1. Aquarius Troubleshooting Game Cards
Reference text may be found in this section
PM /2017-1
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2. Aquarius Troubleshooting Game Cards
Start with six Alarm Cards
Pair a Troubleshooting Circuit Card to each Alarm Card
Finally, match each one with a Cause and Action Card
Trainer notes: print and laminate cards, typical use after Study day, Troubleshooting or Train-the-Trainer activities. Duration min dependent on group, sequence may choose to follow
Note: Image shown low resolution
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3. Low Access Pressure Alarm Card
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4. Cause and Action Card1 Cause: Patient could be hypovolemic
Line could be kinked or clamped
Line could be occluded or clotted
Access could be against the vessel wall
Action:
Check patient’s fluid status
Correct any kinks or clamps on the line
Check the correct size of catheter, correct site and placement
Consider catheter troubleshooting
2 Further Aquarius information may be found in:
Pressure Monitoring, Alarms & Troubleshooting. Nikkiso CARE Module 2, Lesson 4, Page 67 of 76.
Alarms, messages, system errors, and removal options. IFU Aquarius System with RCA SW 6.02, Rev. 4.1 (07/2014), Section 6.2. Pages 136 to 152.
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5. Troubleshooting Circuit Card
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6. High Return Pressure Alarm Card
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7. Cause and Action Card2 Cause Line could be kinked or clamped
Line could be occluded or clotted
Inadequate anticoagulation – partial clot in return drip chamber
Running treatment with No Anticoagulation
Low level of blood in return drip chamber
Action
Correct any kinks or clamps on the line
Consider Catheter Troubleshooting
Check anticoagulant and predilution
Program a small volume of post-dilution
Correct blood level in return drip chamber
2: Overview taken from Joannidis et al. Clinical review: Patency of the circuit in continuous renal replacement therapy. 2007, Critical Care, 11:218 (doi: /cc5937) accessed at
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8. Troubleshooting Circuit Card
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9. Balance Alarm (max. 5 in 20 minutes)
Alarm Card
Balance Alarm (max. 5 in 20 minutes)
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10. Cause and Action Card Cause Kink or clamp on filtrate line or bag
Bag positioning
Kink or clamp on manifold for multiple bags
Action
Remove kink or clamp on filtrate line, bag or manifold
Check bag positioning
If problem persists, return to using one bag per scale
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11. Troubleshooting Circuit Card
Remove clamp on filtrate line
Remove kink on manifold
Remove clamp on filtrate bag
If persists or can’t find kink/clamp return to one bag per scale
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12. Alarm Card
Blood Leak
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13. Cause and Action Card Cause Discoloured filtrate Damage to membrane
Dust or dirt on detector
Action
Urinalysis ‘dipstick’ test effluent. If positive for blood; stop treatment, do not return blood
Consider haemolysis test
Ensure detector pot is in situ and clean
Ensure detector mirror in situ and clean
Do not use cleaning wipes. A clean cloth or paper towel is sufficient.
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14. Troubleshooting Circuit Card
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15. Check Substitution / Dialysate line
Alarm Card
Check Substitution / Dialysate line
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16. Cause and Action Card Cause Insufficient flow to degassing chamber
Incorrect positioning of degassing chamber
Action
Is chamber level low? Check: the bag has both long and short seals broken, is pierced correctly, there is not a clamp on, there is no kink in the line, the lines are not trapped in the heater door
Is chamber level high? Check: the short line with green clamp attached to pot is sitting in the groove of housing door
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17. Troubleshooting Circuit Card
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18. No Fluid Chamber Detected Degassing Chamber Missing
Alarm Card
No Fluid Chamber Detected Degassing Chamber Missing
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19. Cause and Action Card Cause
The degassing chamber is not correctly installed
Action
Lift the degassing chamber out of the holder and replace back down firmly
Ensure the short tubing with green clamp at rear of chamber is in the groove of housing door
Press pot down firmly so the underside of the pot is flush with machine
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20. Troubleshooting Circuit Card
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21. Copyright © 2017 NIKKISO Co., LTD. All rights reserved. | Confidential
AQUARIUS system
NIKKISO Europe GmbH
Desbrocksriede 1
30855 Langenhagen
Germany
ACCUSOL solution*
Nikkiso Belgium bvba
Industriepark 6
3300 Tienen
Belgium
* Registered as a drug and/or a medical device
AQUAMAX hemofilter
Nikkiso Belgium bvba
Industriepark 6
3300 Tienen
Belgium
AQUALINE tubing
Haemotronic S.p.A.
Via Carreri, 16
41037 Mirandola
Italy
AQUASET and CITRASETRCA
Haemotronic S.p.A.
Via Carreri, 16
41037 Mirandola
Italy
AquariusTM, AccusolTM, AquamaxTM and AquasetTM are trademarks of Nikkiso Co., Ltd.
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