PURPOSE
1. To be aware of the complications and hazards that can occur when power fails during haemodialysis.
2. To demonstrate safe and skilled technique in using dialysis equipment.
3. To complete the required hours of dialysis
4. To prevent blood loss during power failure (Haemolysis and blood clot).
CONDITIONS
1. All renal nurses must be aware of how to operate the blood pump manually
2. All renal nurses must be aware of the complications of hazards that may occur due to power failure during haemodialysis e.g. air embolism, Blunt fistula, etc.
3. Haemodialysis machine should be always plugged to emergency sockets if available (UPS).
PROCEDURE
| SN | Nursing Action | Rationale |
| 01 | If the power is accidentally disconnected for individual patient, press the mute alarm keep upon power return, eliminate all alarms and press dialysis start key. | |
| 02 | During power failure, call for help from all staff. | |
| 03 | Explain the procedure to the patient and reassure him/her. | To allay fears and gain patient’s confidence and cooperation. |
| 04 | Release venous air detector clamp. Clamp the venous and arterial pressure monitor lines. |
| SN | Nursing Action | Rationale |
| 05 | Rotate the blood pump manually. Alert All nurses need to be very vigilant because there are no machine alarms. | |
| 06 | Inform the Electrical Department if the generator has not been taken over. | |
| 07 | Continue rotating the pump for 5-20 minutes. | To prevent clotting. |
| 08 | If the power failure last for > 20 minutes, re-infuse the blood manually as per the policy and procedure. | To prevent distraction of RBCS. |
| 09 | Heparinize the access and keep it patent. | To prevent clotting. |
| 10 | If the power returns within 20 minutes, fix the blood pump handle in place and reset all alarms. | To commence safe dialysis. |
| 11 | Check all dialysis parameters. | |
| 12 | Press dialysis START and recommence dialysis. | |
| 13 | Take and record vital sings | To monitor the condition of the patient. |
| 14 | Document the incident including the time, when the power failure started, nursing intervention, the patient condition and the amount of blood lost (if any). |