CHBT Alarm Systems and Emergency Response 1 — Questions and Answers
Question 1: A hemodialysis machine alarms with a 'blood leak' alert. What is the immediate action?
- Stop the blood pump, clamp the blood lines, and do not return blood to the patient until the dialyzer is inspected (Correct answer)
- Reduce the blood flow rate and observe to see if the alarm clears
- Reset the alarm and complete the treatment since false alarms are common
- Increase transmembrane pressure to force the leak to seal itself
Correct answer: Stop the blood pump, clamp the blood lines, and do not return blood to the patient until the dialyzer is inspected
A blood leak alarm means dialyzer membrane rupture is suspected. The blood pump must be stopped immediately, lines clamped, and the dialysate inspected for pink or red color. Blood must NOT be returned until a true leak is ruled out.
A blood leak alarm means dialyzer membrane rupture is suspected. The blood pump must be stopped immediately, lines clamped, and the dialysate inspected for pink or red color. Blood must NOT be returned until a true leak is ruled out.
Question 2: What does a 'conductivity alarm' on a hemodialysis machine indicate?
- The dialysate electrolyte concentration is outside safe limits, posing risk of fatal electrolyte imbalance (Correct answer)
- The blood pump speed has exceeded the prescribed rate
- The venous pressure is too high, indicating a possible access occlusion
- The heparin infusion pump has run out of medication
Correct answer: The dialysate electrolyte concentration is outside safe limits, posing risk of fatal electrolyte imbalance
Conductivity reflects dialysate sodium and total electrolyte concentration. Values outside 13.0–16.0 mS/cm could cause hypernatremia, hyponatremia, or other fatal electrolyte disturbances. The machine automatically bypasses dialysate to drain when conductivity is out of range.
Conductivity reflects dialysate sodium and total electrolyte concentration. Values outside 13.0–16.0 mS/cm could cause hypernatremia, hyponatremia, or other fatal electrolyte disturbances. The machine automatically bypasses dialysate to drain when conductivity is out of range.
Question 3: During a hemodialysis session, the air detector alarm activates. What is the correct response?
- Stop the blood pump immediately and clamp the venous line to prevent air from entering the patient (Correct answer)
- Slow the blood pump to 50 mL/min and watch for visible air bubbles
- Reset the alarm and document it as a false alarm
- Prime the venous drip chamber with additional heparinized saline while treatment continues
Correct answer: Stop the blood pump immediately and clamp the venous line to prevent air from entering the patient
Air entry into the venous return line can cause a potentially fatal air embolism. The blood pump must be stopped immediately and the venous line clamped to prevent air from reaching the patient. Emergency response and physician notification are required.
Air entry into the venous return line can cause a potentially fatal air embolism. The blood pump must be stopped immediately and the venous line clamped to prevent air from reaching the patient. Emergency response and physician notification are required.
Question 4: What action should a dialysis technician take if a patient's access needle is accidentally dislodged during treatment?
- Apply immediate firm pressure to the puncture site, stop the blood pump, and call for emergency assistance (Correct answer)
- Quickly reinsert the needle and resume treatment to minimize blood loss
- Apply a tourniquet above the access site and continue dialysis through the remaining needle
- Elevate the affected limb and continue treating with the remaining connected needle
Correct answer: Apply immediate firm pressure to the puncture site, stop the blood pump, and call for emergency assistance
Needle dislodgement can cause rapid, life-threatening blood loss. Immediate firm pressure must be applied, the blood pump stopped, and emergency help summoned. The volume of blood lost must be estimated and documented.
Needle dislodgement can cause rapid, life-threatening blood loss. Immediate firm pressure must be applied, the blood pump stopped, and emergency help summoned. The volume of blood lost must be estimated and documented.
Question 5: A hemodialysis machine displays a 'transmembrane pressure (TMP) high' alarm. What is the most likely cause?
- Clotting within the dialyzer fibers, increasing resistance to ultrafiltration (Correct answer)
- The dialysate temperature is set too high, expanding fluid volume
- The patient's blood pressure has dropped below 90 mmHg systolic
- The carbon tank has exhausted its chloramine removal capacity
Correct answer: Clotting within the dialyzer fibers, increasing resistance to ultrafiltration
High TMP indicates increased resistance in the dialyzer, most commonly from clot formation in the fiber bundle. It may also indicate membrane fouling. If it continues to rise, the dialyzer may need to be changed.
High TMP indicates increased resistance in the dialyzer, most commonly from clot formation in the fiber bundle. It may also indicate membrane fouling. If it continues to rise, the dialyzer may need to be changed.
Question 6: In the event of a power failure during hemodialysis, what is the first priority?
- Return blood to the patient using the hand crank or gravity if available, and ensure patient safety (Correct answer)
- Disconnect the patient immediately and discard all blood in the circuit
- Wait for power to restore since machines automatically resume on battery backup
- Increase the dialysate flow rate to compensate for reduced treatment time
Correct answer: Return blood to the patient using the hand crank or gravity if available, and ensure patient safety
During power failure, blood in the extracorporeal circuit must be returned to the patient to prevent blood loss and circuit clotting. Most machines have a manual blood pump crank for this purpose. Patient safety is the primary concern.
During power failure, blood in the extracorporeal circuit must be returned to the patient to prevent blood loss and circuit clotting. Most machines have a manual blood pump crank for this purpose. Patient safety is the primary concern.
CHBT Alarm Systems and Emergency Response 1
A hemodialysis machine alarms with a 'blood leak' alert.
What is the immediate action?