I would like to see what method other nurses use when returning the patients blood post dialysis via their tessio/permcath. I use to clamp the arterial line and let the saline run the rest of the blood in the lined back to the patient via the venous line.This way I could give the patient back theirblood and then get scrubbed, keeping it totally aseptic. There is however a small amount of blood they do not get back this way -from the line to the saline arm. The other way I have been showen is to attach a R85 to the saline arm and attach direct to the arterial line. This means once you are scrubbed you have to touch some equipment which is not aseptic, but the patient gets all their blood back. I was told this is better because of the anaemia patients suffer as a result of ESRD. Could anybody tell me the correct way and if any research has been done on the same issue.

Gail,

For future reference this is the 'Technical' forum. There might be some people in here that may be able to help you with your question, but you may have better luck posting this topic in the Nurses forum. Don't get me wrong, your welcome here ANYtime. I just want to help you get the most accurate info. However, the way I have seen it done in the past is like you said, clamping the arterial line, opening the saline line and using saline to flush back the blood. But, like you said, that does leave a little bit of blood in the line before the saline 'T' that doesn't get returned to the patient. However, once you get done returning the blood via venous line, can't you just stop the pump, clamp the venous line, unclamp the arterial line and squeeze the saline bag to force the blood back through the arterial line and to the patient? That should work right? Hope that helps. Good luck.

Gail,

The way it is done at our clinic is as follows:

1. The machine is stopped from pumping and the arterial lines clamped. A 10cc saline syringe is attached to the permacath and the arterial line is flushed with this.
2. The blood tubing is then attached to the saline piggyback and the blood pump started at a slow rate (usually 200 ml/min)until the blood tubing is completely clear from blood.
3. The venous bllod line is disconnected from the patient and a 10cc saline syringe is attached and the venous side flushed.
4. The patients cath is then packed with 10000 units of heparin on each side and capped.

Hope this helps and good luck. MG