Were those of you who are on NxStage trained to clean out the waste line with bleach solution directly following tx? Or do you clean it sometime the next day? Also, how much bleach solution do you use to rinse the waste line out?
Before the pureflow I NEVER cleaned out the waste line, I just changed it weekly. Now with the pureflow I don’t even have to change it.
Did you ever notice your E #'s going high and have any tx problems that day as a result? E #'s are supposed to be about as high as venous #'s. If they go higher that indicates a problem.
We flushed the drain line with bleach/water mixture 1:10. Used it immediately after tx.
I used a 30cc syringe to flush the drain. I flushed 1 full syringe of air into the line, then pushed bleach mixture through. When air exited the line, I flushed 1 more full syringe of bleach through. Then push air to clear line.
Like Epoman said, drain line to pureflow doesn’t get cleaned or replaced, so you got to wonder about how important it is to clean
[QUOTE=billable;12340]We flushed the drain line with bleach/water mixture 1:10. Used it immediately after tx.
I used a 30cc syringe to flush the drain. I flushed 1 full syringe of air into the line, then pushed bleach mixture through. When air exited the line, I flushed 1 more full syringe of bleach through. Then push air to clear line.
Like Epoman said, drain line to pureflow doesn’t get cleaned or replaced, so you got to wonder about how important it is to clean[/QUOTE]
Is this the way you were trained to clean out the waste line or the way you decided to do it? Because we were only trained to flush it with 1 or 2- 30cc syringe after tx. There have been a few txs where I forgot to clean out the waste line, but had no problems. And I have always cleaned out the waste line the next day, not immediately following tx, as I had forgotten that it should be directly following tx. Also, I have only gotten high E #'s on 2 other occassions and each time the waste line was clamped. I unclamped it and the E #'s immediately went down.
The way you are doing it is the way our clinic taught as well. I figured that bleach is cheap and a little extra wouldn’t hurt. I flush the air first so I can tell when I have all the effluent out and have bleach all the way through.
We have a line that is connected to sink plumbing. Then the waste line is connected to that line. Do you think that line should be changed out at some point? I got the high E #'s for a short time tonight again eventhough I changed out the waste line. I’m thinking the line on the sink must have some crystals in it. Do you know, can high E cause clotting of the dialyzer, thus poor return?
We were trained to use one a week. No cleaning or anything other then to close the connection in hang the end up after treatment.
LSB
Can’t believe a couple of you were not trained to flush out your waste line. And you never have any problems with high E pressure, clotting?
I believe in the manual there is no mention of flushing the lines. We get new ones to change weekly and never have a problem. Waste lines do not easily clog. No, I do not have any problems with this method and intend to keep to it until, if and when, I get a pureflow and we don’t get new waste lines weekly.
Cathy
home hemo 9/04
nearing a year on NxStage
Well this is interesting. I was under the impression that it was important to flush the waste line immediately following tx. I called NxStage and the tech agreed it should be done. Yet 3 people have said it is not necessary and were not trained to do it. Well have any of you gotten high E #'s with clotting of your dialyzer, poor return? This is what we are trying to solve.
How do you have your waste line set up? Ours hooks up to another piece of waste line which goes through the closet wall which then attaches to a connection on the pipe under the bathroom sink.
Last night, we changed the waste line out, but we still got the high E’s the first part of the tx. It finally settled down, but saw a very small amount of clotting in dialyzer and we came out with only a 75% return. The previous tx, the high E’s were more prevalent with significant clotting in dialyzer and we only got a 35% return. The NxStage tech said crystals can form in the line if it is not flushed immediately following tx. I am thinking there may be some crystals in the portion of line that connects to the sink pipe. But I’m scratching my head since several of you say you never flush the waste line and have no problems???
Any other ideas for what causes high E’s? This is the first time we have had the problem in 7 months of txs.
My waste line goes directly to a drain and drains there. It sounds as if yours is connected to something else so it doesn’t all get changed weekly. Maybe that is your problem. My pressures are fine, generally in the low 200’s at a 480 pump speed. I don’t notice any difference when I change lines.
Cathy
[QUOTE=Cathy S;12386]My waste line goes directly to a drain and drains there. It sounds as if yours is connected to something else so it doesn’t all get changed weekly. Maybe that is your problem. My pressures are fine, generally in the low 200’s at a 480 pump speed. I don’t notice any difference when I change lines.
Cathy[/QUOTE]
Think I have figured out the problem. Was going to replace the section of line between waste line and plumbing (I had thought it was made from another piece of waste line, but found out it is high quality line. Didn’t know this before as I didn’t install it.). But tried just putting lots of bleach water through as NxStage tech explained to me that bacteria moves around in line if not bleached well/or replaced. I was replacing the waste line each week, but not the section that hooks onto the pipe. So, this took care of it and tonight the tx went fine, no more high E’s!!!
I am hoping this will also explain why sometimes for no apparent reason, I would get a poor return when I had all good returns for 6 months straight. I looked over all my run sheets and observed that the poor returns almost always occured following my day off tx. I had not flushed the waste line directly following my txs, but was doing so just prior to the next tx. Had just forgotten the instructions on that part as my focus was on other things at the time and had never had a problem with this previously. Like you said, it might not have been a problem for me at all if my set up was like yours with line directly in sink.
Are you “guys” using a pureflow?
I was not told to do any of this.
The Purefow does a flush after the drain.
I just close blue clamps and put in a new sak.
When I use the bags as back up I just throw out the drain line.
Pat
[QUOTE=Pat Colongione;12408]Are you “guys” using a pureflow?
I was not told to do any of this.
The Purefow does a flush after the drain.
I just close blue clamps and put in a new sak.
When I use the bags as back up I just throw out the drain line.
Pat[/QUOTE]
No, I am not using a Pureflow. Some patients who use the bags also use a new waste line every tx. We were trained to change the waste line 1x a wk., but to flush out the waste line with bleach solution immediatley following every tx.
I have enough lines to change daily. I use two lines to get to my sink. I usually use the line for a couple days because it is easier. I’ve never cleaned it out. Just open new ones. Of course with the Pureflow I rarely use them.