12/07/2023

Fresenius 5008 Machine Procedure Manual

How to Operate the Fresenius 5008 Machine: A Comprehensive Manual for Dialysis Professionals

The Fresenius 5008 machine is a state-of-the-art dialysis machine that enables high-volume hemodiafiltration (HDF) as a standard in dialysis. HDF is a therapy that combines hemodialysis and hemofiltration, which can improve the removal of middle and large molecules and reduce inflammation and cardiovascular risk. The Fresenius 5008 machine has many features and functions that make it easy and safe to use, such as AutoSub plus, Venous Access Monitor (VAM), Online Clearance Monitor (OCM) and Blood Temperature Monitor (BTM). In this article, we will explain how to operate the Fresenius 5008 machine step by step, and provide some tips and tricks for optimal performance.

Step 1: Preparing the Machine

Before starting the dialysis session, you need to prepare the machine and check its functionality. Here are the steps to follow:

Turn on the main switch at the back of the machine and wait for the self-test to finish.
Select the language and the user level (basic or expert) on the touch screen.
Enter the patient ID and the treatment prescription.
Select the therapy mode (HD or HDF) and the fluid type (bicarbonate or acetate).
Insert the dialyzer, the bloodlines and the saline bag into their respective holders.
Connect the dialysate concentrate lines to the concentrate supply.
Connect the substitution fluid line to the substitution fluid bag or online module.
Connect the arterial and venous pressure transducer protectors to their ports.
Press the “Prepare extracorporeal circuit” button and follow the instructions on the screen.
Check for air bubbles, leaks and kinks in the circuit.
Press the “Rinseback” button to rinse the circuit with saline.
Press the “Priming” button to prime the circuit with blood.
Press the “Test extracorporeal circuit” button and follow the instructions on the screen.
Check for alarms, errors and warnings on the display.

Step 2: Connecting the Patient

After preparing the machine, you need to connect the patient to the extracorporeal circuit. Here are the steps to follow:

Check the patient’s vital signs, weight and blood pressure.
Cannulate the patient’s vascular access (fistula or graft) with two needles: one for arterial blood flow and one for venous blood flow.
Connect the arterial needle line to the arterial bloodline port and secure it with a clamp.
Connect the venous needle line to the venous bloodline port and secure it with a clamp.
Open both clamps and press the “Start treatment” button on the machine.
Adjust the blood flow rate, dialysate flow rate, ultrafiltration rate, substitution rate and other parameters according to the prescription.
Monitor the patient’s condition and comfort throughout the session.

Step 3: Disconnecting the Patient

At the end of the dialysis session, you need to disconnect the patient from
the extracorporeal circuit. Here are
the steps to follow:

Press
the “Stop treatment” button on
the machine.
C
lose both clamps on
the needle lines.
P
ress
the “Rinseback” button on
the machine and follow
the instructions on
the screen.
R
eturn
the patient’s blood from
the circuit to
the patient’s body using saline or heparinized saline.
D
isconnect
the needle lines from
the bloodline ports and secure them with caps.
R
emove
the needles from
the patient’s vascular access and apply pressure dressing or bandages.
C
heck
the patient’s vital signs, weight and blood pressure.
A
ssess
the patient’s condition and satisfaction after
the session.

Step 4: Cleaning and Disinfecting
the Machine

A
fter disconnecting
the patient, you need to clean and disinfect
the machine and dispose of
the used materials. Here are
the steps to follow:

R
emove
the dialyzer, bloodlines, saline bag, concentrate lines and substitution fluid line from
the machine and discard them in appropriate containers.
C
onnect
a new set of disinfection lines to
the machine according to
the manufacturer’s instructions.
S
elect
a disinfection program (heat disinfection or chemical disinfection) on
the touch screen and press start.
F
ollow
the instructions on
the screen and wait for
the disinfection cycle to finish.
C
heck for alarms, errors and warnings on
the display.
D
isconnect
and discard
the disinfection lines in appropriate containers.
C
lean
and dry
the external surfaces of
the machine with a damp cloth and a mild detergent.
T
urn off
the main switch at
the back of
the machine.

Step 5: Troubleshooting the Machine

Sometimes, the Fresenius 5008 machine may encounter some problems or malfunctions that affect its performance or safety. In such cases, you need to troubleshoot the machine and resolve the issues as soon as possible. Here are some common problems and solutions for the Fresenius 5008 machine:

Problem	Solution
The machine does not turn on or displays an error message.	Check the power supply and the main switch. Check the fuses and replace them if necessary. Check the battery and recharge it if necessary. Restart the machine and perform a self-test. If the problem persists, contact the service technician.
The machine displays an alarm or a warning message.	Identify the cause and source of the alarm or warning. Follow the instructions on the screen and acknowledge the message. Correct the situation and reset the alarm or warning. If the problem persists, contact the service technician.
The machine leaks water or dialysate.	Stop the treatment and disconnect the patient. Locate the source of the leak and fix it if possible. Replace the damaged parts if necessary. Clean and dry the affected areas. Restart the machine and perform a disinfection cycle. If the problem persists, contact the service technician.
The machine detects air in the extracorporeal circuit.	Stop the treatment and disconnect the patient. Check for air bubbles, leaks and kinks in the circuit. Remove any air by using the air trap or manual syringe. Restart the treatment and monitor the patient. If the problem persists, contact the service technician.
The machine measures incorrect venous pressure.	Check for clots, kinks and occlusions in the venous line. Check for incorrect positioning or dislodgement of the venous needle. Check for incorrect calibration or malfunction of the venous pressure transducer. Recalibrate or replace it if necessary. Restart the treatment and monitor the patient. If the problem persists, contact the service technician.

Step 6: Maintaining and Servicing
the Machine

T
o ensure
the optimal performance and safety of
the Fresenius 5008 machine, you need to maintain and service
the machine regularly. Here are some tips and recommendations for
the maintenance and service of
the Fresenius 5008 machine:

C
heck
the machine daily before each use for any signs of damage, wear or malfunction.
C
lean
the machine daily after each use with a damp cloth and a mild detergent.
D
isinfect
the machine daily after each use with a heat disinfection or chemical disinfection program.
R
eplace
the consumables (dialyzer, bloodlines, saline bag, concentrate lines, substitution fluid line, disinfection lines) after each use or according to
the manufacturer’s instructions.
R
eplace
the filters (dialysate filter, DIASAFEplus filter, ultrafilter) according to
the manufacturer’s instructions.
R
eplace
the battery every year or according to
the manufacturer’s instructions.
C
alibrate
the sensors (blood pressure transducer, blood temperature monitor, online clearance monitor) according to
the manufacturer’s instructions.
P
erform
a preventive maintenance procedure every six months or according to
the manufacturer’s instructions.
C
ontact
a service technician for any repairs, adjustments or modifications that are beyond your scope of competence.

Step 7: Using the Machine Features and Functions

The Fresenius 5008 machine has many features and functions that make it a versatile and advanced dialysis machine. Some of these features and functions are:

AutoSub plus: This feature automatically adjusts the substitution volume and the ultrafiltration rate to achieve the prescribed total fluid removal and the maximum possible substitution volume. This enables high-volume HDF as a standard in dialysis.
Venous Access Monitor (VAM): This feature monitors the venous pressure and detects any sudden changes that may indicate a needle dislodgement. It also triggers an alarm and stops the blood pump if a needle dislodgement is suspected.
Online Clearance Monitor (OCM): This feature measures the online clearance of urea during dialysis and displays it on the screen. It also calculates the equivalent renal clearance (eKt/V) and the normalized protein catabolic rate (nPCR). This helps to evaluate the adequacy of dialysis.
Blood Temperature Monitor (BTM): This feature measures the blood temperature before and after the dialyzer and displays it on the screen. It also adjusts the dialysate temperature to maintain a constant blood temperature drop across the dialyzer. This helps to prevent hypothermia and improve hemodynamic stability.
Online Rinse: This function allows you to rinse the extracorporeal circuit with sterile water or saline before or after the treatment. This helps to remove any residual blood or disinfectant from the circuit.
Online Substituate: This function allows you to prepare the substitution fluid online from dialysate concentrate and water. This helps to reduce the cost and storage of substitution fluid bags.

Step 8: Understanding the Machine Display and Controls

The Fresenius 5008 machine has a user-friendly display and controls that allow you to operate and monitor the machine easily and efficiently. The display and controls are:

Display/Control	Description
Touch screen	A color LCD screen that displays various information and menus. You can touch the screen to select options, enter data or acknowledge messages.
Rotary knob	A knob that you can turn or press to navigate through menus, adjust parameters or confirm selections.
Start/Stop button	A green button that you can press to start or stop the treatment.
Rinseback button	A blue button that you can press to initiate or terminate a rinseback procedure.
Priming button	A yellow button that you can press to initiate or terminate a priming procedure.
Blood pump clip	A red clip that you can insert or remove to start or stop the blood pump.
SafeLine clip	A red clip that you can insert or remove to activate or deactivate the VAM feature.
Alarm mute button	A red button that you can press to mute an alarm sound for one minute.

Conclusion

The Fresenius 5008 machine is a modern and sophisticated dialysis machine that enables high-volume HDF as a standard in dialysis. It has many features and functions that make it easy and safe to use, such as AutoSub plus, VAM, OCM and BTM. It also has a user-friendly display and controls that allow you to operate and monitor the machine effectively. In this article, we have explained how to operate the Fresenius 5008 machine step by step, and provided some tips and recommendations for troubleshooting, maintaining and servicing the machine. We hope that this article has been helpful and informative for you, and that you will be able to use the Fresenius 5008 machine with confidence and competence.

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