baxter HomeChoice User manual

HomeChoice
HomeChoice PRO
APD Systems
Patient At-Home Guide
Creating a Better World of Care for Renal Patients
PATIENT GUIDE COVERS_Update121109.indd 1 12/11/2009 2:26:51 PM

The HomeChoice
and HomeChoice PRO
APD Systems
Patient At-Home Guide
Document Number 07-19-61-244
October 2, 2009

HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
Baxter, HomeChoice, UltraBag, MiniCap, FlexiCap, OptiChoice, Dianeal, and Extraneal are
trademarks of Baxter International Inc.
Copyright 2009 Baxter Healthcare Corporation. All rights reserved.

07-19-61-244 October 2, 2009 HomeChoice APD Systems Patient At-Home Guide i
Table of Contents
1 Glossary
1.1 Terms Used in This Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
1.2 Symbols Used on the HomeChoice and HomeChoice PRO APD Systems . . . . . . . . 1-12
2 User Assistance Information
2.1 Personal and Cycler Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
2.2 Numbers to Call for Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
3 Warnings and Cautions
3.1 Side Effects and Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.2 Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.2.1 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
3.2.2 Treatment - Overfill / IIPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
3.2.3 Supplies – General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
3.2.4 Supplies – Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
3.2.5 Supplies – Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
3.2.6 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
3.3 Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
3.4 Battery Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
4 Indications for Use
4.1 About This Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
5 Description
5.1 Introduction to HomeChoice APD Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
5.2 Introduction to Peritoneal Dialysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
5.2.1 Continuous Ambulatory Peritoneal Dialysis (CAPD) . . . . . . . . . . . . . . 5-3
5.2.2 Automated Peritoneal Dialysis (APD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
5.3 HomeChoice APD Systems Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
5.3.1 Fluid Pathways: Drain, Fill, and Dwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
5.3.2 Fluid Flow During Power Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
5.3.3 Situations When Fluid Lines are Not Controlled . . . . . . . . . . . . . . . . . . 5-6
5.4 HomeChoice APD Systems Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
5.5 HomeChoice APD Systems Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

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ii HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
5.5.1 The HomeChoice PRO APD System Cycler . . . . . . . . . . . . . . . . . . . . . . . . 5-8
5.5.2 The HomeChoice APD System Cycler . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-10
5.5.3 Control Panel Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
5.6 Disposable Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-13
5.6.1 Luer Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-14
5.6.2 Spike Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-15
5.7 HomeChoice APD System and HomeChoice PRO APD System Differences . . . . . . 5-16
6 Environmental Conditions
6.1 Operating Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
6.2 Use While Traveling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
7 Setup and Check-out
7.1 Check-out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
7.2 Set Up the HomeChoice APD System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
7.3 Grounding Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
8 Operating Instructions – PRO Card and Modem
8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
8.2 Using the PRO Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3
8.2.1 Care and Handling of the PRO Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3
8.2.2 Confirm Your PRO Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4
8.2.3 Confirm a New Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-5
8.2.4 HomeChoice PRO APD System Prompts . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7
8.2.5 Definitions of Data Entry Prompts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-8
8.2.6 Remove Your PRO Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-10
8.3 Display Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
8.3.1 No PRO Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
8.3.2 Card Reader Disabled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-12
8.3.3 PRO Card Full . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-12
8.3.4 Invalid PRO Card, Program Not Valid . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-13
8.3.5 Card Reader Error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-13
8.4 Install the Modem Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-14
8.4.1 Test the Modem Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-16
8.5 If You Require a New System or “Swap” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-17

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9 Operating Instructions – Change Program
9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
9.2 About Your System’s Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
9.2.1 Nurse’s Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
9.3 The Nurse’s Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2
9.4 If You Receive a New System or “Swap” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3
9.5 Manual Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4
9.5.1 Basic Steps for Manual Programming . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4
9.6 Therapy Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-8
9.7 Standard Mode (Standard Fill Mode) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-9
9.7.1 CCPD/IPD Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-9
9.7.2 CCPD/IPD Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-12
9.7.3 Hi-Dose CCPD Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-13
9.7.4 Hi-Dose CCPD Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-17
9.7.5 Tidal Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-18
9.7.6 Tidal Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-24
9.7.7 Hi-Dose Tidal Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-25
9.7.8 Hi-Dose Tidal Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-33
9.8 Low Fill Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-34
9.8.1 CCPD/IPD Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-35
9.8.2 CCPD/IPD Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-38
9.8.3 Hi-Dose CCPD Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-39
9.8.4 Hi-Dose CCPD Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-44
9.8.5 Tidal Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-45
9.8.6 Tidal Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-53
9.8.7 Hi-Dose Tidal Therapy Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-54
9.8.8 Hi-Dose Tidal Calculated Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-62
10 Operating Instructions – Make Adjustments
10.1 Make Adjustments Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
10.1.1 Changing Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
10.2 Option Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
10.2.1 Adjust Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
10.2.2 Adjust Loudness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
10.2.3 Auto Dim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-5
10.2.4 Set Clock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6
10.2.5 Set Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7
10.2.6 I-Drain Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
10.2.7 I-Drain Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-9

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iv HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
10.2.8 Comfort Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-13
10.2.9 Last Manual Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-14
10.2.10 UF Target and Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-15
11 Operating Instructions – Prepare for Therapy
11.1 Gather Your Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1
11.2 Prepare Your Solution Bags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3
11.3 Turn On Your HomeChoice APD System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
11.4 Menu Options at Startup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
11.5 Load the Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-10
11.6 Attach the Drain Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-14
11.7 Connect the Solution Bags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15
11.8 Prime the Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-18
11.8.1 Reprime the Patient Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-23
11.9 Connect Yourself to the Disposable Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-24
12 Operating Instructions – Perform Therapy
12.1 Initial Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1
12.1.1 Menu Options During Initial Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
12.2 Fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
12.2.1 Menu Options During Fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
12.3 Dwell Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
12.3.1 Menu Options During Dwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
12.4 Drain Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-9
12.4.1 Menu Options During Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-9
12.5 Pause Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
12.5.1 Menu Options When STOP is Pressed . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
12.6 Hi-Dose Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-13
12.6.1 Day Dwell Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-15
12.7 Perform a Hi-Dose Day Exchange . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-16
12.7.1 Disconnect Yourself During Hi-Dose Dwell . . . . . . . . . . . . . . . . . . . . 12-18
12.7.2 Reconnect and Continue Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . 12-20
13 Operating Instructions – End Therapy
13.1 Ending Your Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-1
13.2 Disconnect Yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-6
13.3 Shut Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-8
13.3.1 Menu Options During End of Therapy . . . . . . . . . . . . . . . . . . . . . . . . 13-10

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14 Operating Instructions – Effluent Sampling
14.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-1
14.2 Take an Effluent Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-2
15 Cleaning
15.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-1
15.2 Cleaning the Cycler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-2
15.3 Preparing the Cycler for Return to Baxter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-3
16 Maintenance
17 Storage
17.1 Cycler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-1
17.2 Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-1
17.3 Dialysis Solution and Disposables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-1
18 Troubleshooting
18.1 List of Alarms and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-1
18.2 Correcting Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-3
18.2.1 Types of Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-4
18.3 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-5
18.3.1 Check Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-5
18.3.2 Check Lines and Bags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-9
18.3.3 Check Therapy Setting Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-10
18.3.4 Phase Not Finished . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-11
18.3.5 Load a New Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-12
18.3.6 Low Ultrafiltration (UF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-13
18.3.7 Low Drain Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-15
18.3.8 Slow Flow Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-19
18.3.9 Machine Tilted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-20
18.3.10 Warming Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-21
18.3.11 Caution: Negative UF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-22
18.3.12 Check Your Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-24
18.3.13 Reload the Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-26
18.3.14 Caution: Positive UF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-29
18.3.15 Verify I-Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-30
18.3.16 System Errors 2240 or 2267 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-31
18.3.17 System Error nnnn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-33

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vi HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
18.3.18 Temp Stabilizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-35
18.4 Bypass Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-37
18.4.1 Bypass Initial Drain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-37
18.4.2 Bypass Low Drain Volume Alarm During Initial Drain . . . . . . . . . 18-39
18.4.3 Bypass Drain Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-41
18.4.4 Bypass Drain Not Finished Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-43
18.4.5 Bypass Low Drain Volume Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-45
18.4.6 Bypass Caution: Negative UF Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . 18-49
18.4.7 Check Supply Line Alarm During Replenish . . . . . . . . . . . . . . . . . . . 18-52
18.5 Manual Drain Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-53
18.6 End Therapy Early Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-55
18.7 Reprime Patient Line Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-57
18.8 Increased Intraperitoneal Volume (IIPV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-58
18.9 Power Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-62
18.10 Emergency Disconnect Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-65
18.10.1 Disconnect from the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-66
18.10.2 Return to Therapy After an Emergency Disconnect . . . . . . . . . . . . 18-67
19 Technical Data
19.1 Physical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-1
19.2 Electrical Power Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-1
19.2.1 Extension Cords . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-2
19.3 System Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-2
19.4 Environmental Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-2
19.5 Battery Backup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3
19.6 Electromagnetic Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3
19.7 Solution Temperature Protective System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-9
19.8 Audible Alarm Silence Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-9
19.9 Range of Sound Pressure Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-9
19.10 Maximum Pressures Used to Transfer Solution To and From the Patient . . . . . . 19-9
19.11 Protective System Preventing Air Infusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-10
19.12 Protective System Preventing IIPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-10
19.13 Drain Logic Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-11
19.13.1 Standard Fill Mode Drain Logic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-11
19.13.2 Low Fill Mode Drain Logic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-12
19.14 Replenish Logic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-13
19.14.1 Scheduled Replenish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-13
19.14.2 Unscheduled Replenish . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-14
19.15 Determining Maximum Fill Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-14

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19.16 Determining Initial Drain Alarm Volume Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-16
19.17 Determining Tidal Total UF and Last Manual Drain UF Target
Volume Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-18
20 Quick Reference
20.1 Prepare for Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-2
20.2 Perform a Hi-Dose Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-13
20.3 End Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-19
Index

Table of Contents
viii HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244

Section
1
Glossary
1. Glossary

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Glossary
1.1 Terms Used in This Guide
# of Day Exchanges
The number of CAPD manual exchanges performed using an UltraBag system.
If no manual exchanges are performed on a given day, enter a zero (0). The
maximum number of manual exchanges allowed is five (5).
Abdomen
The area of your body that includes your stomach.
Abdominal Fullness
A patient’s feeling of fullness, sometimes referred to as “overfill” or “overfull.”
This feeling can come from Increased Intraperitoneal Volume (IIPV), or can
come from eating a large meal, constipation, or abdominal masses. See also
IPV and IIPV.
Air Infusion
Air in the patient line delivered to the peritoneal cavity. Air infusion can cause
pain in the abdomen and/or shoulder. An incomplete prime can cause air
infusion.
Aseptic Technique
The practice of cleanliness in handling items associated with your therapy. It
means you should put on a face mask and thoroughly wash and dry your
hands every time you connect or disconnect.

1. Glossary
1-2 HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
Automated Peritoneal Dialysis (APD)
APD is any form of peritoneal dialysis that is performed by a mechanical
device, known as a cycler. Treatment settings are programmed on the cycler
and are performed automatically, generally while you sleep.
Before you go to sleep, you attach the tubing and solution bags to the cycler.
You then connect the tubing to your transfer set attached to your catheter.
The cycler then performs the peritoneal dialysis by automatically delivering
the prescribed Fills, Dwells, and Drains of each therapy cycle throughout the
night.
Blood Pressure, Diastolic
The lowest number of your daily blood pressure (mmHg) when your heart
relaxes.
Blood Pressure, Systolic
The highest number of your daily blood pressure (mmHg) when your heart
pumps blood.
Bypass
An option you can select to go on to the next therapy phase if the therapy or
an alarm has been stopped. Some therapy or alarm conditions can not be
bypassed.
Cassette
The clear rectangular plastic piece of the disposable set that is inserted behind
the door of the HomeChoice/HomeChoice PRO APD System.
Catheter (PD Catheter)
In peritoneal dialysis, a catheter is used to deliver dialysis solution into the
peritoneal cavity and drain it out.
Contamination
The presence of foreign material that makes a substance impure or harmful.

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1. Glossary
Continuous Ambulatory Peritoneal Dialysis (CAPD)
With CAPD, the blood is being cleaned continuously, both day and night. The
dialysis solution passes from a plastic bag through the catheter and into the
peritoneal cavity. The solution stays in the peritoneal cavity with the transfer
set closed. After several hours, the solution is drained into a disposable bag.
Then the peritoneal cavity is refilled with fresh solution through the catheter
to begin the cleaning process again. This is a manual type of peritoneal
dialysis (PD) and does not use a cycler.
Continuous Cycling Peritoneal Dialysis (CCPD)
CCPD is a form of APD. It is a continuous therapy in which a cycler performs
exchanges while you sleep. Dialysis solution can be left in the peritoneal cavity
during the daytime, or it can be completely drained before ending the
treatment (referred to as Nocturnal Intermittent Peritoneal Dialysis, or NIPD).
Cycle (Exchange)
In peritoneal dialysis, a cycle consists of three phases: a Fill phase, a Dwell
phase, and a Drain phase. Every APD therapy contains one or more cycles.
Cycler
A mechanical device that performs peritoneal dialysis solution exchanges in
regular cycles. Your HomeChoice/HomeChoice PRO APD System device is a
cycler.
Day Fills
The amount of solution the system delivers to your peritoneal cavity for a
daytime exchange. During the Dwell phase of a daytime exchange, you can
disconnect from the system and have the freedom to conduct your normal
daytime activities. The daytime exchanges are a part of Hi-Dose therapy. See
also Hi-Dose CCPD/Hi-Dose Tidal.
Day Fill Volume
The volume of solution for each daytime exchange. This volume is based on
your prescription.

1. Glossary
1-4 HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
Dextrose
A form of sugar that is an ingredient in most of the solutions used for
peritoneal dialysis. The dextrose draws extra fluid from the body into the
dialysis solution.
Dialysis
The process of cleaning waste from the blood artificially. This job is normally
done by the kidneys. If the kidneys fail, the blood must be artificially cleaned
with special equipment. The two major forms of dialysis are hemodialysis and
peritoneal dialysis. See also Peritoneal Dialysis (PD).
Dialysis Solution
A special liquid used in both hemodialysis and peritoneal dialysis to clean the
blood. Dialysis solution contains dextrose (a sugar) and other compounds
similar to those in the body.
Disconnect Cap
A povidone-iodine solution-filled cap that is placed over the connectors on the
transfer set or the connector on the patient line of the disposable set.
FlexiCap and MiniCap are disconnect caps.
Disposable Set
The organizer and attached tubing lines that connect a patient to the solution
and drain bags. The disposable set is used to deliver dialysis solution to the
peritoneal cavity during therapy. The disposable set is used only once.
Drain/Full Drain
The removal of the dialysis solution from your peritoneal cavity. Depending
on the time of day and type of therapy, the amount of fluid drained may be a
complete Drain or a partial Drain (Tidal therapy).
The volume of fluid is measured in milliliters (mL). One liter is equal to
1000 milliliters.
Drain Bag
The optional bag into which fluid from your peritoneal cavity drains.

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1. Glossary
Drain Line Extension
An optional extension line that attaches to the drain line of the disposable set.
This extra length allows you to drain into a shower, tub, or toilet.
Drain Volume
The volume of a Drain after a Dwell cycle.
Dry Weight
Your weight after a dialysis session when all of the extra fluid in your body has
been removed.
Dwell and Dwell Time
The amount of time the fluid remains in your body during each cycle. Dwell
Time or Dwell is part of the therapy cycle.
Effluent
The used dialysis solution drained from the body as part of an exchange.
End-Stage Kidney Disease (ESKD)
Kidney failure. Requires dialysis or a kidney transplant.
End-Stage Renal Disease (ESRD)
Kidney failure. Requires dialysis or a kidney transplant.
Exchange
The draining of used dialysis solution from the abdomen, followed by refilling
with a fresh bag of solution.
Face Mask
A mask covering the mouth and nose. A face mask is used to prevent bacteria
from contaminating the sterile components of the disposable set, lines, and
solution bags.
Fill Volume
The volume of fluid to be delivered to your peritoneal cavity during each cycle.
The appropriate volume of fluid is determined by your physician.

1. Glossary
1-6 HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
First Fill
The first Fill cycle of your therapy following an Initial Drain (I-Drain).
Fluid Overload
Too much fluid in the body. This is caused by more fluid going into your body
than is coming out. Fluid overload can be dangerous to your heart.
Flush
The process by which the system pumps a small amount of dialysis solution
from the supply bags to the drain line after the supply line connections have
been made. This helps reduce infection from supply line contamination.
Hi-Dose CCPD / Hi-Dose Tidal
The goal of Hi-Dose therapy is to provide a 24-hour therapy that combines
conventional nighttime therapies, such as CCPD or Tidal, with additional
daytime exchanges. This may help improve the outcome of your dialysis
treatment.
During the Dwell phase of each Hi-Dose exchange, you can disconnect from
the system and have the freedom to conduct your normal daytime activities.
Hypothermia
A body temperature that is too far below normal.
Increased Intraperitoneal Volume (IIPV)
This condition is when there is more fluid in your abdomen than was
prescribed. This condition is sometimes called “overfill.” IIPV could result in a
feeling of abdominal discomfort, serious injury, or death. See 18.8, Increased
Intraperitoneal Volume (IIPV), on page 18-58.
Initial Drain (I-Drain)
The Drain that occurs at the beginning of each therapy, before the first regular
Fill.
I-Drain Volume
The volume of an Initial Drain.

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1. Glossary
Intermittent Peritoneal Dialysis (IPD)
A form of peritoneal dialysis in which dialysis sessions take place two to four
times a week, 12 to 20 hours per session. The dialysis solution is drained
completely at the end of the session and the peritoneal cavity remains empty
between the sessions.
Intraperitoneal Volume (IPV)
The amount of fluid in the peritoneal cavity at a given point in time.
Last Fill Concentration
This is the concentration strength of dialysis solution used for the Last Fill.
The Last Fill dialysis solution concentration may be different from the heater
bag and supply bag concentration.
Last Fill Volume
The Last Fill of solution that is delivered at the end of your therapy and left in
the peritoneal cavity during the day. This is also referred to as a Wet Day.
Low Fill Mode
This mode is available only to patients whose Fill volumes are less than
1000 mL. These patients typically weigh less than 44 lbs (20 kg).
In Low Fill Mode, the Drain logic has lower alarm limits for Slow Flow and No
Flow. A Minimum Drain Time must be set, in addition to a Minimum Drain
Volume. The Negative UF alarm and a Positive UF alarm can be set when in
this mode. Low Fill Mode must be used with the Low Recirculation Volume
Set.
Low Recirculation Volume APD Set with Cassette
(Low Recirculation Volume Set)
A disposable set with a 7.5-foot (2.9-meter) patient line made with a smaller
inside diameter tubing than the other lines in the set. This reduces the fluid
flow to patients using Low Fill Mode. The internal recirculation volume of this
set is 17 mL.
Nite (Night) Therapy Time
The total amount of time for the nighttime portion of Hi-Dose therapy. This
time is fixed and begins as soon as you complete your daytime exchanges.

1. Glossary
1-8 HomeChoice APD Systems Patient At-Home Guide October 2, 2009 07-19-61-244
Night Concentration 1
This is the concentration of the primary solution bag placed on the heater pan.
Night Concentration 2
This concentration is for the supply solutions that may be different from the
heater bag solution.
No Flow
This occurs when there is no measurable flow rate of solution. No Flow can
reduce the Dwell Time and decrease the amount of effective dialysis time. This
can be caused by a kink or closed clamp on one or more of the lines or by an
empty bag.
Occluder
The occluder clamps the solution lines if a power failure occurs or when the
system is off. This prevents any solution from being delivered to the patient.
The occluder is located inside the door on the front of the cycler.
Organizer
The blue plastic piece that holds the tubing lines and connectors of the
disposable set during preparation for therapy. The organizer hooks onto the
door of the cycler.
Overfill
A feeling of fullness in the abdomen. This feeling can come from IIPV, or can
come from eating a large meal, constipation, or abdominal masses. See also
Abdominal Fullness, Intraperitoneal Volume (IPV), and Increased
Intraperitoneal Volume (IIPV).
Patient Line Extension
An optional extension line that attaches to the patient line of the disposable
set. This extra length allows you to be up to an additional 12 feet (3.7 meters)
away from your system during therapy.
Peritoneal Cavity
The space around your internal organs inside the lower abdomen.