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baxter AK 98 Operator's Manual
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baxter AK 98 Operator's Manual

Dialysis machine
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AK 98 Dialysis Machine
Introduction module
Reference: AK 98 Operator's Manual 2.XX
Chapters 2 & 3
4/29/20
1

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Summary of Contents for baxter AK 98

  • Page 1 AK 98 Dialysis Machine Introduction module Reference: AK 98 Operator’s Manual 2.XX Chapters 2 & 3 4/29/20...
  • Page 2 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...

  • Page 3: Learning Objectives

    Learning objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • The blood part of the machine • The fluid part of the machine • The operator’s panel •...
  • Page 4 Machine external components – blood part 1. Remote Operator’s panel 2. Operator’s panel 3. Air detector 4. Venous pressure transducer connector 5. Arterial pressure transducer connector 6. Blood pump 7. Heparin pump 8. Priming detector 9. Arterial blood line clamp 10.
  • Page 5 Machine external components – blood part 11. Arm for dialyzer holder 12. Expansion chamber holder 13. Blood pressure monitor (BPM) 14. Blood line guides 15. Level adjustment knob 16. BPM cuff holder 17. Top tray 18. Infusion stand 4/29/20...
  • Page 6 Machine external components – fluid part 1. Safety couplings for dialysis fluid tubes 2. Dialysis fluid tube from machine to dialyzer (blue) 3. Dialysis fluid tube from dialyzer to machine (red) 4. Stand-by port for red concentrate connector 5. Stand-by port for blue concentrate connector 6.
  • Page 7 Machine external components – fluid part 1. Concentrate connector, blue 2. Pick-up tube 3. Pick-up tube holder 4. BiCart cartridge holder 5. Blood leak detector 6. Ultrafilter 7. Fluid leakage detector tray 4/29/20...
  • Page 8 Machine external components - rear 1. Transportation handle 2. Air filters 3. Inlet water tube 4. Outlet tube (drain) 5. Disinfectant inlet tube 6. Mains connection 7. Fuses 8. Main switch 4/29/20...
  • Page 9 Machine external components - rear 1. Ethernet port 2. USB port 3. External communication port 4. Potential equalisation connection 5. Remote panel contacts 4/29/20...
  • Page 10 The Operator’s panel – alarm indication light The machine has an alarm indication light placed on the top of the operator’s panel. It can either be a blue, yellow or red flashing light, depending on the attention or alarm status. When there is no information to display, the light is off. 4/29/20...
  • Page 11 The Operator’s panel – hard buttons On/off button Schedule indicator Main switch indicator Mute button Blood pump increase Blood pump button Blood pump decrease 4/29/20...
  • Page 12 The Operator’s panel – touch screen layout 4/29/20...
  • Page 13 The Operator’s panel – touch screen buttons The machine state indicator shows the state the machine is currently in; functional check, treatment or disinfection. The time indictor shows in It is possible to set a h:mm the remaining time customized name, or The Diascan button opens in different machine identifier for the machine.
  • Page 14 The Operator’s panel – arterial and venous pressure areas The arterial and venous pressure areas show the current pressure as a numerical value and graphically as the grey pointer. The values in white text are the alarm limits, beyond these points, alarms will be generated. When the pressure areas are flashing, pressing them will centralize the alarm limits around the current value.
  • Page 15 The Operator’s panel – direct actions to the alarm limits Centralize the arterial and venous pressures around the current value Move the upper alarm Move the lower alarm Widen both the arterial and limit up/down using limit up/down using venous alarm limits to their the red left and right the red left and right widest point...
  • Page 16 The Operator’s panel – flow paths Depending on the status of the machine the flow paths are lit in different colors. Bypass Treatment Incorrect Isolated conductivity ultrafiltration 4/29/20...
  • Page 17 The Operator’s panel – treatment overview fields Blood flow rate in mL/min. Pressing it opens the blood menu. Accumulated blood volume treated in L. Pressing it opens the blood menu. Accumulated heparin volume delivered in mL. Pressing it opens the blood menu.
  • Page 18 The Operator’s panel – alarms, attentions & graphs When the machine has information to display to the operator it can be found in the information field. If it is an alarm then the alarm tab will be flashing. If it is an attention or operator message then the information tab will be flashing.
  • Page 19 The Operator’s panel – status information bar The status information bar is found at the bottom of the screen. When text appears in grey on the bar that function is not activated. Text in white shows active functions. The icons that appear on the status information bar are; The clock icon indicates that the machine is set for an auto process.
  • Page 20 The Operator’s panel – touch screen buttons The patient button opens the patient page where information regarding the patient is handled. The available functionality will depend on the CIS (Clinical Information System) in use in the clinic. 4/29/20...
  • Page 21 The Operator’s panel – touch screen buttons The priming button opens the priming menu where manual or automatic priming can be selected. The rinse back button can be used to discontinue the treatment prematurely. New blood circuit allows the blood circuit to be changed during the treatment The disinfection/rinse button opens the disinfection/rinse menu where the...
  • Page 22 The Operator’s panel – touch screen buttons The blood button opens the blood menu, which contains the tabs used for setting parameters relating to blood. Access to the technical service area is via the tools tab. The fluid button opens the fluid menu, which contains the tabs used for setting parameters relating to fluid.
  • Page 23 The Operator’s panel – touch screen buttons When the fluid bypass button starts to flash, the dialysis fluid is in bypass. This can be also seen on the fluid flow path. When the ultrafiltration button is lit, ultrafiltration is performed. This can be confirmed by looking at the value in the UF rate treatment overview field.
  • Page 24 The Operator’s panel - menus All of the menus are handled in the same manner described here. Current menu tab Other accessible menu tabs are dark blue shown in white Key actual values are shown on the Press the blue bars to open keypads to change the value...
  • Page 25 The Operator’s panel – setting parameters keypad Keypad name Increase Value Decrease Clear Calculated rate When setting treatment time, use the overtype method. To set 3:45 A decimal type in the number 3, point is used then 4, and then 5. The when setting colon : is added volumes...
  • Page 26 The operator’s panel - setting parameters selectpad Some of the machine parameters can also be set using a selectpad. The dark blue bar and check mark show the selected parameter, to change press one of the light blue bars. Press confirm a change or cancel to exit.
  • Page 27 Baxter, Gambro, AK 98, BiCart and Diascan are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 28 AK 98 Dialysis Machine Preparation module Reference: AK 98 Operator’s Manual 2.XX Chapters 4 & 12 4/29/20...
  • Page 29 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...

  • Page 30: Learning Objectives

    Learning objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Attaching the concentrates • Attaching the blood lines and heparin syringe • Priming the extracorporeal circuit •...
  • Page 31 Preparing the machine – Switch on & functional check Check the connections to water/drain and electricity, and then switch the machine on by lightly pressing the On/Off button. The functional check will start, the lights of the operator’s panel hard buttons, the screen, the alarm indication light and the buzzer will be tested first.
  • Page 32 Preparing the machine - Concentrates Turn the red concentrate connector clockwise and then remove it from the standby port of the machine. Connect the red concentrate connector to a pick up tube until a ‘click’ is heard. Place the pick up tube into the proper acidic concentrate container.
  • Page 33 Preparing the machine – arterial blood line The machine is ready to be lined once the blood pump button is flashing. 1. Blood pump 2. Blood line guide 3. Dialyzer connection 4. Blood line guide 5. Arterial line clamp 6. Saline or priming bag 7.
  • Page 34 Preparing the machine – attach the heparin syringe Manually prime the Press in the end of the Connect the prepared heparin solution all the piston and move it all the luer lock syringe to the way up to the arterial way out to the right hand heparin line blood line...
  • Page 35 Preparing the machine – attach the heparin syringe It is important to correctly install the heparin syringe, it should be installed as follows; Insert the plastic collar of the syringe into the groove of the pump Insert the plate on the end of the plunger into the groove on the piston Turn the locking wheel upwards until resistance is felt...
  • Page 36 Preparing the machine – setting the heparin To set the heparin, press the blood button to open the blood menu. Here choose the heparin tab. Pressing each of the blue bars will open a keypad to set the desired value. To deliver a bolus during Preset brand...
  • Page 37 Preparing the machine – venous blood line 1. Air detector 2. Dialyzer connection 3. Venous line clamp 4. Priming detector 5. Venous patient connector 6. Waste bag 7. Venous pressure transducer connector 4/29/20...
  • Page 38 Preparing the machine – manual priming In manual priming the operator is in charge of the priming process. Priming of the blood side of the circuit can start as soon as the blood pump button is flashing, and the blood lines have been attached. In this case, the caps from the dialyzer blood ports should be moved to the dialyzer fluid ports to prevent spillage.
  • Page 39 Preparing the machine – assisted priming In assisted priming the machine will guide the operator through the priming procedure. By pressing the priming button the priming menu will be opened, the default priming mode is shown, here its manual priming. It is possible to change to assisted priming using the keypad.
  • Page 40 Preparing the machine – activating the air detector The level of the priming fluid in the venous drip chamber should be increased during the priming phase using the adjustment knob. Priming fluid level The level should be well above the air detector head. Once the level is set press air detector icon in the information field to activate the air detector.
  • Page 41 Preparing the machine – extra priming & recirculation It is possible after the completion of either manual or assisted priming, to perform extra priming or to recirculate the priming solution. For both procedures the operator must ensure that there is enough priming solution to complete the action. For recirculation, both ends of the blood lines must be connected together using a sterile accessory.
  • Page 42 Preparing the machine – concentrate stand-by mode The machine can be preset to enter concentrate stand-by mode when; • The green fluid path is achieved, or a preset time thereafter • Or when the set priming volume is achieved Concentrate stand-by mode fluid flow path If concentrate stand-by mode has not been preset, it can be activated manually by pressing the fluid button...
  • Page 43 Preparing the machine – setting treatment parameters To set the treatment parameters press the time indicator, the time menu will open, from here both the time and the UF volume can be set using the keypads. Check and adjust additional parameters by pressing the blood or fluid buttons to view their menus.
  • Page 44 Preparing the machine – IT connectivity Confirming patient ID and retrieving the patient prescription from the CIS. 4/29/20...
  • Page 45 Preparing the machine – IT connectivity Reviewing the prescription Prescription parameters from the CIS CIS prescription parameters that have been altered by the operator Prescription parameters with no icon are set to the machine default or preset settings Once Ok has been pressed in the prescription, then the prescription icon will appear in the settings tab.
  • Page 46 Preparing the machine – IT connectivity Using patient ID as a label Setting station ID 4/29/20...
  • Page 47 Hands on Connect and confirm the concentrate combination Attach the blood lines and heparin syringe Manual priming Recirculation Concentrate standby mode Set the prescription: • Time 3:00 • UF Vol 1.5L • Fluid flow 600mls/min • Heparin – Bolus 1.0ml –...
  • Page 48 Baxter, Gambro, AK 98 and BiCart are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 49 AK 98 Dialysis Machine Treatment module Reference: AK 98 Operator’s Manual 2.XX Chapters 4 & 8 4/29/20...
  • Page 50 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...
  • Page 51 Learning objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Connecting the patient and starting the treatment • Actions during treatment – heparin bolus and BPM •...
  • Page 52 Hemodialysis treatment – check the settings Before starting the patient treatment, the operator should carefully inspect the machine has been lined and primed in the correct manner. Pay special attention to the position of the venous blood line in the priming detector, and observe that there are no kinks in the blood lines, as well as...
  • Page 53 Hemodialysis treatment – connect the patient The patient connection can take place with either just the arterial line connected to the patient (bleed out), or both the arterial and venous blood lines connected to the patient (straight connection). The operator should make all the relevant safety checks and then start the blood pump.
  • Page 54 Hemodialysis treatment – start the treatment When the machine detects blood, by default the blood pump will stop. Press the flashing blood pump button to restart the blood pump and then use the blood pump up and down buttons to adjust the blood flow. Observe that the blood flow path is lit red.
  • Page 55 Hemodialysis treatment – heparin bolus If an additional bolus of heparin is required by the patient during the treatment, this can be delivered by the machine. Press the heparin bolus volume settings bar and use the keypad to set to correct volume.
  • Page 56 Hemodialysis treatment – BPM single and interval To take a single blood pressure reading press the BPM read out field and the measurement will start. To set up automatic blood pressure readings open the setup tab and press the auto mode bar. From here the interval time can be set between 5 and 60 minutes, press OK to confirm the time and activate to activate the automatic readings.
  • Page 57 Hemodialysis treatment – BPM history and alarm limits The blood pressure menu also has tabs for accessing the BPM alarm limits and history. The history tab within the blood pressure menu contains the data from all the blood pressure readings performed during the treatment.
  • Page 58 Hemodialysis treatment – end the treatment When the treatment time is completed the operator’s is alerted by an audible buzzer, a lit alarm indication light and an attention message. After pressing confirm, the on screen instructions should be followed. If the treatment needs to be finished before the set treatment time has expired, then the time needs to be reduced down to 0:00 first.
  • Page 59 Hemodialysis treatment – rinse back After the treatment time expired attention has been confirmed, the rinse back menu will appear. Press rinse back and confirm. When the operator is ready, the blood pump is started. It will run until either the blood is no longer detected, the preset volume is reached, or the blood pump is manually stopped by the operator.
  • Page 60 Hemodialysis treatment – machine aftercare After the end of the treatment, once the patient has been confirmed as being disconnected from the machine, and the venous blood line has been removed from the priming detector, there will be handling instructions on the screen on how to prepare the machine for disinfection.
  • Page 61 Hands on Straight connection Start the treatment Heparin bolus 0.5ml Single BPM measurement Set the BPM alarm guards End treatment Rinse back Drain the dialyzer and the BiCart cartridge Follow the prescription 4/29/20...
  • Page 62 Baxter, Gambro, AK 98 and BiCart are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 63 AK 98 Dialysis Machine Functions module Reference: AK 98 Operator’s Manual 2.XX Chapters 6, 7 & 9 4/29/20...
  • Page 64 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...
  • Page 65 Aims & objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Isolated ultrafiltration • Profiling – UF, sodium and bicarbonate • Diascan monitoring system 4/29/20...
  • Page 66 Functions – isolated ultrafiltration activation The Isolated UF settings are reached by pressing the fluid button and then isolated UF, in the fluid menu. Once in the isolated UF menu, the time and volume for isolated UF are set and isolated UF is activated.
  • Page 67 Functions – isolated ultrafiltration activation Once the isolated UF time and volume are set, they are automatically added, by default to the total treatment time and UF volume. When the isolated UF phase is completed the machine will automatically switch into the diffusive phase.
  • Page 68 Functions – isolated ultrafiltration 2 phase & deactivation Second and subsequent phases of isolated UF can be activated at any point during the treatment. The time and volume for the new phase must be added to the previous to create a cumulative amount. A currently running isolated UF phase can be deactivated at any time as required by the operator.
  • Page 69 Functions - profiling sodium and bicarbonate Both sodium and bicarbonate concentrations in the dialysis fluid can be profiled. They can either be profiled upwards or downwards at a smooth liner rate. When deactivating a profile, check the set value that the treatment will continue 4/29/20...
  • Page 70 Functions - profiling ultrafiltration There are three profile types available for ultrafiltration profiling; • Linear • Step • Interval Changes to the UF are determined by; • Total UF volume • Treatment time • Starting value for the UF rate •...
  • Page 71 Functions – profiling ultrafiltration With linear profiles the machine knows the set time and UF volume, the operator sets the start UF rate, and the machine will calculate a smooth decreasing profile. With step profiles the machine knows the set time and UF volume, the operator sets the start UF rate, and the number of steps and the machine will calculate the profile.
  • Page 72 Functions - profiling settings and activation All of the profiling settings are reached by pressing the fluid button and then profiling, in the fluid menu. Choose the desired mode; depending on which mode is selected, set and OK the other parameters.
  • Page 73 Functions - profiling when using a profiling model All of the profiling settings are reached by pressing the fluid button and then profiling, in the fluid menu. Choose the desired model, and check that the preset values are appropriate for the patient. After doing so, activate profiling.
  • Page 74 Functions – changes to the ultrafiltration profile When running an ultrafiltration profile, any changes to the treatment time and/or the ultrafiltration volume will have an effect on the ultrafiltration rate and change the shape of the profile. The original profile in black The original profile in black and changes to the UF volume and changes to the treatment...
  • Page 75 Functions – Diascan monitoring system checking K, Kt and Kt/V The Diascan monitoring system measures and calculates the following parameters; • Clearance (K) – How much blood has been cleaned per unit of time (mL/min) • Clearance multiplied by treatment time (Kt) – The volume of the blood that has been cleaned so far in the treatment •...
  • Page 76 Functions - Diascan monitoring system measurement frequency The Diascan monitoring system measurements can take place every 30 or 60 minutes, or as a single reading. This is done by pressing interval within the setup tab. 4/29/20...
  • Page 77 Functions - Diascan monitoring system setting the V value To get a Kt/V reading, the patients distribution volume has to be entered into the machine. This can either be done in the setup tab if the distribution volume is known, or through the Watson tab if it needs to be calculated. An already calculated distribution volume can be set manually.
  • Page 78 Functions - Diascan monitoring system targets & alarms It is possible to set both targets and alarms for the Diascan monitoring system readings. The target Kt/V is set here, an alarm can also be set to alert the operator if the Kt/V will be lower than desired.
  • Page 79 Functions - Diascan monitoring system history The clearance rate from the most recent reading of the Diascan monitoring system is always displayed in the clearance area, alongside the current and forecast Kt/V. To view the previous clearance rates, Kt/V actual and forecast, and the Qb at the time of the reading, press the history tab within the Diascan menu.
  • Page 80 Hands on Assisted priming Set the prescription: • Time 3:30 • UF Vol 1.5L • Fluid flow 600mls/min • Heparin – Bolus 1.5mls – Flow rate 1.0ml/hr – Stop time 0 min • Isolated UF – 0.2L – 10 minutes •...
  • Page 81 Baxter, Gambro, AK 98 and Diascan are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 82 AK 98 Dialysis Machine Troubleshooting module Reference: AK 98 Operator’s Manual 2.XX Chapters 2 & 3 4/29/20...
  • Page 83 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...
  • Page 84 Aims & objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Troubleshooting – UF supervision – Halt button – Power failure – Manual rinse back – Air in venous drip chamber –...
  • Page 85 Machine functionality – UF supervision alarms There are two alarms associated with the UF supervision. They appear when the UF volume measurements are not within the specification of the machine, this can happen when: • The UF control is not calibrated or incorrectly calibrated •...
  • Page 86 Troubleshooting – halt button If it is necessary to perform a ‘reset’ of the machine, this can be done by pressing and holding in the halt button on the rear of the machine. This interrupts the power supply to the machine and overrides the battery back up. When the button is released the machine will perform a recovery.
  • Page 87 Troubleshooting – power failure If there is a power failure, the machine has a Battery connect indicator is lit green if the battery back-up has been installed battery back-up which lasts approximately minutes and keeps the screen and the blood pump operational.
  • Page 88 Troubleshooting – manual rinse back The blood can be returned manually in the event of a power failure when no battery back-up is available. • Connect arterial blood line to the rinse-back solution • Open the blood pump cover • Manually turn the blood pump anti-clockwise When returning the blood manually, the operator is responsible for visually observing all safety parameters...
  • Page 89 Troubleshooting – Air in venous drip chamber When the blood level in the venous chamber drops below the level of the air detector, then alarm #100 Air in venous drip chamber is triggered. Check the blood circuit connections are tight. Use the timer or confirm icon in the alarm message to restart the blood pump, at the same time increase the blood level in the venous chamber using the level adjustment knob.
  • Page 90 Troubleshooting – change the BiCart cartridge If the BiCart cartridge needs to be changed during the treatment, follow these steps; 2 sec Remove the empty Close the latches Attach the new BiCart cartridge and wait for 2 seconds BiCart cartridge 4/29/20...
  • Page 91 Trouble shooting – changing the dialyzer & blood lines If the dialyzer and the blood lines need to be replaced during the treatment this can be done by pressing the rinse back button. In the rinse back menu there are two options; rinse back if the treatment should ended and the patient disconnected, or new blood circuit if the treatment should be continued.
  • Page 92 Hands on Resolve an air in venous drip chamber alarm Change the BiCart cartridge Change the blood lines and the dialyzer and continue the treatment End the treatment Simulate a power failure and rinse back the blood manually Follow the prescription 4/29/20...
  • Page 93 Baxter, Gambro, AK 98 and BiCart are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 94 AK 98 Dialysis Machine Single needle module Reference: AK 98 Operator’s Manual 2.XX Chapter 5 4/29/20...
  • Page 95 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...
  • Page 96 Aims & objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Single needle – Lining and priming – Terminology – Activation – Start the treatment – End the treatment...
  • Page 97 Single needle – lining & priming the machine Push the venous expansion chamber, into the expansion chamber holder, until it ‘clicks’ into position. Attach the venous dialyzer line to the expansion chamber blood line. Attach the expansion chamber dialyzer line to the dialyzer.
  • Page 98 Single needle - terminology In single needle the patient’s blood is removed from, and returned to, the single access point in a cycle with two phases; • The Arterial phase. The venous blood line is clamped, and blood is withdrawn from the patient into the arterial blood line.
  • Page 99 Single needle - activate After priming is completed, check the priming fluid level in the expansion chamber is around the groove and return it to the upright position. Press the blood button and open the blood menu. Press the single needle tab and set a minimum stroke volume limit, and then activate single needle.
  • Page 100 Single needle – start the treatment Once the treatment has been started, press the flashing arterial pressure control to centralize the alarm limits around the current value. The alarm limits for the venous pressure are automatically set once the treatment has started to +350mmHg (high limit) and +150mmHg (low limit).
  • Page 101 Single needle – end the treatment At the treatment end before rinseback, deactivate single needle. 4/29/20...
  • Page 102 Hands on Line and prime the machine Connect the patient Activate single needle Optimise the stroke volume End the treatment Deactivate single needle Rinse back Follow the prescription 4/29/20...
  • Page 103 Baxter, Gambro and AK 98 are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...
  • Page 104 AK 98 Dialysis Machine Hygienic maintenance module Reference: AK 98 Operator’s Manual 2.XX Chapters 10 & 11 4/29/20...
  • Page 105 AK 98 Dialysis Machine Important notice The contents of this training module are based on the AK 98 Dialysis Machine Operator’s Manual. The completion of this training does not relieve the operator from their responsibility to read and understand the full text of the Operator’s Manual. If...
  • Page 106 Aims & objectives The aim of this module is to get an overview of the AK 98 dialysis machine with special focus on: • Hygienic maintenance – Exterior – Heat CleanCart cartridge – Short heat citric – Chemical – Integrated Heat –...
  • Page 107 Hygienic maintenance – external components After each dialysis treatment, the machine exterior surfaces must be disinfected. Using a cloth moistened with either ethanol 70% or isopropanol 60%, wipe all of the machines exterior surfaces and the top tray. The pick-up tubes need to be flushed inside and out with water between each treatment, and then returned to the holder to dry naturally.
  • Page 108 Hygienic maintenance - programs There are different programs for cleaning and disinfecting the machine: • Heat • Chemical • Rinse 4/29/20...
  • Page 109 Hygienic maintenance – disinfection schedule The hygienic maintenance of the machine must follow this schedule; Frequency Activity Result After each 1. Run a heat disinfection program (with or without citric acid), or a short heat citric program. Disinfection treatment 2. Wipe the outside of the dialysis machine with 70% ethanol or 60% isopropanol. 3.
  • Page 110 Hygienic maintenance – disinfection history To view the disinfection history of the machine, press the disinfection button. Within the disinfection/rinse menu press the history tab. This will open the list where the details of the previous disinfection processes can be found. 4/29/20...
  • Page 111 Hygienic maintenance – auto schedule It is possible to set the machine up to perform scheduled heat or rinse program. Press the disinfection button and then the tools tab. In the auto schedule select either heat or rinse and then the ready time for each day required. 4/29/20...
  • Page 112 Hygienic maintenance – heat with CleanCart cartridge To run a CleanCart cartridge disinfection program, press the disinfection button. Under the heat tab press Heat CleanCart to start the process. Wait for the attention message to appear before inserting the CleanCart cartridge into the BiCart cartridge holder.
  • Page 113 Hygienic maintenance – short heat disinfection It is possible to run a short heat disinfection with liquid citric acid. The disinfectant inlet tube on the rear of the machine must be placed into the disinfectant solution. Disinfectant inlet tube 4/29/20...
  • Page 114 Hygienic maintenance – chemical disinfection To perform a chemical disinfection, press the disinfection button and then the chemical tab. Chemical disinfections must take place from the front of the machine. Connect the blue concentrate connector to the yellow pick-up tube. 4/29/20...
  • Page 115 Hygienic maintenance – integration CWP The machine can perform a heat disinfection that is integrated with the central water plant (CWP). During this integrated heat clean the machine automatically switches on, and receives hot water from the CWP, it can also be switched on manually if required.
  • Page 116 The integrated heat disinfection procedure includes the following phases when preset by the service technician: • Heat disinfection of the AK 98 dialysis machine • Low flow heat (LFH), where all the wet parts of the system between the machine and the WRO 300 H unit are exposed to hot water at a low flow rate •...
  • Page 117 Hygienic maintenance – changing the ultrafilter Pull the latch and press downwards Pull the ultrafilter gently downwards and remove it Label the new ultrafilter with the actual date Lubricate the ultrafilter connections with RO water Insert the new ultrafilter into the holder and push it gently upwards Push the lower latch into position and close the holder until a ‘click’...
  • Page 118 Hands on Set an auto schedule for heat disinfections Perform a heat with a CleanCart cartridge Change the U9000 ultrafilter Follow the prescription 4/29/20...
  • Page 119 Baxter, Gambro, AK 98, BiCart, CleanCart and U9000 are trademarks of Baxter International Inc. or its subsidiaries. 4/29/20...