Yellow and Red Alarm 24 on NxStage

During a couple of past treatments, I have been having problems with Alarm 24 on the NxStage machine.

The first instance was when I first started the machine to begin treatment. Not more than 10 seconds into the treatment ( the blood had just reached the filter ) I received a Red Alarm 24. I checked with all possible causes and could not find the problem. I checked arterial access - jiggled and played around with the positioning of the needle a little and checked all lines for kinks/blockages and came up with nothing. As soon as I started treatment again, boom, another Red Alarm 24.

The second instance the other day is as follows. A few minutes after treatment began, boom a Yellow 24. I checked all posible causes again and nothing. Could not get the yellow 24 to go away.
I called NxStage and they said as long as it didnt go red, i could continue treatment. They just had me lower the pump speed to 300 instead of my normal 400. During this time, my arterial pressures were ranging from 245 - 280 and my venus pressures in the low 100’s.

At the end of treatment, when I pulled the arterial needle, I noticed that there was a little clotting at the end of the needle. Im wonderiing if this is what caused the problem and the 24 alarms. This has been reported to my Dr and im still waiting to hear back but in the meantime i would like everyones suggestions if they have had similar problems. Could it be the positioning of the needles in the buttonhole?

I will see how todays treatment goes.

What does everyone here on NxStage do when they have received a Yellow or Red Alarm 24? Maybe im missing or overlooking something so your input is much appreciated. I do have a buttonhole access.

Your having arterial access problems and it seems the arterial neegle may be hitting the walls of the fistula…you need to be sure its not htting the walls and also be sure its not taped too tight…also try using a 2x2 gauze folded twice and place under the needle to act as a support…

Are you using 15 gauge needles?

Thanks for the input Gus. I currently do use a folded 2X2. I believe the problem was from a clot at the end of the needle. I have had no problems with the 24 alarm since.

I am however, having problems inserting the needle in the arterial buttonhole. I have posted another message about this. I believe its because im gained 12 lbs over the last 6 months. This is a good thing for i have been trying to gain weight. I lost a lot when I had peritonitis on CAPD. I went from 118 down to 87 lbs.

Oh wow, glad it has been sorted out! I remember having similiar problems like this and it usually occurs when I’d spend a good time trying to insert a buttonhole which after sometime starts building a small clot at the tip, but have found that using some alcohol in between every 2-3min helps minimize the clotting, but people who use Sterigel may not apply to them as I don’t use Sterigel at all…