NxStage users: listen up!!!!!!

[lmunchkin]

 I just finished doing Dialysis on husband for 3hrs & 17mins. Everything was running smooth all the while.  When I went to take him off, his saline bag was blowed up so full it looked like it would burst!  I was thoroughly shocked and wondered how this could happen.

Upon my observations, I had noticed I had not connected the dialysate line nor the waiste line!  Oh S--t!!!!! Therefore his excess went in the saline bag and it was about to bust like a baloon.

When I finally got him off and weighed him, he actually lost more than what I calculated.  So my question is how did this happen and did his blood actually get cleaned?

By asking how it happened, I know what happened, but how did it take off his UF and did it get cleaned? Man talk about freaking out (I didnt) and keeping your cool! I sure hope this hasnt contaminated his blood in some way. He says he feels same as always.

You see, this is what happens when we get in a rush.  We tend to forget the Big things, like Dialysate & drain line!

Thank God, he is alright?  Are there any other DUMMIES out there that did this at some time or am I the First? 

lmunchkin
 

[boswife]

Ohhhhhhhhhhhhh your not the first!!  And i did freek out.  Only thing i didnt handle with at least an apparant 'calm'.  Now, i will say that i noticed the 'swelling' in the very beginning of treatment and called tech support and handled it..  sooo, i can tell you how it happened.  As you know, the saline is not in use during treatment inless we ask it to be in use.(ie a saline bolis)   So, all it was doing was sitting there 'acting' like a waiste container.  So all his waste for the treatment went in there for you to dispose of.  I fear to ask how you 'rinced' him back though???  did you add a clean saline??  Cause thats what you should have done and they even (if ya give them a call) will advise to switch out the spike (kind of weard process) as to not contaminate the bag..  Soooooooo, they also say it is the most called in oops..

[boswife]

hummmmmm, im trying to picture now (after reading again) how it could run without the dialysate connected..   I know if not connected the 'waste' just shoots up into the saline bag,,, but cant get a picture of the other...

[willowtreewren]

You pulled a good one!!!!

If you had no dialysate connected, you only did his UF, but no blood cleaning.

You are lucky that that is all that happened. We had our saline bag get too full and spring a leak, not once, not twice, but THREE times! 

And that is after I swore I would NEVER make THAT mistake. Lesson learned.....never say never.

J will be all right. Just make sure he gets a good treatment tomorrow.

 

Aleta

[vcarmody]

Awww yes we have made this mistake once, I was lucky and caught it, changed out the saline bag before it burst now we do the double check method.  Who ever sets up the machine, the other person person checks everything before we start.  I was advised by our nurse that starting our next delivery there will be new cartridges, they re-designed just so this issue is resolved.  Can't wait to see what they are like. 

[looneytunes]

Oh Munch...I got such a grin out of this....yes, we've done this one before too.  And my hubby will tell you that the worst words he has ever heard during dialysis was me saying "Oh S@#T!"  He doesn't get too concerned if it's an "Oh No!" or a "dang it" but when he hears "Oh S#@T", his heart starts racing and his eyes get REAL big.   

In our case, we caught the saline bag before it exploded and I hooked up and cleaned the spike with Alcavis.   But it was a rather funny mistake.  We also got into the habit of cross checking each other before the "run" button was pushed. 

[lmunchkin]

Oh thank God, Im not the only one.  I was feeling kind a foolish, because I generally am very observant of everything. Like Boswife, the saline is used for priming and it is not used anymore until rinseback. Thank God the saline bag did not burst, but it was like on the edge of it.  I had already pulled 2 needles of saline at the beginning and laid them on table for a flush back of A&V lines at the end of treatment, but I did not do a rinse back.  He lost all that blood in the machine, but I certainly didnt rinse back all that nasty stuff back in him.

I just disconnect both lines and thank goodness, I drew two needles with clean saline and flushed his lines. Vicky I hope you are right about new Cartilidges that will detect this sort of thing from happening.  It would have been nice to have an alarm to warn of this.  It didnt hurt in anyway, but still, it cant be good either!!! Even that little blood left in the machine is precious!

I just never thought to look at saline bag.  Kudo's to those of you that caught it.  Yea, lesson learned for sure.  I'll know better next time.  It was kinda funny the way it all went down. 

Thanks guys for "coming forth" about it!  Whew........ so glad to know! 

lmunchkin
 

[lmunchkin]

hummmmmm, im trying to picture now (after reading again) how it could run without the dialysate connected..   I know if not connected the 'waste' just shoots up into the saline bag,,, but cant get a picture of the other...

Yeap, its hard to imagine, but there was no dialysate.  It was not connected at all.  I too was suprised that machine allowed that to happen.  Looks like a sensor would have picked that up!

lmunchkin

[Bill Peckham]

I've done it more than once haven't had the bag blow up but once I had a  pin hole leak that sent a stream of used saline arcing onto my chest. I had thought that one advantage of kidney failure was that I would never piss myself but you just never know.


You used saline as dialysate LM so in effect you ran on an 0K, 0Ca bath.  Since you multipassed the saline over time the potassium and calcium content would increase limiting overall removal. Doing that that once in blue moon shouldn't cause any complications.


The exploding bag happens when the machine is set to remove more than ~800ml of fluid (depending on how depleated the bag is to start the run).

[lmunchkin]

Thanks Bill, so glad to hear you did it too!    I dialysised him last night, so everything went well. When he met his UF I added 5liters to his 20 and removed alot of toxins.  I about knocked him out. ..trying to remind him of the ole In-center days!  He is going to be fine!

lmunchkin
 

[Dannyboy]

I understand that NxStage is in the process of implementing a design/configuration change to the lines to reduce the chance of/eliminate this situation.   

---Dan

[lmunchkin]

I hope so, but not too much modification, I really like what they have!!!!!

lmunchkin
 

[boswife]

Im with ya imunch!!  besides that......... i very dislike change 

[JohnJ]

Awww yes we have made this mistake once, I was lucky and caught it, changed out the saline bag before it burst now we do the double check method.  Who ever sets up the machine, the other person person checks everything before we start.  I was advised by our nurse that starting our next delivery there will be new cartridges, they re-designed just so this issue is resolved.  Can't wait to see what they are like.

We just got a box of the new design but haven't opened it yet. You should be getting yours soon.

[boswife]

Ok johnj Please get to opening and do tell

[lmunchkin]

I was due a shipment from NxStage today, but I guess Presidents day is a Holiday for them.  Wish I got a Holiday 

lmunchkin
 

[The Noob]

I've done it more than once haven't had the bag blow up but once I had a  pin hole leak that sent a stream of used saline arcing onto my chest. I had thought that one advantage of kidney failure was that I would never piss myself but you just never know.

LOL Bill, too funny.
yep, i think we have all done that and probably alot else if truth be told..at least once, maybe more.

now, i got this machine down right away. dh still misses things. but thats because he rushes. i sometime suggest he take a swig of whiskey to calm himself beforehand.

i'll tell ya something to tell yourself on those days..this is what i told one of the nephs last visit.
he asked us how we liked the machine. i told him we had 7 days of half day trainings and i had it down with all the alarms and all in 2 weeks. i said everyone said "its because of your prior medical training"..i said "No, its bcause i'm frickin brilliant"..
LOL..doc laughed much and said he thought it was probably both.

if you have learned to do Nxstage at home, tell yourself you too, are brilliant..brave..courageous..your a Hero Lady and i mean it! 

[lmunchkin]

Got my Nxstage supplies today, but no new designed cartlidges.

lmunch