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Post by Chuck Weddle on Jun 23, 2022 17:37:11 GMT
Increase in temperature will definitely increase the conductivity , the ENDLF significantly increased beyond limit but BICLF remain constant at 0.3mS/cm. What could have been the cause of this constant value, the bicarbonate sensor was replaced without any change in value. The flow was also monitor for free flow. Kindly advice on what can be done. Temperature will NOT affect what conductivity is being displayed. Conductivity monitors and test equipment for dialysis MUST be temperature compensated (AAMI RD5:2003). Take a step back and start by answering these questions..... - What software version is on the machine?
- Is the bicarb pump actually drawing up bicarb?
- Can you calibrate the temperature sensors?
- Can you calibrate the balancing chamber?
- Can you calibrate the acid and bicarb pumps?
- Can you calibrate the bicarb and acid conductivities?
- On June 21st you stated the temperatures were:
- TSE. 35.6
TSHE.35.8 - TSBIC 34.2
TSD. 34.3
TSD_S 34.3 On June 22nd you stated the temperatures were: TSE 43.3°c
TSHE 46.3°c
TSBIC. 40.6°c
TSD. 41.2°c
TSD_S. 40.9°c
That's a huge difference in temperatures. Did you do something to change them?
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Post by dabiri on Jun 25, 2022 16:15:46 GMT
The machine SW 8.2A, as suggested I will recalibrate the temperature and all other affected sensor as earlier advice.
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Post by dabiri on Jul 6, 2022 22:21:54 GMT
I have carried out the calibration on temperature sensor, balance chamber, acid and bicarbonate pumps and acid and bicarbonate conductivity. The temperature sensor readings were within limit 35.8°c to 37.4°c, ENDLF reading was 14.2mS/cm but the BICLF reading 0.6mS/cm. The alarm still read bicarb cond limit.
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Post by justame on Jul 7, 2022 12:58:06 GMT
Have you tried swapping endlf and Biclf connectors on board and see if values changed? Tried swapping a Know good Biclf.
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Post by Chuck Weddle on Jul 7, 2022 13:42:31 GMT
I have carried out the calibration on temperature sensor, balance chamber, acid and bicarbonate pumps and acid and bicarbonate conductivity. The temperature sensor readings were within limit 35.8°c to 37.4°c, ENDLF reading was 14.2mS/cm but the BICLF reading 0.6mS/cm. The alarm still read bicarb cond limit. If you want help, you really need to give accurate and complete information. Answer ALL questions and someone may be able to help you: 1. Have you called Tech Support? If yes, what did they say? If no, why not? 2. Saying the temperature is within limit but stating a 1.6° range is not helpful at all. Is the temperature constant or is it fluctuating in that range? What temperature is the machine set for? 3. Are you using Solcart or liquid bicarb? If liquid, is it commercially made or mixed on-site? 4. What is the desired bicarb conductivity? 5. In dialysis mode, does the bicarb pump actually draw in bicarb? 6. What is the desired Final conductivity? 7. Are there any air bubbles seen flowing through the tubing? 8. Have you been trained by B. Braun?
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Post by bcjammerx on Jul 9, 2022 16:31:05 GMT
only thing I can add is to emphasize how important it is to calibrate following the manual EXACTLY.
OP if you don't have the manuals that show how to calibrate I could send you a pdf of them depending on the model machine you had when they were new, v8 or newer 9...though you can download the current one from bbrauns website. if you've gone through training you'll have access, that's pretty important too though, you'd really need that as well...these are highly tuned and sensitive machines
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Post by Chuck Weddle on Jul 9, 2022 16:40:02 GMT
bcjammerx,
Any conductivity monitor for dialysis must be temperature compensating. This means that a given solution will read the same conductivity no matter what the temperature of that solution is. The machine doesn't adjust the concentration of the solution regardless of what the temperature is. The machine measures the TRUE conductivity then looks at the temperature and calculates what that conductivity would be if the temperature was a specific temperature (I believe the standard is 25 C). That is the conductivity that is displayed by the machine. You can test this by run a machine at say 35.5 C and let everything stabilize the note what pump RPM's are and your final conductivity reading. Now, turn the temperature up to 39.5 C and let everything stabilize. Your temperature will naturally be higher but your pump RPM's and conductivity will still be the same.
The requirement for conductivity monitors to be temperature compensating is in AAMI RD5:2003 that says....
4.2.4.6 Conductivity monitor
Proportioning delivery systems shall have an online conductivity monitor, and it shall not be possible to dialyze the patient without this monitor in operation. No single fault shall allow dialysis when dialysate conductivity varies more than ± 5 % from its nominal value without activating an alarm. Detected errors in the conductivity of the dialysate shall activate audible and visual alarms, interrupt delivery of the dialysate to the hemodialyzer, or stop the blood flow in the extracorporeal circuit. If adjustable high and low limits are provided, the set points shall be confined to either ± 5 percent of the zero deviation point or the nominal monitor indication known to indicate correctly the proper proportioning of the concentrate in use. The set points shall be easily set and understood. If a front panel display is provided, it shall have a resolution no larger than 1 % of total scale. Conductivity monitors shall compensate for temperature.
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