Fresenius Medical Care – St. Wendel Plant (Update December 2014)
นอกจากการดูบทความนี้แล้ว คุณยังสามารถดูข้อมูลที่เป็นประโยชน์อื่นๆ อีกมากมายที่เราให้ไว้ที่นี่: ดูเพิ่มเติม
At the St. Wendel, Saarland, facility Fresenius Medical Care develops and manufactures lifesaving products for the treatment of patients with chronic kidney failure. These include dialyzers (artificial kidneys) and systems for peritoneal dialysis (dialysis via the peritoneum). St. Wendel is Fresenius’ first and at the same time the most important factory for dialyzer production. Largescale production of the first polysulfone dialyzers started in 1985 at this factory, which has belonged to the company since the mid1970s.
Dialyzer Characteristics(Clearance, Sieving Coefficient,KUF, MWCO,MWRO)
Brief Overview of Dialyzer Characteristics Such as: Clearance,KUF,Sieving Coefficient,MWCO,MWRO,KoA etc
Renal Replacement Therapy: Hemodialysis vs Peritoneal Dialysis, Animation
(USMLE topics) Principles of hemodialysis and peritoneal dialysis, pros and cons. This video is available for instant download licensing here https://www.alilamedicalmedia.com//galleries/allanimations/urinarysystemvideos//medias/d24c73c941c84a1cb37f695c9fe5d709renalreplacementtherapyhemodialysisvsperitonealdialysis
Voice by: Ashley Fleming
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Dialysis is a therapy that artificially removes wastes from the blood of patients whose kidneys can no longer perform this function adequately. There are two main types of dialysis: hemodialysis and peritoneal dialysis.
In hemodialysis, blood is filtered outside the body, in a dialysis machine. The patient’s blood is pumped to the machine, cleansed, then returned to the body. To prepare for regular hemodialysis treatments, a onetime minor surgery is performed to create a vascular access, which is essentially a large and strong vein, enough to sustain the high flow rate through the machine. This can be accomplished by fusing an artery to a vein, forming a fistula; or by adding a graft. For emergency treatment, a catheter can be used for temporary access.
Once inside the machine, blood flows within tiny tubes surrounded by a dialysis solution, called dialysate. The walls of the tubes act as semipermeable membranes that allow only small molecules, such as water, nitrogenous wastes and electrolytes, to pass through. The filtration occurs by osmosis and diffusion, where water and solutes move from higher to lower concentration. The dialysis fluid contains solutes at the levels similar to those in healthy blood. Urea, potassium and other solutes that are present at higher levels in patient’s blood, move out to the dialysate, which is constantly replaced and discarded. At the same time, other substances can be added to the dialysis fluid to be administered to the patient. These may include: bicarbonate, to adjust the patient’s blood pH; erythropoietin, to compensate for its low production by the failing kidneys; and certain medications. Because of the increased risks of blood clotting associated with its contact with foreign surfaces, an anticoagulant such as heparin is usually added. The composition of dialysis fluid is typically prescribed by a nephrologist based on the patient’s needs.
Hemodialysis frequency of treatment: 4hour treatments, 3 times a week, in a dialysis center. Complications: risks of blood infection, thrombosis, internal bleeding due to the added anticoagulant.
In peritoneal dialysis, the dialysis fluid is introduced into the patient’s abdominal cavity via a catheter. The lining of the abdomen, the peritoneum, serves as the natural filtering membrane. The fluid remains in the body for several hours, allowing exchange and equilibrium with the blood running in the underlying vessels, before being discarded. The therapy can also be done automatically at night during sleep.
Peritoneal dialysis is less effective than hemodialysis, but because it can be performed for longer periods of time, the result is comparable. Peritoneal dialysis advantages: more flexibility, is better tolerated by patients, and less expensive; disadvantages: more often complicated with abdominal infections.
Cannulation Introductory for dialysis การเจาะเส้นคนไข้ไตเทียม
วันนี้เป็น video ที่ต่อเนื่องมาจากวันก่อนและเกี่ยวกับการเจาะเส้นคนไข้เพื่อรับการล้างไต เริ่มตั้งแต่รับคนไข้ที่หน้าประตูจนถึงการเปิดเส้นและต่อคนไข้กับเครื่อง
Cannulation and setting up the patient with a dialysis machine
1. Gathering all the supplies from prescribed needles, tourniquet if the patient’s access is fistula, 2 of 10 mL prefilled saline syringes, heparin if gets prescribed, gauze that soaked with soap and water, and tape.
2. By this time, both transducers, Hansen wands should be in place and BFR must be at 400 to rinse off any residual of the sterilants from a dialyzer.
3. Take standing BP, get temperature and assess the access. Then get sitting BP once patient sits on a dialysis chair.
4. Clean a patient’s access with soap and water first. Then alcohol pad afterward. Change the gloves after cleansing process.
5. Start to cannulate the patient at the lower section for venous line. Slowly release the cap at the end of a needle once the access gets punctured. Connect a 10 mL prefill saline syringe and push and pull the saline to test the patent of the line.
6. Start an arterial line with the same process at the spot at least 2 inches above the venous site.
7. Connect heparin syringe and administer it if prescribed.
8. Reduce BFR to 200 and stop blood pump.
9. Turn blood pump off and take the connector between the red end and blue end when we married the line off. Keep this part sterile to avoid any contaminations. Fresh prime the line by rinsing the saline that has been sitting in the line off; turn blood pump on to rinse 50 mL for arterial line then turn BFR off before clamp a venous line and turn it back on to rinse 150 mL for Venous line. Clamp a saline line right the way and using a blue clamp on top of a saline line also.
10. Connect the bloodline to patient’s access by having a blue end goes on the venous site which is on the top and red one goes to the artery site. Unclamp all of the clamps that connected access and bloodline to start a process of dialysis. @@@ Mnemonic==blUe \u0026 Up@@@ Secure the site by blue clamp and tape to comfort the patient.
11. Flip a dialyzer to have arterial end be on top once blood from access reaches it.
12. Slowly gradually increase BFR until it gets to a prescribed rate and watch both of venous and arterial pressure on the “ Home “ tab. Then click a big “ Treatment run/pause “ button on the “ Home “ tab to start a machine clock.
13. Go to “ ChairSide “ and click on “ Start treatment “ which is located in the left lower corner. Must sign off with password to start the treatment. Also get the exact start treatment time from “ Trends “ tab and put the number as a military time.
14. Go to “ Treatment Data “ to record the information of treatment. Which will be as same as documenting the regular vital signs during treatment with this additional information =put “ 250 “ to be an amount of the fluid given. Also click on “ Treatment initiated without problem “ when adding the comment.
นอกจากการดูหัวข้อนี้แล้ว คุณยังสามารถเข้าถึงบทวิจารณ์ดีๆ อื่นๆ อีกมากมายได้ที่นี่: ดูวิธีอื่นๆDream interpretation