Connect concentrates and bicarbonate.
Follow the instructions for action that are Now connect the patient connection of
highlighted yellow on the screen. the arterial line with the connection of
the substitution line which is marked red.
Call up the parameters for HDF-Online
via the Parameter icon and the Online For postdilution: Connect the long end of
Doppelnadel-
icon. the substitution line to an inlet piece of
the venous drip chamber.
Therapie
All values shown can be changed as
required. For predilution: Connect a predilution
adapter between the arterial line and
the dialyzer.
Doppelnadel-
Therapie
To perform an HDF in predilution mode,
When the Online solution has been After touching the Connect patient icon,
processed and tested, a white information the following screen is shown
field is shown.
Now remove the patient venous line from Bolus output with HDF-Online
the return port and connect with the
needle to the patient. Close the cover of If necessary, administer a Bolus
the return port until it latches. (50 250 ml) with the solution produced
by the machine.
Start the blood pump again and set the
blood flow. Only after the desired blood To start the bolus, change to the HDF-
flow is reached, deactivate the bypass to Online parameter window and press the
reduce the risk of filter clotting. Inf. Bolus button.
Online Therapy
Confirm. The administered bolus volume
The HDF therapy begins and the therapy is displayed.
time runs. The substitution pump starts to
HDF/HF
run automatically, all monitoring devices
are activated. Deactivation of HDF therapy/change to HD or HF
During treatment, switch off HDF by
BYPASS or MIN-UF during a therapy selecting the HDF field again and change
to HD or select HF. The dialysate and
Doppelnadel-
If Bypass is activated during a treatment, substitution flows are automatically
Therapie
the substitution pump stops. If MIN-UF adapted.
is activated during a treatment, the
substitution pump continues to run. End of treatment
Touch the Terminate therapy icon. If set
UF/blood flow ratio accordingly, the reinfusion window opens
Doppelnadel-
automatically.
To draw attention to excessive coagulation
Therapie
of the blood, the ratio Blood flow : Total For reinfusion with Online solution,
UF is automatically calculated and connect the arterial end to the connection
displayed. This value should be between of the substitution line which is marked
25% and 28%. When 30% is reached, red and confirm. It can also be closed off
you will be informed with a warning with a 0.9% NaCl bag as usual.
(dependend on machine configuration).
Brief Instructions HDF/HF Online Therapy
followed by a disinfection.
Brief Instructions Single-Needle Cross-Over Therapy (SN-CO)
Do not yet insert the line segment of the The preset limit values for the arterial
2nd (venous) blood pump. Make sure that and venous control pressure are set
the 2nd pump segment is above the automatically.
pump.
Cross-Over Therapy
The connection of the PBS pressure
Adjust the liquid level in the arterial and
Single-Needle
transducer should always be performed
venous chambers according to the
PV PA before the blood-side self-test. If the
drawing.
setting of SN-CO should be required
after begin of treatment, confirm the
PBS values shown then.
Level in venous Level in arterial
expansion chamber expansion chamber
It is also possible to select SN-CO before
connecting the patient.
Doppelnadel-
Recommendations for blood pump rate and phase volume
Therapie
Connecting the patient
Change to therapy mode by touching the Start the blood pump with 100 120 ml/min
Connect patient icon. Confirm the when connected to a fistula.
patient data!
When connected to a central venous
Start the blood pump, fill the system with catheter, start with 150 ml/min.
Doppelnadel-
blood and then connect the venous line
Therapie
to the patient.
Brief Instructions Single-Needle Cross-Over Therapy (SN-CO)
Setup and filling The preset limit values for the arterial and
venous control pressure are entered auto-
matically.
Insert the arterial standard line; lead the
The SN valve mode can also be activated
arterial line through the arterial clamp
during treatment.
(SAKA).
Use a special venous line for the SN valve
with 100 ml pressure compensation
chamber, as this enables a higher phase
Connecting the patient
volume and thus a clearly increased
efficiency of treatment. If the SN valve Change to therapy mode by touching the
dialysis is not planned, the standard line Connect patient icon. Confirm patient
can remain in place. For efficiency data!
improvement, the venous level must Connect the arterial line and fill the
be reduced here before the beginning system with blood; the SN valve mode
of the SN valve therapy. has already been automatically activated.
Fill the liquid level in the venous chamber
Start the blood pump depending on the
only up to approx. 40% so that an
vein condition and increase slowly.
adequate phase volume can be achieved.
Single-Needle
Valve Therapy
SN icon. apart, a larger phase volume is achieved,
closer limits result in a smaller phase
Select SN valve. volume.
Brief Instructions Single-Needle Valve Therapy (SN-V)
The phase volume reacts to: It is possible that the lower arterial limit
value (min PA) has to be adapted.
- Change of blood flow and control
pressures Setting of control pressures:
- Height of blood level in venous chamber - min PV 120 - 150 mmHg
- Pressure changes in the shunt - max PV 350 mmHg
Icons are control buttons on the touch screen used for operating the dialysis machine. Call up overview
Depending on the displayed window, different icons are available, which all represent
a specific action. By touching an icon, the respective action is carried out.
A list of the most important icons is provided below. Call up respective parameter window
Call up help function for explaining the Create (format) floppy disk/therapy card
icons
Call up history of current disinfection Read patient data from disk/therapy card
Switch off all icon functions for 10 sec Select further setting options
to allow cleaning of monitor
Overview Icons
Overview of Icons
Red symbol: error symbol during reading Filter data (only active if option DF filter
of patient data from floppy disk/therapy has been installed or if the machine is
card equipped with HDF-online)
In profile window (except for UF profile): Dialysis on main connection
open numerical keypad for resetting the dialysate flows through dialyzer
profile to a setting
Call up key pad for entering numerical Dialysis Bypass no dialysate in dialyzer
values
Call up window for setting arterial bolus Call up and set substitution data (option)
Call up dialyzer rinsing program with Call up bag change HDF (option)
simultaneous ultrafiltration
Disinfection from water supply inlet Call up linear profile in case of specified
start and end values
Call up profile settings for the respective Delete ABPM measured values list (option)
Overview Icons
parameter
Overview of Icons