stuff
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Post by stuff on Apr 17, 2024 12:25:43 GMT
So I have a random amount of machines that will randomly shut the dialysate flow off in between patient treatments. Thankfully never during. Staff don't pay attention until there is a huge flood on the floor.
I have not been able to narrow it down to a root cause, either machine, or staff related on why this happens.
Any suggestions for things to look at?
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Post by dave74 on Apr 17, 2024 13:00:36 GMT
What do you do to get the flow back to normal?
Could there be a problem the flow rate during idle? I believe there is a setting in the service mode to make idle flow 100 or 300.
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stuff
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Post by stuff on Apr 17, 2024 13:19:49 GMT
to "fix" it, its just turn dialysate flow off, then back on again wait 10 minutes for condo to get back to normal. The autoflow minimum setting is either 300 or 500 and i have them set to 500. 600 flow is the usual for treatments, idle flow rate option is greyed out and not selectable? it is set to 300
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Post by ThereAreSomeWhoCallMeTim on Apr 17, 2024 14:57:00 GMT
I get pulled out on the floor every so often for this, I typically chalk it up to user error. (if you work for fresenius I know they turn the flow off to do the post lab draw, or are at least supposed to (possibly forgetting to turn it back on?) I just instructed my staff to check to make sure the shunt door is fully closed and then go to the prescription screen and turn the flow off there for about 5-10 seconds and then turn it back on. There will typically be an audible click when the flow is activated again. Machine will need to stabilize after this of course. (sometimes typing in the proper flow rate on the front screen doesn't fix it) As for your flood on the floor when this happens, it sounds like your acid and or bicarb pressures are too high on your wall box.
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stuff
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Post by stuff on Apr 17, 2024 16:39:59 GMT
As for your flood on the floor when this happens, it sounds like your acid and or bicarb pressures are too high on your wall box. This i do not doubt 1 bit. The bicarb loop is, what it is, coming straight out the mixer. The acid loop is 12-13 at station 1 and station 34 its at 4ish. Trying to get management to approve things to fix issues, is more than 2 fights. |
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Post by Travis CHBT on Apr 22, 2024 13:19:52 GMT
I have this happen often with my Bluestar standard machines. Supposedly this is a known issue with Fresenius and the pumps stop working. They are releasing an update that should be addressing this along with other stuff. As Stuff stated, the fix is to turn the dialysate flow off and back on but the issue is to catch it sooner than later because you will have a mess! Acid and bicarb loops that are over 2 psi will push through the springs in the pumps and that is what's leaking out of the vent tube. I'd hold a homeroom or whatever you call it and educate the staff on if they notice a machine leaking out of the vent and/or it sounds like the machine is not running to turn the dialysate flow off and back on.
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Post by 48yrshuntinbubbles on Apr 22, 2024 23:51:18 GMT
Is the dialysate flow off, or is it just flashing at whatever the flow rate is?
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Post by 48yrshuntinbubbles on Apr 23, 2024 0:02:47 GMT
I ask because, if there is a TMP alarm, when the reset button is pushed to adjust TMP, flow is turned off. Your staff may be busy and not hit the reset button a 2nd time to reset the new TMP value. I've seen it many times.
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stuff
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Post by stuff on Apr 23, 2024 14:17:18 GMT
Is the dialysate flow off, or is it just flashing at whatever the flow rate is? If the flow rate is flashing, dialysate flow is off. If you reset a TMP alarm the flow rate will flash/stop until tmp resets then the flow will turn back on. If the tmp alarm is activly alarm i do believe dialysate flow does not shut off This issue is the flow will shut off, flow rate flashes and never turns back on |
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Post by robertb on Apr 23, 2024 22:59:40 GMT
sounds like you have a option turned on in service mode to save power or not ?
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stuff
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Post by stuff on Apr 24, 2024 12:17:12 GMT
sounds like you have a option turned on in service mode to save power or not ? I dont think this would be the cause, unless there is a program glitch. So the same machine after it is "fixed" could go a day, a week, or months, before it happens again, or it could never happen again to that machine. Its just random |
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Post by dave74 on Apr 24, 2024 13:15:53 GMT
I looked for a Fresenius field service bulletin on this issue, but I can't find anything.
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phillipashleyludlow
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Post by phillipashleyludlow on Apr 24, 2024 18:02:42 GMT
stuff as conjecture, im curious if theres some link between slow flow settings and idle flow rate settings at play here.
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Post by ThereAreSomeWhoCallMeTim on Apr 24, 2024 18:43:28 GMT
sounds like you have a option turned on in service mode to save power or not ? I dont think this would be the cause, unless there is a program glitch. So the same machine after it is "fixed" could go a day, a week, or months, before it happens again, or it could never happen again to that machine. Its just random I would concur with this. I would only see this issue maybe a couple times a month and then lower as I trained staff on how to resolve it to the point that I rarely ever get called out to see this type of error anymore. I've only ever seen it happen in-between patients which leads me to believe it has something to do with the shunt door as that's really the only thing that staff do that would affect the dialysate flow in any way between tearing down and setting up the machine for the next patient. I don't think that it has something to do with the slow/low flow setting as every time I've seen it happen the flow is always at 500-800 or whatever the last setting was the previous patient was on. My staff usually don't even bring up the fact that the flow rate is flashing until I bring it up. They typically bring up the fact the condo or temp is alarming and that's when I notice the flow rate flashing. |
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