We were awakened about 3:30 this morning by an alarm and a clotted dialyzer which I traced to failure of the heparin pump to pump heparin on our Fresenius 2008K machine even though the heparin screen showed that the proper amount had been dispensed. After discussion with Fresenius techs the problem was further traced to failure of the bottom syringe plunger holder to engage the internal screw drive. I’ve never before seen this in more than three years but was told it can happen. The simple solution is to gently shake the holder after mounting the sysringe and oberve that the red ring on the chrome shaft has retracted into the holder. You can feel when the holder is securely engaged.
I mention this in the hope that other Fresenius nocturnal patients can be alert to this rare problem. One of the few disadvantages of nocturnal is I’m not very sharp at 10:00 PM when I set up and so was not careful enough when I mounted the heparin syringe.
I’m not that sharp myself sometimes when I set up at around 10pm, and even less sharp when something like that happens in the middle of the night. Luckily, it’s not too often.
I’ve never had that happen to me, but I was shown in training to double check that this is properly engaged when I put the syringe in and then when I prime it. Sometimes I probably don’t pay that much attention to it, but I will from now on. I don’t know however if that would prevent the problem you had. A second check I do is to visually watch the syringe being pushed up when I infuse the heparin bolus, just to make sure it’s working.
Thanks for the heads up though. I’ll be doubly careful about this from now on.
I was awakened by an arterial pressure alarm earlier this week. As I said, I’m not that sharp in the middle of the night. Every time I reset it, a few minutes later it would alarm again. I checked all the tubing to make there were no kinks, etc., and then I began to think clotting somewhere. I was about to abandon it for the night when I noticed that the arterial pressure went rapidly haywire the second I bent my arm even just a little. I decided to try and stuff another 2x2 gauze under the arterial needle, and lo’ and behold, that solved the problem completely. What looked like a major problem turned out to be nothing at all. My arterial needle doesn’t usually do that, but I must have taped it down too tight that night. One problem with using a tegaderm for this is that you can’t reposition the needle once it’s taped down.