Transonic HD02 Inservice Training Presentation

1
Transonic HD02 In-service Training Presentation
2

• What is HD02?
• HD02 is a continuous quality improvement program
  for vascular access management.
• Purpose
• The purpose of this slide presentation is to
  train or re-train personnel on how to use the
  Transonic HD02 Hemodialysis Monitoring System. It
  reviews the system, measurement protocols,
  troubleshooting tips and database administration.

3
Transonic Flow QC Hemodialysis Monitoring

• A New Standard
• of Care for the
• ESRD Patient

4
Transonic Flow QC Hemodialysis Monitoring
Training Topics

• K/DOQI Guidelines
• HD02 Hemodialysis Monitoring System
• Measurement Protocols
• Troubleshooting Tips
• Administrator Program

5
K/DOQI Guidelines for Monitoring AV Grafts and
Fistulas

• Intra-access flow measurements are the preferred
  method of A-V graft and fistula surveillance.
• A patient with an access flow less than 600
  ml/min should be referred for fistulogram.
• A patient with an access flow less than 1000
  ml/min that has decreased by more than 25 over
  four months should be referred for fistulogram.

6
K/DOQI Guidelines for Recirculation

• Any access recirculation is abnormal.
  Recirculation exceeding 5 using a non-urea based
  dilutional method should prompt investigation of
  its cause.
• If access recirculation values exceed 20,
  correct placement of needles should be confirmed.

7
HD02 Hemodialysis Monitoring System

• Monitor
• Sensors
• Laptop Computer
• HD02 Software
• Rolling Stand
• Cardiac Output Accessories
• Flow-QC Tubing
• Syringe Warmer

8
Transonic Flow QC Hemodialysis Monitoring
Provides highly accurate and immediate assessment
of

• 1) Delivered Blood Flow
• 2) Vascular Access Recirculation
• 3) Vascular Access Flow
• 4) Cardiac Output

9
HD02 Features

• Provides routine monthly vascular access
  surveillance during dialysis for fistulas, grafts
  and catheters.
• Easy-to-use software that guides the operator
  step-by-step through the measurement protocols.
• Displays comprehensive on-screen patient
  histories.
• Calculates patient and clinic statistics.
• Identifies patients at risk for thrombosis.
• Documents interventions and access history.
• Generates and prints detailed reports.
• Imports and exports existing patient databases.
• Provides an extensive tubing library for
  automatic tubing selection.

10
Setup Monitor, Sensors and Laptop

• Connect laptop to monitor using 9-pin or USB
  cable.
• Plug in and turn on laptop and monitor.
• Plug sensors into front of the monitor.
• Open sensor door and add petroleum jelly into the
  sensing cavity of the sensors.
• Place sensors on bloodlines 2-4 inches from the
  needle connection.
• Clip red sensor on arterial line in direction of
  flow.
• Clip blue sensor on venous line in direction of
  flow.

11
Hemodialysis Setup with HD02
HD02
HD02
12
Check Signal Quality and Delivered Blood Flow
13
Difference Between Delivered and Prescribed Blood
Flow Should be 10

• If gt 10, check
• Needle size
• Needle placement
• Condition of access
• Roller pump tubing segment occlusion or dialysis
  tubing kinked
• Change in blood line type
• Calibration of dialysis machine
• Calibration of sensors

(see troubleshooting section for possible
solutions)
14
Launch Software

• To launch the HD02 software, double click on the
  dilution curve icon on the computer desktop

15
HD02 Main Software Screen

• From the main software screen, the options are to
  select on Monitor, Administrator, Setup or Update
  Tubings.

16
Setup

• To enable the setup features, click on the
  setup icon in the main program screen. Click on
  the check box to enable a parameter.
• Please note that entering Track Systolic and
  Diastolic Pressures, Track Pump Flow, Track
  Minutes into Treatment and Track Height and
  Weight are optional and will add time to the
  measurement protocol.

• FEATURES
• Enable Cardiac Output Measurements enables the
  Cardiac Output measurement option including
  specific trends and reporting capabilities.
• Track Systolic and Diastolic Pressures enables
  the Blood Pressure and Plot Access Resistance
  option.
• Track Pump Flow enables the pump flow option.
• Track Minutes into Treatment enables the option
  for tracking how many minutes into treatment the
  measurement was taken.
• Track Height and Weight enables the height and
  weight.
• Calculate Pediatric Qa enables the option for
  automatically adjusting the Access Flow for
  pediatric patients.
• Serial Device choose either 9-pin serial cable
  or USB connection to the meter.
• Click OK to save the settings.

17
Update Tubings

• To update the tubing list, insert the tubing list
  floppy disk into the floppy drive. Click on the
  Update Tubings icon. The tubing list will
  automatically copy to the hard drive.
• To update the latest version of the tubing list,
  go to the Transonic Systems website at
  www.transonic.com. Click on Hemodialysis
  Products, scroll down to Tubing Lists To update
  tubing lists to current version, click here.
  Update Your HD02 Tubing List Here and follow the
  directions to download the tubing list to a
  floppy disk

Update your HD02 tubing list heretubings.csv Rig
ht click on the tubings.csv link and save to a
floppy disk. This file can be saved to your HD02
laptop to give you the most current tubing
selections. Open Updates.txt to see the latest
changes to the HD02 tubing list.
18
Monitor Program

• To test patients, click on the Monitor icon

19
Select Patient

• To select a patient, scroll and click on a
  patient name or use the up and down arrow keys
  (If there is a large number of patients, the
  first letter of the patients last name will act
  as a short cut).
• When the appropriate patient name is highlighted,
  click Start Patient Session or press the Space
  Bar.

20
Add Patient

• To enter a new patient into the database, click
  Add New Patient or press F1.
• Enter the first and last name of the patient,
  patient ID and clinic.
• Optional information can be entered for group
  name, Nephrologist, Vascular Surgeon and
  Interventional Radiologist.

21
Initial Access Information

• In the Add Patient window, click on the Initial
  Access Information tab.
• Select initial access type and initial access
  location by clicking on the down arrow and
  selecting from the list.
• Select date of initial access placement by
  clicking the up/down arrows to select year, on
  the down arrow to select month and then click on
  the day of the month.
• Clicking on the exclamation point will default to
  the current date.

22
Access Function Guidelines

• In the Add Patient window, click on the Access
  Function Guidelines tab to select access flow
  thresholds for evaluating access function.
• The thresholds are used to identify a patient at
  risk for access failure. Select either Apply
  K/DOQI Guidelines (default) or Apply Modified
  Guidelines to this patient.
• Apply Modified Guidelines allows the thresholds
  to be changed for a particular patient. To change
  the thresholds, click in the small windows and
  type in the new values for access flow and
  percent decrease over 4 months.
• Click OK to save.

23
Communication Between Monitor and Laptop

• Immediately after selecting Start Patient
  Session, the system will check for communication
  between the monitor and laptop.
• The green checkmark indicates successful
  communication.

24
Select Tubing

• Click on the tubing icon in the upper right-hand
  corner of the screen or press F2.
• Transonic Flow-QC tubing is the default tubing.
  Click the down arrow and scroll down or use the
  first letter of the tubing manufacturer as a
  shortcut to select the tubing being used for the
  patient.
• Click on the correct tubing and then OK to save.

25
Optional Session Parameters

• When a measurement protocol is selected, the
  Optional Session Parameter screen will appear.
  Entering these parameters are optional and only
  need to be entered once per patient session.
• Appearance of this screen is dependent on which
  parameters are enabled in Setup. Enter the
  following information systolic pressure,
  diastolic pressure, prescribed pump flow,
  Transonic pump flow, minutes into treatment,
  height and weight.
• Click OK to save.

26
Access Recirculation
27
Benefits of Measuring Access Recirculation

• Transonic is the only technology that identifies
  access recirculation.
• Optimizes Catheter Performance.
• Detects inadvertent reversal of dialysis lines.

28
Recirculation is Tested in the Normal Line
Position
Black arrows simulate saline flow either by
saline release or bolus injection in the presence
of recirculation
29
Access Recirculation Protocol

• Click on the recirculation icon in the lower
  right corner of the screen or press F9.
• Entered optional parameters and click OK.
• Click on Start Protocol or press the Space Bar.
• When the traffic light turns green, open the
  pressure limits on the dialysis machine.
• Release saline from the saline bag for 5 to 6
  seconds or inject 10 ml of saline before or into
  venous bubble trap.
• The software will count down from 60 seconds
  during the measurement process.

30
Abort Analysis

• To cancel a measurement, click on the Abort
  Analysis icon in the middle of the screen.
• You can abort the analysis of any measurement at
  any time during the 60 second countdown.
• The main reason for aborting the analysis is
  because the pump has stopped.

31
Access Recirculation Result
The Dilution Curve and Percent Recirculation will
appear on the screen. The measurement result is
stored in the measurement table.
32
gt0 Recirculation (REC)

• If the initial recirculation value is gt0, please
  follow these steps
• Repeat measurement at same pump flow as first
  measurement.
• If REC is gt0, stop dialysis blood pump, reverse
  blood lines and repeat measurement at same pump
  flow as the previous measurement.
• If REC is 0 or REC is lt initial value, blood
  lines are inadvertently reversed.
• If REC is gt initial value, blood lines were in
  normal position for the initial measurement and
  REC is present.

33
Vascular Access Flow
34
Vascular Access Flow is Tested in the Reversed
Line Position
Black arrows simulate saline flow either by
saline release or bolus injection during access
flow measurement
35
Vascular Access Flow Protocol

• Click on the Access Flow icon in the lower right
  corner of the screen or press F10.
• Stop the dialysis blood pump, reverse the blood
  lines at the needle connection and set the
  dialysis pump at 250-300 ml/min.
• Enter optional parameters and click OK.
• Click on Start Protocol or press the Space Bar.
• When the traffic light changes to green, open the
  pressure limits on the dialysis machine.
• Release saline from the saline bag for 5 to 6
  seconds or inject 10 ml of saline before or into
  venous bubble trap.
• The software will count down from 60 seconds
  during the measurement process.

36
Access Flow Result
The Dilution Curve and Access Flow value will
appear on the screen. The measurement result is
stored in the measurement table.
37
Very Important
When you end the patient session or conduct a
recirculation or cardiac output measurement after
the access flow measurement, reverse bloodlines
back to normal position.
38
Cardiac Output
39
Cardiac Output Measurement

• Arrows simulate saline flow through
  cardiopulmonary system during cardiac output
  measurement

HD02
40
Cardiac Output Setup

• Flow-QC tubing is required for Cardiac Output
  measurements.
• Insert Flow-QC tubing set (see instructions
  inside the Flow-QC tubing box) into the
  hemodialysis circuit during priming of the
  dialysis line.
• Remove all air bubbles from the Flow-QC tubing
  set during priming.
• Place three 30 ml Becton-Dickinson syringes into
  the syringe warmer. Please refer to the syringe
  warmer instructions for use.

41
Required Parameters

• Height, weight, heart rate and blood pressure
  are required parameters that need to be entered
  in order for the system to calculate Cardiac
  Index, Central Blood Volume, Central Blood Volume
  Index, Peripheral Resistance, Systemic Cardiac
  Index and Stroke Volume.

42
Cardiac Output Protocol

• Make sure sensors are placed on the Flow-QC
  tubing.
• Select Flow-QC tubing from the tubing list.
• Click on the Cardiac Output icon in the lower
  right corner of the screen or press F11.
• Enter optional parameters and click OK.
• Set pump to 200 ml/min.
• Click on Start Protocol or press the Space Bar.
• Enter required parameters. Click OK.
• When the traffic light turns green, open the
  pressure limits on the dialysis machine.
• Inject 30-ml of warmed saline into the injection
  port of the Flow-QC tubing.
• The software will count down from 60 seconds
  during the measurement process.

43
Cardiac Output Result
Cardiac Index
Central Blood Volume
Click on Tab 2 for more parameter values
The Dilution Curve and Cardiac Output value will
appear on the screen. The measurement result is
stored in the measurement table.
44
Interpretation of Cardiac Output Results can be
found on the HD02 Quick Reference Guide Cardiac
Output Procedure or in the Cardiac Function
Assessment During Hemodialysis Handbook
45
End Patient Session

• To end a patient
• session, press F1 or
• click the stop session icon.

46
TroubleshootingTips
47
Saline Release
Release saline 5-6 seconds from infusion bag.
48
Bolus Injection

• Use saline injection method whenever the pump
  flow is below 200 ml/min or no result is obtained
  with saline release method.
• Draw 10 ml of saline from patients saline bag
  and inject at a steady pace before or into the
  Venous bubble trap.

49
Venous Pressure Alarms
When releasing saline, open the venous pressure
limits to avoid pump stoppage.
50
Low Flow
An access with low flow and NO recirculation
could indicate a stenosis between the needles.
51
Incorrect Sensor Placement

• Problem Ultrasound signal quality indicator is
  not full or there is a negative delivered flow
  reading on the HD02 monitor.
• Possible Solutions
• Check that the sensors are on the blood line
  tubing, not on the needle tubing.
• Check that the arterial sensor is on the arterial
  blood line and the venous sensor is on the venous
  blood line.
• Check that the arrows on the sensors are pointing
  in the direction of flow.
• Apply a small amount of Vasoline in the sensing
  cavity of the sensors.

52
10 Difference Between Delivered and Prescribed
Blood Flow

• Possible Causes
• Mis-calibration of dialysis machine and/or
  Transonic H4E Sensors.
• Flow limited by needle size or needle placement.
• Not adequate roller pump tubing segment occlusion
  or dialysis tubing kinked.
• Possible Solutions
• Check for occluded or kinked tubing.
• Make sure the selected tubing in the software
  program matches the tubing used on the patient.
• Set dialysis machine pump flow at 200 mL/min and
  compare it to the delivered pump flow
• If difference is lt6, then calibration of
  dialysis machine and sensors are OK. Check the
  following
• Make sure that the tips of the needles are not
  pressed against the wall of the access.
• Consider needle size.
• If difference gt6, check calibration of dialysis
  machine and/or Transonic H4E Sensors.

53
Catheters
When testing catheters, you cannot measure Access
Flow or Cardiac Output.
54
Administrator Program
55
After launching the software, click on the
administrator icon
56
Clinic/Patient Tree

• The house icon represents a clinic. Click on the
  magnifying glass to view list of patients.
• The person icon represents a patient.
• The red exclamation point represents a patient on
  the alert list.
• The trash icon represents deleted data.

57
Data Review Operations
Show Measurement Graph
Identify Patients
Statistics
Reports
58
Statistics

• Statistics work on all three levels of the
  database tree clinic, group, and patient.
• For example, to view the statistics on a
  particular clinic, highlight the clinic in the
  tree in the upper left-hand section of the
  screen, and click the statistics icon. This will
  display a window with statistics on all the
  measurements for the clinic.
• More specific statistics are available for each
  type of measurement and intervention by selecting
  the tabs at the top of the window.
• The options are to print the statistics or copy
  printout to disk.

59
Identify Patients

• To search the database for patients with certain
  criteria, click the identify patients icon.
• This feature can be used to identify patients on
  the alert list, identify patients by criteria,
  identify patients not measured in the last of
  days and identify patients not measured since a
  particular date.
• After selecting search criteria, click OK to
  search database.
• Each patient that matches the identify criteria
  will have the identify patients icon placed next
  to their name in the patient tree.

60
View Identified Patients List

• Once the patients have been identified, click on
  Database Operations and then View Identified
  Patients List.
• This will display a list of all the patients that
  match the criteria.
• The options are to Print List, Print Short Report
  or OK to exit the list.

61
Show Measurement Graph

• To view a particular dilution curve, click on a
  measurement in the measurement table and then
  click the Show Measurement Graph icon.
• The dilution curve will be displayed.
• The options are to print the graph, copy printout
  to disk or copy curve to disk.
• Note Occasionally, Transonic technical support
  personnel will want to troubleshoot a particular
  measurement in question. Use the Copy Curve to
  Disk option in order to attach the file to an
  e-mail message to send to Transonic.

62
Reports

• To generate a report for a patient, select the
  patient in the database. Click on the report
  icon.
• Click on the short 1-page report, the full 5-page
  report or the custom report.
• Click the Generate and Print Report icon.
• This will create a report in the existing report
  window and then display the report on the screen.
• In the print window, click OK to print report.
• Reports can also be generated for clinics and
  databases by selecting the clinic or database in
  the tree and clicking the report icon.
• Other options are to Copy Selection to Disk or
  Delete Selection.

63
Example of Short Report

• The short report shows
• patient name
• patient ID
• clinic name
• physician names
• most recent weight
• most recent access flow
• most recent cardiac output
• current access location, type and creation date
• last intervention type and date
• access flow trending graph
• cardiac output trending graph

64
Database OperationsDrop-down Menu
65
View Alert List

• View Alert List displays a list of all patients
  falling below the set access flow thresholds that
  are entered into each patient's profile.
• The options are to print the Alert List, print a
  short report of all alert list patients or to
  change the fistulogram referral state field.
• Clicking the Change Fistulogram Referral State
  button places a check mark next to a selected
  patients name on the Alert List to identify that
  the patient has been referred for a fistulogram.
• Click OK to exit the alert list.

66
View Logs

• View Logs displays daily log files as a summary
  of daily activity.
• Log files are arranged by year. To access the log
  files, click on the magnifying glass next to the
  appropriate year, and then click again on the the
  appropriate month. Highlight the desired day and
  the log file will appear on the right side of the
  software screen.
• The options are to print the log file or copy the
  log file to disk.

67
View Patients By Nephrologist

• View Patients by Nephrologist sorts the database
  for each Nephrologist.
• Each green person icon indicates a separate
  Nephrologist.
• If a patient's Nephrologist is not entered, the
  patient will be listed under "Unknown".
• The database can also be sorted by Vascular
  Surgeon, Interventional Radiologist or Group.

68
View Patient Trace Plus Database

• This function views CSV files (from HD01
  monitors) that may be saved on the HD02 computer
  or other disk drives. A browsing window is used
  to find, select and view a file.

69
Import PatientTrace Plus Database

• This function imports CSV files from existing
  HD01 database files into an HD02 database file.
• A browsing window is used to find, select and
  import a file.
• Type a name for a new clinic database or select
  an existing one from the pull down list.
• When importing CSV files, it is best to import
  into a new clinic. Importing a CSV file into an
  existing clinic may result in lost data.

70
Export as PatientTrace Plus Database

• This function exports the HD02 database
  information to a PatientTrace Plus CSV file,
  which can be transferred to an HD01 laptop or
  other applications such as Microsoft Excel.
• To export all the data from the current database
  to a CSV file, select Export PatientTrace Plus
  Database.
• Select a current CSV file or create a new CSV
  file.
• A CSV file name will automatically be created
  (exported.csv) or type over the name in the box.

71
Back-up/Restore Data

• To backup data, select the Backup/Restore.
• Press the New Backup button. It is suggested that
  you backup your data before using the other
  functions available on this screen.
• To restore your data to a previous date, select a
  date from the list of backups or press the
  Retrieve Backup from Disk button and follow the
  on-screen instructions.
• After a backup is selected, you can use one of
  the four buttons to preview, copy, restore, or
  delete the selection.

72
Clinic Operations Drop-down Menu
To perform a clinic operation, you must select a
clinic from the clinic/patient tree.
73
View Alert List and Export as PatientTrace Plus
Database

• View Alert List and Export as PatientTrace Plus
  Database in Clinic Operations are the same
  functions as in Database Operations, except these
  functions are for individual clinics only.

74
Rename Clinic

• To rename a clinic, click on the desired clinic,
  select Clinic Operations and select Rename
  Clinic.
• Type the new name in the blank space provided and
  press the OK button.

75
Patient Operations Drop-down Menu
To perform a patient operation, you must select a
patient from the clinic/patient tree.
76
Add Patient

• The Add Patient function is identical to the Add
  Patient function in the Monitor program.
  Selecting this menu will give you a template on
  which to enter patient information.

77
Edit Patient

• To edit patient data, click on the patient name
  from the clinic list.
• Select the Patient Operations menu and select
  Edit Patient. This will give you a template to
  edit the patient information.
• Click OK to save new information.

78
Merge Patient

• The Merge Patient function consolidates patients
  that have been entered twice, have two different
  ID numbers, etc.
• To merge patient information, select the source
  patient to be merged from the clinic list.
• Under Patient Operations, select Merge Patient.
  From the next menu select a target patient to
  merge the information into and select OK.

79
Delete Patient

• To delete a patient from the clinic list, select
  a patient.
• Under Patient Operations, select Delete Patient.
• The patient will disappear from the list and you
  will be prompted to confirm your decision Do you
  want to continue?
• Click Yes and then OK.
• The patients information will be sent to the
  trashcan.

80
Restore Patient

• From the trashcan, click on the clinic and
  highlight the patient to be restored.
• Under Patient Operations, select Restore Patient.
• This function will restore that patient's
  information to the main database.

81
New Intervention

• The HD02 Administrator program can catalog
  vascular access interventions.
• To add an intervention to a patients record,
  highlight the desired patient name from clinic
  list.
• Select the Patient Operations menu and choose New
  Intervention.
• This will give you a template to enter
  intervention type, access location, date and text
  notes.
• Press OK to save.

82
Measurement OperationsDrop-down Menu
To perform a measurement operation, you must
select a measurement from the measurement table.
83
Edit Intervention

• To edit an intervention, select the patient.
• Select the desired intervention from the list of
  measurements in the bottom half of the screen
  (intervention entries are coded in the Mode
  column with a yellow IVT label).
• Select the Measurement Operations menu and select
  Edit Intervention.
• The Edit Intervention template will appear
  displaying the current intervention information.
• Change the appropriate information and click OK.

84
Add Note

• To add a note to a measurement, select the
  patient from the patient list.
• Highlight the desired measurement from the table.
  
• Select Measurement Operations and then Add Note.
  
• Type notes in the space provided and select the
  OK button.

85
Edit Note

• To edit a note added to a patients measurement
  list, select the line in the measurement list
  that contains the note.
• Select the Measurement Operations menu and select
  Edit Note.
• Make the appropriate changes to the note and
  click OK to save the information.

86
Delete Measurement

• This function deletes unwanted measurements,
  interventions, and notes.
• Click on the appropriate patient. Highlight the
  row in the bottom half of the screen containing
  the unwanted data.
• Select the Measurement Operations menu and select
  the Delete Measurement option (multiple
  measurements can be deleted by holding down the
  Control key (CTRL) and selecting the desired
  measurements with the mouse).
• The measurements will disappear from the list and
  you will be prompted to confirm your decision Do
  you want to continue?
• Click Yes and then OK.
• The deleted measurements will be sent to the
  trashcan.

87
Restore Measurement

• This function will restore the highlighted
  measurement information to the appropriate
  patient.
• Open the Trashcan and select the desired clinic
  and patient. Highlight the desired measurement
  and press OK.

88
Move Measurement

• The Move Measurement function allows you to move
  measurements that were performed on the wrong
  patient.
• To move measurements, select the measurements
  from the source patient to be moved.
• Under the Measurement Operations menu, select
  Move Measurement.
• Select a target patient to move the information
  into and select OK.

89
Historical Trending and Patient Information
Peripheral Resistance Profiling
Cardiac Output Profiling
Cardiac Index Profiling
Cardiac Output Graph
Access Flow Graph
Patient Summary
Access History
Patient Notes
90
Access Flow Trending
Graph showing the access flow measurement values
for a patient. Intervention history (yellow
triangles) and the K/DOQI Guideline Threshold
(red line) are also shown.
Documented Intervention
K/DOQI Guideline lt600 ml/min
91
Cardiac Output Trending

• Graph showing the average Cardiac Output
  measurement values for a patient.

92
Cardiac Output Profiling

• CO-CBV graphs the values of Cardiac Output and
  Central Blood Volume over a 6-hour session.

93
Cardiac Index Profiling

• CI graphs the values of Cardiac Index, Heart
  Rate and Mean Arterial Pressure over a 6-hour
  session.

94
Peripheral Resistance Profiling

• PR- graphs the values of Peripheral Resistance,
  Heart Rate and Mean Arterial Pressure over a
  6-hour session.

95
Patient Summary

• To view information on a patient, click on the
  patient name and then click on the patient icon.
• This is the same patient information that appears
  on the reports.
• The information includes patient name, patient
  ID, physician names, most recent weight, most
  recent access flow, most recent cardiac output,
  current access location, current access type,
  current access creation, last intervention type
  and last intervention date.

96
Access History

• To view information on access history for a
  patient, click on the patient name and then click
  on the scroll icon.
• This will display a table of the date and text
  for each surgical and interventional procedure.

97
Patient Notes

• To view notes on a patient, click on the patient
  name and then click on the notepad icon.
• All previous notes will be displayed.
• To add new notes, click in the editor window and
  type in new notes.
• Click Save to save new notes.

98
Table of Measurements

• Tabulates all measurements taken for that
  patient.
• The table includes date, time, minutes into
  treatment (?t), mode, access type and text notes.
  
• The mode column includes the following
  abbreviations
• AXFLW Access Flow Measurement
• REC Recirculation Measurement
• CO Cardiac Output Measurement
• IVT Documented Intervention
• Session Treatment Session Information

99
Please refer to the HD02 Operators Manual or
Quick Reference Guides for more details on using
the HD02 Hemodialysis System
100
Any additional questions can be answered by
calling Transonic Customer Service Department at
800-353-3569 or your local Transonic
representative.Transonic Websitewww.transonic.
com