UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction
  • For the management of home haemodialysis emergencies
Clinical Presentation
  • Errors made in connecting dialysis, or a fault with the dialysis machine, may cause an air embolism to be administered through the patient’s fistula, causing acute neurological symptoms, including:
    • Stroke
    • Seizure
    • Unresponsiveness
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Early disconnection from the dialysis machine is vital, but be prepared for haemorrhage from fistula site
  • Take care to avoid unnecessary contact with blood as serum hepatitis is common in dialysis patients
  • Inspect venous return lines of shunt for air bubbles/pockets
  • Document type of dialysis machine
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • Stem bleeding with Combat Application Tourniquet (CAT) as required
  • Apply cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
Critical & Extended Care (CCP, PSO)
  • RSI with mechanical ventilation as indicated
  • Replace blood product as indicated
Additional Information
  • Peritoneal dialysis emergencies are usually associated with sepsis. For these types of dialysis emergencies treat as per the Septic Shock CPG 4.5.5

References
References
Key Terms & Links
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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Published Date

Review Date

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