CMS SOM App. H, Tag V120

Use external venous and arterial pressure transducer filters/protectors for each patient

treatment to prevent blood contamination of the dialysis machines’ pressure monitors.

If the external transducer protector becomes wet, replace immediately and inspect the

protector. If fluid is visible on the side of the transducer protector that faces the machine,

have qualified personnel open the machine after the treatment is completed and check for

contamination. This includes inspection for possible blood contamination of the internal

pressure tubing set and pressure sensing port. If contamination has occurred, the machine

must be taken out of service and disinfected using either 1:100 dilution of bleach (300–600

mg/L free chlorine) or a commercially available, EPA-registered tuberculocidal germicide

before reuse.

Page 14 of 420

Change filters/protectors between each patient treatment, and do not reuse them. Internal

transducer filters do not need to be changed routinely between patients.

Interpretive Guidance § 494.30(a)(1)(i)

According to the CDC, external transducer protectors, which provide a protective barrier

between dialysis bloodlines and the dialysis machine, should not be reused. “Wet” (“wet with

blood or other fluid”) external transducer protectors must be changed immediately, and the side

of the external transducer protector that faces the machine should be inspected for visible fluid.

If the external transducers are wetted with blood, the staff should inspect the wetted transducer

to see if fluid has passed through. If fluid or blood is visible on the side of the transducer

protector that faces the machine, the machine must be opened by qualified personnel after the

dialysis treatment to allow the internal transducer to be inspected for contamination. This

includes inspecting the internal pressure tubing set and pressure sensing port for possible blood

contamination. Frequent blood pressure alarms or frequent requirements for adjusting the blood

level in the drip chamber can be indicators of contamination of the internal transducer filter.

Recognize that some bloodlines do not have external transducer protectors; this requirement

would not apply in those cases, except for changing the bloodlines between patients.