tag:art-forum.84.s1.nabble.com,2006:forum-15Nabble - Clinical Issues2024-03-29T03:35:15ZMachine settings, policies and procedures for decontamination, isolation polices etc...tag:art-forum.84.s1.nabble.com,2006:post-2061Re: Dialysate flow2021-06-17T04:15:28Z2021-06-17T04:28:12ZGarry
Hi Ian,
<br/><br/>We run at 700ml/min HD and 800ml/min HDF. Finding our 720g carts are running out for HD but possibly as a result of running up too early or not fully using the standby mode on our BBrauns. Use larger cartridges for HDF.
tag:art-forum.84.s1.nabble.com,2006:post-2060Re: Dialysate flow2021-06-17T03:59:28Z2021-06-17T03:59:28ZIan Wilde
Hi Garry,
<br/><br/>We're on Autoflow with our 5008/6008 machines.
<br/><br/>We have it set to x1.5 for HD and HDF so an average flow across the unit of 400-600mls/min with most patients doing the standard 4 hours.
<br/><br/>We use bibags of course - 95% are 650g bags.
<div class="signature weak-color">
Ian Wilde
<br/>
</div>
tag:art-forum.84.s1.nabble.com,2006:post-2059Dialysate flow2021-06-17T01:55:15Z2021-06-17T02:58:29ZGarry
Hi All
<br/><br/>Could I do a quick poll on what dialysate fluid flow rates units use for standard HD and HDF?
<br/><br/>...and, while I'm asking, if you use bicarbonate cartridges, what size are they?
<br/><br/>Many thanks
<br/><br/>Garry
tag:art-forum.84.s1.nabble.com,2006:post-1923Re: COVID-19 Isolation units2020-04-07T14:22:21Z2020-04-07T14:22:21ZIan Wilde
Great going from you and your trust Chris!
<div class="signature weak-color">
Ian Wilde
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</div>
tag:art-forum.84.s1.nabble.com,2006:post-1920Re: COVID-19 Isolation units2020-04-07T07:09:27Z2020-04-07T07:09:27ZGerry Boyle
Hi Chris,
<br/><br/>Our main dialysis unit is separate from the Acutes hospital by about 3 miles. Chronic patients continue to attend this unit and in-patients will be dialysed at the acutes hospital.
<br/><br/>Out-patients who are coronavirus positive but still in the community will be dialysed in a cohort within the chronic dialysis unit with deep cleaning to follow before next shift. Big problem there is patient transport and that seems to change on a daily basis.
<br/><br/>We are in the fortunate position of having a small population of patients though and this would be unlikely to work in a larger unit.
<br/><br/>Gerry
tag:art-forum.84.s1.nabble.com,2006:post-1918Re: COVID-19 Isolation units2020-04-07T06:01:26Z2020-04-07T06:01:26ZChris Bates
<img src="http://art-forum.84.s1.nabble.com/file/n1918/IMG_20200405_110759617.jpg" border="0"/><br/><br/>We now have 6 linked units in position and dialysing Covid patients 3 days a week at 8 isolated stations.
<br/>Using Fresenius 5008 and 5008S. Water ring extended from existing old plant which also feeds the workshop and home training areas.
<br/><br/>Estates, Renal management , Infection control and various others pulled together really well to get this in place so quickly.
tag:art-forum.84.s1.nabble.com,2006:post-1909Re: COVID-19 Isolation units2020-03-19T05:49:01Z2020-03-19T05:49:01ZRoger Moore
Hi Garry
<br/><br/>We have also taken the decision to separate staff as much as possible and along the same lines as you by basing individuals across our various units.
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Kind regards
<br/><br/>Roger
</div>
tag:art-forum.84.s1.nabble.com,2006:post-1908Re: COVID-19 Isolation units2020-03-19T01:44:12Z2020-03-19T01:44:12ZGarry
For a few weeks now, our managers have been transferring as many patients as possible out to satellite units. Once our isolation rooms are full the main unit will become the main treatment area with each bay being sectioned off as a negative pressure room as and when required.
<br/><br/>Clearly a moving target at the moment with impact on staffing levels an unknown. With expectant mothers off for 12 weeks from the weekend, and self isolation for up to 14 days for households it may be all hands to the deck. The whole Trust is reviewing roles and seeing where other staff groups can be 'upskilled' to assist where necessary.
<br/><br/>As well as spare capacity from, various spare points of use, the largest capacity boost will come from opening up further shifts. We have a few units that currently only run two shifts per day so ,dependant on staffing, that is being considered.
<br/><br/>With a group of techs mainly working out of one small workshop I'm considering banishing a few to various satellite units, work load permitting, as I feel there is a potential risk of all of us going off at the same time if anybody picks up the virus.
<br/><br/>
tag:art-forum.84.s1.nabble.com,2006:post-1907Re: COVID-19 Isolation units2020-03-18T11:46:21Z2020-03-18T11:46:21ZIan Wilde
Hi Chris,
<br/><br/>the two facilities we had at North have now been taken back - not sure what happened to one of them but the other became a prayer room - both been fully stripped out though.
<div class="signature weak-color">
Ian Wilde
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tag:art-forum.84.s1.nabble.com,2006:post-1905Re: COVID-19 Isolation units2020-03-18T06:05:38Z2020-03-18T06:05:38ZChris Pearson
Hi Ian,
<br/>Has the virus isolation dialysis unit that used to be at North Manchester closed ?
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tag:art-forum.84.s1.nabble.com,2006:post-1897Re: COVID-19 Isolation units2020-03-10T04:08:13Z2020-03-10T04:08:13ZIan Wilde
Hi Chris,
<br/><br/>So far we managed to find an inpatient ward with siderooms that had space. We were allowed a single sideroom that has its own annex attached with sink. The room itself also had a sink and its own bathroom. I was tasked with getting an RO and machine in there if needed. As there were multiple sinks in the area I was allowed by infection control to rig up an RO to the tap and allow both machine and RO to drain into the sink.
<br/><br/>We have a satellite unit across the road that has a dedicated self-care area. We are planning if required to use that and move the self-care patients elsewhere temporarily. There has been no talk of portacabins or anything like that - yet.
<br/>
<div class="signature weak-color">
Ian Wilde
<br/>
</div>
tag:art-forum.84.s1.nabble.com,2006:post-1895COVID-19 Isolation units2020-03-10T01:35:18Z2020-03-10T01:35:18ZChris Bates
We are looking at the possibilities for separate areas for dialysis of CV19 patients and those suspected of having it.
<br/><br/>If there are no appropriate areas in the hospital available, we are looking at portacabins/shipping containers etc.
<br/><br/>NxStage/Physidia only need drain and power whereas normal machines would need water plant too.
<br/><br/>Need separated areas for donning/doffing of PPE and handwashing, storage, plant if required.
<br/><br/>Confirmed cases could use a communal area but suspected cases would need individual isolation areas.
<br/><br/>What are you all doing out there ?
tag:art-forum.84.s1.nabble.com,2006:post-1638Re: Glucose2019-07-25T02:11:39Z2019-07-25T02:11:39ZJohn Moore
Here at RSUH we use 5 formulations all with 1g/l glucose.
tag:art-forum.84.s1.nabble.com,2006:post-1633Re: Glucose2019-07-17T05:42:31Z2019-07-17T05:42:31ZChris Bates
6 formulations in total.
<br/>5 have 1.0 mmol, including our main one
<br/>1 has 2.0 mmol
tag:art-forum.84.s1.nabble.com,2006:post-1631Re: Glucose2019-07-15T23:51:40Z2019-07-15T23:51:40ZIan Wilde
Hi Garry,
<br/><br/>We have 6 fluids in total, 5 have a glucose of 1.0 and the other has 2.0
<br/><br/>Our main fluid has a glucose of 1.0
<div class="signature weak-color">
Ian Wilde
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</div>
tag:art-forum.84.s1.nabble.com,2006:post-1630Glucose2019-07-15T23:23:14Z2019-07-15T23:23:14ZGarry
Hi All,
<br/><br/>What level of glucose are units using in their range of concentrates? We currently use five concentrates with four providing 1g/l and one (our main concentrate) containing 2g/l.
<br/><br/>Would be good to get an idea of what the range is.
<br/><br/><br/>Cheers
tag:art-forum.84.s1.nabble.com,2006:post-1244Re: Comparison2018-07-02T05:34:20Z2018-07-02T05:34:20ZRoger Moore
Hi Ariel
<br/><br/>Welcome to the ART Forum, an excellent place for debate and discussion.
<br/><br/>You ask a very good question and one that I believe many studies indicate that there still remain more questions than answers on this topic. One of the advantages that appears in most studies is better removal Beta2-microglobulins.
<br/><br/>You may also find these studies of help:
<br/><br/><a href="https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-015-0062-0" target="_top" rel="nofollow" link="external">https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-015-0062-0</a><br/><br/><a href="http://www.crd.york.ac.uk/CRDWeb/PrintPDF.php?AccessionNumber=12005009460&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2018+University+of+York%3Cbr+%2F%3E" target="_top" rel="nofollow" link="external">http://www.crd.york.ac.uk/CRDWeb/PrintPDF.php?AccessionNumber=12005009460&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2018+University+of+York%3Cbr+%2F%3E</a><br/><br/><a href="http://www.crd.york.ac.uk/CRDWeb/PrintPDF.php?AccessionNumber=12005009460&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2018+University+of+York%3Cbr+%2F%3E" target="_top" rel="nofollow" link="external">http://www.crd.york.ac.uk/CRDWeb/PrintPDF.php?AccessionNumber=12005009460&Copyright=Database+of+Abstracts+of+Reviews+of+Effects+%28DARE%29%3Cbr+%2F%3EProduced+by+the+Centre+for+Reviews+and+Dissemination+%3Cbr+%2F%3ECopyright+%26copy%3B+2018+University+of+York%3Cbr+%2F%3E</a><br/>
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Kind regards
<br/><br/>Roger
</div>
tag:art-forum.84.s1.nabble.com,2006:post-1243Comparison2018-06-30T18:07:33Z2018-06-30T18:07:33ZAriel Dulay
Hi Good day! anyone have any idea about this?
HEMODIALYSIS (HD) VS HEMODIAFILTRATION(HDF)
What are the advantages and dis advantages?<img class='smiley' src='/images/smiley/anim_confused.gif' />
tag:art-forum.84.s1.nabble.com,2006:post-1135Re: Home haemodialysis for deaf patients2018-03-02T05:30:02Z2018-03-02T05:30:02ZJane Doe
Thanks Ian,
<br/><br/>Sorry for late response, but will pass this on.
<br/><br/>Many thanks again.
<div class="signature weak-color">
Jane Doherty - B. Braun
<br/>Business Development Manager
<br/>Home HD & CRRT
<br/>jane.doherty@bbraun.com
</div>
tag:art-forum.84.s1.nabble.com,2006:post-1126Re: Home haemodialysis for deaf patients2018-02-14T08:08:38Z2018-02-14T08:08:38ZIan Wilde
Hi Jane, I too have been looking into this. There are a few products on the market for deaf people to enable them to be alerted to doorbells, intercoms and even baby monitors. These in turn like Chris says can be attached to a vibrating pad. Looking at it there are small pads and large ones that would go under an entire mattress. Attaching one of these repeater devices to near the speaker of the machine could work.
<br/>Have a look on Google for deaf doorbell repeaters, baby monitors etc..
<div class="signature weak-color">
Ian Wilde
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</div>
tag:art-forum.84.s1.nabble.com,2006:post-1125Re: Home haemodialysis for deaf patients2018-02-13T03:00:35Z2018-02-13T03:00:35ZJane Doe
Many thanks for this Chris,
<br/><br/>I will pass it on as sounds like it could be an option.
<br/><br/>Jane :)
<div class="signature weak-color">
Jane Doherty - B. Braun
<br/>Business Development Manager
<br/>Home HD & CRRT
<br/>jane.doherty@bbraun.com
</div>
tag:art-forum.84.s1.nabble.com,2006:post-1124Re: Home haemodialysis for deaf patients2018-02-09T09:14:48Z2018-02-09T09:14:48ZChris Pearson
Hi Jane,
<br/>In the absence of any other replies,my mum is partially deaf and has a pad under her pillow in bed which is connected to her alarm clock,wouldn't have thought it would be too difficult for 1 of your engineers to rewire the plug into your machines audio alarm system especially if there is either a audio or visual alarm out on the back.
<br/>There a stand alone system here which might work if it was close enough to the buzzer or perhaps there is something similar which works on lower sound levels..
<br/>Also, if it's OK for a plug, a Redsense alarm would probably be a good idea too.
<br/><br/><a href="http://www.fireco.uk/products/deafgard/" target="_top" rel="nofollow" link="external">http://www.fireco.uk/products/deafgard/</a><br/><br/><a href="http://www.healthandcare.co.uk/paging-systems/silent-alert-sa3000-hard-of-hearing-vibrating-pillow-pad.html?gclid=EAIaIQobChMI74DLupyZ2QIVjpTtCh1yNwfmEAQYBCABEgLrCfD_BwE" target="_top" rel="nofollow" link="external">http://www.healthandcare.co.uk/paging-systems/silent-alert-sa3000-hard-of-hearing-vibrating-pillow-pad.html?gclid=EAIaIQobChMI74DLupyZ2QIVjpTtCh1yNwfmEAQYBCABEgLrCfD_BwE</a>
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tag:art-forum.84.s1.nabble.com,2006:post-1123Home haemodialysis for deaf patients2018-02-07T06:36:36Z2018-02-07T06:36:36ZJane Doe
Hi all,
<br/><br/>I thought I'd ask for your experiences, if any, on deaf patients on home haemodialysis. We have had an enquiry from one of our customers who are wanting to send a deaf patient home and wondering if there are any other Trusts out there who have done the same, and if so, how have you managed this?
<br/>I think their main concern is the patient missing alarms, so if you have successfully done this, what, if any, modifications or additions have you put in place?
<br/>Or just any suggestions you may have that could help would be really appreciated.
<br/><br/>Many thanks in advance,
<br/><br/>Jane Doherty - B. Braun
<div class="signature weak-color">
Jane Doherty - B. Braun
<br/>Business Development Manager
<br/>Home HD & CRRT
<br/>jane.doherty@bbraun.com
</div>
tag:art-forum.84.s1.nabble.com,2006:post-705Re: FX CorDiax Haemodiafilters2016-06-15T02:33:47Z2016-06-15T02:33:47ZIan Wilde
Hi Chris,
<br/><br/>99.9% of the time we use Cordiax 600/800/1000 dialyzers.
<br/><br/>If the machine is capable then we use HDF. I would say that 95% of our patients are on HDF on the 5008 machine - this includes our community patients who are on the 5008S.
<br/>
<div class="signature weak-color">
Ian Wilde
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</div>
tag:art-forum.84.s1.nabble.com,2006:post-704FX CorDiax Haemodiafilters2016-06-15T01:44:23Z2016-06-15T01:44:23ZChris Bates
Hi does anyone use the FX Cordiax 600/800/1000 ?
<br/>Some of the figures look quite good, but they are tested with UF on, which the FX60/80/100 aren't. This makes it impossible to compare from the datasheets.
<br/>The FX600/800/1000 are described as Haemodiafilters - most of our patients are on HDF.
<br/>We seem unable to get much more information from Fresenius.
tag:art-forum.84.s1.nabble.com,2006:post-562Re: Renal Association guidelines2015-11-18T06:12:16Z2015-11-18T06:12:16ZIan Wilde
Hi Garry,
<br/><br/>I know of one in the pipeline as I have seen the draft version and been asked amongest others for comment.
<br/><br/>Not sure when it is due for release but it can't be far off now.
<br/><br/>Ian
<div class="signature weak-color">
Ian Wilde
<br/>
</div>
tag:art-forum.84.s1.nabble.com,2006:post-558Renal Association guidelines2015-11-17T01:39:25Z2015-11-17T01:39:25ZGarry
We have the slightly more recent 2012 'Guideline on Water Treatment Facilities, Dialysis Water and
<br/>Dialysis Fluid Quality for Haemodialysis and Related Therapies' for reference. Does anybody know when the Renal Association Guidelines for Haemodialysis are due for renewal?
<br/><br/>Current version 2009 with review, on RA website, set for 2012! Even this has 'Final Draft' at the top.
<br/><br/>Peer review time again so just ensuring all our documents are current.
<br/><br/>Cheers
tag:art-forum.84.s1.nabble.com,2006:post-439Citrasate concentrate study2015-08-25T04:54:56Z2015-08-25T04:54:56ZChris Pearson
The effect of citrate dialysate on intradialytic heparin dose in haemodialysis patients: study design of a randomised controlled trial
<br/><br/>Davina J. Tai1, Kelvin Leung2, Pietro Ravani23, Robert R. Quinn23, Nairne Scott-Douglas2, Jennifer M. MacRae2* and For the Alberta Kidney Disease Network
<br/><br/> * Corresponding author: Jennifer M MacRae jennifer.macrae@albertahealthservices.ca
<br/><br/>Author Affiliations
<br/><br/>1
<br/>Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
<br/><br/>2
<br/>Department of Medicine, University of Calgary, Calgary, Alberta, Canada
<br/><br/>3
<br/>Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
<br/><br/>For all author emails, please log on.
<br/><br/>BMC Nephrology 2015, 16:147 doi:10.1186/s12882-015-0144-z
<br/><br/><br/><br/><a href="http://www.biomedcentral.com/1471-2369/16/147" target="_top" rel="nofollow" link="external">http://www.biomedcentral.com/1471-2369/16/147</a><br/>
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tag:art-forum.84.s1.nabble.com,2006:post-347Re: Identification of isolated machines2015-06-19T06:46:53Z2015-06-19T06:46:53ZChris Bates
Further to my original question, we can't use tape any more - infection control didn't like it when it started to peel and look tatty.
<br/><br/>So the latest version required a lot of time in my shed cutting plastic rods to length - see photos.
<br/>We are closing one hook on each machines drip pole to attach coloured rods with coloured padlocks and stainless steel cable. We need padlocks as we had an incident a couple of years ago with staff taking off tape and coloured sheets and using the machine on non-isolated patients without the techs de-isolating.
<br/><br/><br/><br/><br/><img src="http://art-forum.84.s1.nabble.com/file/n347/DSC_0030%5B1%5D.jpg" border="0" class="left"/><br/><img src="http://art-forum.84.s1.nabble.com/file/n347/DSC_0031%5B1%5D.jpg" border="0" class="left"/>
tag:art-forum.84.s1.nabble.com,2006:post-320chemical disinfectant mix up2015-05-14T07:47:44Z2015-05-14T07:47:44Zfraser gilmour
I've had a report from a privately run clinic where we provide technical support that two machines were found with Puristeril 340 attached instead of citrosteril, meaning that for weeks the machines have been disinfecting themselves with a hot peracetic acid solution. Just wondered if anyone else had come across this?
tag:art-forum.84.s1.nabble.com,2006:post-317Re: Dialysis fluid composition2015-05-13T02:58:30Z2015-05-13T02:58:30Zfraser gilmour
Thanks for the responses <img class='smiley' src='/images/smiley/smiley_beam.gif' />
tag:art-forum.84.s1.nabble.com,2006:post-309Re: Dialysis fluid composition2015-04-30T23:39:33Z2015-04-30T23:39:33ZLindsay
Hi Fraser.
<br/><br/>We have 5 set up on each of our machines here. Unless the machine is at a home patient.
tag:art-forum.84.s1.nabble.com,2006:post-282Re: Identification of isolated machines2015-04-13T03:17:16Z2015-04-13T03:17:16ZGareth Murcutt
Best to email me and we can discuss.
tag:art-forum.84.s1.nabble.com,2006:post-278Re: Identification of isolated machines2015-04-10T01:30:15Z2015-04-10T01:30:15ZGarry
Hi Gareth, what cohorts do you have in place?
<br/><br/>We have a few machines set up for known BBV status cohorts though it's the 'awaiting results' groups that give us the biggest headache. As an example we currently have 10 machines isolated, mainly from high risk holiday areas, covering a unit of 30 stations.
<br/><br/>I'm sort of hoping someone out there cohorts these groups of patients and, with some robust risk assessment/evidence, it could be introduced here while remaining within guidelines. Possibly a non starter but thought I'd ask!
tag:art-forum.84.s1.nabble.com,2006:post-263Re: Identification of isolated machines2015-03-24T03:47:47Z2015-03-24T03:47:47ZGareth Murcutt
Understood Ian. We only isolate for cohorts rather than individuals, thus ID not relevant to us.