HEMODIALYSIS PROTOCOLS

Receiving patients from other department (ICU,WARD,etc)

I. Proper endorsement should be done when receiving inpatient prior to

hemodialysis treatment.

CONTENT OF ENDORSEMENT:
1. CONSENT FOR HD (if NEW PATIENT)
2. DOCTORS ORDERS
3. Status of the patient
o GCS
o VITAL SIGNS
o SP02
o Connected apparatus (IV site, IFC, ET, NGT, MV, Drainage,etc)
o HD access (AVF,AVG,IJ,FEM)
4. Medications
o PRN meds
o Meds given/Due meds
o Feeding
o IVFs, current IVFs, to be followed IVFs
o Hold meds
Diuretics
Antihypertensive
Vasodilators
5. Labs
o HEPA PROFILE!!!
o CBC
o Bun
o Crea
o K
o NA
o TROP I
6. ECG, MRI, CTSCAN, UTZ and XRAY results

II. For ICU patients, 1 RN must be present in the room all throughout the dialysis
treatment.
III. Receiving and endorsing patients must be done ONLY in the DIALYSIS UNIT.
IV. PRN MEDS & Blood transfusion could be given by HD nurses.
V. For cases in which the ward/ICU nurse is unable to receive the patient
immediately, the patient will remain in the unit until an available nurse will
receive the endorsement.
VI. All procedures to be done after dialysis are the responsibility of the receiving
nurses.
 CODE BLUE/ CARDIAC ARREST

RN 1

Shout CODE BLUE immediately if the patient is unresponsive

START IMMEDIATE CHEST COMPRESSION
(CHEST COMPRESSION 30:2, AMBUBAGGING 5-6 SECS)

RN 2
STOP HD
CHECK VITAL SIGNS- CAROTID PULSE
RETURN REMAINING BLOOD- WITH TECHNICIAN
INSERT CARDIAC BOARD
PLACE THE BED ON FLAT
AMBUBAG CONNECTED TO 02 AT 10 LPM
EARLY DEFIBRILLATION

RN 3
CALL ROD AND ICU CODE BLUE TEAM
CHECK IVFS FLOWING- NEVER HOLD ANY IV MEDS
PREPARE EPINEPHRINE AND ANY INOTROPS
DOCUMENT & REPORT TO ROD- Communicate with other healthcare
personnel
VITAL SIGNS EVERY AFTER 1 CYCLE (2 minutes)

ET INSERTION
ALWAYS WITH SUCTION APPARATUS
LARYNGOSCOPE WITH BATTERY
SYRINGE 10CC
ET TUBE
5CC SYRINGE- DIAZEPAM
DIAZEPAM 10mg
KY-JELLY
AMBUBAG WITH O2 CONNECTOR
STERILE GLOVES
NSS BOTTLE- HYPER-EXTEND THE NECK
TAPE
STETHOSCOPE-CHECK ET PLACEMENT