Baxter PrismaFlex

Asset Type

Continuous Renal Replacement Therapy (CRRT)

Manufacturer

Baxter

Model

PrismaFlex

What This Guide Helps With

This guide helps troubleshoot the Baxter PrismaFlex HP Cartridge Clotted alarm. This alarm may be associated with cartridge pressure drop, hemopurification cartridge clotting, blood-flow restriction, anticoagulation-delivery problems, or pressure measurement issues.

A clotted or restricted HP cartridge can affect CRRT therapy delivery, increase circuit pressure, reduce treatment effectiveness, and may create patient safety concerns if the circuit condition prevents safe continuation of therapy.

Step-by-Step Troubleshooting

Ensure Patient Safety First

• If the PrismaFlex is actively connected to a patient, involve the clinical care team immediately.
• Do not continue treatment on a CRRT system with unresolved clotting alarms unless the care team determines it is safe to do so.
• If treatment cannot safely continue, remove the device from patient use according to hospital procedure.
• Confirm patient support is maintained while the alarm is evaluated.

Verify the Reported Alarm and Behavior

• Confirm the exact alarm displayed is HP Cartridge Clotted.
• Document whether the alarm occurred at treatment startup, shortly after treatment began, after extended runtime, after a blood-flow change, or after an anticoagulation change.
• Check whether the alarm is intermittent, repeated after reset, or associated with rising cartridge pressure drop.
• Look for related symptoms such as reduced treatment performance, visible clotting, pressure-related alarms, or syringe pump concerns.

Inspect the Blood-Flow Lines for Simple Restrictions

• Check the blood-flow path for clamped lines, kinked tubing, pinched tubing, or tubing caught near doors, clamps, cartridge holders, or equipment.
• Verify tubing is routed without excessive tension.
• Correct any obvious external restriction found.
• Observe whether the alarm clears and whether pressures stabilize.

Check for Visible Cartridge or Circuit Clotting

• With the clinical team, visually inspect the HP cartridge and accessible circuit areas for darkened blood path, fibrin buildup, visible clot formation, or uneven flow appearance.
• Review pressure trends for signs of progressive restriction.
• Do not disconnect or manipulate the extracorporeal circuit outside hospital procedure.
• If clotting is suspected, follow facility procedure for managing the treatment set.

Review Anticoagulation Status With Clinical Staff

• Ask the care team to confirm whether anticoagulation is ordered, active, and appropriate for the therapy.
• Check for an empty anticoagulant syringe, incorrect syringe installation, paused syringe pump, occluded anticoagulant line, or incorrect anticoagulation settings.
• Document any recent changes in clotting parameters or known patient clotting concerns reported by clinical staff.
• Do not make clinical anticoagulation decisions unless authorized by facility policy and role.

Confirm the Anticoagulant Delivery Path

• Externally inspect the anticoagulant delivery setup.
• Verify the syringe is seated correctly and the syringe plunger is engaged.
• Check that tubing is connected correctly, not clamped, not kinked, and not leaking.
• Look for syringe pump alarms or unusual syringe pump behavior.

Evaluate Blood Flow Setting With the Care Team

• Review whether the blood flow rate is appropriate for the access, cartridge, and patient condition.
• Ask clinical staff whether recent blood-flow adjustments preceded the alarm.
• If clinically appropriate, the care team may adjust therapy settings according to hospital protocol.
• Document any setting-related findings reported by the care team.

Do Not Continue With a Suspected Clotted Cartridge

• If clotting has occurred or the alarm remains present after correcting line restrictions, do not rely on the affected set for continued therapy.
• Follow PrismaFlex operating procedure and hospital policy for stopping treatment and changing the set when required.
• Coordinate all treatment-set actions with the clinical care team.
• Do not attempt internal disassembly or bypass of alarm functions.

Perform Device Self-Test if Pressure Measurement Failure Is Suspected

• If the alarm occurs without visible clotting, without line restriction, and with appropriate anticoagulation delivery, remove the device from active patient use when clinically safe.
• Perform the required self-test or bench evaluation according to facility service procedure.
• Evaluate whether pressure measurement is functioning correctly before returning the device to service.
• Escalate for service if pressure measurement failure is suspected.

Check Syringe Pump Function if Anticoagulant Delivery Failed

• If anticoagulant delivery failure is suspected, evaluate syringe pump function during bench testing.
• Check for abnormal syringe pump movement, failure to advance the syringe, mechanical binding, syringe detection issues, or repeated syringe pump alarms.
• Run appropriate diagnostic testing according to service procedure.
• Remove the device from service if the syringe pump cannot reliably deliver as intended.

Isolate the Likely Cause

• If a clamp or kink is found, the issue was likely external line restriction.
• If visible clotting is present, the issue is likely cartridge or circuit clotting.
• If anticoagulant delivery is interrupted, the issue may be syringe setup, syringe pump behavior, or clinical anticoagulation status.
• If no clotting or external cause is found, pressure measurement failure should be considered.
• If the alarm repeats after set replacement and proper setup, the device requires service evaluation.

Stop When Resolved

• If the alarm clears after correcting an external restriction and the clinical team confirms therapy can safely continue, monitor for recurrence.
• If the set is changed and the replacement set operates normally with stable pressures, document the resolution.
• Return the device to service only if no device failure is suspected and all required checks pass.

If the Problem Persists

If the HP Cartridge Clotted alarm continues after external restrictions, cartridge clotting, anticoagulation setup, and syringe delivery issues have been addressed, remove the PrismaFlex from service.

Label the device Out of Service and send it for repair or bench evaluation.

At that point, external causes have been ruled out, and persistent alarms may indicate pressure measurement failure, syringe pump malfunction affecting anticoagulant delivery, or another internal device fault.

Clinical Use Tip

Never troubleshoot a PrismaFlex clotting alarm on an active patient without involving the clinical care team. Move or support the patient on a backup device or therapy plan first if extended troubleshooting is needed. Do not rely on a CRRT device with unresolved clotting, pressure, or anticoagulant delivery alarms.

Work Order Documentation (CCR Method)

CCR = Complaint, Cause, Resolution

Complaint

What was reported by the clinical staff.

Example:
"PrismaFlex reported Alarm: HP Cartridge Clotted during CRRT treatment. Staff reported cartridge pressure drop alarm and concern for possible hemopurification cartridge clotting."

Cause

What was observed during troubleshooting.

Example:
"Inspection found restricted blood-flow tubing at the cartridge inlet. Line was corrected and alarm cleared. No device pressure measurement failure was identified during observation."

Resolution

What action was taken.

Example:
"Unclamped and rerouted restricted blood-flow line. Verified HP Cartridge Clotted alarm cleared and pressures stabilized. Device remained in service after clinical team confirmed treatment could continue."

Helpful Details to Include (If Known)

• Alarm behavior
• Accessories swapped
• Power behavior
• Environmental factors
• Indicator lights
• Final device status

Final Thought

The HP Cartridge Clotted alarm should be treated as a therapy-impacting pressure condition until proven otherwise. Start with patient safety, confirm the exact alarm, check for line restriction, cartridge clotting, and anticoagulation-delivery issues, then escalate when pressure measurement or syringe pump failure is suspected. Clear documentation helps separate clinical circuit clotting from equipment failure and supports safe return to service.

That is successful troubleshooting.