Peritoneal Dialysis in the ED?

[robrn1123]

Hi,

I was wondering if any ED RN out there work in an ED that expects them to perform peritoneal dialysis in the ED? I work in an ED that is fairly busy, and patients who come in to the ED in need of PD frequently have it done in the ED. I think this is a bad practice. I have zero experience or knowledge of PD. I have been a nurse for 10 years, all in the ED, and have never worked any other place that required me to do this task. The consensus among our staff is that it is just another attempt to have patients wrapped nicely in a bow before going to a floor that simply doesn't do the work. I have tried to research with ENA and have found no reference to the procedure anyway. So I am wondering does any ER nurse out there think it is within there scope of practice or not. Also if you happen to know of links to any articles pro or con I would appreciate it as I am having a hard time finding any reference to PD being done in the ED. Thanks!

[Old Soul]

We often do continual ambulatory peritoneal dialysis (CAPD) in my department. I work in a medium size emergency department, which is also a trauma centre. We have the all specialties available, but the ED nurses perform the CAPD using the good ol' fashioned gravity systems. The patients we are seeing have established peritoneal catheters, and usually perform their own dialysis at home with a cycler. A physician from the Renal department will consult on the patient, and write orders for the PD - including what type of dialysate to be used, and how many exchanges per day, and dwell times. Exchanges are done using a combination of aseptic/sterile technique (i.e. not wearing sterile gloves, but also not touching the end of the catheter - similar to accessing IVs). We assess the catheter site, and change dressing PRN.

Setting up the CAPD is relatively quick and easy, and does not require to remain at the bed side.

-preparing supplies (including warming the dialysate)

-postural vitals prior to exchange

-connecting to PD catheter

-drain dwelling dialysate

-clamp the catheter, prime the fill line

-fill up the pt

-disconnect

-measure drained amount - chart

[nuangel1, BSN, RN]

absolutely not .dialysis nurse would be called to floor not in my ED.