Home Hemo & Disconnects Mid-run

I need to return a call to a someone who is considering nocturnal home hemo. This person asked if you can get up during the night to respond to someone who needs help. I assume this is discouraged and that it’s done the same way it’s done in-center, but was curious to hear what you guys had been told about this and how to do it, if you had to. Thanks for helping me help her.

It’s easy, but its better with a partner. Basicly, all you have to do is recirculate with low blood pump speed, ufr off, and low saline drip…the needles need to be flushed again with saline syringes leaving them on taped up till you get back to machine…its not a quick process…

Beth, Your right we would do the same thing they do in-center if someone needs to go to the bathroom. As gus said it isn’t a fast procedure.

I know with the NxStage you are not supposed to recirculate, but there is no reason it can’t be done. However, like the others, I would not recommend planning on doing it, it is time consuming and a pain, so doesn’t really work for a baby crying or something.

Cathy
home hemo 9/04

Not in the nocturnal program here. They don’t even teach you how. They say that if you have to come off, you come off… period, and catch up the next night. The procedure used in the centre for when people have to go to the bathroom is not taught to home patients. Even if you come off to do something, you can’t just have your blood recirculating outside your body more than a few minutes. You have to make sure you do your business before you get on :slight_smile:
Pierre

We are taught to recirculate as gus suggests ,although I haven’t had to do it too often. If I need to go to the bathroom it is possible to go while still dialysing as the ensuite is within reach of Freni.(Very interesting thing to do :lol: )
One of the reasons we are taught is because we often have short blackouts they may last less than half an hour. However if it is after midnight I would normally just come off in an emergency, but I get really cranky if i have to waste a treatment.

I was actually trained how to recirculate on the Fresenius, for power outage we manually turn the pump, but have to get off on the NxStage unless it is a momentary outage. However, on the NxStage I was specifically told not the recirculate, not sure why, but I never had to in the first year and one half on the Freni so didn’t really question it.

Cathy
home hemo 9/04

Recirculation does not keep the blood oxygenated. About 8 minutes, 10 max. After that, it’s not blood you would want to put back into yourself. That’s my understanding of it, anyway.
Pierre

They trained me how to recirculate with NxStage…but did they train you how to do it?

What about a UPS as a back up for NxStage?

They trained me how to recirculate with NxStage…but did they train you how to do it?

No, Gus, they were very specific that it was not to be done on the NxStage, according to NxStage, so they did NOT train me. I am sure I could do it, but don’t see a reason to with such a short treatment time.

I do plan on getting a UPS , just have been short sighted and haven’t purchased it yet. I think they are a good idea, especially in areas which often have blackouts. I’ve gotten so lazy because here in CA we really don’t have a lot of power outages.

Cathy
home hemo 9/04

We are taught to recirculate if for whatever reason we need to come off. I think the max was 15-20 minutes. It may differ between machines, I dont know. Ive only ever done it twice for a few minutes, once because I forgot to lock the gate, and secondly and most importantly, I forgot my lunch! :lol:
If there is ever a need to come off in an emergency situation, we are told to clamp the lines, disconnect them, and if time permits flush with saline. Dont worry about recirculating. If there is no time to disconnect or flush, cut the lines with scissors BETWEEN the cannula clamps and the line clamps. Leave needles in.
Peirre is right, after a certain time your blood deoxygenates, thus why it turns almost a black colour. You dont want to be putting that blood back in you as it can cause problems. You may notice that sometimes while your on the machine your venous blood is slightly darker than the arterial. That is also deoxygenation, but this is normal while you are on the machine. It took me almost a year before I noticed the colour change, and it freaked me out lol I had to ring the unit :roll:

Hmmm…never noticed that. Forewarned now tho ! Thanx Amber :smiley:
…and hey! I don’t remember being taught that about cutting the lines!!!
Was I not paying attention that day !??? :oops:
Altho I rarely come off (I’ve only done it maybe 3-4 times in …er…7 months), I always do the recirc. & saline thing. And get back on as fast as poss.! :slight_smile:

Just a trick I was told at the beginning of training. But obviously only something you would do in an emergency if you couldnt unscrew the lines quickly.
I have a tendancy to tighten them up too much so by morning they are often impossible to undo, even using the metal clamps! Thats another situation where you may need to use the scissors. It just means you have to run back your blood closed circut.
Just have to be careful that you dont cut above the cannula clamps or you’ll be in trouble!