Non-profit, charitable dialysis centres which receive no funding from government but depend on public generosity to dialyze needy patients in 3rd world face enormous financial constraints. Unused concentrate in jugs cannot be afford to be disposed of and is instead used for following shift dialysis. what are the possible infections that can pass from 1st shift patient to the following patient sharing the same jug of concentrates? How can we minimiz such risk apart from throwing any unused bicarb? Thanks for your answers.

The jugs should be kept CLEAN, there should be no exposure to the air other than the vent hole, if there is a blood spill or fluid spill on or near the bicarb container, the bicarb solution should be thrown away after the run. If the Bicarbonate is not pre mixed, the jugs, caps and draw tubes, should be regularily disinfected. We regularily used to save unused bicarb solution for the next patient, but at the end of the day, any that was left, was turfed out.

What about a dialysis unit.....................where they use huge bottles on the bottom of the machine..... moving them from pt to pat.. this is a good unit.. etc etc... should this be done???

quote:

Originally posted by Cruisetech:
The jugs should be kept CLEAN, there should be no exposure to the air other than the vent hole, if there is a blood spill or fluid spill on or near the bicarb container, the bicarb solution should be thrown away after the run. If the Bicarbonate is not pre mixed, the jugs, caps and draw tubes, should be regularily disinfected. We regularily used to save unused bicarb solution for the next patient, but at the end of the day, any that was left, was turfed out.

The typical requirement for sodium bicarbonate use is "to follow manufacturer recommendation." Most manufacturers recommend that sodium bicarbonate be used withing 24 hours. Adding left-over solution to another jug to achieve sufficient use volume is not recommended. Dialysis machines are designed as a single-pass concept system; meaning that the dialysate passes through the dialyzer once and exits to drain. It does not allow for "spent" or contaminated dialysate to reverse flow into the dialyzer. Also, the dialyzer is an ultrafilter capable of blocking undesired matter from going into the blood from the dialyzer. Cross-contamination from shared bicarbonate is not the concern with the use of bicarbonate. The concern is the method of storage, time of storage, disinfection method of bicarb lines and containers that could be conducive to baterial growth. The dialyzer is an ultrafilter but proliferated halophilic organisms in high colony count could still overwhelm the dialyzer capability.