deborah mallon

HI Student 60, You are wise to think about other reasons for prolonged post treatment bleeding. The half life of Heparin is relatively shortand with doses as low as you have stated, I would take time to evaluate the access for possible stenosis. Have you done a venous dynamic pressure on these patients? If you need t know how to do this let me know and I can walk you through it. It can be a good indicator of venous stenosis. Keep up the good work and read everything you can about your patient care. There are lots of really good web sites for us. :)

How do you safely do a continuous drip during dialysis? Are you using an infusion pump?

Let me jump in here. Arterial pressure is the negative "pull" on the patient's access if your delivery system is measuring pre-pump arterial pressure. So, a -250mm/hg is the max. arterial presure that should be exerted on an access. To run a patient with a more negative arterial pressure is setting the patient up for potential damage to the access and the risk of hemolysis. Venous pressure ,according to Dr. Steve Schwab, Duke University, should be no more that 60% of the QB. The easiest way to measure the venous pressure is to take a venous pressure reading with the blood pump set at 2oocc/min. Your venous pressure should be no more than 120mm/hg with a pump speed of 200. Conversely, too low vensou pressure is not good either. It is an indicator that you are not moving enough blood through your system to prevent clotting on the dialyzer. Hope this helps.