hhpatient
Joined: 17 Aug 2003
Posts: 1
Posted: Sun Aug 17, 2003 6:11 am Post subject: deaths occured when the patients were asleep...
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"The FDA has learned that three patients died and five were seriously injured when an adapter for the catheter that connects the patient to the dialysis machine came apart, causing severe loss of blood. The events happened at home and the deaths occurred when the patients were asleep."<
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>www.who.int/medicines/lib...lert68.htm
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Mon Aug 18, 2003 3:35 am Post subject: Blood leakage?
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The pts. I know of that do home hemo have a pad under the access arm that triggers an alarm should it become wet at all. It is for all practical purposes a bed wetting type device. I wonder what exactly was the problem in the case of these pts.. Did they not use such a device?<
>The program I looked into uses such devices. Lin.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Aug 20, 2003 2:49 am Post subject: Good Question
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Good Question Lin, Our program also uses a sensor to detect blood leakage should it occur. Makes me wonder too if these were used in-centers and the techs, nurses, or patients saw the leakage and it was corrected. Or another one of those things that went unreported.
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Founding RN
Joined: 10 Jan 2003
Posts: 172
Posted: Wed Aug 20, 2003 4:06 am Post subject: Connections
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Has anyone ever considered taping the connections? We do this when we cap off the catheter connections so that in sleep, patients don't accidently loosen a cap to the point of losing it. Tapping the connections could help prevent them from coming apart.
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Aug 20, 2003 2:03 pm Post subject: Good Idea
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We were told if we access the catheter without an adapter to tape. But I don't think it would be a bad idea to tape with the connector. We also have locking boxes which the connections fit into and then the box is closed and the fittings can't move around.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Thu Aug 21, 2003 12:11 am Post subject: Blood leak at dialyzer
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Interestingly enough on my last tx. I looked over and noticed blood leaking from the top of dialzyer, and no alarm was sounding! This is the first time this has happened and now I'm wondering if this could happen to slow nocturnal pts. too. It was not the access, but the dialyzer itself (connector at top) that was leaking. Lin.
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Worker Bee
Joined: 29 Oct 2002
Posts: 28
Posted: Fri Aug 22, 2003 6:49 am Post subject: Leak on top of dializer
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Lin,<
> That kind of leak is from not making sure that the lines are screwed tightly into place. Sometimes it doesn't leak blood, just pulls in air. That is why it is so important to really make sure that all the connections are TIGHTLY in place. If a person takes their time and makes sure that all is done correctly and tightly, this can easily be avoided. But in the jiffy lubes, time is money and it isn't always attended to.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Fri Aug 22, 2003 7:45 am Post subject: Home hemo
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I wish I had more time to chime in here, but I am in a real rush. Maybe over the weekend. But it is good to see this discussion back again. Founding RN, great idea on tapeing the connections. We were required to do that and we were not doing nocturnal. It is just good common sense, especially is you are using a catheter. Marty great to see you back. I haven't been around because of some hospitalizations.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Fri Aug 22, 2003 12:24 pm Post subject: home hemo
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by going home you increase your life span according 42 percent another 47 percent that is with the same amount of dialysis. more dialysis the longer you live.longer all the treatments have to be practical and cost effective. it would be nice if my wife would set by my bed and sing to me and rub my back until i fall a sleep. but i have not talked her in to it yet. you can put a water detector under the dialyzer. you can get a pad that detects when a baby wets with a alarm. yes some people are going to get run over by slow drivers but the majority will be killed by untrained speeders. remote montering may be nice but we are going to have to consider the expenses and the benifit. we need a treatment that is cost effective and lets people live a normal life with the bounds of their problem.
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ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Sat Aug 23, 2003 10:40 am Post subject: home hemo
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to do slow gentle takes no more supplies per treatment than an ultra speed jiffy lube. cranking up the speed only puts the body under more stress. in the clinic you are subjected to more infections. the main killers in dialysis is heart disease and infections which you can control at home. ultra speed dialysis gets very little more clearance per unit of time. they way they measure clearance has no scientific basis. they set the goals they wanted and developed the facts to support them. we are going to have to keep fighting as we are talking about billions of dollars which the are not going to give up.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Aug 27, 2003 3:04 am Post subject: Selfcare
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Hi Ridgerunner, I just wanted to say that I think you set a wonderfull example! I hope that someday I can set such a good example. Lin.
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patientwife
Joined: 18 Jul 2003
Posts: 47
Posted: Wed Aug 27, 2003 4:44 am Post subject: Home Hemo
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These posts are so educational. Thanks to all of you. I suspect that there are various reasons that some pts do not opt for home hemo. What other modalities are there? Can you provide some info on in-center noctural dialysis, i.e., pros and cons, program availability, etc.
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jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Wed Aug 27, 2003 5:06 am Post subject: You...
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/>
...could start with Lynchburg Nephrology and Dr. Robert Lockridge. He also is leading the way in legislation regarding this modality. I don't have the link infront of me but a search will
ing you to it. Also there is Peritoneal Dialysis but that has its complications too. There is plenty of info out there on the web. Good Luck
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Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Wed Aug 27, 2003 4:07 pm Post subject: Slow Nocturnal
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For Home Hemo, There are not many available programs. You pretty much know all there is to know about doing slow nocturnal if you doing home hemo on the 2008H. The only difference between you and us is we do the treatment while we sleep. Our machine is connected to the center via computer and it is monitored by a tech. I like it alot because we get dialysis done while we would be sleeping anyway. It gives us a lot more free daytime hrs. Another thing good about it is the amount of dialysis you get. 6-7-8 hrs a night for 5 or 6 nights a week. This allows one to rearrange their dialysis schedule quite easily and to take an extra night off doesn't create a problem as patients are well dialyzed all the time. In 2 nights of treatment we get more dialysis than the in-center patients do in 1 week. Another plus is we can change to days once in a while if that will help us out. The only draw back is if the machine gives you alarms to often you can feel a little sleep deprived until you get a chance to catch up on it. I'm glad your coming to this board; it's good to hear from other Home Patients.
