I want to make sure people using the System One understand the importance of keeping the dialysate circuit sterile. I was talking to two other cycler users today and we each followed different procedures when encountering a dialysate bag without the cap.
The dialysate bags come in their own bags, packaging, and sometimes the cap to the bag’s outlet is off but otherwise the bag is intact. I wipe the threads with an alco-wipe and kinda jam the corner of the alco-wipe as far as it’ll go into the outlet wiping what surfaces I can reach before attaching to the heater spider normally. Dialyzor two indicated that he assumed it was alright to just attach normally since the fluid is safely behind the vial seal. Dialyzor three said he didn’t use the bag.
This conversation took place at my home unit and the answer is – you don’t use the bag. Just as there is the step of checking the arterial/venous connections on the cartridge when you remove it from the packaging, I now tighten the caps when I remove the bag from its packaging.
I think we should adopt PD level sterility habits when making the dialysate connections.
Tonight one of the bags had the cap off so I set it aside. Hopefully I can get my PureFlow going after tonight’s run. As long as I’m admitting my user errors I had a doozy two weekends ago.
I sort of set-up throughout the day Saturday. I cleaned the dialysis room, tackled a large pile of accumulated recycle that was blocking passage to the front of the house and in the process hung the bags for the night. Later I laid out supplies, tore tapes, etc… Then about 5 I spiked the bag of saline and set up through the snap & tap, pressing stop. I fixed dinner, ate, took my b/p & weight, entered my fluid goals, changed into sweats, pro’ly took a call or read a thread, eventually cannulating about 6:30.
I was glad to be on before 7 for once; it wasn’t until about 7:45 that I noticed a pinkish tint to the saline. I had not hooked up the waste line or the dialysate lines. I had been dialyzing against saline for about forty five minutes. I called my unit and we decided to continue the run from there; I had to add to my 30L total fluid to make up for what the cycler had counted as 6 or 7 liters already used.
I was glad to be on before 7 for once; it wasn’t until about 7:45 that I noticed a pinkish tint to the saline. I had not hooked up the waste line or the dialysate lines. I had been dialyzing against saline for about forty five minutes. I called my unit and we decided to continue the run from there; I had to add to my 30L total fluid to make up for what the cycler had counted as 6 or 7 liters already used.[/quote]
Ah man, you didn’t even feel weird without dialysate going through? I usually feel unusual when dialysate is not going through for a few minutes…
Bill, you never cease to amaze me!
I read you post of travels and I just keep jotting thing down so I won’t do some of the same things. I have been looking and there is a folding IV pole that will fit in a suite case that I want to look into.
Since we use 9-5L bags on back up or for traveling I am looking into an 8 hook rack to make it easier. This will attach to top of IV pole.
You are such an inspiration!
Pat