Posts Tagged ‘PAO’

Accidents and Incidents hemodialysis

Monday, March 8th, 2010

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)

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

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