The hemodialysis machine is composed of a blood monitoring alarm system and a dialysate supply system. The blood monitoring alarm system (ie the blood circuit part) includes heparin pump, blood pump, air monitoring and arterial and venous pressure monitoring, etc.;
The dialysate supply system (ie the water circuit part) includes a temperature control system, a liquid dispensing system, a conductivity monitoring system, a degassing system, blood leakage monitoring and ultrafiltration monitoring, etc.
The patient's blood is drawn through a blood pump, and an appropriate amount of heparin is injected through a heparin pump for anticoagulation treatment. At the same time, the dialysate supply system degass and warms the dialysis concentrate and dialysis water, and mixes them in a certain proportion to prepare dialysis. liquid.
Then the blood and dialysate act in the hemodialyzer, and the blood completes the process of solute dispersion, infiltration and ultrafiltration, and then returns to the patient through the air detector.
This process is repeated continuously, and the metabolic wastes and excess water and electrolytes produced in the body's metabolic process are excreted from the body, thereby achieving the purpose of treatment.
1. Reasons for the high limit alarm of venous pressure of the dialysis machine:
①Hematoma at the venipuncture site.
②The venipuncture needle is blocked by blood clots or fat droplets; the needle tip is against the vessel wall.
③The venous line circuit is discounted, and the venipuncture needle and venous line clip are not opened.
④ The patient is in a lateral recumbent position and the hemodialysis machine is under venous compression.
⑤ The patient's blood flow is too high, while the venous blood vessels are too thin and have poor elasticity.
⑥ The patient is in a hypercoagulable state.
⑦ superior vena cava stenosis.
⑧ Poor arterial flow, no heparin dialysis or insufficient dosage, causing filter blockage.
2. How to deal with:
① Carefully select blood vessels before puncturing the hemodialysis machine to avoid scars and hematomas.
② Check the venipuncture needle for bleeding or hematoma.
③ Adjust the position or needle of the venous needle, and re-puncture if necessary.
④ Check whether the venous line is twisted, folded or compressed. Whether the puncture needle and tubing clamp are open.
⑤ The patient's blood flow is too high, and the veins are too thin and less elastic.
⑥ Instruct the patient to avoid venous compression when turning over.
⑦ Rinse the venous line of the hemodialysis machine with normal saline to identify the clotting blockage, observe whether the color of the blood in the filter has changed or whether there is blood clot, and adjust the dosage of heparin in time.
If the color of the filter does not change significantly and there is no blood clot, a little normal saline can be drawn to check whether the puncture needle is blocked. If there is a blood clot in the filter and the transmembrane pressure is normal, the color of the dialyzer is normal and the venous line can be replaced immediately.