Good Training

It is really important to strive to get the most out of your training to perform haemodialysis as much as possible. I think nearly every home haemo patient does most of their routine automatically but it's when there's a problem that the quality of the training comes through. I had an experience recently that reminded me of this.

I had my anticoagulant regime changed after a serious bout of clotting. I now use Fragmin and administer it similarly to Heparin, that is, a syringe made up to the correct concentration in the heparin pump and then dispensed via a loading dose and then progressively throughout my treatment. It had been working really well until yesterday.

Yesterday the heparin pump alarm started beeping every ten minutes. At first I stared at the damn thing like a kangaroo trapped in headlights. Swirling through my mind were all sorts of thoughts and feelings. Did I do something wrong? Am I in danger? What do I do now? Am I imagining this? After shaking my head like Wile E. Coyote after an Acme anvil landed on his head, I realised it was happening and I needed to do something. That's when the training kicked in.

Look at the messages. What are they? Two messages, "Err" (Error) and "Heparin Pump Alarm". Look at the lines. Are they kinked?  No, but the blood looks a bit dark. Look at the clamps. Are the ones that are meant to open opened and vice versa? No.

Aha. Blood looking dark. Maybe the Fragmin isn't getting into the circuits. So I test whether the flow is getting through. I start it up again and there seems to be blood in the fine line from the heparin syringe to the main dialysis line. Blood will only go in there if there is no pressure pushing it out. Suggests something about the pump not working. After ten minutes I get the same alarm. So I call the after hours nurse. I tell her all that I have found and she suggests resetting the pump and trying again. Sadly, the alarm goes off ten minutes later so I had to disconnect from the machine. Alternative arrangements for me are being looked into.

So the training about looking at problems and working through them helps. It doesn't always cure a problem; it didn't this time, but in many other cases it works well. And another thing, so many times it's a kinked line or a clamp not being open or closed as needed. 

Pay attention to your trainer and work on the problem solving with them. You will feel dumb as an ox, as I did, until that golden "Aha!" moment when you get what they've been talking about and you can't understand how you never understood before because now it's so simple.