Nephrology

39 Sampling and Culturing PD Effluent

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    Indications

    • To identify infective organisms in suspected or determined peritonitis
    • To enable correct prescription of antibiotics sensitive to organism present 

    Materials

    • Manual drain bag                               
    • Betadine cap                                          
    • Organiser (remove blue clip)                     
    • Alcohol swab
    • 19g needle
    • 30ml leur-lock syringe
    • Yellow top sterile container 
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    Procedure

    • Place the dial of the drain bag into the organiser - remove blue clip
    • Place the capped end of the Tenckhoff into organiser
    • Remove the cap from the drain bag
    • Remove the Tenckhoff from the betadine cap and connect manual drain bag
    • Unclamp the Tenckhoff and drain a minimum of 50ml into the drain bag
    • Once finished draining turn the dial on the bag to 4 dots to engage pin
    • Re-clamp the Tenckhoff
    • Place a new betadine cap into the organiser – remove and keep the white cap
    • Disconnect Tenckhoff from bag and screw in betadine cap
    • Use the white cap to cap off the drain bag
    • It is important to keep both ends of the Tenckhoff and drain bag sterile
    • Swab the blue port and and prepare a 50ml leur-lock syringe and 19g needle
    • Insert the needle  into the port and withdraw 30ml of fluid and place into the sterile yellow top jar.
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    • Never use a syringe to try and drain the Tenckhoff, it should always drain freely.
    • If you are unable to drain freely and there is fluid in the peritoneum, contact the on call nephrologist or PD CNC.
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    • If there is insufficient fluid for adequate sample please fill patient with 50-80% of normal fill volume and dwell for two hours and repeat the above steps.  


    Prophylactic antibiotics may be commenced once sample has been obtained.