Dialysis process at MEDICA includes facilities like:
- Online HDF
- High Flux Dialysis with Bibag
- Low Flux Dialysis
- Single-use Low & High Flux Dialysis
- 4008 SC Dialysis Machines
- SLED in ITU/ICU
- Peritoneal Dialysis
- Ultra-pure Water
- Non-invasive Monitors with Each Bed Individual TV
- Single Needle Heamodialysis
1. Predialysis Assessment
- Identification of patient
- Measure: Blood pressure, Pulse, Temperature & Weight
- Blood glucose, if diabetic
- Observe/assess patient for any other problems or needs
2. Rinsing and Priming
- Done to ensure that all air is eliminated from the circuit and rinse out residual sterilant
- Use the sterile ‘nontouch technique’
- Connect dialysis solution
- Priming of blood lines
3. Testing of Alarms
- Blood circuit, Arterial pressure, Venous pressure, Air detector, Dialysis solution circuit, Conductivity, Temperature & Blood leak
4. Vascular Access
- AV fistula is preferred
- Fistula assessment-examine for bruit, signs of infections, bruising.
- Identify the needle site
- Under aseptic precautions, clean the fistula using chlorhexidine.
- Apply tourniquet
- Stabilise the vessel with dressing.
5. Initiating Dialysis
- Insert the fistula needle bevel up
- Remove tourniquet
- Connect the limbs of needle to the dialysis circuit and start the blood pump at 100 mL/min.
- Observe for pain or swelling
- Increase the blood flow rate to desired level after the circuit filled with blood.
- Initiate dialysis solution flow and adjust transmembrane pressure.
6. Monitoring during Dialysis
- Monitor Pulse rate & BP every 30 to 60 minutes in chronic dialysis & every 15 minutes in acute dialysis
- Food and fluid intake
7. Terminating Dialysis
- Pump sterile normal saline into the arterial side until blood is displaced.
- Cleaning and disinfection of equipment
8. Monitoring Post-dialysis
- Assess & document: Weight, Pulse Rate, BP supine and sitting, Temperature, Blood investigations & Vascular access patency