Dialysate question

[Loveyourkidneys]

What symptoms would I be looking for if I suspected patients dialysate had gotten into their blood stream? Fresenious had a voluntary notice sent out to anyone who uses a certain type of machine. Where the filling program stays on backing up into the saline bag. Ex. You've primed your machine so you should not have a full saline bag. Filling program stays on and next thing you one you have a bulging saline bag. If you suspect that the patient may have gotten dialysate rinsed into them... Symptoms to expect??

[Chisca, RN]

I think the danger to the patient comes from the volume of fluid rather than the compostion of the dialysate. The dialysate solution is diluted with large amounts of water from the r/o system and should have all pathogens removed. Electrolyte compostion would be very close to normal physiology ie Na 138, K 3.0, bicarb 33. Instead of removing fluid your patient would be getting a fluid bolus and at a pretty good rate. Respiratory distress is what I would expect.

"This matter appears to be limited to situations where occlusions of the dialysis machine's drain line in combination with an active internal Filling Program may push dialysate into the saline bag during recirculation if the saline line is unclamped, the company said."

Fresenius clarifies recall of hemodialysis machines | Nephrology News & Issues

[diabo, RN]

Keep in mind that the dialysate solution is not sterile and should never enter the patient's bloodstream.

[Loveyourkidneys]

The non sterile part is what I'm concerned about. The patient was never on the machine. But if they were the line would be clamped. That's how know it isn't salkne. The line is clamped in two spots but the bag fills. I asked an area biomed who says to check valve 42 and change the air separator.

[Loveyourkidneys]

We always leave the line unclamped during recirculation. Then dump the prime before tx starts. I was worried wondering how concentrated the dialysate is. I didn't want to be giving a huge bolus of potassium if the bag filled and someone missed it. Thanks so much for yor input