CRRT: Who does it??

[NephRN]

I am a dialysis nurse working in an inpatient, acute care setting. Where I work, the dialysis staff sets up the CRRT (PRISMA), provides teaching to the critical care staff, changes the set-up when the sytem clots, makes the changes when there is a change in modality ordered (ie: SCUF to CVVHD), on call for problems, and discontinues the treatment when so ordered. Please tell me how it is handled where you work. I would also like to know what area you work in (ie: ICU, CCU, SICU, TICU, CVRR, Dialysis, etc.) and how you feel about your CRRT resonsibilities. Thanks in advance.

[errepiesse]

well, i'm an italian nurse. in our icu, crrt is abitual worked by nurses staff.

assembled and runned by themselves, using Bellco machines. i'm the trainer ad tutor about teaching all the systems. i've a personal program of auto-teaching by clinical cases and courses in multiple hospitals.

any question for me??

[koyeh]

What product are you using and are there any issues?

We are currently using prisamflex: Had a lot of issues when we changed from prisma to prismaflex. The machines suddenly malfunctioned- pumps going crazy and the machine had to be taken for service. Gambro has since placed a softwear upgrade and the machines are running great. Only few issues to be fixed w next upgrade. The problem is that NX stage came in and our nurses want to convert. Seems more nursing freindly. The nephrologist do not like this product. They want CVVHDF and NX, braun etc can not offer that currently. In our intensive care units the nurses do it all and the diaylisis dept. has gotten out of it.

[Kathyiwvu]

Who does the CRRT for infants?? Need ideas for training and education --new nephrologist onboard and need immediate training. Don't want to practice --we have the accura machine. Who does the hemo for babies?? Please help

[TREBORICUNURSE]

Hi,

We do about 1-2 CRRT for every 2 - 3 months. Every time dialysis nurse is present in ICU and take care for machine and CRRT procedure. All others around that patient is ICU nurse job.

Is it CRRT ICU or dialysis job?....Hm....

Critical care nursing and dialysis nursing today are highly specialized fields and every improvization is potential risk for patients health/recovery.

I think that dialysis nurse are expert for CRRT and the best solution for patient who is on CRRT is dialysis nurse. Thay do CRRT, dialysis and other similary procedure every day. Thay have expirience, thay have knowleage.

ICU staff who is 1:2 even 1:3 ( in my ICU ) cannot take responsibility for patients safety during the CRRT procedure.

[6eyes]

Dear collegues, does anybody know what is in the effluent? What about virusses, medication or yeast and fungi?

Kind regards, 6Eyes, The Netherlands

[zimm4er]

we use the fresinus K machine with a micro chip. We turn the blood flow to 200, and the dialysate flow to 200 also. We run replacemnt fluids of Ns at 200 ml /hour into the art/venous chambers. Nothing to weigh, measure or calibrate. We just use our standard nicarb, adjust the bicarb on the machine to the drs orders. Usually we use a 4k, 2.5 ca bath with 1meq mg. We use this on adults and babies. We get excellent clearance and all the ICU nurses are responsible for are writing numbers down every hour, and changing the replacement bags as needed. They are taught how to troubleshoot some, and return if the system is clotting. We reset up as needed. I really do like this method --it works well for the pt and is low maintance for the Icu nurse,