Still having problems with the high conductivity alarm. One tx the alarm goes off a lot, and the next tx it may not go off at all, or goes off in the last few minutes. The machine has been serviced and still the high cond. alarm goes off. The techs say it doesn't go off all day until I come on. I am on a straight 140 sodium. I found out that the two patients on the earlier shifts are on a straight 144 sodium. The bicarb is mixed by a machine. If the alarm doesn't go off all day, what could be different about my peramiters that could be setting it off?

Need some additional info. What type of machine? Is the bicarb mixed in jugs or actually mixed by the dialysis machine (like a Bicart)? If it is mixed in the back by staff, the strength could be varing causing the alarm. How high is the conductivity going to cause the alarm? what are the limits set at? There should be a "tolerance" built in to allow for variances such as bicarb strength, pump calibrations, etc. Please give us some more info. thanks

I am on a Fresenius 2008H. The tech told me the bicarb is mixed by a machine in the back. I will try to get more specifics next time I go to tx. With 140 sodium the machine will alarm if the conductivity goes past 14.5. The limits are set for 13.5, 14.0, 14.5.

Here are some other things to check; what potassium is your bath compared to other patients, on the H machine the staff should be setting the machine for what type of "bath" (dialysate) you run on. If they are not changing that it could be causing a problem. The fact that it is climbing so high is suspect. Normally the limits would be set from 13.5 - 14.5 with ideal being 14.0 (sodium of 140), that is to allow for the variances I discussed in the first posting. Also check to see if this is the same machine (most facilities have a machine number on the front). The fresenius machines have a very straight forward proportioning system, when you go into dialysis mode the pumps (acid and bicarb) start stroking and basically deliver a set amount of each solution to be mixed with water to make the dialysate. If it is the same machine and the conductivity screen is set for the right concentrate then I would request another machine, while looking at the conducivity screen also check the bicarb setting and make sure it is correct for your prescription. One last piece of info needed does the conductivity vary or does it go high and stay high? Please post some more info.

At my next tx, I will observe if they are changing the K and the bicarb from the previous patient to the correct settings for me. I know I have double checked this with them before, so I would think they are. But to be sure, I will definitely double check it from now on. I am definitely on the same machine each tx. The reason I know this is because I have dialyzed on other machines that have a conductivity of less than about 14, and I can not dialyze at that conductivity level or I get extremely uncomfortable symptoms starting the last hour and a half. I have read info on this subject before, that a too low conductivity causes crampy symptoms. So, I specifically asked that I be kept on this machine since the conductivity range it is calibrated for runs higher. I have no symptoms of crampiness on this machine. The lowest it runs is 14.2, but then at a certain point it will get up to 14.5, and then at some point in the tx it will go above 14.5 setting off the alarm. Sometimes this happens a few brief times and other times it is more frequent. And then like last tx, it did not alarm a single time. Also, the techs hit the mute button and the conductivity either drops back down for a short time or a longer time. Every tx is different.

K values have little effect on conductivity. Mostly it is governed by Acid and Bicarbonate proportioning. Sorry I cannot be of more help.

K value have very little effect on conductivity. Mostly is governed by sodium (for about 95%)contained in acid and bicar concentrates. Adequacy hemodialysis means PH dialysate 7.3-7.5 and conductivity setted to 14.3-14.5 mS/cm and very stable flow dialysate.
If PH = 7.00 that means bicar is too low (if cond is really 14.3-14.5) and have to set lower acid conductivity to increase bicar conductivity.
That is my opinion...but not only mine
Hope this help

Have a main. tech. observe the DAC for the flow pump in the troubleshooting screen. It should only fluctuate a little. If it fluctuates for than 5 I would check the gearhead of both the flow pump and dearation. I had this happen to me and found the magnet of the dearation gearhead cracked.

My doctor wants to solve the problem by putting me on another machine (I don't want this unless another machine runs an adequate conductivity of 14.2 or above like my current machine does, as lower conductivity gives me highly uncomfortable crampy conditions), and my RN wants to solve the problem by upping my sodium to 142 or 141 (she thinks that will prevent the high conductivity alarm from going off, but I don't know if that is in my best interest, because when I dialyzed at 144 sodium once because the setting was not changed to 140 from the previous patient, I experienced excessive thirst). I am hoping to be able to present this discussion of the problem to the biotech. The question I still have is, why does the high conductivity alarm only go off on me and no other patient???

At my last tx the high conductivity alarm did not go off at all. The conductivity stayed steady at 14.3 the entire tx. The tx before last, the alarm went off one time at the beginning of the tx and did not alarm again the entire tx. I hope the machine has decided to repair itself lol, because so far no one has approached me with the solution.

To update again, I had another tx and for the 3rd time now, the high conductivity alarm did not go off. The conductivity stayed steady at 14.2 this time. I have noticed that as of the first tx that the alarm stopped going off, my appetite began to improve following the tx. I don't recall if I mentioned it, but ever since this problem started with the high conductivity alarm, I've had a noticeable loss of appetite for the meal when I get home from dialysis. I'm ok the next day, but can not eat a thing after dialysis. Well the appetite picked up again which shows me that the alarms had really affected me. I've been like this for a month or more which is how long the alarms have been occuring. Now that the alarms have suddenly quit going off for 3 txs in a row, can anyone venture a guess as to what the problem has been?

It is possible there was a temperature problem with the machine. If temperature was displaying as 37 but was actually say 36 that would change your conductivity(cond is temp compensated). did you notice if your temp display was stable. Also find out if machine had any service recently. Temperature display accuracy is supposed to be checked quarterly.

It doesn't make sense the connection between your appetite and the high conductivity alarms. The high alarms indicate a problem with the machine and when the conductivity goes beyond the upper or lower limit it goes into alarm and the machine bypasses the dialyser until the conductivity falls within the limits.
Are you on a fixed base sodium ie 142? As far the mixing of the bicarb, I have the same equipment for mixing bicarb in bulk. When the solution is prepared the conductivity is checked and must be within a certain tolerance, 50mS +/- 2mS. I spoke with one of our most experienced dialysis nurses and she sees no connection between conductivity alarms and loss of appetite. She did indicate if you are being under dialysed thatcould possibly cause this. Did you have so many alarms that you were not dialysed enough?

My string of luck ended at my last tx. With just an hour to go the high conductivity alarm went off. It went off 2 more times before txs end causing my time to be extended 4 minutes. I observed that I began to feel uncomfortable symptoms in my body as soon as the alarms began going off, whereas previous to that I felt fine and was having a comfortable tx. You asked if I am on a fixed sodium. I am on a straight 140 sodium. Regarding the RNs comments, my understanding is that when the conductivity alarm keeps going off it compromises the tx. My kt/v dropped from 1.9 to 1.3. So yes, I had a loss of appetite directly related to the conductivity alarms going of anywhere from 2-6 times a tx which have compromised my txs. I haven't been able to talk to the bio tech yet regarding the two suggested repair solutions (gear and temp.) suggested in this discussion (don't even know if I will be permitted to talk to him. I requested the RN to tell him that I wanted to speak to him, myself, but she acted like I wouldn't be able to speak to him. She wanted me to up my sodium to 142 or 141 and said that would probably solve the problem. I told her that might be so, but I wanted to talk to the biotech (and the doctor) before changing my sodium level. I couldn't tell if what she was offering was a valid solution or just a quick fix not in my best interests. Will ask the doctor next time he rounds to put me in touch with the biotech. I was allowed to talk to the biotech at a previous unit I was at. I don't know if they are going to permit it here). Still holding out hope that this tx problem will be resolved...

It seems like you have a eletronic problem.It seems that the control board heats up after a long day and that the board alouse the acid pump start to run fast and then slows down again.It could also be that the bicarb could be losing Co2.It could also be that the bicarb is causing the pumps to run iratice.
Hope this help.