Setting up - Snapping & Tapping the lines

[skyedogrocks]

Hi All,

My husband Rob has just started using the NX Stage, it's our 2nd week at home.  I'm wondering how many of you just hate the setting up of the machine, especially the Venous & Arterial lines?  Ugh, I just hate this!     Getting all that air out, snapping & tapping.  This is what takes the longest time for us.  Rob sets it up and then I do the double check.  It just seems like once all the air bubbles are out, 2 mins later I see them back again.  Rob's nurse gave us the tip of squeezing the saline bag every now and then.  Also, to seep out the air from the Venous line before the blood flows through.

Does anyone else hate this as much as we do?  Any tips?

[Adam_W]

I've never personally had a problem with set up (this is my second week of training), in fact I did 100% of the treatment my second day and didn't have any alarms. The snap and tap is kind of time consuming, but I've never had a problem with air in the lines. My dad set up the machine today, and we did have some air in the arterial line. This is the first air alarm we've had, and when he has set up the machine before, he got all the air out with no problem. I guess it was just an oversight, considering last week was the first time he'd ever touched a dialysis machine in his life. I think he's done quite well considering this.

Adam

[skyedogrocks]

We have had a few Air Alarms, number "11" and a number "14".  11 is pretty easy to clear, but the whole thing is just so time consuming and annoying.  During training, it's not as bad, as the nurse usually checks it.  But when you are home it's a totally different story. 

The good news though, is that they are coming out with a new filter system.  It's going to have another line for the section that goes into the machine to help reduce the air in the vernous & arterial lines and the pod will be further up, so that the patient can give back saline if needed.

Overall, it does get easier as you set it up, I just wish getting the air out of lines in the intial set up was easier.

[Black]

I am soooo glad someone else mentioned this!  I hate that part too, and almost all of the alarms we've had since day 1 has been because of air!    I didn't want to complain because I am so grateful for all of the things this wonderful little machine has eliminated, which we would be doing on other machines; but it is annoying to occasionally have to do the do the "snap-tap" four times and still see large air bubbles going into the saline bag.

We have found that it is also much harder to get the air out of the newer, more compact filters.

We've started doing the prime 45 minutes to an hour before we are ready to do dialysis, so the machine can just run the fluid around and around though the lines.  Mike watches TV in his recliner and occasionally just reaches over and taps the filter and/or the lines.  (It is not really an inconvenience because on most days he would be sitting there anyway.)  Then last thing before I'm ready to put in the needles I do two quick "snap-tap" and it appears all of the air is gone.

I keep a large syringe ready so if there is not time for extra prime, and after treatment starts there is a lot of air in the top of the filter, I can hit "Stop" remove the air, flush with a little saline, and then hit "Treatment".  Only takes a few seconds and prevents alarms.

[cev]

We also find snaping and tapping the lines time consuming, but last night I forgot and we paid the price for that with lots of alarms.  When we have air in the arterial line, I don;t worry much, I know the big red 10 will come up and I just restart and don't have any problems.  With air (tiny bubbles I ignore) in the venous line I send the air to the patient line, disconnect (sterile) and put a syringe on the patient line and draw out the air.  For us this is quicker then trying to get the air out of the machine line.    Also last night we had the yellow 14 alarm, I have never been able to clear this alarm, but it was at the very beginning of the run, after checking everything a billion times I found I had left the heater lines clamped.  After opening the lines I still had the yellow 14 and in desperation I took the filter off the holder and turned it over and bingo the machine shut down and red 10 came up.  I hit start again and had no more problems.   Does anyone have a better way to clear the yellow 14"s?  I ususally get them at the end of the run when the bags empty before the run is over but only 1 time a month at the most.

[skyedogrocks]

I have had Yellow 14 a few times, but it's because I have clamped something I shouldn't have.  Once I have unclamped and hit clear it fixes itself.  You can always call Nx Stage's Tech Support, they are really helpful.

We eliminate the blue line air bubbles by connecting red, disconnecting blue, unclamp and hold over a bucket.  Let the saline flow through until we see light pink, clamp, hit stop and then connect the blue to my husband.  Stopped the air alarms altogether.

[cev]

Hi, I was just re-reading this section and I noticed no one mentioned shaking and hitting the filter to clear the air out before taping the lines.  We always shake and "beat" the filter before tapping the lines. ( It also relieves some personal tension). A lot of the large bubbles will clear and then you just deal with the tiny bubbles in the lines. 

I have found if you forget to attached the pressure pod line when priming or attach it near the end of prime, and it doesn't prime correctly,  You can snap the pod just as the blood comes into it it will fill and be OK.

My husband has been on NxStage 16 months and still loving it.  There are a lot of things that can go wrong and mistakes to make, I think we have made most of them and together manage to work it out.

[Black]

Hi, I was just re-reading this section and I noticed no one mentioned shaking and hitting the filter to clear the air out before taping the lines.  We always shake and "beat" the filter before tapping the lines. ( It also relieves some personal tension). A lot of the large bubbles will clear and then you just deal with the tiny bubbles in the lines. ...

 

I don't know about everyone else but we beat that damn thing to death every time and still occasionally have to draw air out of the top vent tube.  We do the entire circuit three times -- twice right after prime ends and again just before hook up.  In between the first two and the third time, it runs 30 minutes to an hour.  (Mike starts at the same time every evening, but he has to wait until I get the last dog walked and settled in and my clothes changed -- at the end of the day I am "doggy", and sometimes so covered with dog hair that I have to shower before I come into the room.)

... I have found if you forget to attached the pressure pod line when priming or attach it near the end of prime, and it doesn't prime correctly, You can snap the pod just as the blood comes into it it will fill and be OK. ...

Yeah, we have forgotten that a few times as well and hooked it up too late for it to work properly and found the venous pressure was really low.  We just hit "Stop", unscrewed it, it filled up fine, screwed it back in, and then hit "Go" again.

... My husband has been on NxStage 16 months and still loving it. There are a lot of things that can go wrong and mistakes to make, I think we have made most of them and together manage to work it out.

Glad it is going so well for y'all, and I agree about the mistakes -- we made some that were really silly and I'm sure the techs were shaking their heads and laughing over a few of them.  The stupidest was closing the PureFlow door on the drain line and wondering why we were getting alarms, and the other was not opening clamps which should have been open -- DUH!!  Good thing the machine is "idiot proof".