Please concentrate!

[Gareth Murcutt]

Hi all,

We did an audit a couple of years ago and found we are throwing away 1/3 of each can at end of treatment. I barely believed it but following calc shows its true.

4 hrs at 0.5l/min = 120l. HDF -15 litres. Test and priming - 15l. Total =~ 150 litres.

1:44 = 1 in 45. 150l/45 = 3.33 litres conc required.

1:34 = 1 in 35.  150/35 = 4.28 litres req'd.

Simples - get central acid delivery.  

[Garry]

Hi Gareth,

This seems to be a hot topic being highlighted by feedback from green network groups.  Certainly something we'll look into as currently none of our 5 sites have central delivery.  I expect the main stop now, for our existing units, to be space.

In the midlands we have a newly formed technical network group and this is on the agenda for further discussion and business planning guidance.

[Gareth Murcutt]

Drop me a mail Garry. Have done lots of calcs that should help. Or anyone else who wants info. This is all new to me as well. Places like Lister been doing it for years.

[Ian Wilde]

Hi Garry, at MRI the central delivery room was about 2mx6m and had two tanks and pumps in there holding 6,000 litres between them.  CDS's main problem can be the fitting of the ring main itself in some buildings.

[Roger Moore]

Hi Garry

I was interested to read in your reply to Gareth of the newly formed technical network group. Can I ask if you have, or would consider keep ART committee updated on the output from this group? We may be able to offer our support and guidance on certain matters, or indeed relay messages to the wider ART membership.

[Garry]

I can certainly ask.

[Gareth Murcutt]

Hi Garry,

Space can be issue but the tanks normally go where you currently keep the cans of concentrate (+ the extra 1/3 of each can to throw away and rot the drains on the way down).

 

[Gareth Murcutt]

Oh I didn't mention. I've calculated that central delivery will save >1000kgs of CO2e emissions per dialysis station per year.

[Chris Bates]

We have central acid at all 5 units.
We have used each of the 3 usual distribution systems CECON, CDS and CCS - all practically trouble free.
Best to design in at the beginning if possible - retrofitting could be awkward but depend on current layouts.
Weekly pumping in by Fresenius is fine but that is where most of the few problems lie - access, pump failures leaks etc

I prefer the connectors we use at Lister rather than Walther or Althoff LV-004 types used elsewhere.

At Lister we chose CPC non spill connectors - much cheaper and more compatible with the acid than even the most expensive grades of stainless available.

There are plastic versions of the Walther type now which, although less robust, retain the valve in the male if the tip is broken off, preventing large spillages.

See pic for the CPC type:

[Garry]

Hi,

Has anybody in the Midlands been through the process of having a central system installed to an existing unit?  As discussions continue, it would be good to possibly visit/chat to both technical and nursing side get better understanding.

Thanks