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baxter AK98 Quick Reference Manual
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baxter AK98 Quick Reference Manual

Dialysis machine
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AK 98
DIALYSIS MACHINE
QUICK REFERENCE GUIDE

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Summary of Contents for baxter AK98

  • Page 1 AK 98 DIALYSIS MACHINE QUICK REFERENCE GUIDE...

  • Page 2: Table Of Contents

    CONTENTS Note: The contents of this training material are based on the AK 98 Dialysis Machine Operator's Manual for software 3.xx (HC12839). Reviewing this material does not replace the training given to you by your healthcare provider, nor does it replace your responsibility to read and understand the full text of the Operator's Manual prior to operating the machine.

  • Page 3: Configuration

    CONFIGURATION - FRONT AND SIDE PANELS 1. Operator's panel 11. Arm for dialyzer holder 22. Dialysate ports for dialysate lines 2. Air detector 12. Venous blood line clamp 23. Dialysate line from machine 3. Venous pressure transducer 13. Expansion chamber holder to dialyzer (blue) connector 14.

  • Page 4: Back Panel

    CONFIGURATION - BACK PANEL 1. Transportation handle 8. Outlet tube (drain) 16. Blood leak detector 2. Air filters 9. Citric acid inlet tube 17. Priming bucket 3. Halt button 10. Ethernet port 18. Ultrafilter 4. Battery charge indicator 11. USB port 19.

  • Page 5: Buttons On The Operator's Panel

    CONFIGURATION - BUTTONS ON THE OPERATOR’S PANEL 1. On/Off button 2. Schedule indicator 3. Main switch indicator 4. Mute button 5. Blood pump up button 6. Blood pump button 7. Blood pump down button 1. On/Off button: Press to turn the machine on or off. Press and hold for 3 seconds while a disinfection program is running for the machine to automatically turn off after the disinfection program is completed.

  • Page 6: Screen Overview

    CONFIGURATION - SCREEN OVERVIEW 1. Venous pressure control 17. Information tab 2. Arterial pressure control 18. Treatment graph tab 3. Machine state indicator 19. Information field 4. Time indicator 20. Patient page 5. Blood path 21. Functions button 6. Fluid path 22.

  • Page 7: How To Use

    HOW TO USE Operation Start Up Pre-treatment Check WATCH VIDEO • The main power cable must be connected to the main power supply. • The main switch must be turned on. • The water supply must be connected to the inlet water and powered on. •...

  • Page 8: Circuit Preparation And Line Connection - Attaching The Arterial Blood Line

    HOW TO USE Circuit Preparation and Line Connection - Attaching the Arterial Blood Line WATCH VIDEO 1. Open the blood pump door. Press the center of the cover and pull the tab. 2. Place the blood pump segment into the blood pump. Do NOT push/thread the segment into the blood pump rotors.

  • Page 9: Attaching The Priming Solution

    HOW TO USE Circuit Preparation and Line Connection - Attaching the Priming Solution WATCH VIDEO 1. Attach the arterial blood line to one of the blood line holders in the prime bucket. Ensure the tip of the blood line does not touch the bottom of the bucket.

  • Page 10: Attaching The Venous Blood Line

    HOW TO USE Circuit Preparation and Line Connection - Attaching the Venous Blood Line WATCH VIDEO 1. Attach the venous blood line to one of the blood line holders in the prime bucket. Ensure the tip of the blood line does not touch the bottom of the bucket.

  • Page 11: Attaching The Heparin Syringe

    HOW TO USE Circuit Preparation and Line Connection - Attaching the Heparin Syringe WATCH VIDEO 1. If heparin is to be used, attach the prepared syringe to the heparin line. Note: If the heparin pump is not in use, ensure the heparin line is clamped.

  • Page 12: Priming

    HOW TO USE Priming WATCH VIDEO 1. Ensure the arterial blood line clamp is open. 2. Open the infusion line clamp(s). 3. Turn the dialyzer over so that the blue venous end is up. This helps remove the air from the dialyzer. 4.

  • Page 13: Recirculation

    HOW TO USE Recirculation WATCH VIDEO When priming is complete, the option for Recirculation will appear. 1. Press Recirculation. 2. Connect the patient ends of the bloodlines using a sterile recirculation connector. Ensure both patient bloodline clamps are open. 3. Ensure the clamps on the infusion line are open. 4.

  • Page 14: Blood Pressure Monitor (Bpm)

    HOW TO USE Blood Pressure Monitor [BPM] WATCH VIDEO The blood pressure cuff is connected to the side of the machine. Single Blood Pressure Measurement Press the BPM readout field. The machine will start taking the measurement. The heart icon and BPM will start flashing while measurement is taken.

  • Page 15: Manually Entering The Prescription

    HOW TO USE Manually Entering the Prescription WATCH VIDEO Set Treatment Time 1. Press the time indicator on the screen. 2. Press treatment time. 3. Set the desired treatment time and press OK. Set Ultrafiltration Goal 4. Press the time indicator on the screen. 5.

  • Page 16: Retrieving Patient Prescription

    HOW TO USE Retrieving Patient Prescription WATCH VIDEO Note: Applies only for bidirectional connectivity. 1. Press the Patient button. 2. Press the Patient ID bar. 3. Enter your patient’s ID and press OK. 4. Carefully check the correct patient data has been retrieved, and then press Confirm to accept.

  • Page 17: Connecting The Patient

    HOW TO USE Connecting the Patient WATCH VIDEO 1. Prior to stopping the blood pump following completion of recirculation, ensure: - Dialyzer is in treatment position (red arterial end up) - Machine is not in Concentrate Standby Mode (CSBM) - Dialysate path is green Note: Blood pump must be stopped after recirculation for the Connect patient option to appear.

  • Page 18: Starting The Treatment

    HOW TO USE Starting the Treatment WATCH VIDEO 1. Press the flashing blood pump button to restart the blood pump. 2. Adjust the blood flow rate using the +/- buttons above and below the blood pump button. Note: To adjust blood flow rate quickly, hold down the +/- buttons. 3.

  • Page 19: Emptying The Dialyzer And Bicart Cartridge

    HOW TO USE Stopping the Treatment, Rinseback, and Disconnecting the Patient (cont.) WATCH VIDEO 5. Close the clamp of the arterial blood line and the arterial access. 6. Disconnect the arterial blood line from the access. 7. Connect the arterial blood line to the rinseback line. Open the red clamps on the rinseback line, white clamp on the infusion line, and red clamp on the arterial blood line.

  • Page 20: Disconnecting The Blood Line And Dialyzer

    HOW TO USE Disconnecting the Blood Line and Dialyzer WATCH VIDEO 1. Press the center of the blood pump door and pull the tab to open the door. 2. Hold the arterial blood line just before the pump segment on the bottom.
  • Page 21 HOW TO USE Disinfection and Rinsing (cont.) Chemical Disinfection 1. Select the “Chemical” tab from the Disinfection/ Rinse menu. 2. Select the disinfectant. 3. Connect the blue concentrate connector to the WATCH VIDEO yellow wand. 4. Place the wand inside the disinfectant solution. 5.

  • Page 22: Changing The Dialyzer And Blood Lines During Treatment

    HOW TO USE Changing the Dialyzer and Blood Lines During Treatment WATCH VIDEO If clotting occurs, you may have to change the blood line and dialyzer during treatment. If you must replace the dialyzer and blood line during treatment, all values and settings will be saved in the machine, and treatment will resume from where it left off.

  • Page 23: Troubleshooting

    TROUBLESHOOTING Alarm Indication There are two alarm levels: high priority alarms and medium priority alarms. High Priority Alarm: Flashing red light and repeating 5-tone sound. The light will continue to flash and audible tone will  continue to sound until the cause of the alarm is resolved. Medium Priority Alarm: Flashing yellow light and repeating 3-tone sound.

  • Page 24: What To Do During A Power Outage

    TROUBLESHOOTING What to Do During a Power Outage If the machine loses power, a backup battery will temporarily power the Using the Machine During a Power Outage  blood unit. All settings and actual values will be saved. The blood pump and heparin pump will continue to operate using ...

  • Page 25: Changing A Wet Transducer

    TROUBLESHOOTING Changing a Wet Transducer 1. Don appropriate PPE as per facility policy. 2. Stop the blood pump. 3. Clamp transducer line. 4. Remove wet transducer protector from connector on machine and inspect the side connected to the machine for blood or priming solution strike-through.
  • Page 26 TROUBLESHOOTING Machine Screen Code Resolution Guidance Blood is Detected During Functional Check Make sure that the patient is not connected to the blood lines.  Blood in priming Clean the priming detector lens with isopropyl alochol and allow to dry. ...
  • Page 27 TROUBLESHOOTING Machine Screen Code Resolution Guidance Low Arterial Pressure Stop the blood pump. The arterial and venous pressure alarm limits are automatically  widened. Check that the patient´s blood flow rate is the same as the blood flow rate set in the ...
  • Page 28 TROUBLESHOOTING Machine Screen Code Resolution Guidance Incorrect Dialysate Ensure the acid jug container is filled or that the wall connection is secure and that the  Composition right concentrate is connected to the machine. Check set values Check for air in the concentrate line. Verify that the red concentrate connector is free ...

  • Page 29: Advanced Functions

    ADVANCED FUNCTIONS Profiling Profiling  You can define the treatment parameter pattern through profiling. Ultrafiltration rate (UF rate), sodium (Na concentration, and bicarbonate (HCO ) concentration profiles can be used by the machine. Profiling Settings/Activation  You may set up the profiling parameters immediately after the machine turns on and Function Check appears on the machine’s status indicator.
  • Page 30 ADVANCED FUNCTIONS Profiling (cont.) UF-rate UF-rate UF-volume UF-volume Start UF-rate Step START Mean rate Stop UF-rate STOP Time Time Decreasing step mode for UF rate profiling Decreasing linear mode for UF rate profiling UF-rate Interval Start UF-rate UF-volume Stop rate Time Interval mode for UF rate profiling UF rate in I/h...
  • Page 31 ADVANCED FUNCTIONS Profiling (cont.) Sodium, Bicarbonate Profiling 1. Press the Fluid button. 2. Select the UF rate tab or Cond tab. WATCH VIDEO 3. Press Profiling and press Sodium (Na ) or Bicarbonate (HCO ) to set up profiling. 4. Set up the Start and Stop values. 5.

  • Page 32: Diascan Monitoring System

    ADVANCED FUNCTIONS Diascan Monitoring System WATCH VIDEO Diascan Function  The Diascan function shows the estimated clearance value and calculates whether the set Kt/V target and minimum values can be reached at the end of treatment. Diascan Mechanism  Since the molecular weights of urea and sodium are similar, the optional Diascan function enables non-invasive automatic monitoring of the sodium clearance rate, which is considered to be similar to the urea clearance rate.
  • Page 33 ADVANCED FUNCTIONS Diascan Monitoring System (cont.) WATCH VIDEO Results The measurement results will appear in the clearance measurement output field. 1 Time of Last Measurement 2 Current/Estimated Kt/V at end of treatment 3 Last Measured Clearance Value Check Measurement History 1.

  • Page 34: Isolated Uf (Ultrafiltration)

    ADVANCED FUNCTIONS Isolated UF (Ultrafiltration) WATCH VIDEO During isolated UF, diffusion does not occur. Because the dialysate bypasses the dialyzer, the machine only performs ultrafiltration. During isolated UF, because the dialysate bypasses the dialyzer, the blood cannot maintain its temperature in the same way it does during diffusion. Since the UF rate is usually high during isolated UF, a high blood flow rate, within acceptable limits for the patient, is recommended to prevent clotting in the dialyzer and blood line.

  • Page 35: Other Functions

    OTHER FUNCTIONS Concentrate Standby Mode (CSBM) WATCH VIDEO AK 98 can be placed into concentrate standby mode. In concentrate standby mode, the concentrate is no longer used, and water consumption can be reduced. Concentrate standby mode can be activated when the functional check is done and the flow diagram turns green. When concentrate standby mode is active, a message will appear in the information field.

  • Page 36: Service Menu

    OTHER FUNCTIONS Service Menu You may explore and adjust some machine settings, and check the error list. 1. Press the Functions button. 2. Press Service to open the menu. There are 4 functions offered: Set time, Daylight Savings time, Screen brightness, and Volume. Set Time: Select Set Time, open the keypad, and adjust the time of ...

  • Page 37: Automatic Restart

    OTHER FUNCTIONS Automatic Restart What is the automatic restart? The automatic restart is a recovery process of the AK 98 program that usually completes in less than 1 minute. During this process, the screen turns off for ~10 seconds, the blood pump is stopped, and the AK 98 machine is in a patient-safe state.

  • Page 38: Blood Pressure Measurement (Bpm) Alarm Limit Setting

    OTHER FUNCTIONS Blood Pressure Measurement (BPM) Alarm Limit Setting If allowed, you may set upper and lower limits for alarms for the pulse, systolic, diastolic, and mean blood pressure. An alarm will occur when the value is outside the set alarm limits. 1.

  • Page 39: Helpful Tips

    HELPFUL TIPS Air Detector Activation To avoid unnecessary air detector alarms during set up, wait to activate the air detector until all air has been removed from the circuit. Note: Once the air detector test is done, the air detector will be automatically activated either when priming volume is achieved or when Connect patient is selected after recirculation.

  • Page 40: Saline Loss

    HELPFUL TIPS Saline Loss The arterial patient line is primed by gravity and is not counted in the preset prime volume. Example: If the priming volume is set to 300 ml, the remaining saline volume in a 1-liter saline bag after the complete prime procedure would be less than 700 ml.

  • Page 41: Hemodialysis Basics

    HEMODIALYSIS BASICS How Hemodialysis Works In hemodialysis, the cleaning of the blood takes place outside the body in an “artificial kidney”, called a dialyzer. Blood is pumped via disposable circuit to the dialyzer and back again, a process monitored and controlled by a dialysis machine. During the treatment blood flows on one side of a semi-permeable Dialysis fluid Dialysate...

  • Page 42: Blood Access Types

    HEMODIALYSIS BASICS Blood Access Types AV-fistula This is the recommended type of access. The artery (red) has been connected to a superficial vein (blue), and after a maturation period the vein has become arterialized with thicker walls and larger diameter. Graft The connection between artery and vein is made through a tube made either of an artificial material, or from part of one of the patient's blood...

  • Page 43: The Blood Monitor

    HEMODIALYSIS BASICS The Blood Monitor The blood monitor controls and supervises the entire blood circuit. The purpose of the blood monitor is to pass blood from the access through the arterial blood line to the dialyzer, after which it is returned to the patient via the venous blood line. This is done at a continuous flow and controlled speed. The blood pump is placed before the dialyzer.

  • Page 44: The Fluid Monitor

    HEMODIALYSIS BASICS The Fluid Monitor The purpose of the fluid monitor is to prepare dialysate and continuously pass it through the dialyzer and out to drain. Pure or ultrapure water is taken into the machine and mixed with acid and bicarbonate concentrates. The fluid is monitored to ensure the concentration of electrolytes is correct.

  • Page 45: The Water Supply

    HEMODIALYSIS BASICS The Water Supply The water used for dialysis must be of a high quality since the water is used to prepare dialysate. A hemodialysis patient is exposed to several hundred liters of dialysate per week, which is separated from the blood only by a thin membrane.
  • Page 46 HEMODIALYSIS BASICS Efficiency of Hemodialysis (cont.) Solute removal The removal of solutes is directly impacted by the prescribed blood flow (QB). One common waste is urea, which results from the breakdown of protein. The simplest way to follow the urea removal is to analyze and compare the blood urea concentrations before (pre) and after (post) dialysis.
  • Page 47 Notes...
  • Page 48 Rx only. For safe and proper use of the products mentioned herein, please refer to the appropriate Instructions for Use or Operator’s Manual. Baxter, AK 98, BiCart, CleanCart and Diascan are trademarks of Baxter International Inc. All other trademarks mentioned herein are the properties of their respective owners.
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