Starting Dialysis - Fresenius Medical Care 2008K Operator's Manual

Chapter 3—Setting Treatment Parameters

Starting Dialysis

At this point, all treatment parameters and options should be entered. Dialysate should
already be verified for absence of disinfectant, verification of prescription, conductivity, and
pH should also be confirmed. It is now time to connect the patient to the 2008K
hemodialysis machine via the blood tubing and begin the dialysis treatment.
Note: Follow established unit protocol regarding procedures for establishing aseptic blood
connections.
1. Before starting dialysis, complete the patient assessment per unit policy.
2. Wrap the blood pressure cuff around the patient's non-access arm.
Warning! Be sure the cuff is the correct size and placed at heart level. An improperly fitted
cuff may cause inaccurate blood pressure readings due to under or over compression of the
brachial artery. Each centimeter above or below heart level will cause an error of ± 0.8
mmHg.
3. Verify that ultrafiltration is off (UF light is off), and that the UF Removed button is reset
to zero. The UF removed may be reset by touching UF Removed button and then the 0
key and confirming the change.
4. Verify that the venous line is in the venous clamp and the optical detector. Verify that the
optical detector door is closed.
Warning! Do not infuse the recirculated saline prime into the patient. Discard the
recirculated saline and fill the extracorporeal circuit with fresh saline prior to connecting to
the patient. The volume of fresh saline used to fill the extracorporeal circuit should be equal
to the volume of the dialyzer and blood tubing set in use.
5. Lower the blood pump rate to 150 ml/min and then press the blood pump Start/Stop key
to stop the pump.
6. Connect the patient and initiate treatment according to unit protocol.
Warning! Check all bloodline and dialysate line connections for fluid leaks. Keep access
sites uncovered and monitored. Improper bloodline connections or needle dislodgements
can result in excessive blood loss, serious injury, and death. Machine alarms may not occur
in every blood loss situation.
7. Start the blood pump and adjust the blood flow rate to establish dialysis and the alarm
limits. Establish the prescribed blood flow rate.
8. Rotate the dialyzer to arterial inlet up.
9. Touch the Tx Clock button and press CONFIRM to start the treatment.
10. Check that the UF/SVS/Heparin are on, if prescribed. If applicable, a blood pressure
measurement is initiated.
Warning! When establishing blood flow, ensure that air will not be infused into the patient.
Warning! Check all bloodlines for kinking. Improper blood flow may cause hemolysis of
the blood.
94 2008K Hemodialysis Machine Operator's Manual Rev P