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Discussion

pt weights

I went to a facility that had no hoyer with scale or wheel chair scale but had a pt that was a fairly new BKA. We had no way of weighing this pt. I was told by the charge nurse that they were using fluid assessment to come up with a uf per treatment. The facility is working on obtaining an adequate scale, I was told. It looks like the patient had not be weighed in a while. Does anyone know the legalities of this situation?

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    What kind of clinic is this??

    I go to multiple outpt HDU's and even my tiniest clinic - with 5 chairs and located in a trailer has a wheelchair scale. That's insane and does not provide for adequate fluid removal by "guessing."

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    Did they have a crit-line on the patient?

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    • Author

    no crit line. just basic Fresenius H model machines and as of today, still no scale. There was a MD order for his dialysis despite not having a scale. What kind of licensure issues might this cause, if the if a doctor's order to treat him?

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    What is a crit like? And what does BKA mean?

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    • Experts

    BKA below knee amputation

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    The Crit-Line is a small monitor that fits on the top of the hemodialysis machine. It monitors the patient's blood volume change in real time during treatment. It measures the HCT, blood volume change, and oxygen saturation. Its's a great tool to help get the patient to their true or ideal dry weight.

    Hope this helps.

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    I could not imagine a facility not having a scale. However the patient must have dialysis so a UF goal can be based on objective data like BP, edema, I&O's, lung sounds, JVD,and subjective data such as DOE, orthopnea, nausea, progressive weakness, or any other CHF related signs. I found that within the first half an hour of treatment a rapid BP drop means I am pulling too much weight and it needs readjusted. A weight should be a requirement but it is not the make or break factor for deciding the UF goal. I do acute dialysis and sometimes the weights are absurd- they vary ten pounds from one treatment to the next or my favorite--- the patient has the same weight from the past three days!!!

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