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Asset Type
Continuous Renal Replacement Therapy (CRRT)
Manufacturer
Model
What This Guide Helps With
Automated priming stops or will not progress despite apparently correct disposable loading, often from tubing, connection, fluid, clamp, or positioning problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Therapy
Do not troubleshoot an unreliable priming or fluid-management function while a patient depends on the affected circuit.
If therapy is required, use another verified PrisMax and correctly prepared disposable set according to clinical protocol.
Expected outcome: The patient is supported independently of the affected device and the stalled system can be evaluated safely.
2. Confirm Where Priming Stops
Ask staff to identify the stage at which automated priming stalled and note any message displayed on the screen.
Determine whether the system consistently stops at the same point or whether the problem occurs intermittently.
Expected outcome: The priming failure is clearly characterized. A reproducible stopping point helps distinguish loading, fluid-path, accessory, or device-related causes.
3. Inspect the Disposable Installation
With no patient connected, visually verify that the installed disposable set is appropriate for the intended setup and is seated without obvious twisting, pinching, stretching, or misrouting.
Check that all externally accessible components are fully positioned in their intended holders, pump segments, guides, and detection areas.
Do not force tubing or defeat mechanical interlocks.
Expected outcome: The disposable is correctly routed and fully seated. Correcting an obvious loading problem allows automated priming to continue, resolving the issue.
4. Check Tubing for Kinks, Occlusions, or Closed Clamps
Trace the accessible fluid path from end to end.
Look for:
- Kinked tubing
- Tubing trapped behind another component
- Closed manual clamps
- Twisted segments
- Capped or obstructed connections
- Tubing pulled too tightly around holders or pump areas
Expected outcome: The external fluid path is open and unobstructed. Correcting an external restriction allows priming to proceed normally.
5. Verify Priming Fluids and Connections
Confirm that the required fluids for the selected setup are present, correctly connected, adequately filled, and positioned as intended.
Inspect connection points for incomplete engagement, collapsed tubing, empty containers, or incorrectly attached lines.
Do not substitute fluids or alter the prescribed setup.
Expected outcome: Required fluid sources are present and properly connected. Correcting a missing, empty, or poorly connected source restores normal priming.
6. Check Bags, Scales, and External Positioning
Verify that attached bags are hanging freely and are not resting against equipment, the floor, another bag, or surrounding objects in a way that could interfere with measurement or fluid movement.
Inspect externally accessible scale hooks and holders for obstruction or improper loading.
Expected outcome: Bags and external measurement components are positioned freely and correctly. Priming proceeds without unintended interference.
7. Inspect Accessible Sensors and Disposable Interfaces
Check externally accessible detector areas and disposable interfaces for contamination, residual moisture, misplaced tubing, or material preventing proper seating.
Clean only according to approved facility and manufacturer guidance.
Expected outcome: External sensing areas and interfaces are clean, unobstructed, and correctly engaged. If contamination or poor seating caused the stall, priming resumes normally.
8. Try a New Approved Disposable When Appropriate
If the loading appears correct but the same disposable repeatedly stalls during priming, replace it with a new approved disposable set when clinically and operationally appropriate.
Do not reuse a questionable disposable merely to continue troubleshooting.
Expected outcome: A known-good disposable primes normally. If it does, remove the original set from use and document the finding.
9. Repeat Automated Priming and Observe the Entire Sequence
Start a new controlled priming sequence with the external setup verified.
Watch for abnormal pump motion, recurring alarms, unusual sound, repeated stopping, or inconsistent guidance.
Expected outcome: Automated priming completes normally without unexplained interruption. If successful, external setup or disposable issues were the likely cause and troubleshooting can stop after verification.
10. Perform Final Functional Verification
Before return to service, verify that the PrisMax:
- Recognizes the correctly installed disposable
- Advances through automated priming normally
- Operates external pumps and clamps as expected
- Displays guidance consistently
- Produces expected alarms or prompts during controlled testing
- Shows no leaks, abnormal noises, or recurrent stalls
Complete any additional manufacturer-required return-to-service checks appropriate to the work performed.
Expected outcome: The complete priming process is repeatable and reliable. The device may be returned to service when required verification passes.
11. Escalate Repeated Priming Failure
If multiple correctly installed approved disposables exhibit the same priming failure after external fluid-path and positioning checks, stop troubleshooting at the external level.
Do not disassemble pump mechanisms, adjust internal sensors, or enter restricted service functions without appropriate authorization and documentation.
Expected outcome: The device is removed from service for qualified bench evaluation.
If the Problem Persists
Common external causes have been ruled out. Remaining possibilities may involve pump operation, clamp actuation, pressure or fluid-detection systems, scale sensing, disposable recognition, internal communication, or control circuitry.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate manufacturer documentation and approved test equipment
- Repaired or configured only by qualified personnel
Following repair, complete all applicable priming, alarm, fluid-path, and functional return-to-service testing before clinical use.
Knowing when to stop after external causes and disposables have been ruled out is proper troubleshooting.
Clinical Use Tip
Never connect a patient to a circuit that did not complete the intended priming sequence successfully and without unresolved alarms.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that the PrisMax repeatedly stopped during automated priming even though the disposable appeared to be loaded correctly."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a section of tubing pinched behind an external holder, restricting the priming fluid path."
Resolution
What action was taken.
Example:
"Clinical Engineering rerouted the tubing correctly, repeated automated priming successfully, verified normal system operation, and returned the unit to service."
Helpful Details to Include (If Known)
- Stage at which priming stopped
- Exact message or alarm displayed
- Disposable type and condition
- Tubing routing and clamp positions
- Priming-fluid availability
- Bag and scale positioning
- Visible leaks or air
- Known-good disposable substitution
- Results of repeat priming
- Final device status
Final Thought
Protect the patient first, then verify disposable loading, tubing, clamps, fluids, bag positioning, and accessible sensing areas before suspecting an internal problem. Confirm successful full priming and document the correction before returning the system to service.
That is successful troubleshooting.