• Reducing the speed of the pump blood ..
• Last sloping patient.
• Intake of saline (on prescription)
• Eventually, put under O2 (depends on service protocols)

Prevention:

• Never ultrafilter patients below its base weight.
• Weight gain rigorous
• Avoid taking anti-hypertensive before the dialysis session
• Rate of Na in the dialysis at a concentration equal to or lower than the patient. (Reminder: the Na profile is a prescription)

B – angina
Aggravating factors: anemia, decrease in BP, in hyper-debit FAV
What to do:

• Preventing nephrologist
• UF minimum
• Decreased blood flow
• O2 nasal + scope
• possibly following protocols, use nitroglycerin sub-lingual.
• If the crisis continues, stopping hemodialysis, restitution, perform ECGs, biology (KPC / CPKMB / LDH etc. ….), transfer in a specialized

C – PAO
A etiology:

• Hypervolemia
• Acute heart failure or chronic
• Anemia
• Uncontrolled hypertension
• Drug causes (B-Blockers)
• Pump failure causing UF retro-filtration dialysis

Clinic:

• Dyspnea
• Cyanosis
• Anxiety
• Chest pain
• Cough more or less expectoration of pink frothy fluid
• Distended jugular consequences of hypervolemia and / or heart failure

What to do:

• Emergency ultra-filtration (UF isolated, it is possible to mount 2L / H on prescription in this case, it should mount a dialyzes steep)
• Oxygen nasal min 3L/min
• ECG, scope

D – Muscle cramps:
Aetiology:

• Dehydration extracellular
• Dry weight estimated too low
• UF excessive
• Na, Ca, Mg too low concentration in the dialysis

What to do:

• Stop ultra-filtration
• Prescription, Hypertonic NaCl addition and / or saline
• Rub with ice

Prevention:
On prescription, increased concentration of Na, dialysis or concentration of variable Na

E – Acute Hemolysis
Aetiology:

• Dialysate hypo / hypertonic
• T ° inappropriate
• On the CEC, closed for over a quarter of an hour, kinking, pump blood occlusive

Clinic:

• Anxiety, sweating, malaise + + +, brutal
• Back pain sudden and very intense;
• Abdominal cramps
• Tightness, dyspnea
• Presence in the circuit, blood taking an aspect of currant jelly

What to do:

• Stop UF, NOT TO REPAY
• Disconnect
• Symptomatic treatment
• Sampling of water, dialysate, the patient’s blood to determine the cause

F – Air embolism
Aetiology:

• Entry of air into the CEC
• Disconnection unsecured (withdrawal of air detector)
• Debulage, air intake on the venous tubing

Clinic:

• Polypnea
• Cyanosis
• asphyxia
• arrhythmias

What to do:

• Immediate cessation of UF
• Clamp the arterial and venous lines
• Patient sloping + + +
• Aspirate if the patient has a central lane (vacuum bubbles located right in the heart)
• Oxygen

Preventing medical and rescue support for immediate hyperbolic chamber

G – Coagulation:
Aetiology:

• No heparinization,
• failure of the pump causing an increase in PV and PTM, and a bleeding mass of the entire circuit
• Case circuit over 15 minutes

What to do:
Do not return, make a new connection circuit.