Looking at what I had to dialyse in 1976 when I first started compared with today is a doddle. I don't mean to belittle the hell patients cope with this hidious treatment today but I've seen alot different and today, it's pretty simple in comparison
I started on a Drake Willock 1015 and there was no way you could just set the dials and come off within a few grams of target. The negative pressure gauger was set at what you hoped would remove your fluid. Dials fluctuated regularly and so was "going flat". Only the time on would remove toxins. The proportioning pump could actually stall at any time which meant diving into the back of the machine and tightening some set screws. It made a sound like a noisey fridge and once a week we had to pull it down, clean out in hot soapy water, reassemble and grease.
Blood lines were used up to 30 times. After each wash we would take them out to the laundry, join the dialyser ends together with a latex tube to give us one long line, run hot water and bleach thru to break up fibrin and clots, rinse that lot out and fill the lines with 20% formaldehyde with water. They will be ready for use in 8 hours. The dialysers were also used up to 12 times each. This meant a similar process of cleaning and filling with formalin for 8 hours. When setting up we had to run 2 L saline through lines and Gambro to make
sure all formalin was out. We had to run a little of the liquid into a test tube and test it to see it was OK to use. You think that was dangerous? It was. All we threw out was syringes and needles.
When coming off we used an"air kit". How it worked was thus. No saline involved. Disconnect arterial bloodline from arterial needle and attach to pressure kit which was affectively a glass jar which had a blood pressure bulb on one side and the arterial bloodline on the exit side. The more you pump the bulb, air forces blood back up the line , into and around the pump, into dialyser, out the venous side. Now this is where you had to be careful with very gentle pumps or you could risk having air shoot into the patient. Not good. One day unbeknown to my wife of I. I was merrily pump the bulb away and nothing was happening. I spotted one of the bloodlines (which kinked exceptionally easy then) had done so. Guess what happened when I unkinked the line. Yup thats right. The air went racing back very quickly and into Moi before I could stop; it. I started to feel a little ill but that may have been psychological. Hell, I didn't know how much air I could stand in my system if any. I rang the Dialysis manager and informed him of what had happened and he asked how I was. Feeling a little funny but OK. I went to work feeling certain that over 2 feet of air in bloodline was in my system. Spooky day but I was alright. Another luxury we have today is threaded joints of needle lines to blood lines. back in 76 (before the wheel was invented it often seemed), we had push in joints, which we then wiped dry with gauze and wrapped with a piece of surgical tape. Sure, this was sticky take but sometimes some keen pushing together could crack the end of the needle line and you would have to replace the needle. If the crack wasn't picked up the patient would bleed like a stuck pig for the next 8 hours. These basic things have changed so much these days and have made the whole dialysis process easier and safer.
Next story. How I came so close to death taking a dialysis shortcut. Hope you enjoy..cheers..Rob
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