A – Hypotension
Is found in 20 to 30% of the sessions.
There are several etiologies: An excessive decrease in the volume, inadequate peripheral vasoconstriction (diabetic patients for example), or cardiac function improperly or failed.
Clinical: Sudden fall in blood pressure, feeling sick (hot flashes, discomfort, tachycardia, possibly loss of consciousness). Yawning is often a precursor met.
What to do:
- Reducing the speed of the pump blood ..
- Last sloping patient.
- Intake of saline (on prescription)
- Eventually, put under O2 (depends on service protocols)
- 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