Self-cannulation


#101

Yep I sure am aussie :slight_smile:

Just wondering what does Qd mean?


#102

Qd =Dialysate flow rate.
My machine is set for Nocturnal at 300ml per hour so my Part A bottle doesn’t run out over 8 +hours. When I do a run less than 5 hours I manually change rate to 500ml per hours. 8)


#103

Is that the fluid flow rate?? I was talking about blood flow rate LOL :wink:


#104

There’s no way a blood pump speed of 300 can be considered fast. Look at in centre hemo where they regularly use 425 or higher for people with a good fistula. Look at your total blood volume for a treatment. If you pump the blood very slowly, like 250 or less, even though you are doing 8 hours, you’re only getting the same amount of dialysis as if you were doing a 6-7 hour treatment. If you are only doing nocturnal 3-4 times per week on top of that, you’re dialyzing significantly less.
Pierre


#105

Well, it’s considered fast here, Pierre! I know they virtually have to run some in-center patients at higher rates, like 425, just to get the clearances in the pathetically small times allowed. At home haemo, they had 300 as the limit for daytime, they have 250 for nocturnal. I used to run 300-350 on good days, once I was home, but sometimes high pressures would force me to drop to maybe 275. The beauty of home haemo (day or night) is you are getting much more dialysis time, utilising the same consumables (more or less). THe easier you can take it, the better.
Amber can comfortably run on 200, with 300mil fluid rate, as she’s only 1/2 my size!!! :lol: I need the 250 and 500ml My dry weight is currently 128kg Hey! O.K., so I’m a fat bastard :lol: …but when I first came off P.D. I was up to 142kg!!! :shock:


#106

Its considered fast here pierre. Our unit is more about giving adequate dialysis, but at the same time, looking after our hearts. The slower the pump speed, the better it is for you. I do 10 hours at 200 pump speed and 515 fluid flow rate. It is enough to get my bloods very good. Everything is now within the normal range, except the creatinine is still a little high, but its gone from being 1200, down to 140, and Hb is still a bit of a problem, but always has been with me.
I was speaking to one of the nurses and she was telling me how some units go up to 400 blood pump speed, and she was saying its just not really good for you. I cant really remember if she said why.


#107

What are optimal venous and arterial pressures? I run at a blood flow of 450 and dialysate rate averaging just under 12. Tx time 3.5hr. FF now 47. I have to observe VP at 200. I believe 90 to maybe 120.at 200bf.
My AP averaged 180’s and VP now 175 - 200. My VP used to be @250 for most of tx. But since I was finally allowed to create a new venous buttonhole it dropped. It is the lowest VP pressure I have had since starting HHD almost a year ago. Like my BUN and creatinine my Vp droppped dramatically (60%).
BUN n Creatnine went down by 60% right after a recent fistulogram and new venous buttonhole. Now from your site am wondering if my blood flow is too high at 450. Nit looking forward to another battle.


#108

I have a bad habit of forcing the dulls now and again if I miss the “tunnel”, usually this is ok as said tunnels are very short. But recently I did cause some trauma at one of the sites so started to make a new tunnel with sharps at a new site.


#109

are you using touch cannualtio?


#110

ok look this up and it will solve your problems with the scrap."kinder gentler methods for scab removal in buttonhole sites Nephrology nursing journal 2011 Sept Oct p439. this is still be used in Australia Canada and the US we are now over 77,000

without a single infection and **they said it could not be done well it has_