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What This Guide Helps With
Use this guide for repeated blood-leak or air-detection alarms caused by disposables, fluid conditions, positioning, contamination, or detector-related faults.
Step-by-Step Troubleshooting
1. Protect the Patient Immediately
Repeated blood-leak or air-detection alarms involve critical dialysis safety systems. Do not bypass, silence without correction, or defeat these protections.
If a patient is connected, follow clinical procedures to maintain patient safety and treatment continuity. Use another verified machine if the cause cannot be safely corrected through normal clinical workflow.
Expected outcome: The patient is protected and no critical detector is being bypassed.
2. Identify Which Alarm Is Occurring
Determine whether the machine is reporting:
- Blood leak
- Air detection
- Both at different times
- An intermittent detector warning
- A persistent alarm immediately after setup
Record the exact message and when it occurs.
Expected outcome: The specific detector path and operating condition associated with the alarm are known.
3. Inspect the Extracorporeal Circuit for Air
For air-related alarms, have qualified clinical staff inspect the blood tubing and chamber arrangement according to facility procedure.
Check externally for:
- Visible air
- Incorrect chamber fill level
- Loose bloodline connection
- Cracked or damaged tubing
- Tubing improperly positioned in the detector
- Improperly seated disposable components
Do not bypass the detector to continue therapy.
Expected outcome: The blood circuit is correctly assembled, properly filled, and positioned without visible air or damaged tubing.
4. Inspect the Blood Leak Detection Area
For blood-leak alarms, check the accessible detector area and dialysate path for visible contamination, moisture, residue, or improperly seated external components.
A detector area contaminated during prior handling or disinfection may create false indications.
Clean only using approved procedures and materials.
Expected outcome: The detector area is clean, dry, and unobstructed.
5. Verify the Disposable Set and Placement
Confirm that the approved disposable set is appropriate for the machine and has been installed according to normal clinical setup.
Inspect for:
- Twisted tubing
- Flattened tubing
- Misrouting
- Poor detector alignment
- Damaged segments
- Incorrectly installed chambers or holders
If appropriate and permitted, use a new approved disposable set to rule out a defective disposable.
Expected outcome: The disposable circuit is compatible, undamaged, and correctly positioned. If the alarm disappears with a known-good disposable, troubleshooting can stop after verification.
6. Check for Fluid or Optical Interference
Inspect accessible sensor windows and surrounding surfaces for residue, condensation, fingerprints, fluid splash, or other material that could interfere with detection.
Do not insert tools into sensor assemblies or alter detector alignment.
Expected outcome: Accessible sensing surfaces are clean and free of external interference.
7. Reproduce the Alarm Without a Patient
After correcting obvious external conditions, perform the approved setup and machine checks without a patient attached.
Observe whether the alarm returns under controlled conditions.
Expected outcome: The detector passes normal startup or preparation checks without repeated false alarms.
8. Perform Final Functional Verification
Before clinical use, confirm that:
- Required detector checks pass
- No repeated false alarm occurs
- Disposable positioning remains correct
- Relevant alarms remain functional
- Applicable pre-treatment tests complete successfully
Never return the machine to service based solely on temporarily clearing the alarm.
Expected outcome: Detection systems operate normally and required checks pass. Troubleshooting can stop.
If the Problem Persists
If disposable condition, tubing position, detector cleanliness, fluid condition, and approved setup have been verified but blood-leak or air alarms continue, common external causes have been ruled out.
Possible remaining categories include detector sensing, alignment, calibration, signal processing, or other internal service-level faults. These safety systems must not be bypassed or adjusted outside approved service procedures.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate Nipro documentation and approved test equipment
- Repaired or configured only by qualified personnel
Complete all required detector and alarm verification before return to clinical use. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Never defeat an air or blood-leak alarm to keep dialysis running; these alarms protect against potentially serious patient harm.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Dialysis staff reported repeated air detector alarms during SURDIAL X setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found the bloodline tubing was not fully seated in the detector channel."
Resolution
What action was taken.
Example:
"Clinical Engineering corrected tubing placement, repeated the approved setup checks, verified normal detector operation with no repeated alarm, and returned the unit to service."
Helpful Details to Include (If Known)
- Exact alarm text
- Blood-leak or air alarm
- Whether a patient was connected
- Disposable lot or type if relevant
- Tubing and chamber positioning
- Visible air or fluid contamination
- Detector area condition
- Known-good disposable substitution
- Results of detector verification
- Final machine status
Final Thought
Treat repeated air and blood-leak alarms as safety-critical until proven otherwise. Verify the disposable circuit, positioning, and detector area before considering an internal fault, and escalate rather than bypassing an unresolved protection system.
That is successful troubleshooting.