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Post dialysis standing B/P's prior to disconnecting lines
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<deb>
posted
Currently our unit does post standing B/P's after the needle's are removed. Some staff with experience in other unit's have suggested that we trial doing standing B/P's prior to disconnecting the lines, so saline can be given if B/P is low. My concern is that if a Pt. does experience an orthostatic episode and falls, the needles or the IJ catheter could more easily be dislodged, if they are still connected to the lines. Unfortunately I have seen this occur during my career in dialysis and I would prefer not to experience it again. I understand that staff need to remain next to the Pt. during
the standing B/P check, which may prevent fall's from happening, but during the change over, there are numerous distractions that may not always make this possible.
Wondering what the practise is in other unit's?
 
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<Debi>
posted
quote:
Originally posted by deb:
Currently our unit does post standing B/P's after the needle's are removed. Some staff with experience in other unit's have suggested that we trial doing standing B/P's prior to disconnecting the lines, so saline can be given if B/P is low. My concern is that if a Pt. does experience an orthostatic episode and falls, the needles or the IJ catheter could more easily be dislodged, if they are still connected to the lines. Unfortunately I have seen this occur during my career in dialysis and I would prefer not to experience it again. I understand that staff need to remain next to the Pt. during
the standing B/P check, which may prevent fall's from happening, but during the change over, there are numerous distractions that may not always make this possible.
Wondering what the practise is in other unit's?
 
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<Reuckypneup>
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<Guest>
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Standing before disconnecting. Lock their chair and watch them during the BP check. If they look disoriented or wobbly, immediately give them a hard push backwards so they fall into the chair.

If your staff can't be there while the patients do a standing BP, then that sounds like a staffing issue. Even if the patient is disconnected, someone should still be there during the BP. An uncontrolled fall is bad regardless of whether the needles are in or not.
 
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