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Chapter 4: Operation
4-4
Warning
During the treatment, check the following at appropriate intervals:
– The condition of the patient.
– The function of the device and the extracorporeal blood circuit.
To protect the patient against dangerous extraneous blood loss, a
venous pressure monitoring system is used as a safety system for
the extracorporeal blood circuit.
However, the pressure monitoring system cannot detect extraneous
blood loss in all cases. In this respect, a dislocation of the venous
cannula or the occurrence of a small leak in the overpressure area
of the extracorporeal blood circuit must be considered as being
particularly critical.
As a result, the extracorporeal circuit, particularly all of the tubing
system connections and the venous access point, must be checked
for leaks at appropriate intervals during the treatment.
– The tubing system, watching out for air ingress or possible loose
connections. Particularly at the connections downstream of the air
detector, negative pressure can permit air to enter into the
extracorporeal blood circuit. This can be a problem for single-needle
applications or when using central venous catheters.
– The fluid level of the venous bubble catcher. Correct the fluid level if
necessary (target level: approx. 1 cm under the upper edge of the
cap).
– The tubing system is inserted without kinks, tension, or twisting.
– Any leakages in the filtrate, substituate, and dialysate circuit.
– Any discolouration in the filtrate bag caused by blood loss.
Warning
Venous alarm limit
The lower venous alarm limit must be set as close as possible to the
actual venous pressure value. Changing the alarm limit window position
or width can adversely affect or even cancel out the efficiency of the
safety system in identifying extraneous blood loss.
Warning
Dialysate and haemofiltration solutions
When using dialysate or haemofiltration solutions, make sure these
solutions are used in accordance with the manufacturer's specifications
and are at room temperature.
Warning
Citrate and calcium solutions
The citrate and calcium solutions must be at room temperature before
they can be used.
Fresenius Medical Care multiFiltrate IFU-EN-UK 15A-2015
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