General Hemodialysis

Hi, does anyone have information or a policy on how long Danaparoid should be held pre-procedure (surgical or intervention)? We are looking for evidence-based data to add to our P & P. Thanks, Karen

Hi, There is limited information about whether to stop aspirin, clopidogrel before interventional nephrology procedures. What are others doing?
Thanks,
jo-Anne

I am looking for sites using LMWH to prevent clotting in dialysers. Are there any changes to the standards of practice that support the use of allternatives to heparin? I am looking for objective evidence that would support making this change. If you use LMWH, which one do you use? Thanks for any help. Karen Hill

Hi, Anyone ever have a patient allergic to iron dextran, iron sucrose, and sodium ferric gluconate? What next?
Jo-Anne
Halifax, Renal Program

Does anyone make up either the oral capsules or oral solution of sodium thiosulfate for calciphyaxis maintenance thearpy?
Thanks,
Jo-Anne (Halifax, Renal Program, CDHA)

Problem:   This came up at our last program meeting.  The RN in charge of the home dialysis program has been dispensing iron dextran from our ward stock to our home dialysis patients.

Hi everyone.

I am wondering if people are able to give some insight into how your respective dialysis units are documenting delivery of dialysate with each dialysis session. How do you document that the correct concentration of K+ and Ca2+ has been utilized? Does anyone place the dialysate prescription on the Medication Administration Record? Does any unit require double signature as part of the documentation?

Any discussion would be most helpful.

Thanks.

Evelena

I'm wanting to find out from other centres how narcotic prescriptions are being handled in the HD unit. Any formal process in place, i.e., monitoring of narcotic usage, implementing narcotic agreements, and what's done if agreement is broken? Any info would be appreciated.

Emmelia, York Central Hospital

Can anyone share a synopsis of the policy in your dialysis unit re: hazardous drugs precautions such as Megace/Thalidomide/Casodex?  Is your policy the same as for patients receiving chemo?  Thanks, Tracy

I have been asked to find out if there have been any similar incidents reported at your units. I have also notified Amgen of this occurrence. Please e-mail me at hillk@rvh.on.ca

Thanks, Karen

We had an incident today where a nurse in hemodialysis was giving a dose of Aranesp to a patient. This goes into the medication port of the patient’s tubing which sends the medication directly back into the patient.