new cartridges

[alrac]

ok nxstage    My nxstage was delivered on tuesday, so weds my training nurse comes to the house to make sure everything is set up right.  First off, nxstage didn't send the usb plug, so I'll have to drive that 50 miles to go pick one up.  So other than that, I've hung the 4 bags of dead weight for my treatment, and then pull out my cartridge.  It's the new ones.  Great, no worries, I've got some common sense, I can pour rain out of a boot without the instructions on the heel, most days.  I get it all set up and the treatment goes great, no hitches.  The nurse is happy that I know what I"m doing and my partner is snoozing on the couch.  We're all happy.  I get off the machine and have cleaned up when my phone rings.  Who is it? It's the sales rep from Nxstage telling me that she needs to read me the little speal about the new cartridges.  I interrupt her and tell her it's too late, I just got off the machine, but to expect a phone call from my nurse.  (Now my  nurse is NOT a shy timid woman by any means.)  The sales rep whispers, 'great'..LOL  I'm laughing.  I tell her that I had my supplies come on monday and the machine came on tuesday and now it is weds.  I also inform her that if I have the same problem with the snap and tap that I'll be sending back the cartridges and I'll want the old ones instead.   
  When I did the snap and tap the air bubbles refused to move off the side of the lines.  I flicked them so hard that I have a bruise under my fingernail.  I snapped the lines so hard I thought I was going to rip them apart.  Just so you understand how hard I worked on those lines, I picked up my Nx Stage by myself and placed it on top of the Chassis.  I  used all my strength on those lines and the bubbles refused to move.  I'm in hope that they were stubborn due to some type of static electricity crap from moving them around..LOL  (wishful thinking?)  I know they moved the saline T closer to the top, but I found it to be just one more line I had to make sure I didn't get tangled up with my blood pressure line, and that I didn't get tucked down in the chair with me when I sat up.  I did love how they taped down the (pig tail) on the filter.  It was easier to load overall. 
  I'm sorry if it sounds really bad, it really wasn't all that bad, I just don't like change all that much, especially when I JUST learned it another way.  But now all the teaching guides are wrong. 
  Now I hope that once I get the usb port from the center that my batch will pass the conductivity test.  Not sure if one has to do with the other, but it's the only thing I can think of that's wrong.  I'll update once I make a batch that I can use..lol

[alrac]

new cartridges update....The second run wasn't so bad but not perfect.  The bubbles moved easier, but still couldn't get all of them out, but it didn't set off any alarms.  For the first time I had a problem with the pressure pod.  Even after going through the steps twice I couldn't get the pressure pod to reset.  I ended up taking myself off early.  I figured better safe than sorry.  The plastic tabs that hold the Arteriole and Venus lines are soooooo much easier to take off on these new ones.  There is a slit so you just pop them off instead of having to try and rip them.  With this being the first time doing a treatment at home without a nurse, I can't complain.  Over all I think this is going to go well in the long run.  I'm sorry I was frustrated when I made my first post.

[MandaMe1986]

Well I am happy to hear that it went better the secound time around. And I am sure the more you do  it the easier it gets.    And don't be sorry feel free to come and  any time you need

[alrac]

   I just gave a nxstage tech a heart attack    i'm still having problems with the bubbles in the lines not moving.  So I called and asked for the older ones.  He asked what the problem was.  I told him that the bubbles wouldn't move, that I have resorted to using a screwdriver to 'thump' the lines so I wouldn't hurt my fingers and the bubbles still won't move.  I then heard a gasp and a 'OH NO, don't use any tools on it!'  His voice was almost panic stricken.  LOL  I'm laughing so hard I've got tears in my eyes.  Tooooo funny.  So, I should be getting new ones in a day or two.  LOL

[silverhead]

Regarding the POD, well over a year ago I changed my setup routine in the prime of the machine, I do the normal prime but do not hook up the POD line to the machine. The very last connection I make (after making the the Dyalisate, waste line and and the green/white connection)before hooking her to it is to put the POD line connection to the machine. I have not had to do a reset of the Pod since then, it stays full for the 3 plus hours of her runs......

[alrac]

Thanks siverhead, I'll try that tomorrow.  I ended up with the same problem again today with the POD.  Nxstage was trying to say it was my access causing the problem.  My nurse and I think it has to do with the fact that there isn't a clamp on it any longer.  I'll try it tomorrow and look for it to work.  Thank you.

[jbeany]

About the bubbles - have you tried leaving it in recirc for a while?  I never used the new carts, so I don't know how they differ, but with the old ones, I found that if you left the machine in the 23 recirculation setting for at least 15 minutes before you started snapping and tapping, most of the air came out by itself.  I would sometimes start the prime cycle a couple of hours before I needed to start dialysis, and let the machine do most of the work for me.  It works even better if you shake the filter a couple of times during the recirc to get the air out of that as well.

[Wallyz]

What j beany said.  Let it sit on 23 for a while, and then bleed it out of the top of the filter. 

Also- the little bubbles get absorbed quickly by your blood. Relax a little on the bubbles in the lines.

[alrac]

I found out today that I wasn't even supposed to get the new cartridges yet.  They are sending me 5 new cases of the old ones.  The only problem I was worried about was the air alarm on the machine, not getting into my blood.  But thanks for all the suggestions, I found out that I've got to get a new access.  I'm still smiling tho.

[Wallyz]

Finally got the new cartridges for the 171's. I like it so far.

[cev]

bubbles..... for my husband, I snap tap the lines reshake the filter and do it again .... there are always more bubbles.... most of the time we have some really tiny bubbles in the venous line.   3 of 4 runs we get a red 20 at start .... I just restart and no problems.    The pod has been fine for a long time, except last night and it reset ok.   to reset did you stop, clamp arterial line, undo pod, open the 2 clamps(for bolus) and watch the pod fill.     Also wee found when setting up, if you give the pod insert a little pressure and 1/4 turn it helps set the seal.  hope this helps

[willowtreewren]

Re-setting the pressure pod with the new cartridges is easier than ever!

Just stop the pump, disconnect the PP from the machine, watch it fill, reconnect and start the pump!

Had to do it this week. The new directions are in the documentation that comes in the boxes with the new cartridges. Woot!

I also want to weigh in on the snap and tap routine. We spend a looooong time tapping the cartridge and turning it over and over. We don't stop until there are no more bubbles moving through the lines. We also don't start the snap and tap until we can hear that the pump is up to speed. Our time frame doesn't allow us to leave the pump running at 23 for an extended period of time, but I can see that it would work well to eliminate the bubbles.

Thanks for all the tips.

Aleta

[redz812]

What are the new cartridges number?

[Wallyz]

MIne are 171-B