Management of clotted circuit causing blood loss part 3

Actions if dialysis circuit is thoght to have clotted:

• Ensure access is still patent and flush with 0.9% sodium chloride for injection
• Establish reason for clotted circuit, such as inadequate anti-coagulation, over-excessive ultrafiltration, blood flow<200ml/min, rising venous pressure, dropping arterial pressure, rising trans-membrane pressure, high haemoglobin etc
• Once the clotted circuit reason/cause has been identified, re-prime a new set of blood lines and ensure no further loss of blood through clotting occurs again
• Where necessary rehydrate the patient, by infusion 0.0% sodium chloride for injection to the volume of blood loss if required
• At the patient next dialysis session, check haemoglobin if the previous results is <100 g/l and  if loss is greater than 100 ml
• Complete documentation and incident report, indicating estimated blood loss volume