I&O, UF rate, & CRRT

[dorimar]

Hey all. When do you calculate your intake to determine your UF rate? We've always figured the intake at the end of the hour to figure what to set our UF rate at the top of the next hour. Basically, we take off this hour what we put in last hour. The other night i worked and the nurse was "estimating" what she thought would go in on the current hour (top of the hour), and setting the uf rate so she would be taking off that amount at same hour. She stated that the dialysis nurses are teling all of the floor ICU nurses to run it this way, and so that is what everyone is doing. My problem with this is, How do you really know what will go in in the hour until it is over. Especially if your dumping blood products in or doing PRN boluses or albumin and titrateing mega pressors? Plus it is very confusing in the charting. I&O has always been done as: intake charted at 8pm was what went in from 7pm to 8pm, and output is what you empied at 8pm (be it urine, ng or hemofiltration). how are you all doing it? I really would appreciate some input on input on this.

[koyeh]

Thanks, for the answere. There is a huge difference in costs b/t prismaflex/ Fresenius and that seems to be running the negotiations at this point.

[koyeh]

Any SLED users? Is a dialysis nurse responsible for the machine and rotating b/t patients? Nurse for care only.

[koyeh]

Baxter users: Is there good support? Clinical and technical? I know there is an FDA hold but there is on gambro also.

[km5v6r, EdD, RN]

Any SLED users? Is a dialysis nurse responsible for the machine and rotating b/t patients? Nurse for care only.

Sled here is set up by the dialysis nurse, water checks, bath changes etc. Maintance and hourly checks are done by the ICU nurse. If the system begins to clot or the pt is to be taken off the ICU nurse returns the blood. The dialysis nurse is not in house over night. A call person is available to help with troubleshooting and answer questions. Usually if the system clots in the middle of the night. (don't they all?) The pt is left off until morning.

[koyeh]

Tried the dialysis nurse being responsible for prisma at first and it failed miserably. The ICU nurse wants control. Crrt: no matter what method is here to stay. I see a huge learning curve in the future. Thanks for the info.