2. Pay attention to the preparation of dialysate: the role of dialysate is to correct the chemical composition of uremic blood. In order to meet this requirement, the dialysate composition must be similar to the actual normal plasma moisture, that is, protein-free plasma composition. Because the components of dialysate are mainly used to adjust electrolyte balance, attention should be paid to the selection of liquid components to meet the needs of patients.
3. Pay attention to the preparation of concentrated solution: modern hemodialysis uses concentrated solution, dialysis pure water and reverse osmosis water, which are automatically diluted into hemodialysis solution by the machine according to a certain volume ratio. This mixed solution indicates the total ion concentration of electrolyte in dialysate by conductivity method, which is one of the important monitoring indexes to ensure dialysis safety. This automatic detection and monitoring function is generally available in imported dialysis machines, and the preparation of concentrated solution is mostly made by people themselves according to the formula. Generally, there are two kinds of dialysate for acetate dialysis (acetate dialysate and bicarbonate dialysate), and only one kind of concentrated solution is needed, while bicarbonate dialysis needs two kinds of concentrated solutions. Improper preparation of any kind of concentrated solution will cause adverse consequences and easily lead to machine alarm. If the alarm limit of machine conductivity is too wide or the self-check function is abnormal, it will bring a series of dialysis reactions to patients, such as nausea, vomiting, chills, high or low blood pressure.
In addition, in practical work, because the conductivity is too low or too high, several machines alarm at the same time, and dialysis cannot be carried out normally, which is generally caused by the unsatisfactory preparation of concentrated solution. Therefore, the preparation of concentrated solution must be strictly in accordance with the formula, and the prepared concentrated solution is best tested. In addition, it should not be placed for too long to prevent precipitation pollution or deterioration. Filter when using.
4. Pay attention to the power supply of hemodialysis room: hemodialysis machine is different from general diagnostic instruments. Under normal circumstances, the failure of diagnostic instruments and equipment will not cause too much adverse consequences to ordinary patients (except emergency patients). Suspension or delay of hemodialysis treatment due to power supply problems will double the workload of medical staff, more importantly, it will bring great pain and even life-threatening to patients, and it will also bring unnecessary economic losses to hospitals. However, in China, most hemodialysis patients are patients with end-stage renal disease. If you don't have dialysis once or twice or increase the dialysis interval slightly, the patient can't bear it, so the power supply of hemodialysis room is a problem that can't be ignored. The power grid voltage in big cities, hospitals and power shortage areas in China is generally low, especially in the morning when most equipment is running. Sometimes the regulated power supply itself is difficult to work normally and needs to be equipped. Conditional units can consider dual power supply, secondary power supply system and automatic switching to prevent power failure from causing great passive work. At present, most hemodialysis machines are powered by batteries (generally continuous 15min) to avoid panic caused by temporary power failure.