Persiapan dan Pelaksanaan CAPD, Cuci Darah Lewat Perut

SICAPD - Monitoring Cuci Darah Lewat Perut (CAPD)

11 Jul 202105:21

Summary

TLDRThe video script provides a detailed step-by-step guide on performing a dialysis procedure using aseptic techniques. It covers crucial actions such as handwashing, preparing equipment, inspecting fluid bags, and connecting transfer sets to ensure proper setup. The process moves through phases including fluid draining, flushing, and refilling, with clear instructions on monitoring for clarity and preventing contamination. Finally, it concludes with disconnection and post-procedure safety checks, ensuring everything is sterile and ready for future use. The guide emphasizes safety, precision, and maintaining aseptic conditions throughout the procedure.

Takeaways

🧼 Wash hands thoroughly following the 6-step aseptic handwashing procedure before starting dialysis.
🛠️ Remove the transfer set from its packaging and prepare the twin bag for the procedure.
💧 Open the outer packaging of the dialysis fluid bag, place it on the table, and ensure the tubing is straight.
🔍 Check the fluid bag for clarity, ensure there are no leaks, and confirm the prescribed amount of fluid and dextrose concentration are correct.
📅 Verify the expiration date of the fluid and ensure it hasn’t passed.
🔒 Ensure the medical port and the tubing connectors are secure and undamaged before starting the procedure.
🔗 Connect the transfer set to the tubing using aseptic technique, making sure to avoid contamination.
💨 Begin the drainage phase by opening the twist clamp on the transfer set, allowing waste fluid to flow out of the abdomen, which takes 15-20 minutes.
🛠️ Perform the flushing phase by allowing fresh fluid to flow while removing any air bubbles from the tubing.
🔄 Start the filling phase by opening the clamp and letting the prescribed fluid flow into the abdomen, which takes about 10 minutes.
🧴 Once the filling phase is complete, disconnect the transfer set aseptically and replace it with a new one.

Q & A

What are the steps to follow before starting the dialysis procedure?
-Before starting the dialysis procedure, wash your hands using aseptic handwashing techniques with six steps, then prepare the transfer set and twinbag according to the instructions.
How should the twinbag be prepared for use?
-First, open the outer packaging of the fluid bag, place it on a table, straighten the tubing, and check the fluid bag carefully for clarity, the correct dextrose concentration, and any signs of leakage.
What should you check on the dialysis fluid bag before use?
-Ensure the dextrose concentration matches the doctor’s prescription, the fluid is clear, the amount is correct, there are no leaks, and the expiration date has not passed.
What is the significance of using an aseptic technique during the procedure?
-Using an aseptic technique prevents contamination, which is critical to avoid infection during the dialysis process. This includes handling equipment carefully without touching non-sterile areas.
What is the role of the drain phase in dialysis?
-During the drain phase, used fluid is removed from the peritoneum. This phase takes about 15-20 minutes, and it's important to observe the clarity and flow of the waste fluid.
How can you tell when the drain phase is complete?
-The drain phase is complete when the waste fluid is no longer warm or cool to the touch, indicating that all fluid has been drained from the peritoneum.
What is the purpose of the flash phase in dialysis?
-The flash phase aims to remove any air from the tubing, preventing air bubbles from entering the peritoneum, which could cause discomfort or complications.
How long does the filling phase of dialysis take, and what happens during this phase?
-The filling phase takes about 10 minutes, during which fresh dialysis fluid is introduced into the peritoneum through the transfer set.
What precautions should be taken during the disconnect phase?
-During the disconnect phase, a new Minicaps should be prepared, checking the expiration date and povidone-iodine sponge. Ensure that the transfer set and connections are handled aseptically to avoid contamination.
What is the final step in completing the dialysis procedure?
-After disconnecting and securely capping the transfer set with a new Minicaps using aseptic techniques, the dialysis procedure is complete.

Outlines

00:00

🧼 Hand Hygiene and Preparing the Dialysis Equipment

The first step before starting the dialysis procedure is to thoroughly wash your hands following the aseptic six-step method. Afterward, you should retrieve the transfer set from the available storage. To prepare the twin-bag system, begin by opening the outer packaging of the fluid bag and place it on the table. Straighten the tubing and separate the fluid bag from the protective wrapping. Carefully inspect the fluid bag for clarity and check for leaks, ensuring that the dextrose concentration and the amount of fluid are correct according to the doctor's prescription. It’s also vital to confirm that the expiration date is still valid and that the medical port protector and the drain port are intact and undamaged. Once the area is properly set up, you are ready to move on to the connection phase.

05:00

🔗 Connecting the Dialysis Set

In this phase, disconnect the protective covering of the collection line by holding it in one hand and gently pulling it off with the other. Remove the cap of the transfer set by twisting it, being careful not to contaminate any area. Connect the transfer set to the collection line using aseptic techniques. It’s crucial that the ends of the tubing do not touch anything else to maintain sterility. Once connected, hang the fluid bag above shoulder height to ensure proper flow of the fluid into the peritoneal cavity. Place the twin-bag system on a tray with the shiny side facing upward, ready for the next phase.

⏳ Draining and Flushing Phase

Begin the draining phase by opening the twist clamp on the transfer set, allowing the waste fluid to exit the peritoneal cavity. This phase typically lasts between 15 to 20 minutes. Throughout the process, observe the clarity and flow of the fluid to ensure that everything is proceeding smoothly. Once the draining phase is complete, you will notice that the waste fluid is no longer warm to the touch, signaling the end of this stage. Close the twist clamp on the transfer set before moving to the flushing phase. During the flushing phase, let fresh dialysis fluid flow for about five seconds before clamping the drain line with the white clamp. This step ensures that any air bubbles in the line are expelled, preventing air from entering the peritoneal cavity.

💧 Filling Phase and Final Connection

To start the filling phase, open the twist clamp on the transfer set to allow the dialysis fluid to flow into the peritoneal cavity. This phase typically takes about 10 minutes to complete. Once the fluid has filled the cavity, close the twist clamp again. Finally, prepare a new transfer cap (Minecraft) by checking its expiration date and ensuring the povidone-iodine sponge is intact. Disconnect the current transfer set from the tubing, using aseptic techniques, and attach the new transfer cap to the system. This marks the end of the dialysis procedure.

🎉 Completion of Dialysis Procedure

With the final connection of the new transfer cap, the dialysis procedure is now complete. All necessary steps have been followed to ensure the patient’s safety and the effectiveness of the dialysis session.

Mindmap

Keywords

💡Dialysis

Dialysis is a medical procedure used to remove waste and excess fluid from the blood when the kidneys are no longer able to perform this function naturally. In the context of the video, the procedure is demonstrated step by step, highlighting the importance of aseptic techniques to avoid infection. The video walks through the different phases of dialysis, emphasizing its crucial role in maintaining the patient's health.

💡Aseptic Technique

Aseptic technique refers to practices and procedures that prevent contamination from pathogens, ensuring that the environment and materials used are free of harmful microorganisms. In the video, aseptic techniques are crucial, especially during the connection and disconnection of the dialysis system to prevent infections. For example, the transfer set and connection points must be handled without touching other surfaces.

💡Transfer Set

A transfer set is a piece of equipment used to connect the dialysis system to the patient’s body. In the video, the transfer set is carefully handled using aseptic techniques to avoid contamination. It is connected to the tubing and fluid bags, facilitating the flow of dialysis fluids into and out of the patient’s body.

💡Twinbag

A twinbag is a set of fluid bags used in peritoneal dialysis, one for fresh dialysis fluid and another for waste fluid. The video shows how to prepare the twinbag, ensuring it is free from leaks, and that the fluid concentration matches the prescription. It is critical to check the clarity of the fluid and expiration date to ensure the safety and efficacy of the procedure.

💡Drain Phase

The drain phase is the part of the dialysis procedure where waste fluid is removed from the patient’s body. In the video, it is explained that the drain phase takes 15-20 minutes, during which the clarity and flow of the drained fluid should be monitored. This phase is essential for ensuring that the waste is properly removed from the patient’s peritoneal cavity.

💡Filling Phase

The filling phase refers to the stage of dialysis where fresh dialysis fluid is introduced into the peritoneal cavity. The video demonstrates how to open the twist clamp to allow the fluid to flow into the body, a process that takes around 10 minutes. This phase is crucial for exchanging the fluids and filtering the blood effectively.

💡Povidone-Iodine

Povidone-iodine is an antiseptic used to prevent infection by killing bacteria, fungi, and viruses. In the video, povidone-iodine is used on the connection points and equipment before and after the procedure to ensure that no harmful microorganisms contaminate the system, which is vital for patient safety.

💡Peritoneum

The peritoneum is the membrane that lines the abdominal cavity and covers the internal organs. In peritoneal dialysis, the peritoneum acts as a filter, allowing the dialysis fluid to absorb waste products from the blood. The video describes how the dialysis fluid is introduced into the peritoneal cavity, where it remains for a certain period to cleanse the blood.

💡KPD Fluid

KPD fluid, or peritoneal dialysis solution, is a sterile fluid used in the dialysis process. The video shows how to check the clarity and concentration of the KPD fluid to ensure it meets the doctor's prescription. This fluid is critical in absorbing waste and excess substances from the patient’s bloodstream during the procedure.

💡Expiration Date

The expiration date indicates the shelf life of medical supplies, including dialysis fluids and equipment. In the video, checking the expiration date of the KPD fluid and other materials is emphasized to ensure their effectiveness and safety. Using expired materials could lead to complications, such as infections or ineffective dialysis.

Highlights

Wash hands following aseptic handwashing steps before starting dialysis.

Prepare the transfer set from the sterile packaging and ensure it is ready for use.

Open the outer packaging of the fluid bag and place it on the table, ensuring both tubes are straightened.

Examine the fluid bag for clarity and ensure no leaks or cloudiness.

Confirm the dextrose concentration matches the doctor's prescription and check fluid clarity.

Verify the fluid amount matches the doctor's prescription and ensure no leakage from the bag.

Check the fluid expiration date and ensure it hasn't passed.

Ensure the protector and medical port are in place, and check that the freewheel is intact and undamaged.

Connect the transfer set using aseptic technique to avoid contamination.

Begin the drainage phase, allowing the waste fluid to exit the body over 15-20 minutes.

Monitor fluid clarity and flow during the drainage phase.

Start the rinse phase to flush out any air from the tubing before continuing.

Proceed to the fill phase, which takes about 10 minutes to fill the peritoneum with the prescribed fluid.

After filling, close the clamp and prepare for the disconnect phase.

Use a new sterile transfer set and connect it aseptically, ensuring everything is in place.