Long bleeding times - page 2
Hi everyone. Got a cool idea from transient dialysis patient the other night.. He uses Tums on his sites after the needles are pulled to stop the bleeding quickly.. Stopped in 5 minutes.. We have... Read More
Mar 3, '04Quote from nurse dollyWe sometimes use the sticky stuff in the bottom of a tiger top lab tube ( you get it out with a Q-tip!! It works very well when you have someone who keeps bleeding for a very long time. Havent had to use this in a long time.
WOW! Where did you learn this one from??? What's that stuff made from, anyway?
Funny, 'cuz today we were drawing monthly labs, and I had the big tigertop tube in my hand, and my patient (a real joker) looked at me with a dead serious face and said "no, you can't use that one.. you need to get a new one". I looked at him rather befuddled and at the tube, inspecting it,
then proceeded to ask him why. He answered (pointing to the yellowish blob at the bottom)... "cuz that one has a booger in it."
Apr 6, '04[ Now mr 3651bht, I chanced upon your post concerning long time bleeds. I want to know what are "Tums". Look in my country I was the second person to learn and practice haemadialysis. It was a hands on job sort of trainning. My senior left and I was to do most of the dialysis sessions alone but this was on a few patients who would come once a week because of the costs. Our an unsang hello who is the origin of the service in the country finally had an arteriovenous fistula done and after it matured had to start using it. He has been on dialysis for the last 3+yrs and I have been using the fistula for access for the last 1yr or so. Recently I started having trouble with bleeding time and when I told the physician in charge he suggested we reduce on heparin doses(loading from 2500iu to 2000iu,and maintainence from 750iu to 500iu). This had some effect but after a few more sessions the bleeding time increased further. We contacted his vascular suggestion who did the fistular and he suggested we avoid same needle point pancturing and allow the already panctured points time to heal.I did this and the results were tremendous. Now my client told me of clamps which he could purchase and would assist in holding and stopping the bleeding,could these be same as Tums. Please guys I am talking alot but I have had to deal with challenges of haemodialysis as a pioneer. Am glad that finally i found fellow nurses who are involved. Please more education on this subject will be highly appriaciated.
One step for a single man but one big leap for mankind is how I view my experience in pioneering the service in my country. Imagine putting in over 15 hrs because you have one single machine to serve over 8 clients critically ill!!!
Apr 6, '04Am really ewnjoying this whole discussion on bleeding times. Now what are those gels and teabags all about? With calcium gluconate and ferric subsulphates I see the pharma-therapeutical connection. Sure am learning.
Quote from rick3114Scenario varies from patient to patient.
For patient on coumadin, you probably do not need to use heparin when they are on machine, and could squeak by with NS flushes, depending on PT/INR.
Patients with accesses may also take baby ASA so you need to keep this in mind as well when bolusing large units of heparin.
Try stopping the heparin hour before, sometimes 75 mins. before run is complete.
Keep in mind true half life of variety of heparin you are using on a patient.
In our Harvard teaching hospital unit we used to use Ferric subsulfate solution with gelfoam as a last resort for the patients who didn't respond well to merely a 2x2 and gelfoam. We trialed the potato starch in the squeeze bottle but that was ridiculous.
A very old dialysis nurse used to use tea bags, saying the tannic acid promoted clotting and she would use this when the Ferric didn't work. I have never heard of using Tums, but think it is clever. Someone mentioned sterility of using the Tums, but when you have a bleeding patient who goes on and on bleeding for hours what do you do? Send to E.R. and use elastaplast in meantime? When you have worked an 11 or 13 hour day you want to go home and those pesky bleeders can ruin it for you on getting out on time!!!!!!
May 27, '06we use the tipstop brand (quite expensive)for the long time bleeders...tums - very interesting idea and cheaper too, questionable on infection control though...Last edit by JEANJAVE on May 29, '06
Jun 11, '06Sorry but I don't agree by using Tums to press the exit site, Firstly needling site is an open wound and we need a sterile gauze to press the site in which Tums is not sterile.. If the patient is bleeders normally instead of stopping the heparin dose half an hour before conclusion we stop it an hour before conclusion..
Jun 11, '06Quote from bogchi2000Sorry but I don't agree by using Tums to press the exit site, Firstly needling site is an open wound and we need a sterile gauze to press the site in which Tums is not sterile.. If the patient is bleeders normally instead of stopping the heparin dose half an hour before conclusion we stop it an hour before conclusion..
Cannulation is not a sterile procedure. We don't wear sterile gloves. And many out patient units don't use sterile gauze to hold sites. And by opening the sterile gauze with unsterile gloves it becomes contaminated anyway.
I believe the TUMS work because it is flat similar to the clamps some units use. It just gets a better "hold" on the site that a finger or a thumb.Last edit by 1940Nurse on Jun 11, '06