1. Pay attention to the problem of dialysis water
Dialysis water is extremely important in the entire dialysis process. If there is no high-quality water treatment equipment, the dialysis pure water and reverse osmosis water produced will not meet the standards. If the water quality is unqualified, it can cause a series of illnesses, water sources or water treatment systems. Problems will affect the supply of dialysis, forcing the dialysis to stop, and the hemodialysis machine will alarm. Therefore, ensuring that there is water and that the water quality is qualified is the prerequisite and basis for dialysis. Generally, large hemodialysis centers or hemodialysis rooms must have independent tap water storage tanks and source water tanks to ensure sufficient water sources and water pressures, and water treatment systems There is not necessarily a backup, but it is also necessary to consider emergency measures after the failure of the soft water system or the reverse osmosis machine.
2. Pay attention to the preparation of dialysate
The role of dialysate is to correct the chemical composition of uremic blood. In order to meet this requirement, the composition of the dialysate must be similar to the actual normal plasma moisture, that is, the composition of protein-free plasma. Since the composition of the dialysate is mainly used to adjust the balance of electrolysis, care must be taken to select the liquid composition to meet the needs of the patient.
Three, pay attention to the preparation of concentrated solution
The supply of modern hemodialysis is the use of concentrated solution, dialysis pure water, and reverse osmosis water, which are automatically diluted into hemodialysis solution through a fixed volume ratio of the machine. This proportioning solution uses the conductivity method to indicate the total ion concentration of the electrolyte in the dialysate, which is a guarantee One of the important monitoring indicators of dialysis safety. This kind of automatic detection and monitoring function is generally available in imported dialysis machines, and most of the preparation of concentrated solution is made manually according to the formula. Usually dialysate is divided into two types (acetate dialysate and bicarbonate dialysate) for acetate dialysis, only one type of concentrate is used, or for bicarbonate dialysate, two types of concentrates are required, either Improper preparation of these concentrated liquids will cause adverse consequences and easily cause the machine to alarm. If the machine’s conductivity alarm limit is adjusted too wide or the self-test function is abnormal, it will cause nausea, vomiting, chills, and blood pressure to the patient. A series of dialysis reactions, such as high or low, can endanger the life of the patient in severe cases.
In addition, in actual work, I have encountered several machines simultaneously alarming because of too low or too high conductivity, and they can't perform normal dialysis, which is generally caused by the unsatisfactory preparation of concentrates. Therefore, the preparation of the concentrated solution must be prepared strictly in accordance with the formula, and the prepared concentrated solution is best subjected to the necessary testing. In addition, it is not advisable to leave it for too long to prevent sedimentation pollution or deterioration when it is used. It needs to be filtered.
Fourth, pay attention to the power supply of the hemodialysis room
Hemodialysis machines are different from ordinary diagnostic equipment. Usually, the failure of diagnostic equipment will not cause much harm to ordinary patients (except emergency patients). The suspension or postponement of hemodialysis treatment due to power supply problems will double the workload of medical staff. More importantly, it will cause great suffering to patients and even endanger their lives. At the same time, it will bring unnecessary burden to the hospital. Economic losses. However, most of the patients who survive on hemodialysis in our country are end-stage renal disease patients. It is difficult for patients to bear no dialysis once or twice or slightly increase the interval between dialysis. Therefore, the power supply of the hemodialysis room is a problem that cannot be ignored.
The voltage of the power grid in large hospitals in large cities and in areas with tight power supply is generally low, especially when most equipment is running in the morning, sometimes the stabilized power supply itself is difficult to work normally, so it should be equipped with a stabilized power supply. Consider dual grid power supply, secondary power supply system, and automatic switching to prevent power outages from causing great passiveness in work. Now most hemodialysis machines are powered by batteries (usually can last for 15 minutes) to avoid temporary power outages that may cause patients Panic phenomenon.
