U.S.. MARIA ISABEL HERRERA. U.S.. Ibacache YOLANDA C. U.S.. O.

Marcelo Vega
CONTENTS Page 1. January 3 Introduction to What is Dialysis System Co? January 4
b What is the Kidney? July 1 c What is Hemodialysis? Entry Requirements 1 d Jul
y 2. Vascular access September 2 to What is Vascular Access? 10 2 b c Catheter F
ebruary 10 Goretex graft or implant 13 3. Food and Fluid Intake in Food March 14
March 15 b What is the dry weight? March 15 c What should I eat? 17 3c1 The pot
assium in our diet 18 3C2 the salt in our diet 3v3 23 Phosphorus in our diet 3c4
24 Proteins in our diet 24
2
3 d Emergency Food April 25. Drug 4 Drug Medication basic b April 29 5. Renal Tr
ansplantation 31 6. Quality of life 34 7. Emergency 36 7 What do we do in an eme
rgency? Evacuation Method 7b 37 38 8. Rules and Instructions for patients 40 9.
Informed Consent
3
1.I N T R O D U C C M
1st Dialysis SYSTEM WHAT IS CO.? Dialysis System is a group of dialysis services
that have come together to give their patients quality care through continuous
improvement of processes and the development of standards aimed at satisfying th
eir needs and expectations. The group is made up of four services, serving over
three hundred patients with chronic renal insufficiency on dialysis. There are f
our medical specialists
4
in nephrology, dialysis nurses 16 and 60 employees trained. THE MISSION SYSTEM P
roviding Dialysis patients with chronic renal failure the best quality in the tr
eatment of their disease, according to modern standards by a highly qualified te
am in an atmosphere of empathy and warmth. Achieve levels of excellence in meeti
ng the needs and expectations of our patients through continued development of q
uality standards based on them. Position ourselves as leaders in quality care at
the national level, be identified by this and serve as a model to develop other
dialysis services. Encourage employee engagement and the mission now encouragin
g the professional development of workers through continuous training, participa
tion in process design quality and team work. that of the in
5
Kidney failure is a chronic disease, we have designed this manual dialysis patie
nt in order to lead, to educate and train our self-care patient. Hemodialysis tr
eatment you receive, will be held three times a week (Monday, Wednesday and Frid
ay or Tuesday, Thursday and Saturday) in a system of shifts (morning, afternoon
and evening) and times will be assigned according to their turn. These days also
include holidays. Dialysis System Co. has specialized in Medical Director Nephr
ology at each of its dialysis centers, those with the responsibility of evaluati
ng, diagnosing, treating our patients and / or referring them to other specialis
ts as appropriate. Dialysis System Co has professional and highly qualified tech
nical. In all this shift is a doctor who will evaluate and treat you for your di
alysis session. University Nurse and a nurse's aide for six patients. In terms o
f infrastructure, all sites have been conditioned and designed to give comfort,
welfare and safety. It should be noted that all dialysis machines are the latest
generation and what sets us apart is that we have a proper and permanent techni
cal service for each dialysis center, ensuring continuity of treatment.
6
System Co. Dialysis given to patients in need, help with transport and basic med
icines.
1b WHAT IS THE KIDNEY? The kidney is a vital body functions are: Cleanse the bod
y of toxic substances, such as urea, creatinine, potassium and fluids removed th
rough the urine.
7
When the kidneys fail and the presentation of CKD, these features disappear and
it's time to use the replacement therapy of renal function. These include: hemod
ialysis, peritoneal dialysis and renal transplantation.
1c WHAT IS HEMODIALYSIS?
Hemodialysis is a procedure to fill the role purification (cleaning) of the kidn
ey, which is accomplished by passing his blood, which contains toxic materials t
hrough a membrane (filter) that is bathed in a
8
solution of similar composition to the blood but not toxic to cause a series of
changes in their lifestyle as regards food and care.
Feel free to ask and answer any questions that may arise, by telephone or by dir
ectly asking the day of dialysis. It is also important€his family is aware and i
nvolved in their treatment of hemodialysis.
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1 d. ENTRY REQUIREMENTS To enter dialysis dialysis patient must: 1. Submit a med
ical report or epicrisis of hospitalization. 2. Have negative serology for poten
tially communicable diseases in hemodialysis (hemodialysis only) Hepatitis B Hbs
Ag Hepatites C HCV HIV AIDS
3. Have submitted to the secretary their pension records and documents as reques
ted for the processing of programs (or Isapre FONASA credential, last payment of
wages, etc..) 4. Signing the informed consent document and the rights and dutie
s of patients. 1 e. WHAT IS THE peritoneal dialysis? A procedure similar to hemo
dialysis in that instead of a filter using the peritoneal membrane (which covers
the abdomen from the inside). The treatment is performed on the patient's home
and must receive this training. 1 f. WHAT IS THE TRANSPLANT? It is the graft of
a healthy kidney from a living donor or dead.
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2. VASCULAR ACCESS
11
The 2nd WHAT IS VASCULAR ACCESS? In order to perform hemodialysis need an entran
ce through which to take his blood dialysis machine, where it will cleanse itsel
f of substances that the kidneys can not eliminate excess fluid and you may have
. This entry may be temporary, through a temporary catheter and / or in part, th
rough an arteriovenous fistula, graft, or indwelling catheter. 2b catheter is a
plastic tube, flexible and sterile, which is inserted through a blood vessel of
large caliber which allows us to draw blood to perform the hemodialysis procedur
e and then return to the body. This tube protruding outside through an outlet co
vered by a dressing, shows two branches which are always covered with sterile ga
uze. Catheter Care:
• The shower should be carefully (ideally phone type), keeping the catheter prot
ected and dry should not
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include washing head, which should be apart, to prevent the catheter from gettin
g wet. • Communicate to the nurse the onset of pain or heat in the area of the c
atheter and / or fever. • The catheter can not be handled by personnel outside t
he dialysis center, unless hospitalized. • The catheter is unique to hemodialysi
s and should not be used for other treatments.
In case of bleeding, you must: • Click on the patch by placing a handkerchief or
clean gauze compress for 10 minutes. If the bleeding does not stop, call the di
alysis center or go to the nearest emergency center to your home. • If you press
the exit of the catheter insertion hole with gauze or clean cloth and go immedi
ately to the dialysis center or emergency center nearest your home.
2b Arteriovenous Fistula Using an outpatient procedure and is performed under lo
cal anesthesia the fistula, which is the union of an artery and a vein that is i
ntended to obtain a high flow in the vein for blood and will return after spendi
ng by the filter.
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Care for the development and maintenance of the fistula • Every day should feel
his fistula, warning any change: no thrill or decreased, or occurrence of pain,
etc.. • When the fistula is freshly made, avoid the increased volume of the arm,
holding it aloft. • At the beginning, after a medical indication to do exercise
s to your fistula has a better development. To do this, squeeze a rubber ball th
e size of your hand for 10 minutes at least six times per day. • Be alert to low
pressure during dialysis if you feel dizzy notify your treating doctor. The fis
tula may be covered by low pressure. • In your home can also lower blood pressur
e, either by vomiting or persistent diarrhea. Whereupon you must advise the dial
ysis center. • Avoid wearing jewelry or clothes that squeeze your arm. • Avoid s
leeping on the arm of the fistula. • Do not carry heavy objects with that arm. •
After dialysis, remove the patch covering the puncture sites after 5 to 6 hours
or overnight before the morning shower.
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• Keep the arm of the fistulas, wash with soap and water before going on dialysi
s.
Do not allow the drawing of blood, administering medication or have blood pressu
re measurements on the arm of the fistula.
2c OR IMPLANT OF GRAFT Goretex This vascular access use at the impossibility of
Arterio Venous Fistula, either by poor quality vein or by exhaustion of them.€Is
the union of an artery and vein through a Goretex implant or tube which is plac
ed in a surgical operation under local anesthesia.
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2d WHAT TO DO IN CASE of bleeding and bruising?
•
If there is bleeding in the puncture sites, you must compress the arm raised dir
ectly with the fingers without lifting for at least 10 minutes, if after this ti
me, the bleeding does not stop, repeat the above. If it still persists, contact
the dialysis center or go to the nearest emergency center.
• In case of in hematoma during dialysis, the nurse will assess whether to apply
ice, compression only or both. The next day you should apply local heat or a wa
rm cloth wrapped in a towel guatero at least three times a day.
16
3. FOOD AND LIQUID INTAKE
The 3rd FOOD. As already mentioned, a diseased kidney is unable to eliminate exc
ess toxic substances and some
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containing foods, therefore, it is very important to know which should be consum
ed and in some cases restricted. Here are some guidelines and recommendations de
livered in this regard. Another major problem to which dialysis patients are fac
ed with, is that it also alters the elimination of fluids through the reduction
or absence of urine, which means having to restrict their consumption. 3b WHAT I
S DRY WEIGHT? Dry weight, less weight is tolerated by the patient at the end of
dialysis and appears generally normal blood pressure and no edema. It is very im
portant from a dialysis session and another does not have an overweight than 1.5
- 2 kilos, ie do not eat a quantity of liquid than a quart and a half to two li
ters. That will ensure a greater sense of wellbeing during dialysis and also pro
tect your heart from fluid overload.
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Fluid intake. Now that you have started dialysis, it is very important to contro
l the amount of fluid you drink. In this concept of "liquid" should know that it
includes not only water, but all that is liquid and moist, therefore, liquid is
also soups, creams, milks, juices, beverages, fruit, coffee, tea, yogurt, jelli
es, puddings, ice cream.
What happens if you have consumed or accumulated high amounts of liquid? If, aft
er the fluid accumulation occurs: swelling of face, arms and legs, fatigue, tire
dness, difficulty breathing, especially if you try to lie as well, these signs a
re increasing, should call or visit the dialysis center.
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How much liquid can take a day? The amount of fluid you take will depend on the
amount of urine you delete it. As a rule of thumb should always keep in mind tha
t "can take 24 hours both fluid and urine in this period of time, más1000 cc of
fluid intake, including food content." Tips to control fluid intake
•
Limit intake of salty foods that increase thirst, for example, bread, ham, chees
e, sausages and canned products.
• Measure the total liquid to be taken daily (24 hour urine over 1000cc) • The w
ater is removed sautéing vegetables after boiling. • The toast has less water th
an the bread, about 35% less.
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• It is advisable to eat sugarless gum even in the case of non-diabetic. • Drink
iced tea instead of soft drinks which are thirsty. • Never take fruit juice or
nectar. 3c WHAT SHOULD I EAT? This is a very important question on dialysis for
three reasons: • A balanced diet will improve your quality of life. • Allow the
outcome of hemodialysis is better. • Will you be better prepared in case of tran
splantation. Foods contain substances that the body needs to live, some of them
are, potassium, protein, sodium, phosphorus, calcium and water that are of most
interest to you. 3c1 THE POTASSIUM IN OUR DIET IS IMPORTANT WHY RESTRICT THE USE
OF POTASSIUM? It is a substance needed for the proper functioning of the nervou
s system and muscle. Enters the body with food and as the kidney can not elimina
te it accumulates in the blood and can cause alterations in the activity of your
muscles, especially around the heart. The control of foods that contain potassi
um is essential to avoid the increase of this between
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dialysis sessions because their consequences are so serious that may lead to hea
rt failure and death.
ALARM SIGNS MUST GO IMMEDIATELY AFTER SERVICE IS AN EMERGENCY excessive intake o
f foods that contain potassium SEE: • Tiredness.€• Tingling and heaviness in the
arms and legs.
• Difficulty speaking. • Muscle weakness. Although potassium is found in virtual
ly all food, must know that the potassium-rich foods include fruits and vegetabl
es. The recommended daily consumption of fruit is: • Two units of low-potassium
a day or
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• A unit of moderate potassium daily. The recommended daily intake of vegetables
is: • Two servings of low-potassium a day or • A moderate portion of potassium
daily. In relation to foods high in potassium, it is advisable not to consume th
em. Importantly, natural fruit juices and nectars are strictly outside the dialy
sis diet for its high content of potassium.
LIST OF FRUITS AND VEGETABLES WITH: LOW POTASSIUM
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FRUITS Apple Fruit (1 unit Pera (1 small) small unit) Pear ((a regular unit) Cuc
umber 1 small unit) Cucumber (1 regular unit) Watermelon (1 slice regular) Water
melon (1 (regular cut) Cherries 10 units) Cherries (10 units) 2 units Plum) Plum
((21unidades) Pineapple Cup)
Vegetables VEGETABLES Artichokes (1 unit) Chicory Chicory Cress Cress Beet Beet
Onion Cucumber Lettuce Cucumber Lettuce Onion Paprika Pepper Cabbage Cabbage
MODERATE POTASSIUM CONTENT OF FRUIT Strawberry (1 cup) raspberries (1 cup) cooke
d Quince Peach (1 medium) Khaki (1 unit median) Figs (3 small units) Mango (1 cu
p) Loquat (6 units) Tunas (2 units) Kiwi (2 units) beets VEGETABLES Cauliflower
Celery Peas Carrots Tomatoes Green Beans Zucchini Yellow Squash Italian Choclo
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HIGH POTASSIUM FRUIT Banana (unit) Orange (1 large) calameño Melon Tangerine Gra
pefruit (1 regular slice) Melon tuna (1 piece regular) Grapes (15 medium units)
Apricot (2 units medium) Lucuma (a small unit) VEGETABLES Brussels Asparagus (8
units) Spinach bean sprouts, avocado, pomegranate Beans Potatoes Eggplant
It is very important that you know that nuts are extremely high concentration of
potassium so you should avoid drinking alcohol. These fruits are: DRIED FRUIT F
igs Prunes Raisins Dried peach Huesillos
Fruit juices and nectars can not take patients on dialysis for the content extre
mely high in potassium.
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TIPS TO REDUCE THE POTASSIUM OF FRUITS AND VEGETABLES
• Vegetables and fruits lose potassium in contact with water. Should be cut into
 small pieces leaving them to soak at least three hours changing the water sever
al times and without using the soaking water. • Vegetables should be soaked in w
ater and it switches between 3-4 times before cooking, preparing what will be co
nsumed with fresh water. Its use is recommended during weekdays, Tuesday through
Thursday. • The frozen vegetables potassium lost by leaving it thaw at room tem
perature. • The fruit is about half cooked potassium fresh fruit as the other ha
lf is dissolved in the cooking liquid. The fluid MUST NOT DRINK.
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3C2 IN OUR DIET SALT Sodium chloride is table salt. He is responsible for the in
creases in blood pressure, weight gain and swelling of legs, face and eyes, and
cause him to be what it will consume more fluids. Severe hypertensive patients s
hould only consume 2 grams of salt per day, equivalent to a bic pen cap, as an e
xample a pan containing 2 grams of salt.
Is worth noting that dietary salt DO NOT EAT, AND THAT CONTAINS A LARGE AMOUNT O
F POTASSIUM.
Forbidden foods in the diet with salt restriction:
• • • •
Cooking salt and table. Salted and smoked meats. Meats. Smoked fish.
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• • • •
Charquis and cheeses. Olives. On soups, instant mashed, soup cubes. Generally pr
eserved, salty and sweet (we recommend that you read the content information on
labels of canned) • Fruits salty.
3v3 THE MATCH IN OUR DIET excess phosphorus alters bone metabolism and calcium t
hat extracts of these coming to cause pain, deformity and fractures. Additionall
y, calcium tends to stick to the walls of blood vessels especially the arteries
of the heart. Generally, phosphorus enrichment is manifested through an uncomfor
table itching in the body called pruritus. Do not forget to take calcium intake
during the hours between meals, because this drug binds to phosphorus in the int
estine and prevents the blood passes, therefore, both are eliminated through the
stool. Foods rich in phosphorus
•
Milk and dairy products: cheese, yoghurt, custard.
• Flour (bread, noodles, pastries, etc..€) • cola drinks. • Legumes.
3c4 PROTEIN IN OUR DIET
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They are one of the main components of the human body and are essential for the
proper functioning of the body. It recommends eating daily servings of foods con
taining protein. Foods that contain more protein you use can be found at: • Meat
(beef, turkey, chicken) • Fish. • Milk • Egg whites. 3d FOOD IN CASE OF EMERGEN
CY OR DISASTER The scheme aims to delay the onset of complications due to the im
possibility of dialyzed patients, either because of prolonged blackout in the pr
ovision of water and / or electricity or severe structural failure, resulting fr
om earthquakes, fire , floods, etc. The most important restrictions are: 1. Decr
ease consumption of foods that provide protein, such as: meat and dairy. 2. Incr
ease consumption of foods which provide energy, such as mass and sugars. 3. Avoi
d eating foods that provide salt (cold cuts, salted and smoked meats, cheese, et
c.)..
29
4. Avoid eating foods that provide potassium (fruits and vegetables). 5. Limit f
luid intake to slow the symptoms of fluid overload, high blood pressure, swollen
legs, shortness of breath, tiredness.
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Emergency Menu No. 1
•
Breakfast
1 cup sugar 4 tea pure salt-free crackers with unsalted margarine and jam • Lunc
h ¾ cup white noodles with oil and half a beef or chicken croquettes an unsalted
cracker unit 1 tablespoon oil • 1 cup of tea Eleven pure sugar 4 unsalted crack
ers with unsalted margarine and jam • Food ¾ ½ cup rice croquette with beef or c
hicken 1 piece of biscuit without salt 1 tablespoon oil
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Emergency Menu No. 2 • Breakfast 1 cup sugar 4 tea pure salt-free crackers with
margarine and jelly, unsalted tortilla noodles • Lunch with ¾ cup noodles and 1
egg white with a clear jelly
• Once a pure tea cup sugar 4 unsalted crackers with unsalted margarine and jam
• Eating rice ¾ cup egg white (2 units) a jelly biscuit without salt 1 tablespoo
n oil
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Emergency Menu No. 3 • Breakfast 1 cup sugar ½ tea pure salt-free bread toasted
unsalted margarine and jam • Lunch ¾ cup white rice with fried egg and a
tablespoon oil 1 tablespoon oil • Once a cup of tea with sugar ½ pure salt-free
bread with unsalted margarine and jam • Food ¾ cup egg noodles with water curren
ts 1 tablespoon oil
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4. MEDICATIONS
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MEDICATION 4 People who take medications that require dialysis treatment or supp
lement to help reduce the symptoms of the disease. Remember to take medications
as prescribed by your nephrologist and he recommended doses. The drugs most comm
only used are: IRON: used to reduce anemia. Depending on the severity of this, t
he iron to be prescribed can be directly into the vein, a drug known as Venofer
or oral ferrous sulfate, Fierrovitamínico, Iberol, Maltofer. These latter must b
e consumed away from meals. Phosphate binders: used to reduce phosphorus in the
blood. Be taken, usually with meals or as medical advice. Eg calcium carbonate,
Elcal, PhosLo, Calcefor, Levucal. Hypertension: are used to correct hypertension
(high blood pressure. You must take them from the way your doctor tells you and
never stop taking or change the dose on their own, since the risks of inadequat
e doses can be serious. eg Nifedipine, Atenolol, Lozartan, Tareg, Cardura, Carve
dilol. VITAMINS: used both to replenish the vitamins that are removed by dialysi
s, such as those that are altered by renal insufficiency. multivitamins eg, Tono
pron, Folic Acid. ACID Acetylsalicylic: used to prevent clot formation in patien
ts prone to them. eg baby aspirin, Ecotrin.
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Gastric protectors: they are used to protect the stomach irritation that can pro
duce the large number of medications that is necessary to consume. Eg, famotidin
e, ranitidine, omeprazole, Losec.
4 b.Medicamentos Basic
Dialysis System Co. has a program to help with basic medications for hemodialysi
s patients in need. Included in the group of these products: Antihypertensive Ni
fedipine Atenolol Vitamins and supplements retard Polyvitaminic Ferrovitaminico
phosphate binders Ferrous Sulfate Calcium Carbonate Anaprolina erythropoiesis st
imulating Antacids Antidepressant Fluoxetine Famotidine
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Not included in the basket of vitamin D (Rocaltrol Etalpha or Calciyec), erythro
poietin,€And non-drug Venofer to dialysis as antibiotics, antiarrhythmics, etc.
To obtain this benefit is no requirement to fund the treatment, no other way to
obtain medications and clinic controls. At your request, you should contact your
nurse to be included in the program starting next month. During the visit your
doctor's monthly exams, it will make prescribing and medicines will be delivered
during the week. The center can not be responsible for maintaining the supply o
f drugs if at any time there is no existence of them among travel providers.
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5. KIDNEY TRANSPLANT
39
5 Renal Transplant Program When the diagnosis of chronic renal failure, can be u
sed to hemodialysis or peritoneal dialysis. However, there is no alternative to
replace the damaged kidney is renal transplantation, which certainly offers grea
ter advantages, such as improving the quality of life and allow for better emplo
yment and social integration .. What is a kidney transplant? Kidney transplantat
ion is a surgical procedure through which is placed a kidney from a living donor
or cadaver to a receiver, whose purpose is to replace the damaged kidney functi
on. Are all transplanted insufficient? stones can
No. There are certain diseases for which transplantation is contraindicated, suc
h as AIDS and active cancer. There are also behaviors that prevent transplant as
active drug consumption (marijuana, cocaine base, cocaine, etc..) And alcohol.
Currently, advanced age is not a contraindication, provided that the patient is
in optimal cardiovascular conditions. What are the steps to get a transplant?
40
First tell your nephrologist or dialysis nurse intention to be transplanted, whi
ch will evaluate your case and then be referred to the hospital's transplant cli
nic has been applied. If it is accepted into the transplant program will begin i
nterviews and studies (blood tests, x-rays, ultrasounds, endoscopies, etc.), whi
ch will be necessary to repeat them so often to get updated information. Once th
is stage will be sent to the Institute of Public Health to establish (get the ge
netic information of their blood for comparison with potential donors). Once est
ablished, it will be included in the national waiting list of the Institute of P
ublic Health, being a necessary condition monthly take a blood sample, called Se
rotec. The Institute of Public Health will be responsible for comparing the gene
tic information of donors with potential recipients. After selecting the patient
more compatible with the donor, you are notified that you attend to your hospit
al, be essential that you keep a phone number where you can be notified 24 hours
 a day, 365 days a year. How is it funded a transplant?
41
In the event that the patient is FONASA (groups A, B, C or D) that is, a benefic
iary of the public system, the state pays 100% of renal transplant and include:
surgery, the transplant itself, hospitalization, examinations and procedures, an
d immunosuppressive drugs exclusively in public hospitals that are accredited to
perform kidney transplants. It should be noted, that sometimes you may request
tests are not conducted in public hospitals, so these have to be financed by the
patient. If the patient is affiliated with ISAPRE, ie incorporated into the pri
vate system, the entity will carry out the subsidy for the health plan you are.
42
6. QUALITY OF LIFE
6 TIPS FOR BETTER QUALITY OF LIFE dialysis represents an abrupt change in their
lifestyle. There are changes at the personal, social and labor. There is an inst
itution called ASODI (dialysis and Transplant Association) where you can find he
lp and numerous benefits, including prescription drugs at a lower value than tra
de, sports, cultural activities, workshops. It is located in Rancagua Street N °
0250, Providencia, Santiago. For any questions or concerns you can call the fol
lowing telephone numbers 2042851, 2044724, 2742700.
43
• It is recommended to take between exercise habits. In principle, the walks, as
far as possible is a desirable activity and from there can be any physical exer
cise that is not violent. The end of the vascular access must be adequately prot
ected. • Abolish or reduce as far as possible the consumption of snuff, and that
increases the risk of cardiovascular complications.ۥ Do not suppress their rel
ationships with friends, not isolate, list as it always did. The people around y
ou will understand and be willing to help. • If possible do not stop holiday, as
it can move to other cities in advance by contacting your nurse for the respect
ive reservation and seat in a dialysis center in the city to visit. This is poss
ible unless the funding of dialysis either through an agreement with the health
area or through the AUGE.
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7. EMERGENCY
45
7 WHAT TO DO IN AN EMERGENCY? The center is prepared to deal with various types
of emergencies, such as power outages, water shortages, fires. We have also take
n steps to evacuate for earthquakes and disasters of great magnitude. Note that
because it is a health service center has the support of firefighters, police, C
hilectra, etc. As general measures are recommended: 1 Stay calm, do not scream a
nd run. 2nd obey the instructions from your nurse on duty. 3 ° Maintain a curren
t address and phone number, if possible have a number of errands, for easy locat
ion. 4 ° is suggested to always have shoes on, to facilitate evacuation and prev
ent injuries (cuts and falls)
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7 b Method of evacuation proceed to evacuate when some of the above situations e
ndanger the lives of patients and staff. The evacuation is as follows: 1) The au
xiliary nurse come to your room off. 2) It will stop the machine, disconnect the
circuit without blood being returned to the needle clamp. 3) immediately prompt
ed the evacuation site safer. Once the claim will be assessed to reconnect or su
spension of dialysis, proceeding to remove the needles. Where possible the phone
will be provided for each patient to contact his family in the form of rotation
and time. In case of a major catastrophe will assess the situation being advise
d in a timely manner the site and dialysis day and given instructions for self-c
are until the situation returns to normal. (See contacts on page 25) Situations.
Power outages: • In this case proceed to use the power plant with the heart tha
t counts. • Then your dialysis continue as usual and the term of this will be ev
aluated by the doctor and the nurse on duty. We may have to shorten a bit the se
ssion.
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Water cuts: • The center has pool of reserve and if the cut is long the situatio
n will be evaluated to inform you in time any change in the schedule, date and p
lace of dialysis.
Fire: • The center has strategically placed fire extinguishers. • If the situati
on so require the evacuation shall be carried out as described above. • If there
is heavy smoke moving at floor level to prevent aspiration.
Earthquakes: • In this case the situation will be evaluated and depending on the
magnitude of the quake will proceed to the evacuation. • You must stay away fro
m glass and windows. • Stand to shelter in doorways or in areas designated for e
vacuation.
48
49
8. REGULATION OF SYSTEM CO dialysis.
50
8 Rules for Dialysis Center patients. We are aware that you are confronted with
a difficult life situation, that many things about your illness, its causes and
its treatment are still not clear to you, want you to know that this place is a
group of people concerned about him appropriate treatment and minimize discomfor
t. Here's are a few recommendations for you to take into account: • The schedule
of dialysis will let you know when to grant a quota, it can be permanent or tra
nsitory, a condition established after starting treatment. • It is important to
respect the assigned times and that dialysis works in relation to a shift system
, with fixed hours, so proper preparation is made of machines and filters, thus
achieving compliance with the times and schedules for all patients. • You need t
o wait his turn in "Waiting," this would speed up the shift.
51
• Once inside the dialysis room shall be controlling weight and blood pressure.
Then be connected to start the dialysis session. • Once installed and during the
first hour of dialysis, the center will serve you a cup of tea, you may attach
a couple of crackers or half sandwich. • We recommend that you attend and loose
comfortable clothes,€with wide sleeves to facilitate wide neck punctures or if I
had a catheter. You will be assigned a place to store their belongings. It shou
ld not keep valuables as these locations are shared with others. • Any questions
or information is channeled through the nurse on duty, and if necessary will re
fer you to the head nurse or doctor on duty. • consultations in relation to thei
r drug regime and the answer while you dialyze. • Monthly tests that will be mon
itored to ascertain the progress and response to treatment that we are applying.
• The consultation on administrative matters, licensing, programs should be mad
e directly to the secretariat.
52
• Considering that share many hours together, it must be remembered that the bas
is of good relationships based on trust, communication and respect. We hope to m
eet their expectations and are open to listen and take into account their demand
s and suggestions. • First irregularities, complaints and suggestions please cha
nnel them through the Book of Suggestions and Complaints at the reception or in
the suggestion box located in the Waiting Room, which will be answered in writin
g within one week. In situations of extreme urgency, please raise them orally to
the Head Nurse. • The anonymous suggestions or complaints can not be answered 8
b Instructions for the use of patient transport. Dear Patient: We turn now to de
tail the rights and duties that you will have to be a beneficiary of the shuttle
door to door dialysis center. RIGHTS: The recipient patient will be transported
to and from his home in vans provided
53
•
free by the Dialysis Center in the days and times that are appropriate for your
attention. • If for some reason, the assigned vehicle is unavailable, another ve
hicle will be provided by the carrier, which also will be no cost to you. • The
dialysis center will ensure the security, cleanliness and maintenance of the veh
icle. • The vehicle is subject to Law No. 142 of the rules of the Traffic Act, w
hich stipulates the prohibition of smoking within it.
DUTIES: • Once the existence of quota transfers and home carrier will contact yo
u to inform the departure time from home. • Transportation available room ten mi
nutes after arrival in the home, so
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it is essential to be ready ten minutes early. All this for the benefit of and c
ompliance with schedules and time of arrival at the turn of all patients who use
the service. • The vehicle will announce its arrival honking. We ask that you o
r a family take eye contact with the driver as soon as possible to avoid disturb
ing their neighbors. • The vehicle will be waiting with the engine running and d
oors open. The driver will help you climb. • In the dialysis center you will be
helped up and / or lower the vehicle by the driver of the van. • The vehicle sha
ll be removed from Dialysis Center once all the group of patients has been accom
modated in the van. • Upon returning home, it is important that you wait for a r
elative and it should assist the driver to drop the phone. • After a hospitaliza
tion, you or a family member must notify the carrier that is high with at least
12 hours prior to restarting the shuttle. If you fail to comply with this reques
t must go to dialysis on their own.
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• The driver always available to you via cell phone ............................
.... N ° 09 • We welcome help in maintaining the cleanliness of the vehicle, eli
minating waste in plastic bags inside the vehicle available.
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INFORMED CONSENT Hereby undersigned declares the patient has voluntarily gone to
the Santos Dumont dialysis service to receive dialysis treatment is indicated.
For that authorizing the dialysis service Santos Dumont to perform the procedure
itself and those related to this, including making regular examinations among w
hich is the AIDS test (serology for Human Immunodeficiency Virus). Also reported
having received the Manual for the Hemodialysis Patient that includes the dutie
s and rights of the patient, who accepts and agrees to comply and enforce as app
ropriate. In an emergency situation and the fact that the patient is not able to
do so explicitly and specifically,€authorizing the dialysis service team to per
form the maneuvers it deems appropriate and necessary to preserve the patient's
health. Emergency situations, and after considering the doctor, the dialysis tre
atment may be shortened or postponed, provided this does not jeopardize patient
welfare. The center undertakes to compensate the time lost in the following dial
ysis session, so the total time of dialysis is preserved. The center will handle
the necessary programs for the payment of the benefit, the patient agrees to de
liver promptly the necessary documents for this. The patient can express their s
uggestions, complaints or comments by the book claims or mailbox installed for t
his purpose in the waiting room. The center promises to reply in writing within
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a week. answered. Patient Name: Signature: Santiago,
The
messages
anonymous
no
will
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BIBLIOGRAPHY • Charter of Patient Rights, FONASA. • Internet address of Hospital
Universitario Reina Sofía de Andalucía: www.hrs.sas.juntaandalucía.es-nursing-p
ublicacionestratamiento_diálisis.pdf • Extract Societies instructive Chilean Con
gress of Nephrology, Hypertension and Transplantation Viña 2001 • Manual periton
eal dialysis, Baxter .
•
www.CONSUL / manuales.htm
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