Haemonetics Cell Saver 5+ Operator's Manual
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Haemonetics Cell Saver 5+ Operator's Manual

Autologous blood recovery system
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®
Cell Saver
5+
Autologous Blood Recovery System
- Operator's Manual -
Haemonetics Corporation
400 Wood Road
Braintree, Massachusetts 02184, USA
P/N 53063-50, Manual revision: B
©1993, 2000, 2004, Haemonetics Corporation. All rights reserved.
November 2004

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  • Page 1 ® Cell Saver Autologous Blood Recovery System - Operator’s Manual - Haemonetics Corporation 400 Wood Road Braintree, Massachusetts 02184, USA P/N 53063-50, Manual revision: B ©1993, 2000, 2004, Haemonetics Corporation. All rights reserved. November 2004...
  • Page 2 Preface P/N 53063-50, Manual Revision: B...
  • Page 3 Bentley, Cell–3000/3000F, BCR–3000, and BCR–3500 are trademarks of Baxter Healthcare Corporation. Scope This manual is intended for users of the Haemonetics® Cell Saver® 5+ Autologous Blood Recovery System. The contents of this Operator’s Manual explain the operation and basic maintenance for the Cell Saver 5+ System. Diagnostics and subsequent repairs to this system should only be attempted by a qualified technician.
  • Page 4 Information with respect to the availability of such training can be obtained by writing Haemonetics Corporation, Attention: Patient Division. The uses to which the Haemonetics products may be applied, and the results obtained therefrom, shall be the sole responsibility of the Buyer. Haemonetics...
  • Page 5 Chiyoda-ku 102, Tokyo, Japan In the United States, telephone inquiries may be made by using the toll-free number: 1 (800) 225-5242, or by calling (781) 848-7100. All Haemonetics products are manufactured in accordance with ISO 9000 standards. Authorized European Representative HAEMONETICS U.K.
  • Page 6 Preface P/N 53063-50, Manual Revision: B ONTACTING AEMONETICS WORLDWIDE Use the following list when contacting the appropriate Haemonetics representative for each region. Haemonetics Asia Inc. Haemonetics France S.A.R.L. Taiwan Branch 46 bis, rue Pierre Curie 26F-1, No. 102 Roosevelt Road Sec. 2 Z.I.

  • Page 7: Table Of Contents

    Historical Overview ........1-6 Haemonetics Cell Saver Systems ......1-7 Special features of the CS5+ .
  • Page 8 Table of Contents P/N 53063-50, Manual Revision: B Chapter 2: Equipment and Disposable Description General ........... . 2-3 Controls and indicators .
  • Page 9 P/N 53063-50, Manual Revision: B Table of Contents Chapter 4: Setup Procedures for Cell Salvage General operation ..........4-2 Setup .
  • Page 10 Table of Contents P/N 53063-50, Manual Revision: B Chapter 8: Maintenance General ........... . 8-2 Maintenance and cleaning .
  • Page 11 Historical Overview ........1-6 Haemonetics Cell Saver Systems ......1-7 SPECIAL FEATURES OF THE CS5+ .

  • Page 12: Introducing The Cell Saver 5+ System

    5+ S NTRODUCING THE AVER YSTEM The Haemonetics Cell Saver 5+ Autologous Blood Recovery System, shown in Figure 1-1, represents the fifth generation of autologous blood recovery systems. Using the latest microprocessor technology, the Cell Saver 5+ System (CS5+) Haemonetics introduced the first delivers a new level of automation in the processing of autologous blood.
  • Page 13 P/N 53063-50, Manual Revision: B Introduction Figure 1-1: The Haemonetics Cell Saver 5+ Autologous Blood Recovery System...

  • Page 14: Indications For Use

    P/N 53063-50, Manual Revision: B Indications for The Haemonetics Cell Saver 5+ System and its related accessory components are intended to be used for the recovery and processing of blood shed during or subsequent to an operation or as a result of trauma. The recovered blood is...

  • Page 15: Autologous Blood Transfusion

    P/N 53063-50, Manual Revision: B Introduction UTOLOGOUS BLOOD TRANSFUSION Autologous blood is The term, autologous blood, refers to blood derived from the same individual. An now widely accepted autologous blood transfusion therefore, is one in which a patient receives his or as the first choice for her own blood.

  • Page 16: Historical Overview

    Introduction P/N 53063-50, Manual Revision: B Historical The following paragraphs are a brief summary of the history of transfusion methods. Overview Early Experiments with Transfusion Some of the earliest recorded attempts at transfusion were undertaken by a French physician, Jean Denys, who in the 1660’s performed transfusions between animals and humans with predictably disastrous results.

  • Page 17: Haemonetics Cell Saver Systems

    Haemonetics Cell Haemonetics Cell Saver Systems are aptly named. Their primary purpose is the recovery of red blood cells (RBCs). The RBCs are recovered from the shed blood Saver Systems that has, in the past, simply been discarded after an operation.

  • Page 18: Special Features Of The Cs5

    The CS5+ improves upon the design and performance of its predecessors. The CS5+ processes shed blood faster without compromising the quality of the end product (concentrated RBCs). Haemonetics has improved and streamlined the features and functions of earlier units and introduced the latest microprocessor...

  • Page 19: Computer Guided Setup

    Caution: The instructions provided by the display panel are not intended to replace formal training by Haemonetics in the operation of the Cell Saver 5+ System, nor do they relieve the operator of the obligation to read this manual.

  • Page 20: Specifications

    Introduction P/N 53063-50, Manual Revision: B PECIFICATIONS Dimensions and Weight Table 1-1: Dimensions and weight* Depth/in. (cm) Height/in. (cm) Width/in. (cm) Machine alone IV Pole extended 14.5 (37) 74.5 (189) 16 (41) IV Pole down 14.5 (37) 37 (94) 16 (41) Machine with Cart IV Pole extended 23 (58)

  • Page 21: Fluid Management Systems

    P/N 53063-50, Manual Revision: B Introduction Fluid The CS5+ is equipped with a pole for hanging saline solution, the anticoagulant solution, the reservoir, reinfusion bag, and transfer packs. The IV pole has a Management handgrip at the base of the IV pole and contains pigtails for hanging bags. The Systems lower half of the IV pole may be raised and lowered by turning the handgrip at the base of the IV pole counterclockwise, adjusting the IV pole to the proper...

  • Page 22: Construction

    Cabinet and Cart Materials: Fabricated sheet metal and cast aluminum. b. Control Panel: Membrane switch technology, environmentally sealed with backlit option keys. Note: Only Haemonetics disposable sets may be used with the Cell Saver 5+ System; the system will not function properly with other sets. 1-12...

  • Page 23: Machine Symbol Chart

    P/N 53063-50, Manual Revision: B Introduction Machine Symbol (as per IEC 601–1:88) Chart Type BF Class 1 equipment with isolated (floating) applied part providing adequate protection against electrical shock, particularly regarding allowable leakage currents and reliability of the protective earth connection. Alternating Current IPX1 Protection against Dripping Water...

  • Page 24: Disposable Packaging Symbol Chart

    Introduction P/N 53063-50, Manual Revision: B Disposable Packaging Symbol Chart Catalog number Expiration date Lot number Contents sterile by exposure to ethylene oxide Fluid path sterile by exposure to ethylene oxide Do not reuse Caution: consult operator manual for instructions Storage conditions, humidity level Storage conditions, temperature level Fragile, handle with care...

  • Page 25: Bowl Symbol Chart

    P/N 53063-50, Manual Revision: B Introduction Bowl symbol During a procedure, the bowl icon on screen reflects the bowl size currently in use. See below for bowl sizes and corresponding icons. chart 70 mL bowl 125 mL bowl 225 mL bowl Primary Power a.

  • Page 26: Ordering Information

    RDERING INFORMATION The following is a summary of the List Numbers associated with the Cell Saver 5+ System. Note: There is no latex present in the fluid pathways of the Haemonetics disposable components in the following list. List No. Description Collection Reservoir, 3L, 150 micron filter.
  • Page 27 Basic Mini Volume (70 ml) Cell Saver 5+ Bowl Set, Includes tubing harness, reinfusion bag, waste bag, and 70 ml centrifuge bowl. Sterile fluid path, disposable, for single patient use. 2005 110 EP Haemonetics Cell Saver 5+ System for 110 Vac English Language. 1-17...

  • Page 28: References

    Introduction P/N 53063-50, Manual Revision: B EFERENCES “Guidelines for Blood Salvage and Reinfusion in Surgery and Trauma,” Ameri- can Association of Blood Banks, 1993. Geoffrey Keynes, ed., Blood Transfusion. Bristol: John Wright & Sons Ltd., 1949, pp. 15-16. Keynes., p. 22. Blundell, James, “Experiments on the Transfusion of Blood by the Syringe,”...
  • Page 29 Chapter 2 Equipment and Disposable Description GENERAL ..........2-3 CONTROLS AND INDICATORS .
  • Page 30 Equipment and Disposable Description P/N 53063-50, Manual Revision: B Pigtails for Saline, Anticoagulant and Reinfusion Bags Reservoir Bracket Pump Display Centrifuge Control Panel Tubing Manifold Waste Hangers Figure 2-1: Cell Saver 5+ components...

  • Page 31: Chapter 2: Equipment And Disposable Description

    P/N 53063-50, Manual Revision: B Equipment and Disposable Description ENERAL This chapter identifies the major components of the Cell Saver 5+ System (CS5+), and explains their intended uses. A general description of the operation of the system is also provided. For detailed setup and operating instructions for the various protocols performed by the CS5+, please refer to Chapters 3 through 6.

  • Page 32: Controls And Indicators

    Equipment and Disposable Description P/N 53063-50, Manual Revision: B ONTROLS AND INDICATORS Figure 2-1 shows the CS5+. The control panel consists of a plastic covered key pad section, a backlit key pad section, and the display screen. Only the necessary readouts are illuminated, thus helping the operator to focus on information needed.

  • Page 33: Control Panel

    P/N 53063-50, Manual Revision: B Equipment and Disposable Description State Mode WASH CELLS AUTOMATIC Processed Vol: 800 ml Wash Vol: 50 ml NaCl Reinfusion Vol: 0 ml Bowls Processed: Pump Rate: 500 ml/min Wash Volume: 150/1000 ml Press MODE twice to enter EMERGENCY option Press MODIFY to change volume of wash Prompt Information Procedure Data...
  • Page 34 Equipment and Disposable Description P/N 53063-50, Manual Revision: B The other control keys are backlit when moving into Manual operation or when modifying the preset parameters as shown in Figure 2-5. Following is a summary of the functions of the controls on this panel. Auto Mode Start...
  • Page 35 P/N 53063-50, Manual Revision: B Equipment and Disposable Description WASH Cell Saver: Pumps saline into spinning bowl from saline bag. Sequester: Not used. EMPTY Cell Saver: Pumps fluid from stationary bowl into product bag or reser- voir. Sequester: Pumps fluid from stationary bowl into product bag or reser- voir.
  • Page 36 Equipment and Disposable Description P/N 53063-50, Manual Revision: B Automatic Controls (See Figure 2-4.) Located directly below the display, the Automatic controls regulate the automatic functioning of the CS5+. The Automatic Controls are as follows: a. START, as its name suggests, is used to initiate the first cycle of a set of cycles. Also, if the system is in STANDBY, pressing START resumes the process where it was stopped.

  • Page 37: Major Components

    P/N 53063-50, Manual Revision: B Equipment and Disposable Description AJOR COMPONENTS The CS5+ consists of two groups of components: the machine and the disposable. The machine controls the fluid pathway provided by the disposable. The machine includes a centrifuge, peristaltic fluid pump, pinch valves, and various sensors. A cart is provided with the system for added maneuverability and for setting the system at the proper working height.
  • Page 38 Warning: Do not grease any part of the mechanical centrifuge. If grease has been applied to the mechanical chuck, contact Haemonetics hotline immediately. Bowl Optics Sensors...
  • Page 39 P/N 53063-50, Manual Revision: B Equipment and Disposable Description Note: The Bowl Optics sensors ARE disabled in the manual mode and when using the 70 mL bowl. Fluid Sensors (See Figure 2-6) The fluid leak sensors are mounted in the centrifuge well. These sensors stop the pump and the centrifuge if fluid comes in contact with the fluid sensor surface in the unlikely event of a bowl leak.
  • Page 40 Equipment and Disposable Description P/N 53063-50, Manual Revision: B CLAMPED LINE DETECTED Check for kinks or occlusions in tubing. Ensure clamp on reinfusion bag and reservoir are open. Effluent Line Sensor The effluent line sensor monitors the quality of the bowl effluent. During FILL and WASH it adjusts pump speed to reduce red cell spillage.

  • Page 41: Disposables

    A variety of disposables are available for use with the CS5+. Chapter 4 explains the available disposables in detail. The purpose of this section is to give a general understanding of the uses and operating characteristics of the disposables rather than to provide specifications: HAEMONETICS IOOO Reinfusion Bag MILLILITERS...
  • Page 42 Equipment and Disposable Description P/N 53063-50, Manual Revision: B Receptacles Every CS5+ disposable setup must be equipped with a waste bag and a reinfusion bag. There must also be a source of unprocessed blood which may be either a collection reservoir or an extracorporeal circuit. Figure 2-8 identifies the receptacles used in a typical set up.
  • Page 43 P/N 53063-50, Manual Revision: B Equipment and Disposable Description The two subassemblies are joined with a rotary seal which forms a barrier between the inside and outside of the bowl. The seal’s effectiveness may be lost if the bowl is incorrectly mounted in the chuck. Fully seating the bowl in the chuck will assure proper alignment.
  • Page 44 Equipment and Disposable Description P/N 53063-50, Manual Revision: B supernatant is forced through the outlet port. The hematocrit of blood in the bowl increases as more blood solution is pumped in and the supernatant is forced out. Supernatant From From Air To Collection Waste to...
  • Page 45 P/N 53063-50, Manual Revision: B Equipment and Disposable Description Warning: Prior to pumping blood through the CS5+ harness and bowl, the blood must be anticoagulated, either systemically or regionally. Non-anticoagulated blood or blood components introduced into the bowl/ harness assembly will clot.

  • Page 46: General Operation

    Equipment and Disposable Description P/N 53063-50, Manual Revision: B ENERAL OPERATION This section provides a general overview of how the CS5+ works. For detailed instructions for each protocol performed by the CS5+, consult Chapters 5 – 7. Note: Note that the Cell Saver 5+ System is programmed to produce consistently good results in most procedures.

  • Page 47: Filling The Centrifuge Bowl

    Warning: Normal saline is the recommended wash solution for use with the Haemonetics Cell Saver 5+. At the start and finish of the WASH mode there is a brief “switching” of the valves that the operator may notice. At the start of the WASH mode, the blue line valve...

  • Page 48: Washing Partial Bowls

    Equipment and Disposable Description P/N 53063-50, Manual Revision: B In the Automatic mode the wash volume is programmable from 750 - 3000 ml (500 - 3000 ml for a 125 ml bowl, 300 - 3000 ml for a 70 ml bowl). The recommended wash volume for a 225 ml bowl is 1000 ml(750ml for a 125 ml bowl and 300ml for a 70 ml bowl).
  • Page 49 Chapter 3 Safety and Patient Care Precautions GENERAL ..........3-2 SAFETY AND PATIENT CARE PRECAUTIONS.

  • Page 50: Chapter 3: Safety And Patient Care Precautions

    Safety and Patient Care Precautions P/N 53063-50, Manual Revision: B ENERAL Chapter 3 provides general information on Safety and Patient Care Precautions for the Cell Saver 5+ System (CS5+), and discusses parameters that affect processing times.

  • Page 51: Safety And Patient Care Precautions

    P/N 53063-50, Manual Revision: B Safety and Patient Care Precautions AFETY AND PATIENT CARE PRECAUTIONS The following paragraphs outline precautions that must be taken to ensure safe operation of the CS5+. Storage and Many plastics are sensitive to chemicals such as solvents, refrigerants, and detergents.

  • Page 52: Rotating Machinery

    OSHA Blood Borne Pathogen Standard. When any Haemonetics product (equipment or disposables) which has been used during a procedure is returned to Haemonetics for any reason, the customer must decontaminate and repackage the product in compliance with the medical facility’s Infection Control Plan and U.S.

  • Page 53: Twists And Kinks In Tubing

    P/N 53063-50, Manual Revision: B Safety and Patient Care Precautions Twists and Kinks A careful recheck of the mounted harness should be carried out to make certain that each section is in the correct position on the machine, and that all tubes are in Tubing free of twists or kinks that would prohibit fluid flow.

  • Page 54: Red Cell Spillage

    Safety and Patient Care Precautions P/N 53063-50, Manual Revision: B Red Cell Spillage Under normal conditions there should be little or no red cell spillage. The effluent line sensor should mitigate any spillage. During the WASH mode, two conditions may especially result in red cells spilling over into the waste bag: 1.

  • Page 55: Depletion Of Clotting Factors

    P/N 53063-50, Manual Revision: B Safety and Patient Care Precautions Depletion Warning: Washed, concentrated cells are depleted of clotting factors. The physician must monitor the quantity of washed cells returned to the patient, and of Clotting supplement the washed, concentrated cells with fresh frozen plasma and Factors platelets if required for hemostasis.

  • Page 56: Factors Affecting Processing Time

    Safety and Patient Care Precautions P/N 53063-50, Manual Revision: B ACTORS AFFECTING PROCESSING TIME Cell Salvage The time required to process a centrifuge bowl of salvaged blood is dependent upon the following factors: Salvaged blood hematocrit Bowl volume Bowl filling rate Wash volume Wash flow rate Empty flow rate...
  • Page 57 Chapter 4 Setup Procedures for Cell Salvage GENERAL OPERATION ........4-2 SETUP .

  • Page 58: Chapter 4: Setup Procedures For Cell Salvage

    Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B ENERAL OPERATION Chapter 4 provides detailed setup procedures for the Cell Saver 5+ System (CS5+) and required disposable components. The following sections describe the basic setup regardless of how the system will be operated for a Cell Saver procedure. Note: Machine should be powered on and given an opportunity to complete the self-test prior to loading disposable.

  • Page 59: Setup

    The unit then goes into self-test to insure that all the functions are operating before the unit is allowed to be used in a procedure. A SELF-TEST screen will be displayed indicating the stage of self-test completion: HAEMONETICS CORPORATION CELL SAVER CS5+-X.X...
  • Page 60 Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B If a fault is found an appropriate message with actions will be displayed: SELF TEST NOTICE UNEXPECTED SENSOR READING Waste bag weigher To retry the test, press YES To proceed in MANUAL mode, press MODE Figure 4-3: Self-Test Failure Screen Note: Do not load disposables until the self-test is complete.

  • Page 61: Installing The Cell Saver Disposables

    Cell Saver Disposables Note: The setup instructions provided by the HELP key are merely reminders and are not intended to serve as a substitute for formal Haemonetics training on the use of the CS5+. 1. Prepare the Collection — “Standby”...
  • Page 62 Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B Figure 4-7: Hang the anticoagulant solution from the IV pole Connect the Aspiration and Anticoagulation set to the reservoir. Attach suction source to reservoir and set suction at a minimal acceptable flow rate (under 200 mmHg).
  • Page 63 P/N 53063-50, Manual Revision: B Setup Procedures for Cell Salvage 2. Ready the Machine and Bowl Disposable. Open the fluid deck cover, pump lever, and manifold door. Open the centrifuge cover by pulling the grey/blue knob on the right side of the cover and opening the header arm.
  • Page 64 Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B Thread the effluent tubing through the effluent line sensor. Be sure that the tubing is threaded deep into the effluent line sensor notch. Figure 4-10: Thread Tubing through Line Sensor 4.
  • Page 65 P/N 53063-50, Manual Revision: B Setup Procedures for Cell Salvage Hang the waste bag on the pins on the front of the machine. Ensure that the waste bag is securely connected to the effluent line and the drain port is completely closed. Figure 4-12: Hang Waste Bag and Check Connection to Effluent Line 5.
  • Page 66 Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B 6. Set up the saline. (Each cycle requires approximately 750 to 1000 ml.) Hang the saline wash containers on the IV pole. Close the clamps on both of the yellow wash lines before spiking the saline bags.
  • Page 67 P/N 53063-50, Manual Revision: B Setup Procedures for Cell Salvage Warning: The bowl base (or adapter) must be firmly installed and evenly seated in the centrifuge chuck. If the centrifuge chuck spins with the bowl base (or adapter) not evenly seated, as indicated by bowl wobbling or noise, bowl damage will occur and the bowl and harness set must be replaced.
  • Page 68 Setup Procedures for Cell Salvage P/N 53063-50, Manual Revision: B Note: Changes made at this point will become permanent until changed by the user. The no wash option, pump regulation off option, and min wash volumes below 1000 ml for a 225 ml bowl, 750 ml for a 125 ml bowl are retained on a per procedure basis only.
  • Page 69 Chapter 5 Automatic Operation: Cell Salvage GENERAL ..........5-2 PROCESSING IN THE AUTOMATIC MODE .

  • Page 70: General

    Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B ENERAL This section explains how to operate the Cell Saver 5+ (CS5+) Autologous Blood Recovery System in the AUTOMATIC mode.

  • Page 71: Processing In The Automatic Mode

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage ROCESSING IN THE AUTOMATIC MODE Before any blood can be processed, the disposables must be loaded correctly. Follow the directions in the previous chapter. Note: Anticoagulant, as prepared in Chapter 4, is not controlled by the CS5+. This should be done manually in a 1:7 ratio (for heparin solution) of anticoagulant rate to the rate of blood entering the reservoir.
  • Page 72 Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B The following screen will be displayed: FILL BOWL AUTOMATIC Processed Vol: xx ml Wash Vol: 0 ml Reinfusion Vol: 0 ml Bowls Processed: Pump Rate: 600 ml/min Press MODE twice to enter EMERGENCY option 3.
  • Page 73 P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage The operator can begin a FILL mode at anytime during Standby by pressing the START key. But at this point, the operator has other options, depending upon which keys are lit. The operator can: a.
  • Page 74 Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B In this AUTOMATIC WASH mode, the CS5+ will optimize the processing by operating at the optimum pump speed between 250 ml/min and 500 ml/min (or 200–300 ml/min if the 125 ml bowl is being used or 100-300 ml/min for the 70 ml bowl).
  • Page 75 P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage When the appropriate volume of saline has entered the bowl, the system will automatically stop the pump, the centrifuge will stop spinning, and the red blood cells suspended in saline will be pumped out of the centrifuge bowl and into the reinfusion bag.
  • Page 76 Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B Warning: Close the clamp between the reinfusion bag and the patient between reinfusions. Do not close the white clamp on the blue line between the reinfusion bag and the CS5+. Warning: Washed, concentrated cells are depleted of clotting factors. The physician must monitor the quantity of washed cells returned to the patient, and supplement the washed, concentrated cells with fresh frozen plasma and platelets if required for hemostasis.
  • Page 77 P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage When air is sensed in the WASH mode and less than 90% of the wash volume has been processed, the pump stops, an audible chime is sounded and the display reads: Saline bag empty Replace saline bag The operator should replace the saline bags and then press START to resume...

  • Page 78: Modifying The Preset Parameters

    Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B ODIFYING THE PRESET PARAMETERS The CS5+ is programmed with preset processing parameters that can be modified by the operator while in AUTOMATIC operation. These parameters can all be modified from the STANDBY state or some parameters can be changed at various points in the processing cycle.

  • Page 79: Additional Functions In Automatic

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage DDITIONAL FUNCTIONS IN AUTOMATIC CONC The concentrate option is used when the volume of red cells in the bowl is low, and it is necessary to wash and return whatever cells there are. (This is sometimes (Concentrate) at the end of a procedure when the bowl is less than full, and no more blood loss Option...

  • Page 80: Pump Regulation Option

    Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B When the RBCs reach the trip point, the WASH mode is initiated. To prevent overfilling of the bowl with red cells before the WASH mode begins, the blue line valve closes, the red line valve opens, and the pump reverses to withdraw blood from the tubing to the bowl header into the red line.

  • Page 81: Empty Rbcs To Blue/Red Line (Return Option)

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage EMPTY RBCs TO “Empty RBCs to Blue Line” directs the CS5+ to send a bowl of washed RBCs to the blue line and the reinfusion bag after a wash cycle has been completed. This BLUE/RED LINE is the default value.
  • Page 82 Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B Once the MODIFY key is pressed a screen similar to the following is displayed: CELL SAVER SETUP AUTOMATIC Min Wash Vol. - 225: 1000 ml NO WASH Option: -125: 750 ml 800 ml Reservoir Level: 400 ml...

  • Page 83: Wash Option

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage An example of the display that will appear when the system trips into RETURN is: RETURN AUTOMATIC Processed Vol: 2525 ml Wash Vol: 2000 ml Reinfusion Vol: 400 ml Bowls Processed: Pump Rate: 250 ml/min Press MODE twice to enter EMERGENCY option...
  • Page 84 Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B STANDBY AUTOMATIC Processed Vol: 0 ml Wash Vol: 0 ml Reinfusion Vol: 0 ml Bowls Processed: Need 800 ml in reservoir to FILL automatically Press START to FILL bowl or CONC to concentrate Press MODIFY to change parameters Once the MODIFY key is pressed a screen similar to the following is displayed: CELL SAVER SETUP...

  • Page 85: Emergency Option

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage EMERGENCY The emergency option is available for those situations in which the speed at which blood is available for return to the patient is the most important factor. The Option emergency option is accessible from the AUTOMATIC mode when the machine is in the FILL,WASH, EMPTY, CONC, and RETURN functions.

  • Page 86: Empty Blue Line Option

    Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B EMPTY BLUE At the completion of the procedure, approximately 40 mL (13 mL for the 70 mL bowl) of RBCs remain in the blue line that should be emptied to the reinfusion LINE Option bag.

  • Page 87: System Status

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage YSTEM STATUS The next section briefly discusses some information regarding the display and how current procedure statistics are displayed. The current system status is displayed as shown in the following example: FILL BOWL AUTOMATIC Processed Vol:...

  • Page 88: Wash Volume Monitor

    Automatic Operation: Cell Salvage P/N 53063-50, Manual Revision: B To return to full automatic operation (enabling the effluent line sensor): 1. Press the UP (▲) or DOWN (▼) key until the “Pump Regulation Off” message disappears from the screen. This will occur when the pump is returned to its original speed.

  • Page 89: Volume Accounting Function

    P/N 53063-50, Manual Revision: B Automatic Operation: Cell Salvage Volume The Volume Accounting Function of the CS5+ allows the operator to monitor the approximate fluid volume processed and the approximate fluid volume returned Accounting to the patient by the CS5+. This information is constantly displayed during each Function mode, and is being constantly updated.

  • Page 90: Troubleshooting

    If you are not comfortable troubleshooting problems with your equipment or disposables, Haemonetics has a 24 hour Hotline (800) 433-3431 that you may call for assistance. 5-22...
  • Page 91 Chapter 6 Manual Operation GENERAL ..........6-2 CONTROLS AND INDICATORS .

  • Page 92: General

    Manual Operation P/N 53063-50, Manual Revision: B ENERAL This chapter explains how to operate the Cell Saver (CS5+) System in the MANUAL mode. Though not recommended, it is possible to process blood manually in the CS5+. Given the processing capabilities of the CS5+, manual processing is unnecessary. The steps involved in manual processing during autotransfusion are outlined below.

  • Page 93: Controls And Indicators

    P/N 53063-50, Manual Revision: B Manual Operation ONTROLS AND INDICATORS By pressing the MODE key once the machine switches from Automatic operation to Manual operation. Once MANUAL operation is selected the backlit control panel lights up and additional control keys become functional as shown in Figure 6-1.

  • Page 94: Manual Operation

    Manual Operation P/N 53063-50, Manual Revision: B ANUAL OPERATION 1. Set up the system and disposables as described in Chapter 4. Choose the Cell Saver Protocol as described in the section, Processing In Automatic Mode in Chapter 5+, at which time the following display will be shown: STANDBY AUTOMATIC Processed Vol:...
  • Page 95 P/N 53063-50, Manual Revision: B Manual Operation 3. Initiation of the FILL mode is largely dependent upon the rate of fluid collection in the reservoir. If the patient’s rate of blood loss is steady and rapid, processing may begin as soon as 100 ml of fluid enter the reservoir. Typically, however, the processing mode (FILL) can be initiated after the reservoir has accumulated 600–900 ml of volume or 200-600 ml when using the 70 ml bowl...
  • Page 96 Manual Operation P/N 53063-50, Manual Revision: B During the WASH mode the following display will be shown: WASH CELLS MANUAL Processed Vol: 800 ml Wash Vol: 150 ml NaCl Reinfusion Vol: 0 ml Bowls Processed: Pump Rate: 500 ml/min Wash Volume: 150 ml Press MODE key for AUTOMATIC Press ARROW keys to change values Note: If during the WASH mode the red cell/supernatant interface disappears and...
  • Page 97 Warning: DO NOT PRESSURE REINFUSE. Pressure reinfusion can lead to the fatal infusion of air into the patient. The Haemonetics Cell Saver 5+ System’s disposables are not intended to be used with a pressure reinfusion cuff. For information on removing air from the reinfusion bag see the section, Pressure Reinfusion in Chapter 3.

  • Page 98: Emergency Option

    Manual Operation P/N 53063-50, Manual Revision: B EMERGENCY An emergency option is available from the MANUAL mode. This option is described in detail in Chapter 5. The EMERGENCY option is not available for use Option with the 70 ml bowl. To enter the EMERGENCY option from the MANUAL mode, press the MODE key twice.
  • Page 99 Chapter 7 Sequestering on the Cell Saver 5+ System GENERAL ..........7-2 OVERVIEW OF THE SEQUESTERING PROTOCOL .

  • Page 100: General

    Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B ENERAL This section explains how to perform sequestering on the Cell Saver 5+ (CS5+) Autologous Blood Recovery System. This protocol allows for the separation of platelet-rich plasma (PRP) and platelet-poor plasma (PPP) from RBCs.

  • Page 101: Overview Of The Sequestering Protocol

    P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System VERVIEW OF THE SEQUESTERING PROTOCOL The Sequestering Protocol is usually performed before the Cell Saver Protocol. After the power on and self-tests complete, the system is set up with the standard bowl processing set.

  • Page 102: Setting The Parameters

    Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B Step 7: Install the large bore tubing on the sequestering harness into the effluent line sensor by grasping the distal (towards the bags) con- nection tubing stop and using a “flossing” motion, pull the tuning down through the sensor until the bowl end connection tubing stop reaches the upper end of the effluent line.
  • Page 103 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System 2. Press MODIFY to see the SETUP screen. CELL SAVER SETUP AUTOMATIC NO WASH Min Wash Vol. - 225: 1000 ml NO WASH Option: Protocol: Cell Saver -125: 750 ml Reservoir Level: 800 ml...
  • Page 104 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 4. Press MODIFY to save changes and return to the current settings screen. 5. Press START to enter the STANDBY screen. STANDBY SEQUESTER Processed Vol: 0 ml Reinfusion Vol: 0 ml Bowls Processed: Press START to FILL bowl or CONC to concentrate...

  • Page 105: Method 1 - Manual Sequestration

    P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System 1 — M ETHOD ANUAL SEQUESTRATION 1. Collect whole blood from the patient via short intravenous or arterial cannula into anticoagulated blood bag(s). Warning: Only one unit of blood should be collected and processed at a time. Unless directed by a physician, do not begin withdrawal of the second unit of blood from the patient until the first unit of concentrated red autologous blood cells has been returned.
  • Page 106 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B Caution: Never close the yellow (PPP), Blue (PRP), and white (air) bag clamps at the same time. 5. Continue to observe the centrifuge bowl. Allow plasma to run into the PPP bag at the same flow rate.
  • Page 107 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System If the “Return Plasma?” parameter in the Sequester Setup is set to “YES” the following screen is displayed: EMPTY BOWL SEQUESTER Processed Vol: 910 ml 236 ml Reinfusion Vol: Bowls Processed: OPEN PPP bag clamp CLOSE PRP bag clamp...
  • Page 108 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 8. When the bowl completely empties, the pump will stop and the following display will be shown: STANDBY SEQUESTER Processed Vol: 510 ml 125 ml Reinfusion Vol: Bowls Processed: Press START to fill bowl or CONC to concentrate Press MODIFY to change parameters Press YES to select Cell Saver protocol...

  • Page 109: System Breakdown

    P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System System 1. After the final pass, remove the collection bag(s) from the pin(s) and invert it (them). Tap the sides of the tubing going from the bowl to the collection bag Breakdown to dislodge any plasma/platelets that might have adhered to the tubing wall.
  • Page 110 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 6. To perform a cell salvage procedure once the sequestering procedure is complete, press the YES key while the system is in STANDBY to return the CS5+ to the Cell Saver Protocol. LOAD DISPOSABLE NaCl When disposable is loaded, press START...
  • Page 111 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System 2 — A ETHOD SSISTED SEQUESTER MODE 1. Collect whole blood from the patient via short intravenous or arterial cannula into anticoagulated blood bag(s). Note: Only one unit of blood should be collected and processed at a time. Unless directed by a physician, do not begin withdrawal of the second unit of blood from the patient until the first unit of concentrated red autologous blood cells has been returned.

  • Page 112: Sequester Setup Terminology

    Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B SEQUESTER SETUP - ASSISTED SEQUESTER ↑↓ PARAMETER Default Assisted Sequester Mode: Toggle Fill Bowl DRAW Rate: Fill Bowl Centrifuge Speed: 4750 5650 2050 PRP Collection DRAW Rate: PRP Collect Centrifuge Speed: 4750 5650 2050...
  • Page 113 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System Milk Delay: The time in seconds the pump will be stopped during the PRP collection phase before starting to pump the programmed Milk Vol parameter. 2. Once the Assisted Sequester Setup parameters have been set and the START key is pressed to begin a new procedure, the screen display changes to the STANDBY screen and further information is requested before processing can begin.
  • Page 114 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B If the AIR bag was selected to manage the system air: STANDBY SEQUESTER Processed Vol: Reinfusion Vol: Bowls Processed: CLOSE RED bag clamps PPP Volume: OPEN AIR bag clamp PRP Volume: CLOSE YELLOW bag clamp CLOSE BLUE bag clamp...
  • Page 115 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System 6a. Observe the centrifuge bowl filling and allow air from the circuit and the bowl to flow to the air bag or PPP collection bag. b. When plasma reaches the effluent line, the machine will decide if the process should pause as determined by the selection that was made for air management.
  • Page 116 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B On the first cycle the bowl size is determined by the machine. The high volume bowl (225 ml) and low volume bowl (125 ml) can both be used for sequestering. By default the machine expects to detect a low volume bowl (125 ml).
  • Page 117 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System 8. The white buffy coat band (made up of platelets and white cells), which is immediately adjacent to the top of the red cell level, will be seen coming up over the shoulder of the bowl.
  • Page 118 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 9. Once the START key is pressed the machine first looks at the centrifuge speed for PRP collection that was programmed in Sequester Setup. If the programmed PRP collection centrifuge speed is equal to or greater than the programmed Fill Bowl centrifuge speed, the pump is started and PRP collection is resumed.
  • Page 119 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System has been reached the pump restarts and the process repeats. This process of stopping and starting will continue until the PRP collection is completed. 11. After 10 ml of PRP have been collected the effluent line sensor starts looking for RBCs spilling into the PRP collection bag.
  • Page 120 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 12. Once the pump has pumped the programmed PRP Extended Collection Volume, the pump is stopped and the PRP collection is complete and the display adds COMPLETE to the screen as follows: COLLECTION SEQUESTER COMPLETE...
  • Page 121 P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System If the “Return Plasma?” parameter in the Sequester Setup is set to “YES” the following screen is displayed: EMPTY BOWL SEQUESTER Processed Vol: 299 ml 0 ml Reinfusion Vol: Bowls Processed: PPP Volume: 100/...
  • Page 122 Sequestering on the Cell Saver 5+ System P/N 53063-50, Manual Revision: B 15. When the bowl completely empties, the pump stops and the following display is shown: STANDBY SEQUESTER Processed Vol: 299 ml Reinfusion Vol: 199 ml Bowls Processed: PPP Volume: 40 ml PRP Volume: 60 ml...

  • Page 123: System Breakdown

    P/N 53063-50, Manual Revision: B Sequestering on the Cell Saver 5+ System System 1. After the final pass, remove the collection bag(s) from the pin(s) and invert it (them). Tap the sides of the tubing going from the bowl to the collection bag Breakdown to dislodge any plasma/platelets that might have adhered to the tubing wall.
  • Page 124 6. To perform a cell salvage procedure once the sequestering procedure is complete, press the YES key while the system is in STANDBY to return the CS5+ to the Cell Saver Protocol. LOAD DISPOSABLE NaCl When disposable is loaded, press START 7.
  • Page 125 Chapter 8 Maintenance GENERAL ..........8-2 MAINTENANCE AND CLEANING .

  • Page 126: General

    The date and type of maintenance performed should be recorded regularly. Warning: Do not grease any part of the mechanical centrifuge. If grease has been applied to the mechanical centrifuge, contact Haemonetics hotline immediately.

  • Page 127: Maintenance And Cleaning

    OSHA Blood Borne Pathogen Standard. When any Haemonetics product (equipment or disposables) which has been used during a procedure is returned to Haemonetics for any reason, the customer must decontaminate and repackage the product in compliance with the medical facility’s Infection Control Plan and U.S.

  • Page 128: Cleaning The Effluent Line Sensor

    Note: If the mechanical chuck becomes contaminated with blood, call Haemonetics hotline at (800) 433-3431 for further assistance. If blood has entered the finger-locking mechanism, the mechanical chuck must be cleaned by a trained biomed or a haemonetics field service engineer.
  • Page 129 P/N 53063-50, Manual Revision: B Maintenance Filter Cleaning Procedure Cleaning the air filter is simple and easy. The following steps outline the correct procedure. 1. Unplug the CS5+. 2. If there is a louvered panel covering the filter, remove the four screws which hold it in place, and set the panel and screws aside.

  • Page 130: Field Service

    P/N 53063-50, Manual Revision: B IELD SERVICE Throughout the United States and in many locations worldwide, Haemonetics maintains a network of factory-trained field service engineers. If a problem should arise, one of these equipment specialists can usually be on-site within twenty-four hours to diagnose and correct any malfunction.

  • Page 131: Technical Services

    Maintenance ECHNICAL SERVICES Installation and Haemonetics has a large network of clinical specialists proficient in both the medical and technical aspects of all Haemonetics equipment. They are Training experienced trainers who can listen and respond to your questions and concerns.

  • Page 132: Returned Goods Authorization (Rga) System

    RGA Procedure The steps that should be followed in returning any equipment are outlined below. All devices to be returned to Haemonetics for product performance or quality problems should be handled according to the Product Complaint Coordinator’s instructions ([800] 433-3431). Merchandise received by a customer which was shipped in error by Haemonetics will be handled by the Customer Services Department (800) 225-5297.
  • Page 133 P/N 53063-50, Manual Revision: B Maintenance 5. Should Haemonetics request the return of contaminated disposables, or equipment, the disposables or equipment must be decontaminated prior to shipment pursuant to those policies and procedures dictated by the medical facility’s Infection Control Plan, as required by OSHA Blood Borne Pathogen Standard.
  • Page 135 Appendices APPENDIX A: COMPLICATIONS AND CONTRAINDICATIONS..APP-2 References ..........APP-6 APPENDIX B: CLEANING PROCEDURES .

  • Page 136: Appendix A: Complications And Contraindications

    Appendices P/N 53063-50, Manual Revision: B A: C PPENDIX OMPLICATIONS AND CONTRAINDICATIONS Complications of and contraindications to perioperative blood recovery (Per 1997 AABB Guidelines for blood recovery and reinfusion in surgery and trauma pg 19-22) Substance Effects Recommended Action Pharmacologic Agents A.
  • Page 137 P/N 53063-50, Manual Revision: B Appendices Complications of and contraindications to perioperative blood recovery (Per 1997 AABB Guidelines for blood recovery and reinfusion in surgery and trauma pg 19-22) Substance Effects Recommended Action 4. Chloropactin (Bleach) Causes red cell lysis. Avoid aspiration in area where product is being used.
  • Page 138 Appendices P/N 53063-50, Manual Revision: B Complications of and contraindications to perioperative blood recovery (Per 1997 AABB Guidelines for blood recovery and reinfusion in surgery and trauma pg 19-22) Substance Effects Recommended Action Contaminants A. Amniotic Fluid Contains proteolytic Cell salvage is an option after enzymes which may delivery of the fetus, removal of the activate clotting.
  • Page 139 P/N 53063-50, Manual Revision: B Appendices Complications of and contraindications to perioperative blood recovery (Per 1997 AABB Guidelines for blood recovery and reinfusion in surgery and trauma pg 19-22) Substance Effects Recommended Action Malignancy A. Primary at Operative Site Cell salvage is widely used Avoid cell salvaging at tumor site.

  • Page 140: References

    Appendices P/N 53063-50, Manual Revision: B Complications of and contraindications to perioperative blood recovery (Per 1997 AABB Guidelines for blood recovery and reinfusion in surgery and trauma pg 19-22) Substance Effects Recommended Action C. Cold Agglutinin Antibody Agglutination of red cells If cold agglutinins show significant may occur at temperatures activity at room temperature...

  • Page 141: Appendix B: Cleaning Procedures

    P/N 53063-50, Manual Revision: B Appendices B: C PPENDIX LEANING PROCEDURES Cleaning Procedures for Cell Saver 5+ Parts (detailed instructions in chapter 8) Part Procedure Air Detector 1. Floss with lint-free cloth dampened with clear water. 2. Floss again using a dry lint-free cloth. Air Filter 1.

  • Page 142: Appendix C: Machine Messages/Troubleshooting

    Appendices P/N 53063-50, Manual Revision: B C: M PPENDIX ACHINE MESSAGES TROUBLESHOOTING Machine Messages/Troubleshooting Condition/Reason Mode Action “AIR DETECTED EARLY” EMPTY/RETURN 1. Check tubing placement. Air detected before bowl has been 2. Check for occlusions in effluent tubing. emptied. 3. Check for bowl displacement air in waste bag.

  • Page 143: Appendix C: Machine Messages/Troubleshooting

    1. Check for occlusions or kinks in tubing. Pressure sensed in fluid lines. 2. Ensure clamps on reinfusion bag and res- ervoir are open. DISPLAY INOPERATIVE Contact Haemonetics Hotline. “LONG EMPTY (or RETURN) EMPTY/RETURN 1. Check tubing placement. CYCLE“ 2. Check for occlusions in effluent, blue and Air should be detected by 300ml.
  • Page 144 Empty or change waste bag. Greater than 9 L in waste bag. Ensure bowl is empty. If you are not comfortable troubleshooting problems with your equipment or disposables, Haemonetics has a 24 hour Hotline (800) 433-3431 that you may call for assistance. APP-10...

  • Page 145: Operation Precautions

    Cell Saver device precautions using a power cord not supplied by Haemonetics, a multiple portable socket outlet or an extension cord. Mobile RF communication equipment not approved by Haemonetics and portable communication equipment can affect the system.
  • Page 146 Appendices P/N 53063-50, Manual Revision: B IEC 60601-1-2: 2001, Table 202: Guidance and manufacturer’s declaration - electromagnetic immunity The Cell Saver system is intended for use in the electromagnetic environment specified below. The customer or the user of the Cell Saver system should assure that it is used in such an environment. Immunity test IEC 60601 Compliance level...
  • Page 147 P/N 53063-50, Manual Revision: B Appendices IEC 60601-1-2: 2001, Table 204: Guidance and manufacturer’s declaration - electromagnetic immunity The Cell Saver system is intended for use in the electromagnetic environment specified below. The customer or the user of the Cell Saver system should assure that it is used in such an environment. Immunity test IEC 60601 Compliance level...
  • Page 148 Appendices P/N 53063-50, Manual Revision: B IEC 60601-1-2: 2001, Table 206: Recommended separation distance between portable RF communications equipment and the Cell Saver device The Cell Saver system is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled.
  • Page 149 Index AABB standards 5-8, 7-10, 7-11, 7-24, 7-25, APP-2 Air Detector 1-8, 2-9, 2-13, 4-9, 5-17, 6-2, 8-4, APP-7, APP-8, APP-9 Anticoagulant 2-14, 2-16, 2-17, 2-18, 2-19, 3-8, 4-6, 5-3, 5-16, 6-5, 7-3, 7-11, 7-25, APP-3, APP-4 Aspiration and Anticoagulation Assembly 1-16, 1-17, 2-14, 4-5 Automatic 1-11, 1-12, 2-5, 2-6, 2-7, 2-9, 2-11, 2-12, 2-20, 4-11, 4-12, 5-1, 6-2, 6-8, 7-12, 7-26 Automatic Controls 2-5, 2-8, 2-17...
  • Page 150 Index P/N 53063-50, Manual Revision: B Depletion of Clotting Factors 3-7 Dimensions 1-10 Display Panel 2-4 Drip Chamber 2-14, 4-6 Effluent Line 1-8, 2-13 Effluent Line Sensor 1-12, 2-12, 2-19, 2-20, 3-6, 4-8, 5-4, 5-6, 5-12, 5-19, 5-20, 8-4, APP-7 Electrical Shock Hazard 1-13, 3-3 EMERGENCY Option 2-6, 2-12, 5-17, 6-8 Emergency Option 2-8...
  • Page 151 P/N 53063-50, Manual Revision: B Index Indications 1-4 Installing the Disposables 4-5 IV Pole 1-10, 1-11, 4-6, 4-8 Kinks 3-5 Leakage Current 1-13, 3-3 Line Sensor 8-4 Machine Symbol Chart 1-13 Maintenance 8-3 Malignancy 1-4, APP-5 Managing the Inventory of Air 3-6 Manifold 4-7, 4-9 Manual 2-5, 2-6, 2-8, 6-1 Manual Controls 2-8...
  • Page 152 Index P/N 53063-50, Manual Revision: B Partial Bowls 2-20 PAUSE 2-7, 6-2 Plasma Hemoglobin 3-5 Plasma Sequestration 7-3 Platelet Poor Plasma (PPP) 7-2, 7-3, 7-8, 7-14, 7-15 Platelet Rich Plasma (PRP) 7-2, 7-3, 7-8, 7-14, 7-15 Power Cord 1-15 Power Switch 2-4 Preset Parameters 5-3, 5-10, 5-17, 6-4, 6-5, 6-8, 7-5 Pressure Cuff 3-6, 5-8 Pressure Reinfusion 3-6, 5-8, 6-7...
  • Page 153 P/N 53063-50, Manual Revision: B Index Warning iii Warranty iv Wash Rate 1-12, 5-5, 5-17, 6-5 Wash Solution 2-19, 2-20 Washing Partial Bowls 2-20 Waste Bag 1-16, 2-11, 2-12, 2-13, 4-9, 5-5 Waste Bag Weigher 2-11, 6-2 Yellow Line 2-9, 2-13 IX-5...

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