B. Braun Omni User manual

1
B. BRAUN OMNI
Troubleshooting guide
Citrate,
Heparin and no
anticoagulant
use

2
PROTECT
and
around the world.
We
the
of people
HEALTH
IMPROVE
OUR VISION

3
The OMNI technical helpline is for
reporting technical problems with the
machine.
Technical helpline: 0114 225 9204
(available Mon – Fri, 8:30am – 4:30pm)
Out of hours: 0114 225 9299
Any issues with patient electrolytes,
protocol or clinical issues please refer to
your consultant/pdn/senior nursing sta.
ALWAYS ensure the OMNI
is plugged in,
even when not in use
CONTENT
Power on and o
Set up
Priming
Entering parameters
Prior to start of therapy
Starting therapy
Common troubleshooting during therapy
Temporary disconnection and recirculation
Change of kit
Ending therapy
This guide is linked to the OMNI 1.75 software
and IFU. This guide does not replace the OMNI
IFU SW 1.75 and is recommendation only. It
should be used in conjunction with appropriate
training as an additional help guide.

4
POWER ON AND OFF
The OMNI has a battery capacity of 30 minutes. Therapy stops when the
machine is unplugged.
To switch the OMNI on, the green power button should only be pressed once
for a short time. Do not press and hold as this will power the machine on and
then o. To switch o the OMNI, press and hold the green button.
ALWAYS keep the OMNI plugged in, even when not in use. If the OMNI does
not switch on, it is likely to have run out of charge. Plug in and allow to charge
before retrying.
30
FULL
CHARGE minutes
=
Short press Press and hold
To turn ON
ALWAYS PLUGGED
INKEEP
To turn OFF

5
The ‘Connect Pressure Lines’ action does not have an hourglass or get a tick
when the pressure lines are attached. There will be a tick once the machine has
loaded the set, always follow each instruction in turn.
ALWAYS choose the correct syringe line when inserting the syringe when using
OMNISET L or PRO. Calcium Chloride is ALWAYS attached to the line that says
Calcium line, which is always used with CITRATE anticoagulation. The HEPARIN
syringe is always attached to the long thin syringe line that has no writing on
it. It is imperative to ALWAYS choose the right line.
Let the machine load itself, never try and load the lines manually and never
try to unload the set manually. Pulling the lines out of the pump manually can
result in breakages in the pumps.
Ensure to click both top and bottom at both uid and blood sides when
inserting set.
LOADING
SYRINGE LINES
PRESSURE LINES
SET UP
If using CVVHD then always put one bag of saline (either 500 ml or 1000 ml)
onto the purple line/substitution side, this is for priming of the purple line only
and stays there for the entirety of the therapy. In CVVH and CVVHDF there is a
substitution bag on this scale for post dilution and for these therapies we can
connect two substitution bags to this scale.
Dierent uid bags are used for either CVVHD or CVVHDF with citrate
anticoagulation. Ensure to always follow the protocol and prescription carefully
when setting up and changing uid bags on the OMNI.

6
All scales are separate and do not need to be balanced. It is worthwhile putting
two uid and euent bags on at the start, to reduce workload.
Frangible pins: ensure to make sure all pins on uid bags are broken correctly.
If there is a ow problem/pump failure/solution pressure/empty priming bag
related alarm, this COULD be caused by unbroken or partially broken pins,
please always double check that they are fully broken.
SET UP

7
Prior to priming: ensure all unused clamps are closed and all used are open
before pressing Automatic Priming. When using heparin or no anticoagulant
and using the OMNISET L or PRO, ensure to close the clamps on syringe lines
not being used AND the white clamp on the calcium line at the top of the
blue venous/return line. This line does not get primed in heparin, therefore it is
imperative that it is closed.
Press automatic prime and leave to prime.
‘Arterial Line Blocked’ may appear and if so, push the spike into the priming
bag further attached to the red access line and press reset alarm. This should
resolve this alarm, if the alarm appears again press reset again and it should
continue to prime.
If there are any ow problem alarms or any alarms relating to uids, then
double check the clamps and pins.
PRIMING

8
This can be done during priming, or prior to the patient being put onto the
OMNI. Be careful not to move the machine during priming to avoid any errors.
It is important to ensure the Calcium Chloride and Citrate used adhere to the
concentrations set on the OMNI to ensure the volumes being delivered by the
machine are correct.
When using citrate we must not change the blood ow unless stated on the
protocol or informed so by a Consultant. If we change our blood ow, we are
altering the amount of citrate we are giving. Consult medical/senior nursing
sta regarding queries over the citrate protocol.
ENTERING PARAMETERS
When entering parameters it is advisable to leave the ‘therapy time limit’
section as a dash, not entering anything into this box to allow the machine
to run for the lifetime of the set. Therapy time limit does not appear on the
Conrm Therapy Parameters page.
Enter the net uid removal as zero or desired ow prior to start of therapy.
Please be careful to enter net uid removal (uid to be removed in mls/hr) and
the dialysate ow in the correct boxes. Ensure to follow the protocol carefully
and check parameters that have been input to avoid any potential errors.
THERAPY TIME LIMIT
NET FLUID REMOVAL

9
If we need to re-prime the red/access and blue/return lines with saline following
initial priming then we do this by rinsing. Attach a new bag of saline to the
red access line where the priming bag is and enter the amount needed to rinse.
We can recirculate prior to commencing therapy. To do this attach the access/
red line to the three way tap on the waste bag (next to the return/blue line),
CLOSE THE WHITE CLAMP to avoid sterilisation chemicals that will be present
in the waste bag from priming being recirculated and then press recirculate.
Always leave the machine on during recirculation.
RINSING
RECIRCULATION
PRIOR TO START OF THERAPY

10
When enter therapy is pressed please start the blood pump, increase the blood
ow to protocol target blood ow at a rate based on the patient’s stability.
Once we have started the blood pump and therapy using the red and blue
buttons in the bottom corner, please avoid from pressing these unless required
to stop the blood pump or therapy. During therapy if the machine needs to stop
them it will and it will similarly restart these itself. For example, during a bag
change the therapy will stop and by pressing of the ‘bag change/weight reset’
button the therapy will then restart itself.
STARTING THERAPY
If you experience this alarm, please double check your connections as it can
happen when the lines become disconnected. However, if the blood lines have
not been lled during the patient connection page it may occur whilst the
blood is making its way around the set from the patient. This can be due to the
saline being returned to the patient at present (from priming) being less viscous
than blood and triggering a low venous alarm. If the connection is secure, we
can try and raise the height of the bed which can increase the venous pressure
and press reset alarm. Once the blood is returning to the patient the problem
should be resolved.
LOW VENOUS ALARM

11
ALWAYS press the ‘bags’ button when changing any uid bag. If done without
pressing the button, it will trigger an alarm and could cause a ‘safety check
error’ message to show and a possible inability to continue treatment. If this
alarm shows and is unable to be reset you may need to make a power failure
on the machine (turning it o and then on), this should resolve the alarm. The
OMNI will take approximately 3 minutes to switch back on and will return to
the last state after restart. Always press the ‘Bags’ button to ensure this does
not occur.
This alarm happens when the anticoagulation has been stopped for
approximately 5 minutes. The anticoagulation stops when doing a bag or
syringe change, always ensure to preempt bag or syringe changes to ensure
the set does not clot.
Ensure to use a small syringe and slowly pull the air out, it should only be a
small volume required to be removed. Keep the calcium line clamp open when
doing this to be able to pull the air out. Do not pull too hard or there will be
blood returned in the calcium line from the venous line.
BAG CHANGES
LONG ANTICOAGULATION STOP
AIR IN CALCIUM SYRINGE
COMMON TROUBLESHOOTING DURING THERAPY

12
There is visible blood in the euent caused by a crack or problem
with the lter itself – a new kit is required as it is faulty. Do not
return the blood in this case.
Additionally, if there is bright light shining on the blood leak detector
(underneath the euent chamber) this can trigger the alarm, remove
the light source and press ‘no override’.
It can additionally trigger when there is a discolouration of the
euent (for example from high bilirubin levels), if you are satised
that this is the reason you can press ‘temporary override’, causing
the small box to show in the left hand bottom corner of the screen.
Finally, if the euent chamber is empty, this can trigger the alarm.
Go to the ‘levels’ button on the screen and VERY SLOWLY ll the
euent chamber using the up arrow until the uid is half way only.
Do not do this too fast or ll the chamber too full as this can cause
a change of pressure within the set and possible subsequent alarms.
Once the chamber is lled half way, press ‘no override’ on the blood
leak detector and this should resolve the problem.
If the blood leak detector is put into override, please consider testing
the euent for blood using the small line at the uid side of the
machine to draw out some euent.
BLOOD LEAK DETECTOR ALARM
COMMON TROUBLESHOOTING DURING THERAPY
1
3
2
4

13
COMMON TROUBLESHOOTING DURING THERAPY
Pressing ‘patient care button’
Clamping the access/arterial line at patient access
Removing the red arterial pressure line from the pressure port on
the side of the machine only a small amount
Check to see if the blood has returned to the chamber from the
pressure line
Re-attach the red pressure line to the pressure port on the side
of the machine
Unclamp the access/arterial line at patient access
Take o patient care mode by pressing the ‘patient care’ button
again
1
2
3
4
5
6
7
This is due to stops in the blood pump/low blood ow causing a back ow of
blood from the arterial/access line. When blood is seen in the arterial pressure
line try and resolve this by:
BLOOD IN THE ARTERIAL (RED) PRESSURE LINE
As long as the blood pump is running this will cause the blood to move out
of the line and return to the chamber. If there is an arterial pressure alarm
during this procedure as a result of the access/arterial line being clamped
the blood pump will stop, ensure to reset the alarm to allow the blood
pump to run for enough time for the blood to be removed from the line and
continue as the steps detailed above. Ensure to always attach the pressure
line back on before unclamping the arterial/access line.
If the blood is already clotted in the pressure line DO NOT return it into
the machine, leave it as it is as you do not want to return clots to the
chamber. If blood reaches the pressure measurement sensor at the top of
the pressure line you may experience an arterial pressure measurement
failure alarm. Attempt to remove the blood if not clotted following the
steps above, and reset the alarm. If the alarm does not reset the kit may
require to be changed.

14
Ensure to diagnose and rectify as soon as possible to avoid a uid balance
management error. Often these alarms can be triggered by unbroken pins.
Always ensure pins are broken, at times they can seem broken, however if they
are not fully open the machine is unable to pull the uid at the desired rate
and therefore an alarm is triggered, which will then trigger subsequent alarms.
Ensure to double check pins/clamps if any of these alarms are triggered to
ensure this is not the problem.
This can happen for various reasons, around 50% of these being access issues –
please speak to medical sta regarding any access problems. The OMNI cannot
run successfully if the access is poor. Several blood pump or therapy stops will
cause the OMNI to clot. Ensure not to press the ‘BLOOD PUMP’ and ‘THERAPY’
buttons on and o when in therapy. Ensure anticoagulation is appropriate.
The machine carries out tests every 24 hours during therapy, it will alarm and
ash, leave it to go through this process. If another alarm triggers during this
time, it may cause the tests to fail. Press reset alarm and allow the tests to
continue, this should resolve this issue. Please note that pressing the blood
pump icon o can block the 24 hour self test.
SOLUTION FLOW/PUMP FAILURE/FLOW PROBLEM
OMNI CLOTTING
SELF TESTS
COMMON TROUBLESHOOTING DURING THERAPY

15
The most common reason for this alarm is due to a pin not broken properly on
the dialysate bag or there is a clamp left on, causing a level regulation problem
in the solution chamber. Check the pin and clamps and reset the alarm, it can
take 2 or 3 alarm resets for the dialysate uid level to resolve, giving it time
to ow through the warmer bag to the solution chamber. During the problem
resolution if the alarm does not reset after 2 or 3 times, it may be required to
release the green solution pressure line for a second by disconnecting from the
green pressure port at the side of the machine and connecting it securely back
on to the green solution pressure port and then resetting the alarm.
SOLUTION CHAMBER REGULATION FAILURE
COMMON TROUBLESHOOTING DURING THERAPY
Additionally, if not a pin or clamp it could be due to condensation within
the solution chamber. If condensation is noted, go to the ‘levels’ page where
you see the 4 chambers. Going to the solution chamber, keeping it in auto
regulation, slowly increase the level in the chamber to get rid of the bubbles,
the machine should bring the level back down automatically, clearing the
bubbles and resolving the issue. Press reset alarm, and allow the machine to
continue with therapy automatically.

16
This is for when the patient will be o the OMNI for a short period.
Only press temporarily disconnect patient when ready to return the blood, with
equipment and sterile eld prepared. Once this is pressed, the blood pump
stops and the blood will begin to clot.
Return the blood as listed on the screen, ensuring to follow all steps in turn.
Put into recirculation once blood returned, connecting the blue and red lines
to the 3 way tap.
Once ready to reconnect to the patient, ensure there are no clots within the
set, if so a new set may be required as we cannot risk returning blood clots to
the patient.
Follow the steps on screen and reconnect the patient.
If recirculation following temporary disconnection has been done for longer
than the recommended recirculation time then we must change to a new set.
TEMPORARY DISCONNECTION AND RECIRCULATION

17
This is used when we are taking the current kit o and a new one is required.
Follow the steps for returning the blood (ensuring to only press the Change Kit
button when prepared to return the blood).
Once completed, the OMNI will then take you to setting up a new kit. Ensure
to follow all steps in turn.
CHANGE OF KIT

18
For ending the therapy return blood as stated following all steps in turn,
reading the screen carefully and ensuring again to only press the end therapy
button when ready to do so to avoid the blood clotting prior to blood return.
If ending therapy due to being unable to continue therapy (for example access
issues), the machine will only return blood if it is able to do so, it does not
return clotted blood.
Once the blood is returned ensure to take the RETURN/BLUE line o the patient
and make sure that the patient is fully disconnected before pressing unload
disposables.
Once unloaded click NEW THERAPY and this will take you back to the home
page where you can switch the machine o or visit the HISTORY page.
ENDING THERAPY
Follow these steps on screen. Pressure lines do not get a tick until unloaded.
Blood or uid side door alarm on unload is when the doors open due to the
force of the pumps unloading. Hold your nger on the door that is open and
press reset alarm, unload will continue and complete. If there is any other
alarm, ensure to reset this alarm to allow the kit to unload. It will not unload
if there is an alarm to be dealt with.
UNLOAD DISPOSABLES

19
EFFECTIVE
SOLUTIONS
and
customers and partners.
We develop
for the
healthcare system in a
with our
CONSTRUCTIVE
DIALOGUE
GUIDING
STANDARDS
OUR MISSION

20
B. Braun Avitum (UK) Ltd | Thornclie Park | Sheeld | S35 2PW
Tel [phone] | Fax [phone] | www.bbraun.co.uk
XX-TAG-09-20