Dialysis Safety Series Clinical Safety Resources
Dialysis is not safe. Accidents will happen unexpectedly.
The nurse is the last line of defense. These pages are your preparation.
Vigilance — Critical Thinking — Rapid Action
Water Treatment Flow Chart – Dialysis Safety
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Water Treatment Flow Chart

From City Water to Dialysis Machine — and Back
Animated Flow • Clinical Reference
IN
🏙️ City Water In
Raw municipal supply — contains chlorine, hardness, suspended solids
1
Two Feed Pumps
100 L/min each → Pressure Gauge
2
Online Chlorine Monitor
Current = 730 mV ≈ 1.2 mg/L total chlorine
3
Auto Sand Filter
50 gal → Pressure Gauge → Sample Port
4
5 Micron Sediment Filter
Slim housing — removes suspended particles >5µ
5
Auto Carbon Tank #1 MOH Test
50 gal → Pressure Gauge → SAMPLE PORT — MOH tests chlorine here
6
5 Micron Carbon Filter
Slim housing — captures carbon fines before second tank
7
Auto Carbon Tank #2 MOH Test
50 gal → Pressure Gauge → SAMPLE PORT — MUST = 0.0 chlorine
8
5 Micron Carbon Filter
Slim housing — final carbon fines removal
9
Duplex Softener
Hardness removal → Sample Port — target <1 gpg
10
RO System — 4 Membranes MOH Checks
Feed Pressure • Product Pressure • Feed Flow L/min • Product Flow L/min ← recovery % • Drain/Reject L/min ← L/shift
11
Ventilation Filter
0.2µ hydrophobic — prevents airborne bacteria from entering tank
12
Storage Tank ✅ Reserve
1,000 L — sealed, vent filter, 3-float level system (Green/Yellow/Red)
13
Two Circulation Pumps
100 L/min each = 26.4 gpm → Loop velocity maintained
14
UV Lamp
12 gal, 254nm → Pressure Gauge — kills bacteria in loop
15
0.3 Micron Biological Filter ⚠️ FINAL BARRIER
Absolute rated → Pressure Gauge — removes bacteria and endotoxins
16
To Dialysis Machines ✅ SAFE WATER
Ultra-pure water delivered to 60+ dialysis machines for dialysate preparation
Return Loop — Continuous Circulation
From Machines Back to UV Lamp Back to Storage Tank Recirculate

Water continuously circulates through the loop to prevent stagnation and biofilm formation. Sample ports at return point for MOH testing.

Standard Step
MOH Test Point
Critical Monitoring
Safe / Reserve
Animated Flow

Critical Checkpoints

Water Treatment Flow • Dialysis Safety Series
flow-chart.php • rev. 2026‑07‑03
✍️ Author: Ahmed Mohmad Rashyd Musleh Registered Staff Nurse