CRRT Pressure Alarms Algorithm

1 Which alarm?

Access pressure too negative → step 2Return pressure high → step 3Return pressure suddenly low → step 4TMP or filter pressure rising → step 5Blood leak detector → step 6Air in the line → step 7

2 Access (draw) problem

• Check for kinks and closed clamps
• Reposition the patient; coughing or a bent leg can block a femoral line
• Flush the access lumen per protocol
• Lower blood flow; reversing the lines is a protocol decision

End of this path.

3 Return (venous) side blocked

• Kinks or clamps on the return line
• Clot in the return limb or the air chamber
• Catheter position

End of this path.

4 Possible disconnection

• Stop the blood pump and check every connection now
• Press on any bleeding site
• Assess for blood loss and air entry

End of this path.

5 Filter clotting

• Check anticoagulation (citrate or heparin) is running
• Look for dark streaks in the filter
• Return the blood promptly per protocol before it clots, then set up a new circuit

End of this path.

6 Blood leak: filter membrane rupture

• Stop the pump and confirm blood in the effluent
• Do not return the blood if the leak is confirmed (follow the protocol)
• Change the filter

End of this path.

7 Air detected

• The pump stops automatically: do not override
• Find the source (loose connection, empty bag)
• Remove the air per the machine instructions

End of this path.