Do you use crit lines?

RNintherain · Dec 7, 2003

I use critlines whenever my pts dry wt is in question, or if they suddenly start crashing at the end of tx. Holiday time is a good time to use them since pts, like the rest of us, tend to put on wt. Some of our docs call us /c dw for pts and are totally unrealistic so the critline becomes our proof of pt dw. We can't help it if they go to the Country Buffet and gorge themselves...I tell them I may be able to get the fluid off but can't get the roast beef and mashed potatoes. (horrors! the pia is eating potatoes again!!) I hope you got an inservice on using the critline, I started doing dialysis /p almost 20 yrs of hospital work and no one inserviced me on it. I finally had to drag someone over to teach me how to use the dang thing, now I love it.

jnette, ASN, EMT-I · Dec 7, 2003

Originally posted by RNintherain
I use critlines whenever my pts dry wt is in question, or if they suddenly start crashing at the end of tx. Holiday time is a good time to use them since pts, like the rest of us, tend to put on wt. Some of our docs call us /c dw for pts and are totally unrealistic so the critline becomes our proof of pt dw. We can't help it if they go to the Country Buffet and gorge themselves...I tell them I may be able to get the fluid off but can't get the roast beef and mashed potatoes. (horrors! the pia is eating potatoes again!!) I hope you got an inservice on using the critline, I started doing dialysis /p almost 20 yrs of hospital work and no one inserviced me on it. I finally had to drag someone over to teach me how to use the dang thing, now I love it.

hmmmmmmmm... interesting ! Never heard of these... any links or info on this you could point me to? Would like to take a look and familiarize myself with these crit lines. Got me curious now...

Thanx ! :)

RNintherain · Dec 7, 2003

Critlines work on the same principle as a sat monitor..you initialize it and clip a light sensor onto an add in on the blood line above the kidney and it reads out the current hct, then you set the goal for (usually) 5% above that reading. You then get a linear readout and watch your line..if it's too steep you back off on your target on the dialysis machine, too flat you increase your target. Nice tool for pts who crash during tx, or those who come in with high wt gains. We have a few pts we can't weigh for various reasons so the crit line is our only means of achieving a decent tx..works pretty well too. Our techs are also trained to use them which helps alot.

jnette, ASN, EMT-I · Dec 7, 2003

WOW !!! Kool ! :cool:

Have never heard of nor seen one of these... wonder why? Does it work better in keeping a pt. from crashing than say, UF profiling and sodium modeling ? Are there any websites that depict this critline option?

I'd sure like to see it and read more about it ! I'll ask our Clinical Mgr. about it tomorrow... bet she hasn't heard of it, either.

By the way, in my new issue of RN Magazine yesterday, I read an article about... LIVER dialysis !!! Showed a picture of the machine, bloodlines, dialyzer, and was a toitally new concept in liver failure, and those awaiting liver transplant.

VERY INTERESTING... and another opportunity in nursing in the near future, as they continue to work out the bugs, and develop the :perfect" machine for this....

Was pretty neat to read about !

nursefiggy · Dec 16, 2003

go to

http://www.hemametrics.com/

It is the most valuable tool I have found. Some fo the more difficult pts to dialyze I have figured out their own uf profile. For instance, I know that with a particular pt I can begin the tx with a uf of 2000for one hr and then a uf of 300 for half and hr and then a uf of 600 for the remainder of the tx with the last 15 min at 300 to check for refill. Of course that varies with how much fluid they have on.

I also know that on a pt with an 02 sat of 88 on room air, if i put 02 on them and I get their 02 sats above 90, say to 94, i will see refill and then more fluid is available to pull. I wish i had 02 and a crit line for every pt!

RNintherain, we were inserviced on them when we aquired them and even got CEUs.

babyboomerRN, RN · Dec 16, 2003

thanks so much for posting the above site. i had trouble finding alot of info on crit lines but this site is great.now i've got some info to take to our manager!

Hellllo Nurse · Dec 16, 2003

Never heard of this, thanks for the info and the link. Sounds great!

However, I know it would be a cold day in heck before my facility would ever get these.

$$$, ya know.

jnette, ASN, EMT-I · Dec 16, 2003

Originally posted by Hellllo Nurse
Never heard of this, thanks for the info and the link. Sounds great!

However, I know it would be a cold day in heck before my facility would ever get these.

$$$, ya know.

heh heh heh heh heh heh heh heh heh heh heh........... :rotfl:

Ditto.

nursefiggy · Dec 18, 2003

Unfortunately, they are very spendy and break alot. The drs love them though and research has proved that the hcts are very accurate so we can do a hct check without taking blood or sending to a lab! We can check a hct and give blood if necessary in the same tx.

BeckieRN · Dec 28, 2003

I manage a small acute dialysis unit and we use crit-lines on all patients. We have seen a significant reduction in intradialytic hypotension and cramping as well as much better control of fluid removal. Neither my staff or I would do without!!

Hellllllo Nurse, BSN, RN · Dec 28, 2003

Originally posted by BeckieRN
I manage a small acute dialysis unit and we use crit-lines on all patients. We have seen a significant reduction in intradialytic hypotension and cramping as well as much better control of fluid removal. Neither my staff or I would do without!!

I want to have these at my unit!

We use older machines- all analog, no UF or Na+ profiling. Do crit lines work w/ these type of machines?