I am concerned about them not being able to stop bleeding after dialysis usually takes one hour or more, is this normal. Linda

quote:

Originally posted by Ruby:
I am concerned about them not being able to stop bleeding after dialysis usually takes one hour or more, is this normal. Linda

how much heparin are you using in your circuit and how long before your treatment is finished is the heparin turned off?

There's so many factors on that, such as the amount of anticoagulant being used. Is the dose just right for the patient? have we done anticogualtion studies prior giving the prescribe anticoagulant as well as the shut off time?( if using heparin, have we done heparin modelling to that patient?) were the line & dialyser clear after dialysis? On the other hand, maybe the patient is a bleeder in relation to her/his blood results.

One other issue is the needle may be coring the site. Some needles actually punch a hole in the site and then you get excessive bleeding. Also, is this a fistula or graft? I am also curious as to what constitutes heparin modeling. Last I heard clotting times cannot be done in a facility.

Another option you may consider is the pressure in the vascular access. If there are higher pressures d/t stenoses, this may cause prolonged bleeding post tx.

quote:

Originally posted by pinky:
how much heparin are you using in your circuit and how long before your treatment is finished is the heparin turned off?

Maybe you don't need ANY heparin

DO ALL PATIENTS REQUIRE HEPARIN, EVEN A SMALL AMOUNT.. AND ... ANOTHER QUESTION... SILLY, BUT HAVE TO ASK... IF A PATIENT IS GETTING HEPARIN DURING TREATMENT, DOES THIS HELP ALSO ... IE TAKING COUMADIN.. IS THERE RESIDUAL EFFECT TO PREVENT CLOTS?

quote:

Originally posted by bettyboop:
Maybe you don't need ANY heparin