Today our topic of discussion is Hemodialysis of Medical Surgical Procedures.
Hemodialysis of Medical Surgical Procedures
HEMODIALYSIS
Definition
It is defined as the lifesaving procedure in which the toxic waste, removed from the blood through purifying dialyzer and the purified blood return back to the body through arteriovenous fistula.
Indications
- Patient with acute reversible renal failure
- For regular long-term treatment of patient with chronic end-stage renal disease
- Acute poisoning, such as barbiturate or analgesic overdose.
Equipment
Preparation of Hemodialysis Machine
- Hemodialysis with appropriate dialyzer
- IV solution, administration set, lines, IV pole
- Dialysate
- Injection heparin, 3 mL Syringe with needle, medication label, and hemostats.
Preparation of Double Lumen Catheter for Dialysis
- Povidone-iodine sponges
- Two sterile 4″ x 4″ gauze pads
- Two 3 mL and two 5 mL syringes
- Tape
- Injection heparin bolus syringe
- Clean gloves
The hemodialysis blood circuit: A dialysis machine blood from the patient, through disposable tubing, through a dialyser, or artificial kidney, and back into the patient. Waste solute, salt and excess fluid is removed from the blood as it passes through the dialyser (Fig. 29.114). pumps
Preparation for AV Fistula for Dialysis
- Two winged fistula needles (each attached to 10 mL syringe filled with heparin flush solution)
- Linen- saver pad
- Povidone-iodine sponges
- Sterile 4″ x 4″ gauze pads
- Tourniquet
- Clean gloves
- Adhesive tape
Preparation for AV Shunts for Diathesis (Fig. 29.115)
- Sterile 4″ x 4″ gauze pad
- Povidone-iodine sponge
- Alcohol sponge
- Sterile gloves
- Two sterile shunt adapters
- Sterile Teflon connectors
- Two bull dog clamps
- Two 10 mL syringes
- Normal saline solution
- Four short strips of adhesive tapes
- Sterile shunt spreader.
Equipment Needed after the Procedure
- For Double Lumen Catheter
- Sterile 4″ x 4″ gauze pad
- Povidone-iodine sponges
- Precut gauze dressing
- Clean sterile gloves
- Normal saline solution
- Alcohol sponge
- Heparin flush solution
- Leur-lock injection caps
- Transparent occlusive dressing, tape, skin barrier preparation, materials for culturing drainage.
For AV Fistula (Fig. 29.116)
- Clean gloves
- Sterile 4″ x 4″ gauze pads
- Two adhesive bandages
- Hemostat
- Sterile absorbable gelatin sponge.
For AV Shunt
- Sterile gloves
- Two bull dog clamp
- Two hemostat
- Povidone-iodine solution
- Sterile 4″ x 4″ gauze pads
- Alcohol sponges
- Elastic gauze
Preparation of Equipment
- Maintain strict aseptic technique to prevent the introduction of infection into the bloodstream
- Test the dialyzer and the dialysis machine for residual disinfectant after rinsing Test all the alarms.