CVVH操作指南用户,pps
贝朗CRRT CVVH操作规程
背景亮BP+ (增加血泵速度) 背景暗BP- (降低血泵速度) 维修模式EQ (确认结果)对比度增加 +(上/右)对比度降低 -(下/左)RAM 测时从新启动(1 秒)(激活命令)转换语言SN (废液壶)维修屏幕(壶液面下降)贝朗CRRT CVVH操作规程1．打开电源开关：打开机器背后的电源控制开关（ON/OFF）2．必须确定两个控制系统检测一致，用户必须比较屏幕上显示的特征线，并按EQ键确定。
3．用和键来选择连续性透析治疗，用键确定，再选择CVVH并用键确定。
4．选择好治疗方式后，机器开始硬件自检测试，A继电器自检，B安全空气检测硬件检测，C安全空气检测定标，D红色（血液）检测器自检，E漏血监测器测试，F零压力自检5．硬件测试通过后进行管路安装及治疗参数设臵。
管路安装步骤：A挂盐水袋和臵换液袋到秤上。
B 放滤器到滤器夹子里，静脉（蓝）端朝上。
C 安装和连接臵换液管（绿），夹住不用的接头。
D 挂超滤收集袋到秤上，夹住出口。
E 穿过漏血，安装超滤管（黄），夹住不用的侧管。
F 挂静脉收集袋到输液杆。
G安装和连接静脉管（蓝）和动脉管（红）。
6．确认必要的夹子是打开的，然后启动“预冲”血泵自动运转。
7．在准备阶段结束后，系统会出现声音信号并且显示治疗选择的功能，按显示的指导操作。
（如果需要，可以继续按冲洗键进行冲洗）8．通过“进入治疗”键可以自动进行用户参数设臵。
9．设臵好参数通过“进入治疗”进入治疗状态。
10．处于治疗状态。
用EQ键确认漏血校正，血泵开始转动进行血循环。
11．停血泵连接病人，并调节血泵转速，检查动静脉压力是否正常。
12．当血泵运行2-3分钟后没有报警就可以开始治疗了，按治疗 键来激活进入治疗。
注意: 治疗过程中动脉壶面应为50%壶高，静脉壶面应为80%壶高。
13．在菜单选择中可以选择结束治疗。
当结束治疗阶段被激活后，虽然补液泵停止，但血泵仍然转动，转速降低 (50ml/min)14. 用户将动脉管路从病人身上取下，连接到盐水袋上。
CVVH操作指南用户,pps
Terminate bag change?
Clinical & Training Department
治 疗
治疗菜单
--暂时中止治疗
•
进入天平数据菜单 点击平衡开关键 off
Clinical & Training Department
治 疗
治疗菜单
--暂时中止治疗
• 点击ESC两次返回主菜单，血流量
Clinical & Training Department
血泵的流量率
在这里血泵的流速是100 毫升/分钟，超滤 率/血泵流速显示为红颜色37% 因此，如果我们继续下去，血液浓缩的结 果将会发生，滤器堵塞的可能性大。 血泵流量已经增加到 300 毫升/分钟和 超 滤率/血泵流量比率是减少12%
血泵流量已经增加到 200 毫升/分钟和 超 滤率/血泵流量已经减少18%
Clinical & Training Department
按图示顺序安装管路
•
•
•
•
•
安装肝素泵
按图示顺序安装管路
•
•
必须使用50 ml注射器
按▼键，使推进器打开至最大 位置
•
排出肝素注射器内的空气，将 注射器与动脉管路系统的肝素 管端口（f）连接。
将注射器放在注射器支架上 注射器必须嵌入注射器插槽内 按住▲键，使注射器活塞末端 嵌入推进器的夹子中间。与注 射器活塞末端相接触。
Clinical & Training Department
动静脉、废液管路的安装排列
按图示顺序安装管路
CVVH
• • • • • • •
•
• •
将血液滤过器装于固定架上 打开血泵、废液泵门，空气监测 器，光学监测器和漏血监测器。 将静脉气泡捕捉器插入在空气监 测器中。 装入动脉泵管和废液泵管路使管 路卡入血泵和废液泵凹槽内。 按住“START/RESET”键，将泵管 带入凹槽内。关上泵门。 连接动脉，静脉，废液连接器。 连接红色（动脉），白色（滤器前） ，蓝色（静脉），黄色（滤过液）的 压力传感器。 将静脉血路管安装在管路夹和光 学监测器中。 连接废液管路至废液袋。 将废液管路安装在漏血监测器中 。
(仅供参考)CRRT中CVVH模式操作流程
置 换 液 管 路 安 装
滤 出 液 管 路 安 装
检查管路安装
预充
预充
备妥治疗
注
预充期间必须是“后稀释“，否则仪器测试 无法通过，预充结束改“前稀释”。
参数设置
u遵医嘱设定安全相关参数，置换液流量、超滤率、血 流量、肝素追加量。 置换液流量：一般为2000ml/h。 超滤率:根据病人血压，病情等各项指标决定。 血流量：一般调160~180ml/min。 肝素追加量：NS18ml+肝素钠2ml(一般以
检查显示屏幕上的动脉和静脉压值是否在正常范围内
换袋
选择“袋子更换” 进行换袋后 反选“袋子更换” 回到“治疗”
结束治疗
断开病人
停止血泵 从病人动脉接口断开动脉管路并将其连接到生理盐水
开启血泵并将管路中血液输回病人体内 在生理盐水即将进入病人体内之前停止血泵
从病人静脉接口断开静脉管路 为病人进行冲封管，选择“新的治疗”，关机，
CRRT中CVVH模式操作流程
心脏监护室 李腾龙
CRRT简介
定义
lCRRT(连续性肾脏替代疗法，又名CBP)是指连 续缓慢地清除体内的水分及毒素，以替代肾脏功 能而进行的持续至少24小时的体外血液净化治 疗技术。
CRRT简介
主要原理
弥散
对流
溶质清 除机制
水清除机 制：超滤
吸附
CRRT简介
弥散 u经由半透膜两侧的血液及透析液中的分子，在 限定的空间内自由扩散，以达到相同的浓度，最 终，分子由高浓度一侧转运至低浓度一侧。
主要参数监测及意义
uPD2滤出压：又称废液压，一是滤器中血流的小 部分压力通过超滤液传导产生，为正压，另一部分 由超滤液泵产生，为负压，通常为负压，反映滤器 是否受阻，静脉壶是否凝血。
血滤(CVVH)操作
• 并按下“OK”开始治疗
Clinical & Training Department
治
治疗主屏幕
疗
在整个治疗过程中均显示主屏幕 菜单字段显示： • 当前压力 (动脉、静脉、跨膜压) • 当前流速：置换液速率，血流量， 超滤速率，抗凝剂速率 状态栏显示：
治疗模式 (CVVH) 治疗时间进程(Treatment time 0:00 h:min)
• 点击ESC两次返回主菜单，血流量 自动降到100mL/min 同时关闭持续 肝素用量。 • 准备一袋生理盐水挂在输液架上， 然后按 【STOP】 • 把动脉管路与生理盐水相连。按 【 START/RESET 】 • 光学检测器感应到没有不透明液 体后连接静脉管路至生理盐水或者 与动脉管路泵前的侧管相连，按【 START/RESET 】开始再循环。
Terminate bag change? [OK] to confirm!
Clinical & Training Department
治 疗
治疗菜单
--暂时中止治疗
•
进入天平数据菜单 点击平衡开关键 off
Clinical & Training Department
治 疗
治疗菜单
--暂时中止治疗
Clinical & Training Department
置换液管路的安装
• 将置换液袋出口向后放于秤上 打开置换液泵门，装入置换液泵管， 使管路嵌入置换液泵凹槽内 按住“START/RESET”键，将泵管带 入凹槽内。关上泵门。 将保护帽从置换出口管上取下，挤压 加热囊尽量排出空气。 将置换加热囊放入置换液加热器中 （ 出口端向上) 。 将置换液管路出口端与静脉壶（后稀 释）连接/与动脉壶（前稀释）连接
BOSCH Sicherheitssysteme GmbH(3)操作文件 2019版说明书
使用帮助 查找信息 打印帮助 简介 系统概述 硬件要求 软件要求 许可证要求 概念 BVMS设计理念 单个Management Server系统 Enterprise System Server Lookup Unmanaged site 自动网络补偿(ANR) 报警处理 兴趣区域(ROI) Intelligent Tracking 非活动注销 故障继电器 文本数据 脱机Operator Client 在脱机模式下进行工作 不指定版本的Operator Client 在兼容模式下工作 全景摄像机的查看模式 360度全景摄像机 - 适合安装在地板或天花板上 180度全景摄像机 - 适合安装在地板或天花板上 360度全景摄像机 - 适合安装在墙壁上 180度全景摄像机 - 适合安装在墙壁上 全景摄像机的裁剪视图 验证真实性 SSH数据通道 使用入门 启动 Operator Client 接受新配置 访问系统 使用 Server Lookup 显示摄像机图像 选择时区 在图像窗格中显示摄像机 显示全景摄像机 切换全景摄像机的查看模式 显示双重热成像/光学摄像机 显示多个 Management Server 的摄像机 在逻辑树中查找项目 更改图像窗格行数 排列图像窗格并调整其大小
使用联机帮助时，您可以随时从浏览器窗口中打印帮助主题和信息。 要打印帮助主题： 1. 右击右窗格，选择打印。
此时会打开打印对话框。 2. 单击打印。 P 主题会在指定的打印机上打印出来。
2019.08 | V 1 | Operator Client
操作手册
Bosch Sicherheitssysteme GmbH
2019.08 | V 1 | Operator Client
6 zh-CHS | 目录
14.3.5 14.4 14.4.1 14.4.2 14.4.3 14.4.4 15 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.14.1 15.14.2 15.14.3 15.14.4 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 15.36 15.37 15.38
车卫士产品操作手册
福建移动车卫士操作手册2013年8月目录1短信查车 (4)2手机WAP查车 (5)3网上查询操作指南 (7)3.1用户登录 (7)3.2忘记密码 (7)3.3成功登录界面 (10)3.4终端状态 (10)3.4.1车辆图标含义 (10)3.4.2报警类型 (11)3.4.3车卫士状态 (11)3.5定位功能 (11)3.5.1位置查询 (11)3.5.2实时监控 (12)3.5.3轨迹回放 (13)3.5.4末次位置 (15)3.6报警管理 (16)3.6.1预设报警区域 (16)1.6.1.1自定义报警区域 (16)1.6.1.2显示自定义报警区域 (20)1.6.1.3删除自定义报警区域 (21)3.6.2设置报警区域 (22)3.6.3取消报警区域 (24)3.6.4显示越出报警区域 (25)3.6.5显示进入报警区域 (25)3.7管理功能 (26)3.7.1终端命令 (26)1.7.1.1终端重启 (26)1.7.1.2远程设防 (27)1.7.1.3远程撤防 (28)3.7.2参数查询 (29)3.7.3参数设置 (30)3.7.4车辆管理 (31)3.7.5设置地图中心点 (32)3.7.6修改用户信息 (33)3.7.7修改用户密码 (34)3.7.8日志查询 (35)3.8报表管理 (36)3.8.1报警报表 (36)1.8.1.1按日统计 (37)1.8.1.2按月统计 (38)3.8.2轨迹报表 (39)3.8.3超速报表 (40)1.8.3.1按日统计 (41)1.8.3.2按月统计 (42)4手机客户端查询操作指南............................................................................ 错误！未定义书签。
前言福建移动车卫士以满足个人或企业电动车/摩托车“防盗”需求为主线，基于中国移动网络，通过平台、满足智能终端、客户手机的信息交互，实现电动车/摩托车的定位监控、自主防盗、智能报警等功能。
贝朗
压力监测指标
• 动脉压（PA） 为血泵前的压力，由血泵转动后抽吸产生， 通常为负压。主要反映血管通路所能提供 的血流量与血泵转速的关系，血流不足时 负压值增大，正常情况下大于-200mmHg,低 于此值时需干预。
压力监测指标
• 滤器前压（PBE） 是体外循环压力最高点，与血泵流量、滤器阻力 及血管通路静脉端阻力相关，血流量过大，滤器 凝血，血液回路静脉端受阻都可导致其压力增大。 PBE不仅是压力指标，还是治疗是否能安全完成的 指标，各种原因引起的PBE升高，都可造成循环管 路接头处崩裂，失血及导致滤器破膜，而使治疗 中断。
压力监测指标
静脉压（PV） • 血液回流体内的压力，反映静脉回流 通畅与否的指标，通常为正值，不可 低于0以下（通常须在10以上）。
压力监测指标
滤出液压（PD2） 又称废液压 • 由二部分组成：一是滤器中血流的小部分 压力通过超滤液传导产生，为正压。另一 部分超滤液泵产生，为负压。反映滤器是 否受阻，静脉回路是否凝血。
血液灌流
一、定义
血液灌流技术是将患者血液从体内引到体外循环系 统内，通过灌流器中吸附剂非特异性吸附毒物、药 物、代谢产物，达到清除这些物质的一种血液净化 治疗方法或手段。与其他血液净化方式结合可形成 不同的杂合式血液净化疗法。
以CVVH治疗模式为例
七、预冲完成备妥治疗
选择前后稀释模式 默认为后稀释 涂黑为前稀释
预充管路连接都默认后稀释
需要再冲洗时涂黑冲洗建，盐水量自定义
以CVVH治疗模式为例
七、预冲完成备妥治疗
第一个备妥治疗EQ灯不亮 按 键，进入参数设置
以CVVH治疗模式为例
七、预冲完成备妥治疗
参数设置完毕按 键，再 次回到备妥治疗界面，EQ灯 亮，同时右上显示进入治疗 并闪烁，此时不要按EQ
Compact II逆渗透系统操作手册说明书
OPERATING MANUALReverse Osmosis EquipmentModel: Compact - IIMade in U.S.A.TABLE OF CONTENTSSAFETY INSTRUCTIONSINSTALLATION GUIDELINES AND REQUIREMENTS R. O. SYSTEM INSTALLATIONSYSTEM PRE-START AND START CHECK LIST GENERAL MAINTENANCEITEMIZATION OF COMPONENTSIMAGE OF COM-II MODEL, front viewIMAGE OF COM-II MODEL, back viewEXPLODED VIEW OF WASTE/RECYCLE VALVE WIRING DIAGRAMTROUBLE SHOOTING GUIDE Page 1 Page 2 Page 3 Page 6 Page 9 Page 10 Page 12 Page 13 Page 14 Page 15 Page 16SAFETY INSTRUCTIONS1)Read this manual before installing system.2)Electrical connection must be made by a licensed electrician or qualified personthat can make all connections to code.3)Check that the proper-sized breaker(s) is used to prevent possible fire risk. ThisR.O. system must be grounded.4)All water connections must be made by a licensed plumber.5)Make sure that all electrical connections will not become exposed to water incase of leaks or possible rupture in water lines due to pressure spikes, possible component failure, etc.6)Give the area around the system plenty of room for servicing and generalmaintenance. Allow for plenty of ventilation in the room where the system isplaced. Some installations may have to be made where the system is placedoutside. If installed outside, it is advisable to construct a small box around thesystem to protect it from the elements.7)The water supply must be turned off before servicing.INSTALLATION GUIDELINES AND REQUIREMENTSELECTRICAL REQUIREMENTS: A label identifying the voltage requirement is affixed to the junction box where the power cord is located. The voltage will be either “220v or 110v” and “50HZ or 60HZ, single-phase”.WATER SUPPLY: A minimum of a 1/2" copper or PVC pipe leading close to the R. O. System as possible. From there, feed line requirements to the system vary depending on system size:150, 250, 450 gpd models have 3/8" FPT connection.The 800 gpd model has 1/2" FPT connection.DRAIN: The drain for R. O. waste water can be one of the following:Floor sinkStandard household or commercial ABS drain line (accessible)Leach field - used only if local laws allow waste discharge from an R. O. to be drained into a leach field.FEED WATER CONDITIONS: In order to operate efficiently, the conditions of the feed water must be:Turbidity freeSilica level @ 50 ppm maximumIron level @ .05 maximumFree of hydrogen sulfideFeed water temperature 85o F maximumFeed water pressure 40 - 80 psiOperating pressure 200 psi maximumpH range 3 - 11Feed water TDS 2,000 ppm maximum. If levels are higher than 2,000, consult the factory for possible system design changes.R. O. SYSTEM INSTALLATIONThe following is a typical installation procedure for installing the R. O. System in a normal application. There may be other procedures for installing the R. O. System, since the application varies for R. O. system use (such as pre-treatment, post-treatment, reclaim and processing). Consult factory if there are any special circumstances for installation.Decide where the R. O. System is to be placed, keeping in mind that sufficient space is available to service the system. There must be ample space around the system for heat dissipation from the motor. A drain must be accessible. Feed water must be accessible. Electrical supply must be available.ELECTRICAL REQUIREMENTS:110v: The R. O. System uses very little current for operation. If designed for 110v power supply, the R. O. System can be plugged into any household outlet receptacle.220v: If the R. O. System was specified to be built for a 220v power supply, you will need to supply your own 220v plug (can be purchased at a local hardwarestore or electrical parts supplier). Install the 220v plug onto existing power cord of the R. O. System.Have a licensed electrician run conduit for a power supply and connect to the R.O. System, if the system is to be hard-wired.FLOAT SWITCH CONNECTION (optional)The float switch (if supplied) is a non-mercury style liquid-level switch. The switch is supplied with a piggy back plug.For 110v power requirements, the R. O. System plugs directly into the piggyback plug of the float switch. The other side of the piggy back plug to plug into 110v outlet. Instructions are supplied by the manufacturer of the float switch.For 220v power requirements, the piggy back plug must be cut-off of the floatswitch cord. Then, follow the instructions supplied by the manufacturer of thefloat switch.FEED WATER CONNECTION: The feed water fitting is to be supplied by the installer. The connection is made at the inlet of the pre-filter.Models 150, 250, 450 gpd R. O. Systems have 3/8" FPT.The 800 gpd R. O. System has 1/2" FPT connection.NOTE: If there is a considerable distance from the R. O. System to feed water supply, it is best that 1/2" copper or PVC is used to bring the water supply as close to the R. O.System as possible. This will help eliminate a potential cycling problem due to insufficient water pressure or volume supplies. Make sure that a shut-off is located at the end of the piping for turning off water supply to the R. O. System.DRAIN CONNECTIONUse 3/8" polyethylene tubing from drain (waste) water connection on the R. O.System to drain. Make sure that a tubing insert is used as a tubing support.CAUTION: Failure to use polyethylene tubing can result in possible leaks. Refer to drawing for more details on drain fitting.Connect drain (waste) line according to local codes if using a floor sink.A drain saddle may be used if connecting drain line to a typical sink drain.The drain (waste) water from the R. O. System should not be elevated more than necessary (maximum 10 feet). If drain line is elevated, use a 2 PSI, or less,check valve so the waste water does not return back to the R. O. System. This will help prevent contamination, in case of sewage back-up.PRODUCT WATER CONNECTION(pressurized or atmospheric storage “open storage”)Use 3/8" polyethylene tubing from R. O. System to storage tank. Make sure a tubing insert is used as a tubing support. Install into tubing and tighten.CAUTION: Failure to use polyethylene tubing can result in possible leaks. Refer to drawing for more details on product fitting.PRODUCT WATER CONNECTION - pressurized storage:If the R. O. System was purchased with pressure switch operation, the systemwill be set-up for that purpose. When the pressure in the product water linereaches 50 PSI (or field re-adjusted pressure setting), the product pressureswitch on the R. O. System will turn the R. O. System off. It will then turn backon when the pressure in the product water line drops to approximately 20 PSI,re-filling the pressurized storage tank. When using a pressurized storage tank(bladder tank), make sure that the tank is approved for reverse osmosis orpurified water use. The diaphragm pressure should be set to about 15 PSI.IMPORTANT: Some tanks are supplied with galvanized inlet fittings. Thesegalvanized fittings will deteriorate when subjected to reverse osmosis or purerwaters. Replace these fittings with PVC.Use a T-connection on the pressurized tank. One side of the T-connection willbe connected with polyethylene tubing from product water of the R. O. System.The other side of the T-connection will be used as a connection to P.O.U. (Point Of Use) after post-filtration. It is advisable to install a ball-valve on the tankconnection to shut-off water flow coming out of the tank, in case of emergency or service. CAUTION: Failure to use polyethylene tubing can result in possibleleaks.PRODUCT WATER CONNECTION - Atmospheric (open) storageIf your R. O. System was purchased for float switch operation, there will be afloat switch supplied for this operation. Read all instructions regarding this float switch for proper set-up and understanding of float switch operation. If you donot use the float switch provided, the R. O. System will not turn off and willoverflow the storage tank, causing flood damage.When using an atmospheric storage tank, connect 3/8" polyethylene tubing from product connection to the upper portion of tank. Use a bulkhead (tank adaptor) for making this connection. Make sure that the connection is not higher thanfloat switch shut-off level. Follow directions enclosed in float switch carton foroperation. CAUTION: Failure to use polyethylene tubing can result in possible leaks.NOTE: Installation connections such as feed water, tank adaptors, tank fittings, 220v electrical plugs, drain clamps, polyethylene tubing, and misc. accessories are not included with the R. O. System due to many types of installations. These are common items found at your local hardware or electrical supply store.SYSTEM PRE-START AND START CHECK LISTAfter the R. O. System connections have been made, including the post-treatment and dispensing mechanism, a Checklist has been provided to review that all required steps have been followed:______Feed water connection has been made and secured.______Drain connection has been made and secured.______Product from R. O. System has been made to storage tank and secured. ______Float switch (if applicable) is installed into tank, adjusted and secured.______Post-treatment installed, plumbed, and secured, including faucet and post-filters.______Necessary shut-off valves installed on feed water supply, storage tank, etc., and turned-off.______Install pre-filters into the R. O. System in order, according to the R. O.System diagram.______Turn water supply on from feed water connection and check for any leaks on all pre-filters for the R. O. System.______Connect R. O. System to electrical supply and turn power on. At this time, the inlet solenoid valve will open and allow water to enter into thepump. After the pressure stabilizes throughout the R. O. System, it willstart to run. The R. O. System may start and stop a few times. If the R.O. System continues to start and stop, disconnect power and refer to thetrouble shooting guide.______When the R. O. System continues to run, observe system pressure gauge. If the pressure exceeds 200 PSI, adjust the pressure relief valvelocated on the pressure pump. ***200 PSI MAXIMUM***. If your R. O.System has been equipped with an automatic hourly flush feature,pressure adjustments must NOT be made during flushing cycle.Adjustments must now be made to the waste and recycle valves.When adjusting the waste and recycle valves, the system pressure andwaste flow rates must be monitored.TO ADJUST VALVES (with optional flow meters):1. Note system pressure2. Note waste flow rate.3. If the system pressure is low, slowly close waste valve to increase pressure.In doing so, the waste flow rate will drop. DO NOT EXCEED 200 PSI.4. If the flow rate to waste is too low (depending on desired recovery rate), thewaste valve must be opened a little.The recycle valve can now be closed slowly to increase system pressure. DONOT EXCEED 200 PSI. Check the waste flow rate again to make sure desiredrecovery rate is correct.TO ADJUST VALVES (without optional flow meters):1. Same as above, but the waste flow must be monitored manually. To do this, use a container which has capacity markings to catch the waste water. Calculations must be made for a 24/hour period. This will indicate the total for the waste flow. Use this method to determine desired recovery rate.Recovery rate is the amount of total water used, divided into good waterproduced. Example:150 gpd product flow and 300 gpd waste flow equals:450 total gallons150 gallons divided by 450 gallons equals:33 % recoveryIt is not suggested to obtain more than 33 % recovery if there is no pre-treatment used in front of the R. O. System, such as water softener, antiscalant injections, etc.If proper pre-treatment is in place, or the water conditions allow, a 50 % recovery could be set.______Check to ensure water is running to drain.______Check product pressure shut off.If pressurized storage tank application, turn off valve at pressurizedstorage tank and dispensing faucet. At this time, pressure will begin tobuild. The R. O. System should shut off after a while. The gauge on thefront panel is used to check system ON and OFF pressures. The productwater must fill all post-treatment and associated lines. This will determinehow long it will take to pressurize and shut-off the R. O. System. Watershould discontinue to run to storage tank and drain. Once the R. O.System shuts off, check all post-treatment water lines, filters, etc. Storagetank pressure can be increased (instructions located inside pressureswitch cover), but DO NOT EXCEED 80 PSI turn off pressure.______If atmospheric storage tank application, allow the R. O. System to run.Raise float switch inside the storage tank and check for system shut-off.Water should discontinue to run into tank and drain line.______Turn storage tank shut-off to the ON position.______Turn off feed water supply and check the R. O. System for low water pressure shut-off. Make sure the R. O. System stays turned off whenwater supply is interrupted. If the R. O. System turns off and on too long,the low pressure switch must be set for a higher setting. Adjustmentinstructions are inside low pressure switch cover.______Turn water supply back on.______Instruct customer about all shut-off valves and electrical disconnections.Also, tell customer that the storage tank will take some time to fill. Oncestorage tank is full, the post-filter should be rinsed before using the water.GENERAL MAINTENANCEPRE-FILTERS: There are pre-filter-in and pre-filter-out gauges mounted on the front panel. These gauges measure the water pressure before and after the pre-filters. When there is a drop 10 - 15 psi difference of pressure readings between the two gauges, the pre-filters are getting clogged and must be changed.R. O. MEMBRANE: The quality of the product water should be checked periodically for rejection of total dissolved solids (TDS). When the rejection isbelow desired limit, the membrane should be changed or cleaned.PRESSURE SWITCHES: The operation of the pressure switches should be checked at least once a year for proper operation.PUMP: The single-stage vane pump and has carbon impellers to increase the water pressure. Over time, the impeller may begin to wear. Adjustments can be made to the pressure relief on the pump to bring the pump back to desiredoperating pressure. If the impellers are too worn, the pressure relief adjustment will have little or no effect on system pressure. If this occurs, the pump must be replaced.ITEMIZATION OF COMPONENTS(refer to front and back view image of system)1)SYSTEM PRESSURE GAUGE: This gauge is liquid-filled with a range of 0-300psi. It will register the pressure of water applied to the input of the membraneonly while system is running.2&PRE-FILTER INLET AND OUTLET PRESSURE GAUGES:3)The two gauges on the pre-filters sense the pressure between the inlet and finalpressure after passing through the pre-filters. When there is a pressure drop of15 psi or more between gauge readings, the filters should be changed. The pre-filter in gauge will register a reading at all times. The pre-filter out gauge willregister a reading only while system is running.4)PRESSURIZED STORAGE PRESSURE GAUGE (if applicable):This gauge is used to monitor tank pressure. System product ON and OFFpressures can be set by viewing this gauge.5)20" CARBON BLOCK PRE-FILTER AND HOUSING: The carbon block filter isused before the membrane to remove the chlorine from the inlet water. TFCmembranes used on this system are chlorine sensitive. Care must be taken toensure that all chlorine is removed from the water supply. It is suggested that a ½ cu.ft. carbon filter is used on 800 gpd R. O. Systems to limit the frequency ofcarbon pre-filter change-outs.6)20" 5 MICRON PRE-FILTER AND HOUSING: The sediment pre-filter (rated at 5micron) removes the dirt particles to 5 micron and larger. This filter helps extend membrane life.7)INLET WATER CONNECTION: The feed water connection is made at the inletof the sediment pre-filter. The fitting is to be supplied by the installer.Connection sizes 3/8" FPT or 1/2" FPT.8)INLET SOLENOID VALVE: The inlet solenoid valve provides positive water flowshut-off when the R. O. system is not in operation.9)LOW INLET WATER PRESSURE SWITCH: This switch registers the amount ofinlet water pressure supplied to the R. O. pump. If the inlet pressure is too low,(below 10 psi) the pump will not start. This is a protection feature to extendpump life. This switch is rated for 30 amps9)AUTOMATIC FLUSHING SOLENOID VALVE (optional): This is an optionalfeature to the R. O. System. Once an hour for two minutes, only during systemoperation, this valve opens. The drain flow is dramatically increased at this time.This increased flow rate helps remove any particles clogged in the membrane.11)R. O. MEMBRANE AND HOUSING: The Thin Film Composite membraneremoves up to 99%+ of the suspended solids. The membrane housing contains the R. O. membrane.12)WASTE ADJUSTING VALVE: This valve restricts the flow of waste water exitingthe membrane. It creates the necessary operating pressure in the membrane.CAUTION: This waste control valve should NEVER be closed completely.Recovery rates are determined by pre-treatment used and the type of watersupply the R. O. System is installed on.13)RECYCLE ADJUSTING VALVE: This valve takes a portion of the waste waterfrom the R. O. membrane and feeds it back into the inlet side of the pump. It is used to fine-tune and adjust the pressure of the pump.14)SINGLE-STAGE ROTARY VANE PUMP: The pressure pump increases the inletpressure and flow to the membrane. The increased pressure must not be more than 200 psi maximum. The pump is constructed of brass with carbon impellers.15)PRESSURE RELIEF ADJUSTING SCREW: The pressure relief adjustment willincrease or decrease the operating pressure of the pump. Adjustments with the relief valve should only be used when pump output flow decreases due tocarbon impeller wear over time.16)MOTOR: The motor turns the pump at 1725 rpm at a 60hz electrical supply and1425 rpm at 50hz electrical supply. On 50hz electrical supplies, the operatingpressure will be lower than 200 psi because the motor turns slower than thepump output specifications require.17)ELECTRICAL CORD (110v comes with plug, 220v without plug): The electricalcord is provided for connection to a power supply.18)JUNCTION BOX WITH ELECTRICAL REQUIREMENTS AND RATING: A labelis affixed to the junction box identifying voltage requirements. There should be no reason for removing this cover, unless any of the electrical components onthis R. O. System is to be replaced.19)PRESSURIZED STORAGE TANK PRESSURE SWITCH: This pressure switch isstandard and is necessary for pressurized storage tanks. It will allow the R. O.System to fill the pressurized storage tank until 45 - 50 psi is sensed by theswitch and shuts off the R. O. System. This switch is rated for 30 amps.20)PRODUCT OUTLET CONNECTION: This is where the product water comes outof the membrane. This water must be connected to the pure water storage tank.A plastic compression fitting is at this location that has a 3/8" OD dimension.MUST USE 3/8" POLYETHYLENE TUBING. Failure to use polyethylene tubing can result in possible leaks.21)WASTE OUTLET CONNECTION: There must be water flowing across themembrane at all times during operation. There is a portion of water that is “de-salted”; what’s left behind is a concentrate. This concentrate must be directed to the drain at a certain flow rate. This flow rate is adjusted with the waste valve.This valve must NEVER be completely turned off. Damage to the membrane will occur. A plastic 3/8" compression fitting will make the connection to drain.MUST USE 3/8" POLYETHYLENE TUBING. Failure to use polyethylene tubing can result in possible leaks.TROUBLE SHOOTING GUIDESYSTEM NOT STARTING1) Check power supply to system2) Inlet solenoid non-functional3) Pre-filter clogged4) Low pressure switch defective5) Not enough water pressure(must be at least 15 psi)6) Defective motor7) Product pressure switch non-functionalSYSTEM NOT TURNING OFF WHENTANK IS FULL1) Defective product pressure switchSYSTEM CYCLING ON AND OFF1) Clogged pre-filters2) Malfunctioning low pressure switch3) Defective product check valveSYSTEM NOT UP TO FULL PRESSURE (175-195 psi)1) Defective pump2) Defective flow controlFOUL TASTE OF PRODUCT WATER1) Defective membrane2) Check carbon post-filter。
融威网络行为管理系统用户操作手册V1.0
3.1 站点审计 ...................................................................................................................................... 16 3.1.1 所有站点.................................................................................................................................... 17 3.1.2 新采集站点................................................................................................................................ 17 3.1.3 高度可疑站点............................................................................................................................ 17 3.1.4 中度可疑站点............................................................................................................................ 17 3.1.5 低度可疑站点............................................................................................................................ 17 3.1.6 分析正常.................................................................................................................................... 18 3.1.7 已经禁止.................................................................................................................................... 18 3.1.8 无法打开.................................................................................................................................... 18 3.1.9 其他分类.................................................................................................................................... 18 3.2 安全审计 ...................................................................................................................................... 18 3.2.1 机器流量汇总............................................................................................................................ 18 3.2.2 外出流量汇总............................................................................................................................ 19 3.2.3 进入流量汇总............................................................................................................................ 19 3.2.4 协议流量汇总............................................................................................................................ 19 3.2.5 远程断网.................................................................................................................................... 19 3.3 行为审计 ...................................................................................................................................... 19 3.3.1 聊天行为.................................................................................................................................... 20 3.3.2 游戏行为.................................................................................................................................... 20 3.3.3 BT 下载行为.............................................................................................................................. 20 3.3.4 流媒体行为............................................................................................................................... 21 3.3.5 HTTP 行为 ................................................................................................................................ 21
费森CRRT设备操作流程--CVVH
费森尤斯CRRT设备操作流程---CVVH一、管路的安装步骤注释图示1检查仪器, 确保仪器已核查消毒, 处于随时备用状态2连接电源将机器平稳推至患者床旁, 位置适宜, 踩下脚轮锁, 将机器固定将电源插头插入电源3打开机器电源开关直接按机器背面电源开关键（注意手部干燥）前面板指示灯亮4开机按【I/O】键, 持续3秒后开机按【I/O】键，持续3秒后开机5电路系统自检, 无需干预6确认开始条件屏幕显示天平I、II上没有袋子天平III、IV上没有袋子没有管路安装没有压力传感器安插没有管路卡在光学检测器内没有管路在漏血检测器内7屏幕显示All conditions fulfilled？【OK】to confirm！检查完毕, 确认开始条件符合要求, 按【OK】键进入下一步检查完毕，确认开始条件符合要求，按【OK】键进入下一步8自检完毕是否选择Ci-Ca模式选择Off, 按【OK】键进入下一步选择Off，按【OK】键进入下一步9屏幕提示肝素泵建议使用FMC 50ml注射器废液袋最大承载量10 Kg10屏幕显示选择新的治疗模式继续原来的模式治疗历史前一次治疗事件11选择新的治疗模式机器会默认继续原来的模式旋转【OK】键, 将光标移至新的治疗模式按【OK】键进入12确认治疗模式在治疗模式中, 遵医嘱选择确认将要实施的治疗模式本流程选择CVVH模式按【OK】键确认13屏幕提示检查耗材管路检查废液袋检查置换液管路14屏幕提示返回到治疗的选择条件满足核查物品准备无误, 完好备用选择【Conditions fulfilled】, 按【OK】键进入选择【Conditions fulfilled】，按【OK】键进入15准备安装机器清晰显示安装步骤的图示, 安装全过程参照图示逐项安装注意图示中管路颜色的提示连接好预冲液体、置换液及废液袋, 检查完毕16屏幕显示Set up？【OK】to confirm！按【OK】键结束安装, 准备预冲按【OK】键结束安装，准备预冲二、管路的预冲步骤注释图示1准备预冲屏幕显示a.检查夹子是开放的b.检查液体已正确安装c.确保所有连接紧密确认以上条件具备（安装结束时已检查）2设置预充量开始预冲前, 按【ESC】键将光标移至system parameters, 按【OK】键进入系统参数设置3系统参数界面, 旋转【OK】键,将光标移至default treatment settings, 按【OK】键进入默认设置4特别注意以下4项的设定, 建议Blood flow 血流速设定为100ml/minRinse volume预充量设定为1000mlUF volume超滤预充量设定为500ml Reinfusion volume 回血量设定为500ml设定完成, 旋转【OK】键光标至图示黄色区域, 按【OK】键返回准备界面5预冲光标停在start priming？【OK】to confirm！按【OK】键开始预冲6预冲盐水经动脉端流入滤器,再由静脉端流出（确保静脉端在上）, 完成膜内排气此过程无需干预, 如排气后静脉端有微小气泡, 可以轻拍滤器静脉端, 将气泡完全排出可以轻拍滤器静脉端，将气泡完全排出7液体进入静脉壶后, 界面自动转换,屏幕右上角显示预冲剩余时间和剩余液量；屏幕中显示各项治疗参数,建议治疗开始后再分别设置8光标移至▲, 按【OK】键,手动提升静脉壶液面至4/5高度9 屏幕右上角显示预冲剩余时间和剩余液量均为“0”时, 机器提示预冲完成；超滤预冲前需要建立动静脉回路, 先夹闭静脉回路袋的夹子, 断开静脉连接三、治疗的开始10将静脉连接至动脉端三通, 确保三通呈开放状态,动脉端、静脉端、预冲液三向相通, 同时确保动静脉端夹子呈开放状态11动静脉回路建立完成光标移至 start UF rinse ？ 【OK 】to confirm ！按【OK 】键开始超滤预冲12排滤器膜外空气 可看到液平面逐渐向上 将膜外气体排出13屏幕右上角显示超滤预冲剩余时间和剩余液量均为“0”时,提示超滤预冲完成 屏幕提示可以连接患者14等待连接患者期间, 血泵继续运转屏幕右上角显示动、静脉回路累积循环时间步骤注释图示1预冲结束 等待连接患者2建立体外循环---连接动脉端 准备血管通路, 按【STOP 】键, 血泵停止运转, 准备连接患者 血泵停止运转，准备连接患者3关闭动静脉回路的动脉端三通 关闭动脉夹（红色）, 取下动脉端管路确保静脉端与废液收集袋通畅静脉夹（蓝色）开放4管路动脉端与中心静脉导管动脉端（红色）紧密连接并确保双侧的夹子（红色）均处于打开状态5屏幕提示Start connection ？ 【OK 】to confirm ！按【OK 】键确认启动连接6 建立体外循环---连接静脉端血液通过滤器注入静脉壶7 光学检测器检测到有不透明液体通过机器报警, 血泵自动停止转动8屏幕提示如果静脉端还没有连接患者, 连接静脉血路管至患者各个夹子都打开了吗？必要时连接到前稀释的位置必要时旋转滤器所有的连接是否紧密？所有的连接是否紧密？9 关闭动静脉回路的静脉端三通关闭静脉夹（蓝色）取下静脉端管路10 管路静脉端与中心静脉导管静脉端（蓝色）紧密连接并确保双侧的夹子（蓝色）均处于打开状态11屏幕提示Start treatment？【OK】to confirm！按【OK】键开始治疗12屏幕提示Pressure venous静脉压TMP跨膜压连接静脉后, 应注意观察静脉压及跨膜压数值如压力过高, 应及时查找原因如压力过高，应及时查找原因13固定导管将动、静脉管路妥善固定, 确保无打折、无扭曲14体外循环建立完成调整核对治疗参数, 连接回血生理盐水调整核对治疗参数，连接回血生理盐水四、治疗的结束步骤注释图示1准备下机用物2进入结束程序遵医嘱结束治疗, 按【ESC】键, 移动光标至end of treatment 按【OK】键进入结束程序3屏幕提示准备断开患者连接按STOP键血泵停止转动4打开回血生理盐水依靠重力回血泵前血液回完泵前血液后关闭管路动脉夹子（红色）5开始回输屏幕提示Start disconnection？【OK】to confirm！确认断开患者端连接, 按【OK】键开始回血确认断开患者端连接，按【OK】键开始回血6结束回输当光学检测器感受到透明液体后机器报警, 血泵停止转动屏幕显示结束确认程序7屏幕提示Continue reinfusion？继续回血Terminate reinfusion？停止回血血液未回干净可选择继续回输, 按【OK】键继续回血血液未回干净可选择继续回输，按【OK】键继续回血8当管路中的血液冲洗干净, 将光标移至Terminate reinfusion？按【OK】键停止回血血泵会自动停止在3点钟方向9屏幕提示断开患者端静脉连接,按住【START/RESET】移除泵管移除管路系统10回顾记录数据将光标移至View treatment history？【OK】to confirm！按【OK】键, 回顾全部治疗数据, 并记录按【OK】键，回顾全部治疗数据，并记录11排空废液袋, 拆除管路12仪器处理持续按住【I/O】键3秒, 电源指示灯熄灭；关闭机器后面的电源开关拔掉电源线13 遵照医院感染防控要求擦拭消毒机器14消毒后经核查挂上相关标识牌, 备用挂上相关标识牌，备用备注: 其他治疗模式可参照此流程操作。
美国血液CS5+自体血液回输机操作手册簿
前言用户须知本手册内容属美国血液技术公司（Haemonetics Corporation）财产。
Haemonetics®和Cell Saver®为美国血液技术公司的注册商标。
本手册包含的任何资料或说明未经美国血液技术公司书面许可，不得复制和公开发表，或与任何专业教学一起使用。
任何书面询问请直接投递下列地址：International Headquarters Corporation HeadquartersHaemonetics SA Haemonetics CorporationSigny Centre, rue des Flecheres 400 Wood RoadP.O. Box 262, 1274 Signy 2, Switzerland Braintree, MA 02184, USATel: [+41 22] 363 90 11 Tel: [+1 781] 848 7100Fax: [+41 22] 363 90 54 Fax: [+1 781] 848 5106了解本手册的宗旨本手册旨在用作仅适用于美国血液技术公司供应的材料的指南。
它给操作人员提供安全实施特定步骤和妥善保养美国血液技术公司生产的设备的必要资料。
本手册可与合格的美国血液技术公司工作人员提供的指导和培训结合使用。
美国血液技术公司的产品由受过适当培训的操作人员使用时，公司对其产品负责。
不遵循描述的步骤可导致设备功能损害以及操作人员和/或病人损伤。
血细胞回输机经正确装配、保养和操作，可安全而适当地施行各种血细胞回收步骤。
美国血液技术公司对违反公司规定所产生的问题概不负责。
任何用户认为必要的修改应受到美国血液技术公司临床专家的评定。
美国血液技术公司的材料和设备的安全使用要求操作人员正确处理血液污染材料。
任何美国血液技术公司设备的操作人员必须充分了解和执行当地通行的有关血液污染材料和血液制品的政策以及每家使用美国血液技术公司产品的机构关于血液污染材料和血液制品的处理步骤。
哈希便携式浊度仪安全操作及保养规程
哈希便携式浊度仪安全操作及保养规程哈希便携式浊度仪是一种高精度测量水质的设备。
为了确保使用时的安全性和仪器的长寿命，我们需要对它进行正确的操作和保养。
本文将详细介绍如何安全地使用哈希便携式浊度仪并对其进行保养。
1. 使用前的准备1.1. 确保使用场所符合使用要求。
设备应在相对干燥的室内环境下使用，避免在潮湿、多尘、强磁或强电场等环境下使用。
1.2. 安装电池。
便携式浊度仪使用两节R20干电池或Ni-MH可充电电池。
建议使用充电式电池，并在使用前充电。
请不要使用不同的电池混合使用。
1.3. 准备样本。
样本为待测溶液，需要在使用前取一定量的样本并装入样品容器中。
2. 正确的操作2.1. 打开仪器。
便携式浊度仪有开/关机键和选单键，按下开/关机键，仪器即可开机。
2.2. 设置参数。
在使用前，需要设置一些参数，例如波长、自动关机时间等。
按下选单键，选择需要设置的参数，用左右方向键进行调整，最后确认并保存设置。
2.3. 校准仪器。
浊度仪在使用前需要进行校准。
可以在干净的水中进行空白校准，并在标准溶液中进行标准校准。
按照说明书中的步骤进行校准。
2.4. 测量样品。
将已经准备好的样品倒入样品容器中，将样品容器插入仪器插孔中。
按下测量键开始测量，测量完成后，将样品容器取出。
2.5. 关机。
按下开/关机键，仪器即可关闭。
3. 注意事项3.1. 避免操作不当。
请严格按照说明书中的步骤进行操作，避免操作不当对仪器造成损坏。
3.2. 避免强烈光照射。
长时间暴露在强烈光线下会对仪器产生损害，因此在存放和使用时，需要避免强烈光照射。
3.3. 避免水或湿气进入仪器。
浊度仪对水和湿气非常敏感，因此需要避免在潮湿环境下使用。
3.4. 避免碰撞。
仪器需要轻拿轻放，避免碰撞或撞击造成损坏。
4. 保养方法4.1. 定期清洁仪器表面和样品容器。
将仪器和样品容器用干净的布擦拭干净，避免使用化学溶剂。
4.2. 保持干燥。
将仪器存放在相对干燥的环境中，不要长时间暴露在潮湿环境中。
CVVH操作指南(5.2版本)
自检通过
Clinical & Training Department
选择新的治疗
遵医嘱“选择新的治疗”或“继续原来的治疗”
选择 新 的 治 疗 select new treatment 继 续原来的 治 疗 continue Previous treatment 治 疗数 据 回 顾 treatment history 原来治 疗事 件 Events previous treatment
• 装入动脉泵管和废液泵管路使管路卡入 血泵和废液泵凹槽内。
• 按住“START/RESET”键，将泵管带入凹 槽内。关上泵门。
• 连接动脉，静脉，废液连接器。
• 连接动脉、滤器前、静脉、滤过液压力传 感器。
• 将静脉血路管安装在管路夹和光学监测 器中。
• 将废液管路安装在漏血监测器中，连接 废液管路至废液袋C。linical & Training Department
注意 •肝素泵建议使用FMC50ml注射器 •废液袋的最大承载量 10kg
•选择“OK”键确认
Clinical & Training Department
治疗模式
• CVVH
连续静脉-静脉血液滤过
• Pre- Post CVVH 前-后稀释连续性静脉-静脉血液滤过
• CVVHDF
连续静脉-静脉血液透析滤过
• CVVHD
连续静脉-静脉血液透析
• MPS
膜式血浆分离
• HP
血液灌流
遵医嘱选择治疗模式 按“OK”键确认
警告！
SCUF
缓慢连续性超滤
paed-CVVH 儿童-连续静脉-静脉血液滤过 必须使用儿童管路
paed-CVVHD 儿童-连续静脉-静脉血液透析
CVVH操作流程
CVVH操作流程
1.打开电源开关
2.秤上下无杂物无管路安装
3.按"I/0"键开始自检
4自检毕按OK键
5选择新的治疗模式
6选择CVVH
7打开血泵门，废液泵门成90°
8连接管路使管路
9关闭泵门
10连接四个保护罩
11固定人工肾（倒立）
12将动脉(接下端)，静脉（接上端），废液（接侧端）连接管，连在透析器上，更换堵头密
封透析器
13挂好废液袋，连接废液管路
14静脉端袋子挂上端输液架上，动脉段连接肝素盐水
15夹闭所有盲端
16置换液放在天平1,2上
17连接置换液管
18将置换液管旋入置换液泵内
19置换液出口连接后稀释
20置换液入口连接置换液（此时需要两个针头）
21检查所有管路夹子是否打开
22连按两次OK
23开始预冲
24排动脉壶
25等待界面自动跳转按“↑”排静脉壶
26带界面右上角排到0ml（注意排气的过程中不要使肝素盐水滴空，即时更换）
27动脉端静脉端相连，开始冲透析器
28待充满排到0
29输入治疗参数
30置换液出口接前稀释
31按STOP
32连接碳酸氢钠先暂停碳酸氢钠（必须使用输液泵）
33铺无菌巾，回抽血液2ml，从静脉端推入首量肝素
34动脉端连接病人打开夹子，按开始
排出管内肝素盐水
35静脉端接病人
36置换液泵走，打开碳酸氢钠
37连接肝素泵并设置剂量。
E+H pH分析仪223操作手册(中文)
BA 194C/07/c n .hz /01.2001软件版本２．０或以上liquisys SCPM 223 /253pH/ORP 分析仪操作说明书（简明） Hauser+Endress Nothing beatsknow-howQuality made by Endress+HauserISO 9001ENDRESS+HAUSER LIQUISYS SENDRESS+HAUSER LIQUISYS S首页内容打印退出１．５产品结构仪表型号可通过铭牌得知：左：ＣＰＭ ２５３ 铭牌右：ＣＰＭ ２２３ 铭牌liquisys S CPM 223/ 253Endress+Hauser23.4电气接线图接线liquisys S CPM 223/ 2533 Endress+Hauser操作1操作界面2显示LED 指示器液晶显示界面705pH R262Setpoint液晶显示测量值和组态值４个控制键标定和组态用自动／手动切换开关LED 显示限位继电器状态LED 显示报警功能触点状态显示手动方式时继电器开关键用户标签LiquisysＳ 的操作单元指示目前的操作模式:“自动”(绿色LED) 或者“手动”(黄色LED)指示手动状态时继电器输出状况（红色ＬＥＤ）指示继电器１和２的状态绿色ＬＥＤ：测量值在正常范围内，继电器不激活红色ＬＥＤ：测量值超出正常范围，继电器激活故障报警05SetpointpHR262测量方式指示（正常操作）标定方式指示设置方式指示（组态）测量方式时：第二测量值显示设置／标定方式时：参数设置名称自动温度补偿指示 电极符号(标定时闪烁）出错指示测量方式时：主测量值指示设置／标定方式时：参数值指示‘Hold’状态指示输出电流处于保持状态继电器３／４状态指示动作 未动作功能代码显示测量方式时：测量值显示设置方式时：可调整参数值liquisys S CPM 223/ 253操作Endress+Hauser 43功能键标定键当按下ＣＡＬ键时，仪表立刻要求输入密码（标定可用２２），然后用ＣＡＬ确认并进入标定过程，整个过程都用ＣＡＬ键连续完成。
CVVH操作指南
CVVH操作指南CVVH操作指南目录：1.简介2.设备准备3.患者准备4.检查前操作5.操作步骤5.1 连接设备5.2 设置参数5.3 监测过程5.4 故障处理5.5 检查结束6.常见问题及解决方案7.安全注意事项8.相关附件1.简介CVVH（持续性静脉-静脉血液滤过）是一种透析治疗方式，通过连接患者的静脉通路，将患者的血液清除毒素和废物，并平衡体液成分。
本操作指南将详细介绍CVVH的操作步骤和注意事项。
2.设备准备在进行CVVH治疗前，需要确保以下设备准备齐全：- CVVH机器及配件- 血液滤过器及滤器套件- 静脉导管及插管套件- 输液泵- 生理盐水和透析液- 防滑垫和床单- 取样器及相关试剂3.患者准备在进行CVVH治疗前，需要做好以下患者准备：- 测量患者的体重、身高和体温- 静脉通路准备：清洁皮肤、穿刺并固定导管- 监测各项生命体征4.检查前操作在进行CVVH治疗前，需要进行以下操作：- 检查设备是否正常工作及是否连接正确- 检查滤器是否完好- 准备好透析液和生理盐水，并根据患者情况设定相应参数- 检查输液泵是否正常工作5.操作步骤5.1 连接设备- 将CVVH机器连接到电源- 连接适当的输液泵和监测设备- 连接滤器和静脉导管5.2 设置参数- 设定患者的体重、身高和体表面积- 设定透析液和生理盐水的流速和浓度- 根据患者情况设定治疗时间和治疗目标5.3 监测过程- 监测患者的生命体征，如血压、心率等- 定期检查透析液和生理盐水的流速和浓度- 监测滤器的状态和滤器通路压力5.4 故障处理- 对于滤器堵塞或漏液等故障，及时处理并更换滤器- 对于电力故障或设备故障，采取相应的应急措施- 对于导管脱落或出血，及时处理导管并止血5.5 检查结束- 在治疗时间结束后，逐步停止治疗，缓慢断开患者的静脉通路- 监测患者的生命体征和透析液排放情况- 记录治疗过程和治疗效果6.常见问题及解决方案在CVVH操作过程中，可能会遇到以下常见问题：- 滤器堵塞或漏液- 导管脱落或出血- 设备故障或电力故障针对这些问题，本指南提供了相应的解决方案。
卡莫齐 CST-CSV-CSH 磁性接近开关 使用手册说明书
Magnetic proximity switches Series CST - CSV and CSHReed, ElectronicThe magnetic proximity switches CST-CSV-CSH detect the position of the cylinder piston. When the internal contact is actuated by a magnetic field, the sensors complete an electrical circuit and provide an output signal to directly actuate a solenoid valve or a PLC. A yellow LED diode shows when the internal magnetic contact is closed.Switches are available in two different versions: Reed with mechanical switching and electronic with electronic switching. The electronic versions are suggested for heavy duty with frequent operations and strong vibrations.»Designed to fit into thecylinder profile barrel»The three Series CST - CSV- CSH are suitable for allCamozzi’s cylinder range»With or without M8 connectorGENERAL DATAModels CST-...CSV-...CSH-...Operation Reed contactElectronicTyper of output Static or electronic PNPType of contact Normally Open (NO) or Normally Closed (NC) contacts Voltage See model characteristicsMax current See model characteristicsMax load Reed switches 8 W DC and 10 VA ACElectronic switches 6 W DCProtection level IP 67Materials Plastic body encapsulating epoxy resincable in PVCconnector PVRconnector body in PUMounting Directly into the groove, or by means of adapters. Signalling By means of yellow diode LedProtections See model characteristicsSwitching time Reed switches <1,8 msElectronic switches <1 msOperating temperature-10 ºC ÷ 80 ºCElectrical duration Reed switches 10.000.000 cyclesElectronic switches 1.000.000.000 cyclesElectrical connection cable 2x0,14 (2m) high flexibilitycable 3x0,14 (2m) high flexibilityconnector M8 and cable 0,3 mProducts designed for industrial applications.General terms and conditions for sale are available on ./9.05.02 1Reed switches BN = brown BU = blueBK = black Electronic switches BN = brownBU = blueBK = blackUseful information for correct use of the magnetic sensorsProducts designed for industrial applications.General terms and conditions for sale are available on .Ø b ( mm )H ( mm ) 169,21,2 20121 2511,71,1 2010,51,6 2510,91,6 3210,71,1 4012,11,7 5012,11,2 6314,11,3 12101,3 1611,81,5 2011,11,6 2510,61,6 3212,71,2 4012,51,1 5015,41,6 6316,71,5 8013,21,7 10016,81,8 129,21,4 167,91,3 209,11,5 2510,61,5SeriesØ6032 6040 6050 6063 6080 60100 60125 6132 6140 6150 6163 6180 61100 61125 4232 4240 4250 4263 QCT20 QCT25 QCT32 QCT40 QCT50Products designed for industrial applications.General terms and conditions for sale are available on ./9.05.051Load curve - CSHLoad curve - CSH Load curve - CST/CSVLoad curve - CST/CSV Load curve - CSH, CST/CSVProducts designed for industrial applications.General terms and conditions for sale are available on ./9.05.06 1DC applications: there is no protection on the Reed sensors on the inductive load, therefore it is advisable to use an electric ciruit with protection against the voltage spikes.See picture above for a typical example.Legend:1 = Sensor2 = Load3 = Protection diodeDC and AC applications: there is no protection on the Reed sensors on the inductive load, therefore it is advisable to use an electric ciruit with protection against the voltage spikes.See picture above for a typical example.Legend:1 = Sensor2 = Load3 = Protection varistorElectric circuit with protection against voltage spikesProducts designed for industrial applications.General terms and conditions for sale are available on .Operation Voltage (V)Output Max. current Max Load Protection 10 ÷ 110 AC/DC *-250 mA 10VA/8W None 10 ÷ 110 AC/DC *-250 mA 10VA/8W None 10 ÷ 110 AC/DC *-250 mA 10VA/8W None5 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing 5 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversingElectronic 10 ÷ 27 DC PNP 100 mA 6W Against polarity reversing and overvoltage Electronic10 ÷ 27 DCPNP100 mA6WAgainst polarity reversing and overvoltageIn case of polarity reversing Magnetic proximity switch Series CST with male connector M8Length cable 0,3 mt.Voltage (V)Output Max. current Max Load Protection 10 ÷ 110 AC/DC -250 mA 10VA/8W None 10 ÷ 110 AC/DC -250 mA 10VA/8W None5 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing 5 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing10 ÷ 27 DC PNP 100 mA 6W Against polarity reversing and overvoltage 10 ÷ 27 DCPNP100 mA6WAgainst polarity reversing and overvoltageIn case of polarity reversing the sensor will still be operating, but the LED diode won’t turn on.Products designed for industrial applications.General terms and conditions for sale are available on ./9.05.081Voltage (V)Output Max current Max Load Protection10 ÷ 30 AC/DC -250 mA 10VA/8W Against polarity reversing 10 ÷ 30 AC/DC -250 mA 10VA/8W Against polarity reversing 30 ÷ 230 AC30 ÷ 110 DC -250 mA 10VA/8W Against polarity reversing 30 ÷ 230 AC30 ÷ 110 DC-250 mA 10VA/8W Against polarity reversing 10 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing 10 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing10 ÷ 27 AC/DC PNP 250 mA 6W Against polarity reversing and overvoltage 10 ÷ 27 AC/DCPNP250 mA6WAgainst polarity reversing and overvoltageIn case of polarity reversing the sensor will still be operating, but the LED diode won’t turn on.Magnetic proximity switches with male connector M8 Series CSHFor max. operating current see load curves diagrams.Voltage (V)Output Max current Max Load Protection10 ÷ 30 AC/DC -250 mA 10VA/8W Against polarity reversing 10 ÷ 30 AC/DC PNP 250 mA 10VA/8W Against polarity reversing10 ÷ 27 AC/DC PNP 250 mA 6W Against polarity reversing and overvoltage10 ÷ 30 AC/DCPNP250 mA10VA/8WAgainst polarity reversingIn case of polarity reversing the sensor will still be operating, but LED diode won’t turn on.Products designed for industrial applications.General terms and conditions for sale are available on ./9.05.091Length 2 m 5 m 10 mProducts designed for industrial applications.General terms and conditions for sale are available on ./9.05.10 1Mod.Cylinders seriesS-CST-01S-CST-01Mounting brackets for sensors Series CST - CSHProducts designed for industrial applications.General terms and conditions for sale are available on .Proximity switches Series CST-CSV-CSH MOVEMENT >CATALOGUE >Release 8.5/9.05.111Mounting brackets for sensors Series CST and CSHMod.S-CST-45N1S-CST-45N2。
CRRT中CVVH模式操作流程
处理报警原则
处理报警首要原则：
在处理报警的过程中，任何情况都不要因报 警而让血泵停转，易造成加快凝血。
主要参数监测及意义
uPV静脉压：血液回输体内的压力，又称回路压， 测量位置在血泵之后，是反映静脉回流通畅与否 的指标，通常为正值，典型压力值为+50至 +150mmHg。
uTMP跨膜压：CRRT中的CVVH主要是通过对流 的原理来清除溶质的，所谓对流是指从压力高的 一侧通过半透膜向压力低的一侧移动，液体中的 溶质以等渗性对流转运和水一起穿过半透膜。
血滤机基本部件
压力监测 体外循环血泵
空气监测
滤出液泵 置换液泵
漏血监测 称重平衡系统
血滤机参数
主要参数监测及意义
uPA动脉压：为血泵前的压力，由血泵转动后抽 吸产生，通常为负压。主要反映血管通路所能提 供的血流量与血泵转速的关系。
uPBE滤前压：测量血液进入滤器时的压力，也就 是滤器入口处血液管路内的压力，测量位置在血 泵之后，滤器之前，是体外循环中压力最高处， 数值是正值，典型压力值为+100至 +250mmHg。
CRRT简介
对流
u在跨膜压（TMP）的作用下，液体从压力高的 一侧通过半透膜向压力低的一侧移动，液体中的 溶质也随之通过半透膜，这种方法即为对流。
CRRT简介
吸附 u溶质吸附在滤器膜的表面、或滤器中的活性炭 及吸附树脂上，从而达到清除的效果。
CRRT适应症
肾脏疾病
Ø 急性肾衰 Ø 严重高血钾症 Ø 水中毒 Ø 严重代谢酸中毒 Ø 尿毒症症状加重
置 换 液 管 路 安 装
滤 出 液 管 路 安 装
检查管路安装
预充
预充
备妥治疗
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Start UF rinse? 【OK】 to confirm!
准备程序
连接病人 •核对治疗参数 •按“stop”键
• • •
按下“stop”键 血泵停止，连接动、静脉建立体外循 Start connection? 环 选择 【OK】 to confirm! 按“OK”键
(9600 ml/h) (4200 ml/h) (3000 ml/h) (6000 ml/h)
预充/冲洗/结束治疗
• • • 冲洗量 超滤量 再输液量 0 - 5000 ml 300 - 2000 ml 0 - 2000 ml
- 建议最好放在后稀释模式进行机器的准备
- 在结束准备机器后，你会被要求改变模式= 前稀释或者后稀释模式。
• 如果静脉端还没有连接病人，
连接静脉血路管至病人 • 夹子都打开了吗？ • 必要时连接到前稀释的位置 必要时滤器回正，动脉端朝上 • 所有的连接是否紧密？
•
选择
Start treatment? “OK” to confirm!”
• 并按下“OK”开始治疗
Clinical & Training Department
Clinical & Training Department
治疗参数
• 成人治疗参数
• 儿童治疗参数
Clinical & Training Department
血泵流率
泵管尺吋 所有 = 6.1 毫米 可选择在治疗的参数菜单
后稀释 • 如果超滤率/血流率 的比率大于20%将显示
出红颜色在血流量的左边。 • 如果超滤率/血流率之间 的差是在正常的范围 将会显示出白颜色。 • 这样是预防后稀释时血液浓缩的发生。
继续循环.按[start/reset] •连接动脉（或动静脉同时连接） •检查：管路夹是否打开？ •所有连接是否正确？
Clinical & Training Department
准备程序
开始治疗
• • • 光学检测器监测到不透明液体时 血泵停止 如果静脉端还没有连接病人，连接静 脉血路管至病人 • 注意屏幕提示
准 备 程 序
超滤冲洗
• 当预设冲洗量完成，血泵停止并 有声音提示。 • 将静脉血路管与收集液袋断开与 动脉管路相连，将输液器接盐水 袋与泵前侧枝相连 • 注意屏幕提示
• 打开管路上的夹子 • 保证有足够的超滤冲洗液体 • 所有的连接是否紧密？
• 使用旋钮选择 • 并按下“OK” • 开始超滤冲洗，冲洗时间受控于 血泵速率
•
使用旋钮选择 并按下“OK”
Start priming? “OK ” to confirm!”
•
开始管路系统预冲
• 翻转动脉捕气壶调节液位至3/4处回正位
Clinical & Training Department
准备程 序
• 当超声传感器检测到静脉气泡捕捉器中的 液位时，可通过“Venous bubble catcher level” 字段的上下键手动设置静脉壶液位水平。
确认管路系统正确连接 确认置换液正确连接并 打开管路夹子 确认预冲生理盐水已连 接并打开管路夹子
Set up? “OK” to confirm!
•
•
并按下 “OK”
Clinical & Training Department
准备程 序
预冲管路系统
• 注意屏幕提示！
• 检查所有的夹子是否打开。 • 盐水袋的连接口是否打开。 • 确认所有的连接是否紧密。
Clinical & Training Department
血泵的流量率
在这里血泵的流速是100 毫升/分钟，超滤 率/血泵流速显示为红颜色37% 因此，如果我们继续下去，血液浓缩的结 果将会发生，滤器堵塞的可能性大。 血泵流量已经增加到 300 毫升/分钟和 超 滤率/血泵流量比率是减少12%
血泵流量已经增加到 200 毫升/分钟和 超 滤率/血泵流量已经减少18%
• 机器显示屏自动切换至“治疗参数”界面 • 使用旋钮选择 All treatment parameters
entered? 【OK】 to confirm! ”
•
并按下“OK”键确认治疗参数，显示屏返 回准备界面 显示屏右上角指示正在减少的冲洗容量和 剩余的冲洗时间。
•
Clinical & Training Department
Terminate bag change?
Clinical & Training Department
治 疗
治疗菜单
--暂时中止治疗
•
进入天平数据菜单 点击平衡开关键 off
Clinical & Training Depart-暂时中止治疗
• 点击ESC两次返回主菜单，血流量
Clinical & Training Department
置换液管路的安装
• 将置换液袋出口向后放于秤上 打开置换液泵门，装入置换液泵管， 使管路嵌入置换液泵凹槽内 按住“START/RESET”键，将泵管带入 凹槽内。关上泵门。 将保护帽从置换出口管上取下，挤压 加热囊尽量排出空气。 将置换加热囊放入置换液加热器中 （ 出口端向上) 。 将置换液管路出口端与静脉壶（后稀 释）连接/与动脉壶（前稀释）连接
【OK】 to confirm!”
•
并按下“OK”显示治疗数据
Clinical & Training Department
治疗数据参考
• • • • • 血液流量 置换液流量 透析液流量 血浆率 超滤率 10 - 500 ml/min 10 - 160 ml/min 10 - 70 ml/min 10 - 50 ml/min 0 - 100 ml/min
Clinical & Training Department
准备结束治疗
• • • • 按下“ESC”键。 使 用 旋钮从菜单栏中选择 End of treatment 按下“OK”键确认 查看屏幕上的提示。 - 断开与病人的连接 - 按“stop”键，血泵停止运行，静脉夹关 闭，断开动脉连接至回血生理盐水 Start disconnection? • 选择 【OK】 to confirm! • 按“OK”键血泵速率降至100ml/min开始回 血
治
治疗主屏幕
疗
在整个治疗过程中均显示主屏幕 菜单字段显示： • 当前压力 (动脉、静脉、跨膜压) • 当前流速：置换液速率，血流量， 超滤速率，抗凝剂速率 状态栏显示：
治疗模式 (CVVH) 治疗时间进程(Treatment time 0:00 h:min)
平衡状态 (balance -0.82 L) 关闭连续抗凝(Cont heparin adm Off
注意事项
警告
• 无菌技术：在所有血液一侧的连接器，和所有使用消毒 溶液的连接器上应用无菌技术。 • 在压力管路上使用带疏水过滤保护罩的管路系统，以预 防交叉感染。 • 不得用注射器将压力测量管路中的血液推后。这可能会 损坏疏水过滤罩的保护膜，造成污染。 • 确保过滤液袋自由悬挂，不要接触其它任何物体，以保 证平衡系统正常工作。 • 漏血检测器和过滤液袋之间的过滤液管路不要插得太紧
• • •
Clinical & Training Department
检查管路系统连接
压力监测
体外循环管路的4个压力监测
感应器必须正确、紧密连接
动脉压 滤器前压力 静脉压 滤过液压力
Clinical & Training Department
检查管路系统连接
•
1.动脉血路管（a) 2.静脉血路管（b） 3.滤过液管路（c） 4.将置换液袋放于秤（A或B） 5.置换液管路 6.肝素管路（f）
Clinical & Training Department
按图示顺序安装管路
•
•
•
•
•
安装肝素泵
按图示顺序安装管路
•
•
必须使用50 ml注射器
按▼键，使推进器打开至最大 位置
•
排出肝素注射器内的空气，将 注射器与动脉管路系统的肝素 管端口（f）连接。
将注射器放在注射器支架上 注射器必须嵌入注射器插槽内 按住▲键，使注射器活塞末端 嵌入推进器的夹子中间。与注 射器活塞末端相接触。
Operating Procedure
开始条件
• • • • • • •
1、2 秤上没有袋子 3、4 秤上没有废液袋 没有管路安装 没有压力感受器安插 没有管路卡在监测器内 没有管路在漏血监测器内 按“OK”键
Clinical & Training Department
功能检测正在进行中
Clinical & Training Department
按“ OK ”继续回血，直至体外血 液 Terminate 回输干净。 • 使用旋钮选择 Reinfusion？ • 按“OK”回输程序结束 • 但是如果回输剩余量为0 ml时，回 输将自动停止。 • 血泵缓慢转至三点位时停止
Clinical & Training Department
治疗结束
• • 将静脉病人管路与患者断开。 从凹槽中将泵接头滑出。按住 “Start/Reset”键直到泵完全取下。 • 从加热器上取下加热袋打开加热袋前后 的夹子帮助清空加热袋。 • 取下并丢弃管路系统。 • 如上取下其他的泵段。 • 使用旋钮选择 View treatment parameters?
Clinical & Training Department
治
治疗菜单
疗