Acute Renal Replacement Therapy

Troubleshooting Guide
for the multiFiltrate
Contents Balancing error on scales

Introduction Check the message box for the

Balancing error on scales 1 affected scale (I, ll, lll, lV).
Arterial pressure too low 2
Arterial pressure too high 3 Are the cones broken and the NO
Break cones (open clamps) press
clamps open from the bag to the
Venous pressure too low 4 circuit connection for the affected
start/reset key to recommence
Venous pressure too high 5 treatment.
scale?
TMP pressure too low 6 YES
YES
TMP pressure too high 7 Enter bag change menu, tighten
Blood leak detected 8 Is there a fluid leak from the bags? connections, press start/reset key to
Air detected in venous return chamber 9 recommence treatment.

Pressure before filter too low 10 NO

YES
Pressure before filter too high 11
Is there an object (inc. curtains etc) Remove the objects, press start/
Non-opaque/opaque fluid detector 12 on or touching the affected scale? reset key to recommence treatment.
Balancing error – UF rate or substituation rate too high 13
Heater unable to achieve set temperature 14 NO
YES Move machine or close window
Heater over temperature 15
Is the machine in a draft or under (stop air conditioning flow). Press
Scales reverse alarm 16 the outlet of the air conditioning? start/reset key to recommence
Drop Counter Rate Citrate/Calcium too low 17 treatment.
Drop Counter Rate Citrate/Calcium too high 18 NO
NO
Recommended filter size and blood flow rates 19 Are scales III and IV affected?
Useful contact numbers 20 YES
YES
Are the blood lines or other objects Remove the objects and press start/
in contact with the filtrate bag? reset key to recommence treatment.

NO
YES
This Guide has been produced by Fresenius Medical Care to help you get the best Is the filtrate outflow Unclamp it and press start/reset key
out of the multiFiltrate machine. This Guide is intended as a support tool and will line clamped? to recommence treatment.
not replace the operating manual or the judgement and experience of the nurse and NO
the attending physician. Enter bag change menu. Is the YES Was a bag with fluid on the scale during
effluent scale value negative after self test? If yes, the TARE weight has
a bag change? been set to include the volume
Please read this Guide and familiarise yourself with the content. This Guide contains
contained in the bag during set-up. This
information on how to resolve some of the most common machine alarms. This Are scales I and
cannot be corrected. End treatment and
ll affected?
Guide is intended to be kept with the multiFiltrate machine so it is always to hand. NO re-start with new circuit.
Decisions concerning specific treatments for patients are within the sole
responsibility of the attending physician and nurse. YES Examine the scale pans, are they seated NO Access bag change menu, manually
correctly on the scale plates (are the remove and replace scale pans to
plates recessed and flat or are they tilted)? have them seated correctly on the
YES scale plates. Press start/reset key to
There might be a technical fault with recommence treatment.
the machine. Please contact the
Technical Services Department.
1
 Arterial pressure too low Arterial pressure too high

YES
Is the patient catheter kinked
at the patient end?
NO
NO Manipulate catheter. Press start/reset key until
Is the access catheter in the correct
position to allow adequate flow?
YES
NO
Press start/reset key. Clamp and disconnect
arterial transducer line. Does arterial pressure
drop to zero?
YES
YES Replace transducer line with appropriate spare.
Check the arterial transducer line (red). Has
fluid advanced all the way to the hydrophyllic
filter?
NO
YES
Is there a clot at the base of the arterial
transducer line (red)?
NO
YES Remove clots manually, following unit policy.
Establish if there are clots in the catheter.
Are there clots in the access catheter?
NO
YES
Reconnect arterial transducer line (red). Blood
pump rate may be too high for patient’s
condition. Reduce blood pump speed.
Does this reduce the negative pressure?
Unkink catheter, press start/reset to
recommence treatment.
flow is re-established. Consider swapping
over lines if difficult to re-establish flows.
Internal failure of arterial pressure sensor.
Stop treatment. Washback patient blood.
Remove machine from service and contact the
Technical Services Department.
(Clamp off existing line, disconnect, attach new
line to transducer port, and connect to additive
port near to arterial transducer site). Press
start/reset key to recommence treatment.
Replace line as detailed above.
Flush catheter once clots removed,
recommence treatment with start/reset key.
Consider patient’s hydration – have they
become underfilled? Consult medical staff for
fluid assessment. Consider reducing goal for
fluid removal.
YES
Consider the patient's condition. Are there
patient factors that are creating a positive Take necessary action.
pressure at the access site?
NO
YES Stop infusions, or YES
reduce infusion rate.
Are there any infusions being
Press start/reset
administered before the blood pump Continue treatment.
key. Observe effect
(To the two additive ports)?
on arterial pressure.
Has it reduced?
NO NO
YES Clamp transducer line and cap off.
Observe arterial transducer line (red). Attach replacement line to one of the two pre-
Are there clots in the line or at the line junction filter ports. Attach to arterial transducer and
with the blood circuit? unclamp line. Arterial pressure should now be
monitoring normally.
NO
YES Replace transducer line with appropriate spare.
Clamp arterial transducer line (red). Remove (Clamp off existing line, disconnect, attach new
transducer line from transducer port. Does line to transducer port, and connect to additive
arterial pressure drop to zero? port near to arterial transducer site). Press
start/reset key to recommence treatment.
NO
Internal failure of arterial transducer system.
Stop treatment. Return blood to patient.
Remove machine from operation and contact
the Technical Services Department.

NO
YES
Consider general circuit clotting. It may be
Has the circuit been up for a significant period,
time to change the circuit before failure due to
do they have a high platelet count?
clotting.

NO

There might be a technical fault with the machine.

Please contact the Technical Services Department.

Please refer to Page 20 for useful contact telephone numbers.

2 3
 Venous pressure too low
Consider the patient's
condition. Have they become
hypovolaemic etc? Check for
a systemic factor leading to
the low return pressure.
NO
Check return connection to
the access catheter.
Is the catheter connection
loose or leaking?
NO
Is the catheter still correctly
placed?
YES
Press start/reset key. Clamp NO
venous transducer line (blue).
Remove from connection
port. Does venous pressure
return to zero?
YES
Replace venous transducer line YES
(blue). Attach replacement
transducer line to one of the
outlet ports on the venous
chamber. Unclamp line. Does this
alter the monitored pressure?
NO
Is the blood flow rate
adequate to generate a
'normal' venous pressure?
YES
There might be a technical fault with the machine.
Please contact the Technical Services Department.
4 5
Venous pressure too high
YES YES
Check the patient’s access catheter. Unkink catheter, press start/reset key
Is it kinked at the access site? to recommence treatment.
Take necessary action. NO
YES Manipulate catheter. Press start/reset key until
Is the venous (return) access line kinked or
flow is re-established. Consider swapping
occluded before reaching the patient?
over lines if difficult to re-establish flows.
NO
YES Run circuit at reduced pump speed. If pump
Is the blood pump rate too high? Reduce
speed needs to be less than 150 - 180 mls per
blood pump rate by 20%. Press start/reset
minute, consider the circuit to be clotting.
key. Observe effect on venous pressure.
Consider circuit washback and recommence
Does this solve venous pressure issue?
YES treatment.
Tighten connection to eliminate leak. NO
YES
Clamp and cap existing transducer line.
NO
Attach replacement line to one of the two
Examine venous transducer line (blue).
Emergency halt of treatment. Summon assistance for ports on the venous chamber and to the
Is it wet or contaminated with blood?
maintenance of haemostasis and patient's condition. venous transducer port. Unclamp line. Venous
pressure monitoring should be re-established.
NO
Internal transducer monitoring failure. Stop treatment. Return NO
blood to patient. Remove machine from operation and contact Potential internal monitoring failure. Washback
Clamp venous transducer line (blue).
the Technical Services Department. circuit, remove machine from operation and
Disconnect from transducer port.
contact the Technical Services Department.
Does pressure drop to zero?
YES YES
Examine venous bubble chamber for clots YES
Is the pressure now within (observe visually for dark patches externally Consider clotting as the potential cause of
Continue treatment.
the normal limits? first, shining a light through the chamber may venous pressure increase. Consider circuit
make these more visible. Consider dropping the washback if venous pressure is excessive.
level of blood in the chamber temporarily to Reducing pump speed will reduce venous
NO check for clots below the surface). pressure in the short term.
NO Increase blood pump rate by YES Aim to achieve a target Are clots present?
20% (if patient’s condition blood flow appropriate to the NO
allows). Does this produce therapy you are utilising
There might be a technical fault with
an increase in the venous (normally a minimum of
the machine. Please contact the Technical
pressure? 150mls/min).
Services Department.
NO
Consider blood clot in the
filter. Return blood to the
patient if possible.
Please refer to Page 20 for useful contact telephone numbers.
 TMP pressure too low
YES
Increase the replacement fluid Ensure replacement rate is kept
rate by 20%. Press start/reset at a suitable level for the
key. Does this increase the TMP patient’s body mass and the
pressure? size of the filter being used.
NO
YES
Is the blood pump rate high Aim for a blood pump speed
enough? Increase the blood that is adequate for the therapy
pump rate by 20% (if tolerated chosen, the replacement fluid
by the patient). Does this volume selected and the filter
increase the TMP pressure? size used.
NO
YES Can the connections be
Is there a leakage in the tubing
tightened to stop the fluid leak
system from the filter to the
(and re-establish correct
waste bag? pressure)?
NO YES
Press start/reset key and
recommence treatment.
YES Reduce infusion rate, or change
Is there a pre-filter infusion infusion site. A change in blood
running? viscosity can artificially reduce the TMP.
Has this altered the TMP pressure?
NO NO
YES The TMP pressure transducer cannot be
replaced. Accurate TMP pressure
Check the yellow pressure monitoring will no longer be possible. It
transducer. Is it wet? is advised that the patient’s blood be
washed back and treatment be
recommenced with a new circuit.
NO
YES Clamp line and remove from the white YES
pressure transducer port. Attach
replacement transducer line to the port
Check the white pre-filter
on the top of the arterial chamber, and
transducer line. Is it wet?
then to the pressure monitoring port.
Unclamp the line. Has this altered the
monitored TMP pressure?
NO NO
Consider undiagnosed issue with YES Return machine to patient use.
the fluid lines or machine. Retain used kit for examination,
Discontinue treatment. Wash blood place in yellow bag. Contact the
back to patient. Once circuit is Quality Helpline to report incident
unloaded, switch machine off and and arrange collection of kit in
then switch on. Perform pre- question. Observe for further failures
treatment self test. Is test passed? of same batch in short term.
NO
There might be a technical fault with the machine.
Please contact the Technical Services Department.
6 7
Discontinue treatment,
recommence when able. If the
leak may be due to a
NO manufacturing error, retain kit for
examination in a yellow plastic
bag. Contact the Quality Helpline
to report incident and arrange
collection of kit in question.
Observe for further failures of
same batch in short term.
YES
Press start/reset key and
recommence treatment.
Press start/reset key and
recommence treatment.
TMP pressure too high
Is there evidence that the filter
is clotting? (Associated rise in
the pre-filter pressure, visibly
clotted areas at the top surface
of the filter etc).
NO
Is the effluent outlet line
clamped?
NO
Check the blood pump rate, is it
too high for the filter size?
(Check reference ranges of
maximum blood flow rates for
AV 600 and AV 1000 filters).
NO
Press start/reset key. Check the YES Either reduce the rate of ultrafiltrate YES
blood pump rate to ultrafiltration
rate ratio (BPR/UFR). Is this too
high (above 20%)?
NO
Check the yellow pressure
transducer. Is it wet?
NO
Check the white pre-filter
transducer. Is it wet?
NO
Is the venous return line kinked YES
or occluded?
NO
Consider undiagnosed issue with the YES
fluid lines or machine. Discontinue
treatment. Wash blood back to
patient. Once circuit is unloaded,
switch machine off and then switch
on. Perform pre-treatment self test. Is
test passed?
NO
There might be a technical fault with the machine.
Please contact the Technical Services Department.
YES
Consider that the circuit has reached its lifespan. Wash back blood to
the patient and recommence treatment. If circuit lifespan has been
low, consider the dose of anticoagulant, exchange rate, blood pump
rate etc.
YES
Unclamp line and press start/reset key to recommence treatment.
YES YES
Reduce blood pump rate to
within acceptable operating
limits. Press start/reset key. Has Continue treatment.
this altered the monitored TMP
pressure?
NO
removal, or increase the blood
pump rate to compensate. Press Continue treatment.
start/reset key. Has this altered the
monitored TMP pressure?
NO
YES
The TMP pressure transducer cannot be replaced. Accurate TMP
pressure monitoring will no longer be possible. It is advised that the
patient’s blood be washed back and treatment be recommenced with
a new circuit.
YES Clamp line and remove from the YES
white pressure transducer port.
Attach replacement transducer
line to the port on the top of the Press start/reset key to
arterial chamber, and then to the recommence treatment.
pressure monitoring port.
Unclamp the line. Has this altered
the monitored TMP pressure?
NO
Unkink or clear return line to re-establish unimpeded flow.
Press start/reset key to recommence treatment.
Return machine to patient use.
Retain used kit for examination,
place in yellow bag. Contact Quality
Helpline to report incident and
arrange collection of the kit in
question. Observe for further
failures of same batch in short term.
 Blood leak detected
YES
Check filtrate line for the
presence of 'frank' (visible)
blood. Can you see blood in
the line?
NO
Microscopic blood leak.
Consider unit policy on
microscopic blood leak
(washback or continue as
advised by local policy).
Clotting will occur within filter
once the membrane has
ruptured, circuit lifespan is
likely to be greatly reduced.
Please refer to Page 20 for useful contact telephone numbers.
8 9
NO
Consider filter production
issues. Retain filter in yellow
bag for collection by
Visible blood suggests a
Fresenius staff. Take filter
significant membrane failure.
reference number if possible.
Were TMP pressures high
Contact Quality Helpline to
before blood leak detected,
report incident and arrange
or has it failed very early in
collection of filter in
treatment?
question. Observe for further
failures of same batch in
short term.
YES
Discontinue treatment.
Washback circuit blood and
recommence treatment.
Air/microbubbles detected in venous
return chamber
NO
Has the treatment begun – is
blood in the venous chamber?
YES
NO
Is the level of blood above the
air detector (within 2 cm of the
top of the venous chamber)?
YES
YES
Press start/reset key. Has the
replacement fluid flow become
turbulent following a bag change
(small amounts of air entering via
the replacement line)?
NO
YES
Is a large amount of air entering
the bubble chamber?
NO
Lower venous chamber using down arrow until chamber is clear of air.
Raise using up arrow. Press start/reset key to recommence treatment.
Use up arrow to raise the level
of the venous chamber to within
2cm of the top.
Press start/reset key.
Raise the level of the bubble
chamber above the inflow port of
the replacement line. Check for any
remaining air in the replacement
line. Continue treatment, observing
for any drop in the level of blood in
the chamber.
YES
Check connections on fluid
replacement bags. Tighten if
Does the source appear to be
necessary. Check connection of
the replacement fluid line?
line to the venous bubble
chamber. Tighten if required.
NO
YES Check outlet connection to the
filter. Tighten if necessary. Check
Does the source appear to be
the 2 pre-filter fluid additive
the filter outlet line (blue)?
ports are clamped. Check that
access line is not kinked.
NO
Are the two additive ports on NO
the top of the venous chamber Clamp port lines.
firmly clamped?
YES
If a large amount of air is entering the circuit from an unidentified source,
attempt to wash the blood back. It may not be possible to achieve safely.
Disconnect patient. Consider circuit flaw. Retain circuit for examination in
yellow bag. Contact Quality Helpline to report incident and arrange collection
of circuit in question. Observe for further failures of same batch in short term.
Is the replacement flow YES Raise the level of the chamber
turbulent due to a low level using the up arrow to above the
in the venous chamber? inlet port.
NO
If a cause of the air detector alarm cannot be identified, the blood should
be returned to the patient if possible and treatment discontinued. (Note, it
may not be safe to return the blood if it appears to be frankly airated).
Please contact the Technical Services Department.
 Pressure before filter too low
Press start/reset key. Is there YES
any visible leakage in the
Tighten loose connections, ensure pre-filter additive ports are
tubing system? (Consider
from the patient access to the
filter blood circuit connector).
NO
NO
Is the pre-filter pressure
transducer (white) connected
firmly and correctly?
YES
YES Clamp line and remove from YES
Check the white pre-filter
transducer line. Is it wet?
NO
NO
Check blood pump segment.
Is it correctly positioned
within its housing?
YES
YES
Consider undiagnosed issue
with the fluid lines or
machine. Discontinue
treatment. Wash blood back
to patient. Once circuit is
unloaded, switch machine off
and then switch on. Perform
pre-treatment self test. Is
test passed?
NO
There might be a technical fault with the machine.
Please contact the Technical Services Department.
10
Pressure before filter too high
Is there evidence that the YES Consider that the circuit has reached its lifespan. Press
filter is clotting? (Associated start/reset key. Wash back blood to the patient and
rise in the pre-filter pressure, recommence treatment. If circuit lifespan has been low,
clamped.
visibly clotted areas at the consider the dose of anticoagulant, exchange rate, blood
top surface of the filter etc). pump rate etc.
NO
Check the blood pump rate. YES YES
Tighten transducer into connector port. If accidently cross Reduce blood pump rate to
Is it too high for the filter
threaded and a tight fit is no longer possible replace pre-filter within acceptable operating
size? (Check reference
pressure transducer with a replacement line attached to the top limits. Press start/reset key. Continue treatment.
ranges of maximum blood
of the arterial bubble chamber. Has this altered the pre-filter
flow rates for AV 600 and AV
pressure?
1000 filters).
NO NO
the white pressure YES Clamp line and remove from YES
transducer port. Attach the white pressure
replacement transducer line transducer port. Attach
to the port on the top of the Press start/reset key to replacement transducer line
arterial chamber, and then to recommence treatment. Check the white pre-filter to the port on the top of the Press start/reset key to
the pressure monitoring port. transducer line. Is it wet? arterial chamber, and then to recommence treatment.
Unclamp the line. Has this the pressure monitoring port.
altered the monitored TMP Unclamp the line. Has this
pressure? altered the monitored pre-
filter pressure?
NO
NO NO
Stop blood pump temporarily. Open blood pump door. YES
Manipulate pump segment until blood tubing lies correctly in its Unkink or clear return line to
housing. Close door and restart blood pump. Is the venous return line re-establish unimpeded flow.
kinked or occluded? Press start/reset key to
recommence treatment.
NO
Return machine to patient
YES
use. Retain used kit for Consider undiagnosed issue Return machine to patient
examination, place in yellow with the fluid lines or use. Retain used kit for
bag. Contact Quality Helpline machine. Discontinue examination, place in yellow
to report incident and treatment. Wash blood back bag. Contact Quality Helpline
arrange collection of the kit to patient. Once circuit is to report incident and
in question. Observe for unloaded, switch machine off arrange collection of the kit
further failures of same batch and then switch on. Perform in question. Observe for
in short term. pre-treatment self test. Is further failures of same batch
test passed? in short term.
NO
There might be a technical fault with the machine.
Please contact the Technical Services Department.
Please refer to Page 20 for useful contact telephone numbers.
11
 Non-opaque/opaque fluid detector Balancing error – UF rate or substituation rate
too high

NO YES
Override alarm. Press start/reset key. Allow If alarm persists,
Override alarm,
priming with blood to continue. Consider override alarm. If
Is the venous chamber filled with blood ? increase blood
starting treatment with blood pump speed If alarm persists blood pump rate
pump rate to target
increased by 20%. after target rate is cannot be increased
Has the message as tolerated by the
achieved, examine due to the patient’s
appeared during the patient (ideally over
YES BPR/UFR, if this condition, then
transition into the next 3 minutes).
YES Stop infusion. Press start/reset key. Allow figure is above 20%, reduce the rate of
'treatment' mode? If identical alarm
circuit to re-establish flow. Restart infusion at increase BPR replacement fluid
Is there an infusion of clear fluids in progress occurs during this
a reduced rate. Rate can be incrementally further. until BPR/UFR is
via the venous chamber? time, override until
increased if blood return appears less than 20%. Does
target rate achieved.
sufficiently opaque. alarm persist?

NO NO YES
NO YES Please note: NO
Is there an unimpeded flow from the access? Unkink line, or re-establish unimpeded flow To accommodate If maximum
(If not the replacement flow may over-dilute from access. Press start/reset key to very high fluid tolerated blood
the blood within the venous chamber) recommence treatment. removal rate or pump rate has been
Has there been a
replacment fluid achieved or the
change in blood
rates, there must be blood pump is set
YES pump rate, Press start/reset key
adequate blood at the maximum for
YES replacement fluid to recommence
flow. Check the the filter, it will be
Press start/reset key. Is the blood flow lower Consider a reduction in post-dilution rate or the quantity treatment.
current BPR/UFR necessary to reduce
than anticipated (less than 150mls/min) with replacement until blood pump rate can be of ultrafiltrate that is
figure. If it is above either the
normal to high post-dilution replacement? increased. being removed from
20%, increase blood replacement fluid
the patient?
pump speed rate, or the volume
NO incrementally until it of patient fluid being
NO is 20% or below. removed as
Open the door to the detector, re-insert line so ultrafiltrate.
Is the return line correctly routed through the NO
that it lies correctly within the return clamp
opaque/non-opaque detector?
and the detector. Consider YES
Return machine to
undiagnosed issue
patient use. Retain
YES with the fluid lines or
used kit for
YES machine.
Consider undiagnosed issue with the fluid examination, place
Return machine to patient use. Retain used kit Discontinue
lines or machine. Discontinue treatment. Wash in yellow bag.
for examination, place in yellow bag. Contact treatment. Wash
blood back to patient. Once circuit is Contact Quality
Quality Helpline to report incident and arrange blood back to
unloaded, switch machine off and then switch Helpline to report
collection of the kit in question. Observe for patient. Once circuit
on. Perform pre-treatment self test. Is test incident and
further failures of same batch in short term. is unloaded, switch
passed? arrange collection of
machine off and
the kit in question.
then switch on.
NO Observe for further
Perform pre-
There might be a technical fault with the failures of same
treatment self test.
machine. Please contact the Technical batch in short term.
Is test passed?
Services Department.
NO
There might be a technical fault with the
machine. Please contact the Technical
Services Department.

Please refer to Page 20 for useful contact telephone numbers.

12 13
 Heater unable to achieve set temperature Heater over temperature

YES
Initially allow alarm to occur,
reset 2-3 times, particularly if
replacement flows are
Override alarm, allow further very low.
Are the replacement fluids
fluids to warm to room
colder than standard room
temperature before they are
temperature? NO
used.
Press start/reset key to
Does the alarm persist?
recommence treatment.

NO YES
NO NO
Please note: It may be Please note: It may be
necessary to clamp the fluid necessary to clamp the fluid
line to the venous bubble line to the venous bubble
Reposition heater bag until
Is the heater bag fully Enter bag change menu. catcher, disconnect the fluid catcher, disconnect the fluid
Is the door to the heater door closes fully. Press
housed within the heater Attempt to reseat bag to a replacement line (as asceptic replacement line (as asceptic
chamber fully closed? start/reset key to
chamber? position fully within housing. technique) and expel some technique) and expel some
recommence treatment.
of the fluid in the heater bag of the fluid in the heater bag
in order to manipulate it into in order to manipulate it into
the correct position. the correct position.

YES YES
NO NO
Please note: It may be Please note: It may be
necessary to clamp the fluid necessary to clamp the fluid
line to the venous bubble Change heater bag to the line to the venous bubble
Is the heater bag in the Is the heater bag in the
Change heater bag to the catcher, disconnect the fluid corresponding colour heater catcher, disconnect the fluid
correct heater chamber (ie correct heater chamber (ie
corresponding colour heater replacement line (as asceptic chamber. Press start/reset replacement line (as asceptic
green line in corresponding green line in corresponding
chamber. technique) and expel some key to recommence technique) and expel some
green heater etc)? green heater etc)?
of the fluid in the heater bag treatment. of the fluid in the heater bag
in order to manipulate it into in order to manipulate it into
the correct position. the correct position.

YES YES
YES
There might be a technical Check if the clamps in the replacement fluid bag are open. If
fault with the machine. Is there air in the not, open the clamps. Then enter bag change menu. Select
Please contact the Technical heater bag? deaeration of corresponding line. Carry out deaeration
Services Department. procedure. Continue treatment.

NO

There might be a technical

fault with the machine.
Please contact the Technical
Services Department.
Please refer to Page 20 for useful contact telephone numbers.

14 15
 Scales reverse alarm Drop Counter Rate Citrate/Calcium too low

YES NO
Manipulate until seated correctly in chamber
Is the drip chamber correctly seated in
holder. Press start/reset key to recommence
its holder?
Enter bag change menu. treatment.
Are the bags sat on the
Swap bags to the opposite
wrong scale for
scales. Press start/reset key YES
corresponding pump?
to recommence treatment. YES

Is the line from solution bag kinked or Free line / undo clamps. Press start/reset key
are the clamps on? to recommence treatment.
NO

There might be a technical NO

fault with the machine. NO
Please contact the Technical Is the cone in citrate bag broken? Is the Break cone on citrate bag / fully pierce
Services Department. calcium bag punctured fully with the calcium bag. Press start/reset key to
access spike? recommence treatment.

YES
YES Kink line below the chamber outflow. Remove
chamber from holder. Move solution bag to
Is the drip chamber overfilled? below chamber and invert. Manually expel
excess fluid bag into the solution bag. Press
start/reset key to recommence treatment.
NO
NO

Press start/reset key to

Is the blood pump activated?
recommence treatment.

YES

There might be a technical fault with the

machine. Please contact the Technical
Services Department.

Please refer to Page 20 for useful contact telephone numbers.

16 17
 Drop Counter Rate Citrate/Calcium too high Recommended filter size and blood flow rates

YES Recommended Ultraflux®-Filter usage in CVVH (Post-dilution)

Has the machine been moved / knocked Press start/reset key. Observe for
6
immediately before the alarm? alarm recurrence.
5
NO
YES 4
Remove chamber from holder. Manually fill

QF [l/h]
Is the drip chamber too low (producing chamber slightly by squeezing. Return 3
double drops from splashing)? chamber to holder. Press start/reset key
to recommence. 2

NO
1
YES
Remove chamber from holder. Hold on side
Is there any droplet accumulation on the and rotate until all droplets are removed. 0
wall of the drip chamber? Return to holder. Press start/reset key to 0 100 200 300 400 500
recommence treatment. Blood flow QB [ml/min]

NO

There might be a technical fault with the

machine. Please contact the Technical
Services Department.

Please refer to Page 20 for useful contact telephone numbers.

18 19
 Useful contact numbers

If you have followed all the advice in this guide, and you are still
experiencing problems, please refer to the table below to help you
decide how to proceed.

8.30am - 5.00pm Telephone

Monday to Fresenius Medical

Friday
01623 445100
Care (Switchboard)

Technical Services
Day of week

Monday to 01623 445197

Friday Department

Monday to Quality Helpline 01623 445215

Friday

24/7 Acute Operational Helpline* 08704 587971

* All calls are put through to a call centre in the UK. The call centre will bleep the
on-call person who in turn will respond to the customer within 15 minutes.

20 21
 FMC UK 05/08 310 TC © Copyright 2008 Fresenius Medical Care (UK) Ltd

Fresenius Medical Care UK Limited · Nunn Brook Road · Huthwaite · Sutton in Ashfield · Notts · NG17 2HU · England ·
Phone: +44 (0) 1623 445100 · Fax: +44 (0) 1623 550807 Head office: Else-Kröner-Straße 1 · 61352 Bad Homburg v. d. H. · Germany
www.fmc-ag.com