Baxter’s HomeChoice APD System

Alarm Troubleshooting* and Prevention Tactics

TROUBLESHOOTING

Low Drain Volume Alarm (LDVA)

Root Causes • Patient reabsorbed more solution than expected • Catheter obstruction
or incomplete Last Fill • Poor catheter position
• Patient empty at start of Initial Drain (I-Drain) • Cycler position too high relative to patient position
• I-Drain Alarm setting too high • Fibrin blockage
Troubleshooting • Check Drain Volume – press down arrow • Have you completed a day drain?
• Change position to try to drain more fluid • Verify cycler position relative to patient supine position
• Check for kinks, air or fibrin in patient line • Call dialysis center to help diagnose problem causing
• Have you changed your prescription? LDVA
Prevention • Review or adjust the Initial Drain (I-Drain) Alarm • Review Therapy Log to monitor I-Drain Volume
setting if the Last Fill volume, Last Fill dwell time, - Check for incomplete Last Fill
or if the Last Fill solution type changed • Routinely assess catheter flow
• Determine root cause for patient absorbing more • Routinely ask patient if he/she is experiencing LDVA
solution than expected during treatment
- Increased sodium intake?
- Recently ill – dehydrated?
NOTE: Patients should not bypass Initial Drain without talking to a clinician.

Check Lines Alarm

Root Causes • Empty solution bags • Kinks
• Blocked solution bag port • Disconnected solution bags
• Closed clamps • Fibrin blockage
Troubleshooting • Reposition bags to push fluid to port and clear blocked port
Prevention • Use the appropriate solution volume to prevent empty solution bags
• The total solution volume connected must be 3. Priming and flushing volume
greater than the sum of: a. Heater bag prime and integrity test - 250 mL
1. Total solution volume prescribed b. Supply bag - 120 mL for each additional supply bag
2. Patient line - 45 mL 4. Extension set - 45 mL (if used)

SYSTEM ERROR 2240 Alarm

Root Causes • Patient presses GO to start therapy, but has not • Disrupted tip protector on unclamped and unused
connected themselves supply lines
• Disconnected disposable tubing • Loose connections
• Use of dummy tummy during training • Leaks
• Incomplete prime
Troubleshooting • Ask patient if he/she disconnected during therapy • Did patient follow the Emergency Disconnect procedure?
• If patient disconnected – was this during drain, - Press STOP before disconnecting
fill or dwell? - Press GO when reconnected
- Dwell – preferred phase to disconnect
• Therapy needs to be terminated and a new therapy
(on cycler or via manual exchange) initiated
Prevention • Review the Emergency Disconnect Procedure (Patient At-Home Guide, page 18-65)
• If a SYSTEM ERROR 2240 occurs, you must end the therapy and start a new therapy (on cycler or via manual
exchange)
*For more information about troubleshooting alarms refer to the Troubleshooting section in the Patient At-Home Guide.
Baxter’s HomeChoice APD System
Teaching Opportunity - Alarm Simulations

STEPS TO SIMULATE THE: STEPS TO ADDRESS ALARM:

Low Drain Volume Alarm When Alarm Occurs

• Training prescription – CCPD • Turn to Troubleshooting section in Patient At-Home Guide
• Therapy volume – 4900 mL – walk patient through action items
• Therapy time – 1:30 • Discuss with patient when he/she should bypass an alarm
• Fill volume – 1100 mL • Review treatment data – drain volumes
• Last Fill volume – 500 mL • Has patient changed position and repeated drain cycle?
• Dextrose – Same • Emphasize importance of notifying dialysis clinic if patient
• I-Drain Alarm – 350 mL had to bypass
• Dummy tummy should have 100-150 mL of solution,
no air present in dummy tummy
• Review Troubleshooting section in Patient At-Home
Guide while waiting for alarm to occur

Check Patient Line Alarm When Alarm Occurs

• Close the clamp on the patient line during Drain or Fill • Turn to Troubleshooting section in Patient At-Home Guide
until the system alarms – CHECK PATIENT LINE – walk patient through action items
• Auto Restart alarm • Have patient check the line referenced
• Have patient correct alarm
• Patient did not need to press any buttons

SYSTEM ERROR 2240 or 2267 Alarm When Alarm Occurs

• Total volume = 6000 mL • Press STOP to mute the alarm
• Therapy time = 1:30 • Write down the System Error number and treatment
• Fill volume = 2000 mL phase that appears on the display screen
• Last Fill volume = 2000 mL • Turn the power switch OFF and ON to end therapy
• Dextrose = Same – SYSTEM ERROR 2267 appears
• I-Drain Alarm = 1400 mL • Press the power switch OFF and ON again
• Dummy tummy should have 2000 mL of solution – PRESS GO TO START appears
• Disconnected during dwell, did not press STOP, • Close all clamps
and left clamp open on patient line • Discard the disposable set and solution bags
• Notify dialysis nurse
• Complete treatment with a manual exchange -OR-
• Set up the cycler with new supplies

Caution: Federal (U.S.) law restricts this device to sale by or on the order of a physician or other
licensed practitioner. For safe and proper use of this device, refer to the device Operator’s Manual.

Baxter and HomeChoice are trademarks of Baxter International Inc. AL11081 05/11