By Roger Gabriel (auth.)
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Extra resources for A Patient’s Guide to Dialysis and Transplantation
Problems associated with haemodialysis can be divided into two groups - technical and psychological. Often these overlap and one can worsen the other. Similar problems trouble people being treated with chronic peritoneal dia lysis (see Chapters 9 and 10). In this chapter only the most common difliculties will be discussed. Technical Problems Vascular Access This is the system by which blood is taken from a patient to the PROBLEMS WITH DIALYSIS machine and then returned. Fistulae and shunts have been described on pages 41 and 42.
Heparin is a liquid drug which stops blood from clotting. The effect wears off quite quickly so it has to be used continuously during haemodialysis. The rest of this chapter covers the main points of haemodialysis technique. (I) Before the patient arrives the machine will have been selfsterilized. It is then rinsed through with fresh softened water. (2) The next step is to clip the artificial kidney (dialyser) to a stand and to connect the lines carrying dialysate to and from the machine to the dialyser.
While these operations are minor in themselves repeated failures are depressing and worrying for the patient. Given time adequate vascular access can always be achieved. During the period of trying to make a good fistula it will not be possible to dialyse adequately and the health of the patient may suffer. This in turn may worsen his anxiety. Needling The insertion of needles into a fistula has been described on page 62. Some fistulae can be very difficult to 'needle' - even by expert nurses. Repeated attempts are therefore needed.
A Patient’s Guide to Dialysis and Transplantation by Roger Gabriel (auth.)