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What This Guide Helps With
Troubleshoot abnormal or unstable dialysate conductivity caused by concentrate supply, connections, water supply, preparation, configuration, or service-level problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Stop Unsafe Dialysate Delivery
Do not continue treatment on a machine with unreliable dialysate conductivity. Follow clinical procedure to maintain patient safety and transfer treatment to another verified machine when necessary.
Keep the affected Dialog+ out of patient use until the cause is identified and conductivity performance is verified.
Expected outcome: The patient is protected from potentially incorrect dialysate composition and the machine is available for safe evaluation.
2. Confirm the Exact Conductivity Problem
Determine whether conductivity is consistently high, consistently low, fluctuating, slow to stabilize, or failing only during certain operating phases.
Record any displayed message exactly and note whether the problem began after concentrate replacement, water-system work, cleaning, disinfection, or machine relocation.
Expected outcome: The conductivity symptom is clearly defined and reproducible.
3. Verify Concentrate Selection and Supply
Inspect the acid and bicarbonate concentrate sources as applicable. Verify that the intended concentrate is present, not empty, correctly labeled, and appropriate for the configured treatment setup.
Do not alter dialysis prescription parameters to make an abnormal conductivity reading appear acceptable.
Expected outcome: Correct concentrate supplies are available and correctly matched to the intended setup. If replacing an empty or incorrect supply restores stable conductivity, troubleshooting may stop after verification.
4. Inspect Concentrate Connections
Check concentrate pickup connections, hoses, connectors, caps, and accessible fittings for loose connection, incorrect placement, kinks, obstruction, leakage, or air being drawn into the system.
Reseat accessible connections and replace damaged approved external accessories as appropriate.
Expected outcome: Concentrate connections are secure and unobstructed. If correcting the connection stabilizes conductivity and the machine completes required checks, troubleshooting may stop.
5. Verify Water Supply Conditions
Confirm the machine has the expected treated-water supply and that water flow has not been interrupted by facility work, a closed valve, kinked hose, disconnected connection, or upstream water-system condition.
Compare with another dialysis station if appropriate to determine whether the issue is isolated to one machine or affects multiple machines.
Expected outcome: Stable treated-water supply is confirmed. If the condition follows the facility water source rather than the machine, escalate to the appropriate water-system support personnel.
6. Inspect for Residual Cleaning or Disinfection Conditions
Determine whether the machine recently completed a disinfection or cleaning cycle and whether the required rinse process was completed.
Do not use the machine clinically if residual disinfectant or an incomplete rinse is suspected.
Expected outcome: The machine is confirmed ready for normal dialysate preparation. If proper completion of the required rinse process restores normal conductivity, troubleshooting may stop after all required verification.
7. Verify Configuration Without Unauthorized Changes
Review accessible treatment and concentrate configuration to confirm that the setup matches the supplies connected to the machine.
Do not enter restricted service menus or change calibration values to compensate for an unexplained reading.
Expected outcome: User-accessible configuration matches the intended concentrate and treatment setup.
8. Compare With an Approved Independent Measurement When Required
Using approved test equipment and applicable service procedure, compare the machine's conductivity indication with an independent measurement if this is within Clinical Engineering scope.
Do not return the machine to service solely because the displayed value appears reasonable.
Expected outcome: Machine indication and independent verification are consistent within applicable manufacturer requirements. If verification passes after an external correction, troubleshooting may stop.
9. Escalate Persistent Conductivity Instability
If correct concentrate, secure connections, treated-water supply, rinse status, and configuration are confirmed but conductivity remains unstable, stop external troubleshooting.
Expected outcome: A likely internal mixing, sensing, flow-control, calibration, or service-level issue is referred for qualified evaluation.
If the Problem Persists
Common external causes have been ruled out. Remaining causes may involve internal conductivity sensing, proportioning, concentrate delivery, hydraulic control, calibration, or another service-level condition.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate B. Braun documentation and approved conductivity test equipment.
- Repaired, calibrated, or configured only by qualified personnel.
Complete required conductivity, dialysate, alarm, and functional verification before returning the machine to service.
Knowing when to stop after ruling out external concentrate and water-supply causes is proper troubleshooting.
Clinical Use Tip
Never use a conductivity adjustment or prescription change to mask an unexplained conductivity problem during patient treatment.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported that dialysate conductivity remained unstable during machine preparation."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the acid concentrate pickup connection was not fully seated and was intermittently drawing air."
Resolution
What action was taken.
Example:
"The connection was reseated, conductivity stabilized during preparation, required checks passed, and the machine was returned to service."
Helpful Details to Include (If Known)
- High, low, or fluctuating conductivity
- Exact displayed message
- Acid concentrate type and condition
- Bicarbonate supply condition
- Concentrate connection condition
- Treated-water availability
- Whether other machines are affected
- Recent disinfection or rinse cycle
- Independent conductivity test result
- Results before and after correction
- Final device status
Final Thought
Protect the patient, verify concentrate and water supplies before assuming an internal fault, confirm conductivity using appropriate testing, escalate persistent instability, and document the final correction clearly.
That is successful troubleshooting.