By G.A. Coles
Peritoneal dialysis (PD) is in frequent use for the therapy of acute and protracted renal failure. a large amount of wisdom in regards to the a variety of tactics and difficulties linked to this type of therapy has amassed over contemporary years, quite because the advent of constant ambulatory peritoneal dialysis (CAPD). even though thus far the knowledge in regards to the extra technical or functional elements of PD has been mostly scattered in a variety of books and journals. There seems to be no effortless textual content focused on those issues appropriate for recommending to junior medical professionals or nurses facing sufferers receiving this remedy. notwithstanding in-house-training is of substantial price it takes time and i've spotted that on a couple of events in our personal unit, technical issues of PD haven't been handled quick as a result of lack of awareness within the employees on responsibility. There therefore seemed to me to be a necessity for a quick e-book giving enterprise recommendation on the right way to practice a number of the approaches and the way to accommodate difficulties as they arose. This guide is an try to fulfil that goal. first and foremost it used to be attempted and proven at the renal unit within the Cardiff Royal Infirmary for three years. ahead of publishing it's been greatly revised and updated.
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Extra resources for Manual of Peritoneal Dialysis: Practical Procedures for Medical and Nursing Staff
Both the abdominal skin and the peritoneum must be free of infection. 1. 2. 3. 4. 5. 6. 7. Explain to patient the procedure and the reasons for catheter insertion. Ensure bladder is empty. Patient lies with just one or two pillows on operating table. Patient wears a mask. Patient's abdomen is shaved to just above pubis. Operator wears cap, mask, sterile gown and sterile gloves. All other personnel wear masks. Cleanse the abdomen with povidone-iodine. Pay particular attention to the umbilicus and any old puncture sites.
Drop on to sterile field a 20 ml syringe and a 21 gauge needle. Aseptically draw up 1000 units heparin. Sterilise injection port on a 250 ml bag of saline with alcohol wipe and inject heparin into bag. Wash hands and put on sterile gloves. Place sterile towel under tubing connection. Wrap povidone-iodine soaked swab around connection. Press firmly to ensure complete wetting. Leave for 5 minutes. Sterilise injection port on bag with alcohol wipe. Using syringe and needle draw up 10 ml of heparinised saline.
Bags should only be warm to touch and not hot or the patient will get severe pain. D Peritoneal dialysis machines The peritoneal dialysis system can be automated to varying degrees. The simplest machine consists of a timer-controlled clamping device controlling inflow and outflow. More sophisticated equipment uses pre-sterilised fluid in 5 or 10 litre containers and after heating controls volume and time of inflow, 44 MANUAL OF PERITONFAL DIALYSIS dwell and outflow. Reversed osmosis machines purify water by reversed osmosis and filtration and then mix the product with sterile concentrate.