Nephrology

331b Home Choice Automated Peritioneal Dialysis -Ccpd

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    The Automated Peritoneal Dialysis (APD) system used at RCH is the Fresenius Sleep.Safe cycler, used with Sleep.Safe balance bags and lines. Fresenius Sleep.Safe balance bags are 5L. Glucose concentration 1.5% (Yellow cap), 2.3% (Green cap), 4.25% (Red cap); Calcium concentration of 1.25mmol/L.

    PD_machine

    PROCEDURE

    Setting up Sleep.Safe Cycler

    1. Simple hand wash (ensure visible dirt is removed and nails are clean)

    2. Clean work surface with chlorhexidine, and dry thoroughly with paper towel

    3. Collect equipment and place on work surface: 

    • Sleep.Safe balance solution (check glucose concentration and expiry date)
    • Sleep.Safe cycler lines (please note there are adult and paediatric lines) 
    • Drainage bag
    • Microshield Antimicrobial HAND GEL

    4. Insert the child's programmed card into the sleep.safe cycler.

    5. Turn on the machine

    6. Press the "teddy bear" or "smiley face" icon

    7. The screen that follows, titled "treatment overview",  summarises the child's PD regimen.

    8. Press the "information" icon (top left) to fully review child's PD regimen. When you are satisfied that you have the correct regimen, press the blue forward arrow to proceed with setting up machine.

    9. "Crack" the Sleep.Safe balance solution on your clean work surface. The number of bags you will need to crack is dependant on the PD regimen, and by fully reviewing the PD regimen in the information section you will know how many bags to set up.

    10. The sleep.safe cycler will give step-by-step instructions on how to set up the machine. When it asks you to insert the PD set into the loading tray make sure the sets tubings on the side are straight and fit into the side grooves of the tray. When it asks you to attach the bags, microshield hands thoroughly, take colored cap off the bags and click the bar coded ends down into the free space of the loading tray. Do not push the bar codes forward, do not attempt to connect the bar code onto the PD set.

    Patient Connection

    1. The sleep.safe cycler will tell you when you can connect child to machine.

    2. Place the patient connector of the sleep.safe set into the organizer

    3. Procedure hand wash or thoroughly clean with microshield handgel (ensuring any visible dirt is removed first)

    4. Place child's catheter extension into one of the side holes of the organizer

    5. Unscrew the protective cap from the patient connector of the sleep.safe set and discard

    6. Unscrew child's catheter extension from the old disinfection cap

    7. Screw catheter extension onto the patient connector of the sleep.safe set.

    8. Remove line from organizer, open white clamp on child's extension

    9. Confirm connection on the machine and commence PD

    Disconnection

    1. Check that the machine display reads 'end of treatment'. 

    2. Close the white clamp on the child's catheter extension

    3. Turn the blue button on the patient connector clockwise and firmly push the blue button

    4. Insert the patient connector of the sleep.safe set into the organizer

    5. Procedure hand wash/or thoroughly clean with microshield handgel (ensuring any visible dirt is removed first)

    6. Place new disinfection cap into one of the side holes of the organizer

    7. Unscrew its protective cap

    8. Unscrew child's catheter extension from the patient connector

    9. Screw it onto the new disinfection cap

    10. Confirm disconnection on the machine.

     

    The Fresenius Machine will require the cycler tubing sets to be changed every 24 hours.