davnmf

Hello there. I work at PICU that does CRRT quite frequently. Sometimes we go in spurts where we have 5 kids at one time on it and other times it'll be months before we get a pt that requires that kind of therapy. The only education that is offered to take care of these pts is a 4 hour class that is just about how the machine works, the basic things you need to know about the machine, how it works, and the kinds of pts that need it. Then there is an 8 hour class that goes more in detail where you learn how to set the machine up. These classes are only offered twice a year and you are not required to take them before you can take care of a pt w/ CRRT (although that rarely happens). The PICU bedside nurse pretty much does everything. The ICU fellow must be present when setting up or changing a circuit and a nephrologist is always there when initiating the therapy. If a circuit stops working for whatever reason the PICU nurse can stop the therapy w/o nephrology being present. If the nurse and nephrologist are comfortable, the PICU RN can setup and restart therapy along w/ ICU fellow alone. There is always a nephrologist on-call to adjust rates and fluids. Now that we use Calcium and Citrate instead of heparin, filters rarely clot off, even after 3 days but there are some instances where it occurs. I know this is a long reply, I hope it helps.