What are the reasons for dumping the prime? My unit has changed protocols and will be dumping the prime for now on. I have had several txs. with this procedure and I have found it to be much more gentle on my body.

Interesting. Did your facility say why they changed protocols? What state are you in?

Some facilities and physicians recommend 'dumping' prime prior to initiation of treatment purely for fluid reasons. Why add that extra 300 cc's of fluid on that will simply need to be removed?

Other facilities feel that discarding the prime prior to hook up is another way to make sure that any residual disinfectant has been removed from the lines and dialyzers (nothing left in the circuit, even if it was tested).

In either case, if done properly and with undivided attention from the individual begining your treatment, this can be a safe way to initiate treatment.

I would be interested in knowing why the change, however, purely from a curiousity standpoint. Let me know if you ask your facility why they made this change.

Best wishes,
Carol

Carol,
I did ask and my head RN told me she didn't know the reason. If it removes residual disinfectant that may be the reason. When I switched from reuse to non-reuse I felt an immediate difference with that too. Reuse was causing my legs to feel jumpy and my feet to jerk like I was about to go into a cramp any second. Needless to say it, was very uncomfortable. Once I got off reuse, the symptoms diminished about 90%. With dumping the prime, I have felt another 5% better. I can definitely feel a difference. If I ever find out why the change I will let you know.

Sandi:

I am glad you are feeling better. My only concern with dumping prime has been - and will always be - the risk that can occur if someone becomes distracted and 'forgets' that the patient is not fully hooked up to the system. In this case, the potential for injury is great.

If your unit continues to follow this procedure, please make sure that all staff members pay constant attention to that arterial blood line. You should NEVER waste blood into the dump bucket during this procedure! DO NOT allow your technician or nurse to walk away during this procedure... even for a minute!

Best wishes,
Carol

In our satillite and hospital unit we do not give the prime for several reasons.
Firstly, why add the extra fluid unless a pts cardiovascular status cannot compensate the loss. We have 65 pts, and only about 4 who require a prime or half prime. Secondly, if we do give a prime it is with 150-300mls from the saline bag not what is in the lines. The rationale behind this is you potentially could have some leaching out of chemicals from the dializer, depending on the steriliztion used by the company, especially if your lines have been primed for longer than 20 minutes, which is our policy.

quote:

Originally posted by Carol Isaac MacKusick:
Interesting. Did your facility say why they changed protocols? What state are you in?

Some facilities and physicians recommend 'dumping' prime prior to initiation of treatment purely for fluid reasons. Why add that extra 300 cc's of fluid on that will simply need to be removed?

Other facilities feel that discarding the prime prior to hook up is another way to make sure that any residual disinfectant has been removed from the lines and dialyzers (nothing left in the circuit, even if it was tested).

In either case, if done properly and with undivided attention from the individual begining your treatment, this can be a safe way to initiate treatment.

I would be interested in knowing why the change, however, purely from a curiousity standpoint. Let me know if you ask your facility why they made this change.

Best wishes,
Carol

quote:

Originally posted by Sandi M.:

What are the reasons for dumping the prime? My unit has changed protocols and will be dumping the prime for now on. I have had several txs. with this procedure and I have found it to be much more gentle on my body.

DUMPING THE PRIME CAN BE EXTREMELY DANGEROUS PRACTICE. RINSING THE DIALYZER WITH AN EXTRA LITER OF SALINE WOULD BE A MUCH SAFER PRACTICE BUT A MORE COSTLY ONE. PLEASE...PAY ATTENTION AS THE NURSE "BLEEDS YOU ON" AS SHE COULD BLEED YOU OUT IF SHE BECOMES DISTRACTED/........