|
HD02
- Why does the message “AC ER” appear on the front of the HD02 meter when it is powered on?
- Why does the message “ NO PR” appear when the HD02 Meter is powered on?
- How do I get the Latest HD02 Tubing list?
- How do I load the latest tubing list into the HD02 software?
- What reports are available to print from the HD02 Administrator?
- I did Transonic measurements today but cannot find them in the HD02 Administrator.
General
- Why does the message “To Monitor Patients Turn On Meter and Plug In Sensors” appear on the laptop screen or why is the Monitor Icon grayed out when I
open software? (HD02 or Step – up – to 02)
- Why am I getting an Error Message when Importing the HD01 ALL.CSV file into the HD02 Software?
- Why do the following messages appear when the HD01 and HD01Plus and Step – up – to -02 meter is powered on: “ No U- Sonic Signal”, “No Tube”, “Air in
Tube”, “Bad Cable”?
- Why does the message “Flow Sensor?” appear on the HD01, HD01Plus or Step–up–to- 02 when powered on?
- How often do the HD02 or the Step – Up – To – 02 systems need to be sent in for calibration and why?
- How often do the HD01 or the HD01Plus systems need to be sent in for calibration and why?
- Laptop is displaying No Probe or No Meter when I open the software to the measurement screen. (HD01 or HD01Plus)
- Does the arterial needle always need to face the access flow?
- How can the HD01 Monitor indicate Zero recirculation at a pump flow of 400 ml/min when access flow in reversed line position was only 350 ml/min?"
HD02 Answers
1. Why does the message “AC ER” appear on the front of the HD02 meter when it is powered on?
This message occurs because there is an interruption of the ultrasound signal.
Solutions:
Is there damage to the 15-pin connector?
Check that sensors are connected to the blood tubing.
Check that the hinged door is closed tightly.
Check that there is Vaseline between the sensor and tubing.
2. Why does the message “ NO PR” appear when the HD02 Meter is powered on?
This message appears when the sensors have not been connected to meter. If they are connected and “NO PR” is still displayed check solutions.
Solutions:
Check that the flow sensor is an H4E.
Check that you have sensors connected to meter.
Is the 15-pin connector damaged?
If all of the above check out ok then it could be an indication that the EPROM in the 15-pin connector has been
damaged in some way or a problem with the meter.
3. How do I get the Latest HD02 Tubing list?
Go to the Hemodialysis Homepage and scroll down. On the right hand side you will see Tubing List – Instructions
for downloading, underneath that you will see tubings.csv and Updates.txt. If you click on the Updates.txt it will open and you will find what the latest tubing list
is. To download the tubing list follow the Instructions for downloading.
If you need assistance contact Transonic Systems
4. How do I load the latest tubing list into the HD02 software?
Note: sensors need to be connected to meter and meter powered on before opening software.
If you copied it to a floppy disk, just insert into the floppy drive and when the HD02 software opens, click on
update tubing’s list.
For systems running version 1.4.5 software or later:
You can copy to floppy or burn to CD.
When the HD02 software opens, click on Update’s Tubing.
A window opens that allows you to select the location of the file.
In the (Look in) box click on the down arrow and you will get a drop down menu.
Select the appropriate drive, when it opens you should see the tubing’s.CSV file.
Click on the file once to highlight it, then click open and tubing list will load.
If you need assistance contact Transonic Systems.
5. What reports are available to print from the HD02 Administrator?
Please refer to Section VI in the HD02 Operators Manual. This section takes you through the Administrative
functions of the software including Reports. If you still need assistance contact Transonic Systems Inc.
6. I did Transonic measurements today but cannot find them in the HD02 Administrator.
First check that the time and date on your Laptop is correct. That can be found in the lower right-hand corner,
next drag the arrow down to the right-hand corner and place it on the time. You should see the date pop up.
If the date is wrong then the measurements that you did will be found under that date.
Suggestion- Write that date down before changing to correct date.
General Answers
1. Why does the message “To Monitor Patients Turn On Meter and Plug In Sensors” appear on the laptop screen or why is the Monitor Icon grayed out when I
open software? (HD02 or Step – up – to 02)
These messages occur because the software doesn’t recognize that the meter is connected to the laptop.
HD02 - RS232 communications:
- Check the connection between the Sensors and Meter with power on and software open.
- Check the 9-pin RS232 communications cable between the Meter and Laptop.
- Check that no other software has been installed on the Laptop.
- Has the communication port (Comport) selection been changed? (Most are set to Com1)
- Check the 9-pin connector for damage.
- Have you replaced the 9-pin RS232 communications cable?
- (Correct cable is 9-pin RS232 straight through cable)
- Check the Meter or Laptop connectors for damage.
HD02 and Step-up-to-02 – USB communications:
- Check the connection between the Sensors and Meter with power on and software open.
- Check the USB communications cable between the Meter and Laptop.
- Check that no other software has been installed on the laptop
- Has the communications port (Comport) selection been changed? (Check HD02 Operators Manual under Check Com Port Settings, in the HD02
software look in Setup to determine if they match if not change it in Setup and click ok)
- Check your USB cable for damage.
- Check the Meter or Laptop connectors for damage.
2. Why am I getting an Error Message when Importing the HD01 ALL.CSV file into the HD02
Software?
Information in the All.CSV file is corrupt and the file needs to be edited.
A typical error message that you may see: Line #? Is missing valid date or Line #? Is missing patient
information.
You can email the All.CSV file to support@transonic.com along with the error message and someone will edit your file and return it to you in a timely manner.
3. Why do the following messages appear when the HD01 and HD01Plus and Step – up – to -02 meter is powered on: “ No U- Sonic Signal”, “No Tube”,
“Air in Tube”, “Bad Cable”
These messages occur because there is an interruption of the ultrasound signal.
Solutions:
Is there damage to the 15-pin connector?
Check that sensors are connected to the blood tubing.
Check that the hinged door is closed tightly
Check that there is Vaseline between the sensor and tubing.
4. Why does the message “Flow Sensor?” appear on the HD01, HD01Plus or Step–up–to- 02 when powered on?
This message appears when the sensors have not been connected to meter. If they are connected and “Flow Sensor?” is still displayed check solutions.
Solutions:
Check that you have sensors connected to meter.
Check that you have the correct sensors connected? (Remember H4D for HD01 and H4E for Step-up)
Is the 15-pin connector damaged?
If all of the above check out ok then it could be an indication that the EPROM in the 15-pin connector has been
damaged in some way or a problem with the meter.
5. How often do the HD02 or the Step – Up – To – 02 systems need to be sent in for
calibration and why?
Note: The HD02 and the Step – Up – To – 02 systems will give you a reminder message (shows up on the laptop Schedule Next Meter Service By: Month, Day, Year) when it is time.
Transonic Systems recommends that the Meter and Sensors be sent in for calibration annually.
Why: These are precision measurements and Transonic Systems is the only firm, which can perform such
certifications and calibration. In addition, there may be updates that apply to your equipment that are performed as routinely returned that either improves the
equipment performance or quality.
6. How often do the HD01 or the HD01Plus systems need to be sent in for calibration and why?
Transonic Systems recommends that the Meter and Sensors be sent in for calibration annually.
Why: These are precision measurements and Transonic Systems is the only firm, which can perform such
certifications and calibration. In addition, there may be updates that apply to your equipment that are performed as routinely returned that either improves the
equipment performance or quality.
7. Laptop is displaying No Probe or No Meter when I open the software to the measurement
screen. (HD01 or HD01Plus)
These messages occur because the software doesn’t recognize that the meter is connected to the laptop.
Solutions:
- Check the connection between the sensors and meter with power on and software open.
- Check the 9-pin RS232 communications cable between the Meter and Laptop.
- Check that no other software has been installed on the Laptop.
- Has the communication (ComPort) selection been changed? (Most are set to Com1)
- Check the 9-pin connector for damage.
- Have you replace the 9-pin RS232 communications cable?
- (Correct cable is 9-pin RS232 straight through cable)
- Check the Meter or Laptop connectors for damage.
8. Does the arterial needle always need to face the access flow?
Only in AV fistulae. When the arterial needle faces the incoming access flow
(points toward arterial anastomosis), the best mixing conditions are created when the lines are reversed
The Transonic User instructions tell me to repeat my access flow measurement to be certain
that the results are accurate. What variations can I expect between consecutive measurements?
You can expect to see a variation of 100 ml/min in flows < 1 L/min. For access
flows > 1 L/min, a 10% difference between the first and second access flow measurement (made within 5 minutes of one another) can be expected. If the second
measurement falls outside these criteria, a third measurement should be taken and the outlying measurement can be discarded. The remaining two measurements are then
averaged for a final access flow value.
Access flow depends on a number of variables such as systemic blood pressure, the respiratory cycle, and coughing which can alter
measurements taken even within minutes of one another. Despite these factors, the overall reproducibility of access flow measurements made with the Transonic Monitor
is excellent.
9. How can the HD01 Monitor indicate Zero
recirculation at a pump flow of 400 ml/min when access flow in reversed line position was only 350 ml/min?"
0% Recirculation when Access Flow < Pump Flow
Indeed, as a rule of thumb you will find that access recirculation (AR) exists when access flow (AF) is less than pump flow (Qb). Natural
(baseline) access flow is the blood flow that is shunted between the access artery and vein. As it withdraws blood, a hemodialysis pump produces a negative pressure
which actually helps the natural flow through the access.
Therefore, a dialysis pump may increase baseline access flow. When blood lines are reversed to measure access flow, the pump pushes flow
against the natural access flow. This may decrease baseline access flow. Although rigorous testing of HD01 access flow measurements in the reversed line position
demonstrates that these minor differences between measured access flow and baseline access flow have no clinical significance (see Transonic Hemodialysis Publications
HD7T, HD40A, HD7A, HD27V, HD9A) , they are responsible for two exceptions to the recirculation rule (AR exists when AF< Qb). These two exceptions show Zero
recirculation even though access flow is less than pump flow. They are:
1. Significant narrowing (stenosis) between the needles.
This condition presents when measured access flow (AF) is
significantly smaller (difference _ 200 ml/min) than pump flow (Qb) when Zero access recirculation (AR) is detected:
Example: Zero AR at Qb = 400 ml/min, AF = 120 ml/min
When this relationship between pump flow and Zero access recirculation exists, one can conclude that there is a significant narrowing
(stenosis) between the needles. The stenosis causes considerable flow resistance. In normal line position, the pump simply bypasses the stenosis because the
arterial needle is located before the narrowing and the venous outflow needle is located after the narrowing. A mid-access stenosis never produces access
recirculation. There still can be adequate pump flow for hemodialysis, although baseline access flow is close to zero and the access is in trouble.
2. Significant inflow and/or outflow narrowing (stenosis).
This condition exists when access flow is slightly smaller
(difference _ 150 ml/min) than pump flow when Zero access recirculation is detected:
Example: Zero AR at Qb = 400 ml/min, AF = 350 ml/min
Here, one can conclude that there is an inflow (arterial) and/or outflow (venous) stenosis creating the low access flow. This is also
caused by the effect of the dialyzer pump on baseline access flow. Suppose the pump flow prescription is 400 ml/min and baseline access flow is 380 ml/min. Suppose
also, that the pump flow has a 10% (of pump flow) effect on baseline access flow. Then, with dialysis lines in normal position, access flow becomes 380 + 40 = 420
ml/min. A recirculation measurement will indicate Zero recirculation because pump flow is less than access flow (400<420). When the access lines are reversed
with pump flow at 300 ml/min, access flow may decrease by 10% of pump flow (30 ml/min). The HD01 Monitor would thus register
AF = 380 - 30 = 350 ml/min.
Conclusion
Trust your access flow
measurements! Do not rely on an absence of recirculation. A vascular access may be severely compromised even when there is no sign of recirculation.
|
