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Post by heatpete on Dec 13, 2023 13:46:05 GMT
Hey! So I am new to the B Brauns. I have been working in biomed for only 2 years but have been working with the Fresenius machines for 15 years. Before I went to B Braun training I had had zero interactions with the B Brauns. I am in hospital services with 12 hospitals full of Fresenius machines… BUT I am also over the 2 home patients we have on B Brauns. Haven’t had to do anything except for PM’s on them until now. I have zero trouble shooting experience. I have a machine that intermittently gives a Final Conductivity Limit (SUP) error during treatment. The ENDLF and ENDLF-S both spike up to a 15.0 conductivity. And then immediately drops back down into range. B Brain tech support says it may have something to do with the FPE. I have been studying my training materials and am wondering if it might be BICP getting stuck (?) because I did notice a small amount of dried bicarb around the top of the pump when I opened it up yesterday. Can anyone help please?
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Post by Chuck Weddle on Dec 13, 2023 14:03:23 GMT
I think the FPE is your likely cause or possibly an air leak. If it were related to the bicarb pump, it would be a bicarb SUP alarm. If the a bicarb or acid pump were to stick momentarily, the conductivity would drop not spike.
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Post by Admin on Dec 13, 2023 15:13:15 GMT
Chuck is correct - I'd also be weary of the temperatures. Also if you could provide the age, operating hours, sw version we could probably help a bit more.
Please list at the time of the alarm FPE FPA TSE TSBIC TSD TSDS TSDE TSDE_S (if present) KP KP_S
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joey
Full Member
Posts: 227
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Post by joey on Dec 13, 2023 17:25:35 GMT
Could also be the coupler/wand. I had a new machine that the new coupler was sucking air. Every time the air bubbles go through it would set it off. I changed the Oring in the coupler and that didn't do it, so I tried a new coupler and that fixed it.
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Post by heatpete on Dec 14, 2023 13:03:07 GMT
Thanks everyone! The machine is an only a little over a year old and has only been in use about 6 months. I noticed the acid wand was sucking air so I replaced the line (it had the long pink tubing for central delivery systems) and replaced the o-ring and the small piece of tubing that connects the stick part of the wand to the wand holder. I still see air bubbles being sucked in often so I had originally thought I needed to just replace the whole thing. But then when I saw it was spiking instead of dropping then I got confused. Can you explain to me why the conductivity would be spiking instead of dropping if the acid wand is sucking air?
I did notice too though that right before the conductivity spiked up to around 15, the conductivity would start slowly dropping down to around 13.3 and then it would alarm and spike at the same time. So is it actually spiking because it is going into bypass?
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Post by Chuck Weddle on Dec 14, 2023 16:41:18 GMT
I think what you're seeing is that when the air goes through ENDLF the conductivity starts to drop which causes KP to speed up. By the time the air clears, there is already too much acid in the solution resulting in the conductivity spiking.
I think if you fix your air problem your conductivity problem will go away. As Joey stated, try replacing the entire acid suction coupling.
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Post by SrCusEngr on Dec 14, 2023 22:38:32 GMT
I would like to add my two cents here because many people do not think about the workings of the DF Manifold. When looking at it from the rear door, in the upper left corner is the water inlet. On the other side (front) is the connector for the bicarbonate fluid. That fluid enters the bottom of RVB and then flows into an internal flow path, which then makes a downward direction to mid-height, and then goes horizontally to the bottom of the Bic conductivity cell. The fluid then goes thru the cell and re-enters the manifold and goes right to be mixed with acid coming from RVK. The path then goes to the bottom of the block (important!!), and then goes horizontally to the inlet of the End conductivity cell. It then flows thru the cell and back into the manifold near the top, and then flows to the port for FPE.
Now, we all know air bubbles float in water. Those two downward tubes can capture air bubbles if the flow is not sufficient to push them thru the entire length. Hence, the vertical tube just before the End condo cell can collect an enormous amount of air before the fluid has no choice but to push the air bubble out of its way. The air bubble flows thru the End condo cell causing a complete loss of conductivity (but you won't see this on the screen as zero because of 'averaging values over 1 minute'; only a trend will capture it). This loss causes the pump to suddenly ramp up but then the fluid hits the cell, and the pump returns to normal.
When I experienced this, the air infiltration was small enough to cause the alarm to occur every 13-15 minutes. From there, it was just a matter of finding the source of the air.
I hope this helps, because not many people think about the inner piping of the Manifold and how it can screw up your thinking when trying to solve a problem. Note: The PM has a procedure to pressurize the DF Manifold and then check for leaks. Good start.
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Post by heatpete on Dec 15, 2023 1:24:28 GMT
I replaced the entire acid wand and simulated a treatment and didn’t have one alarm. The conductivity stayed the same the entire time. The patient is about to test it out, so fingers crossed. Thank you everyone!
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