CMS SOM App. H, Tag V197

5.2.5 Carbon adsorption: (positive sample of chlorine or chloramine)

When samples from the first sampling port are positive for chlorine or chloramine,

operation may be continued for a short time (up to 72 hours) until a replacement bed is

installed, provided that samples from the second sampling port remain negative. The

replacement bed should be placed in the second position, and the existing second bed

should be moved to the first position to replace the exhausted bed. If it is not possible to

rotate the position of the beds, both beds should be replaced.

Interpretive Guidance § 494.40(a)

AAMI Rationale for the Development and Provision of This Recommended Practice

A.5.2.5 Carbon adsorption

The AAMI RDD Committee recognized that it might not be practical to rotate the bed positions

in installations that use large, backwashable carbon beds. However, there was concern that the

capacity of the second bed might decrease unpredictably and no longer provide adequate backup

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if a breakthrough occurred in the first bed. For this reason, the AAMI RDD Committee

recommended replacing both beds if bed rotation was not possible.

Additional Guidance:

When facilities operate with one exhausted carbon bed for up to 72 hours, the log of testing

should include the actual times testing was done rather than indicating “1st, 2nd, or 3rd” shift.

A “negative” sample is interpreted as a total chlorine (the sum of free chlorine and chloramine)

level less than or equal to 0.1mg/L. A “positive” sample is interpreted as a total chlorine level

above 0.1mg/L.

Note: When separately analyzing the removal of free chlorine and chloramines, a maximum level

for free chlorine removal is 0.5 mg/L, and removal of chloramine to a maximum level of 0.1mg/L

is necessary to protect hemodialysis patients from red cell hemolysis.