Alarm Systems and Emergency Response Flashcards

A patient develops sudden rigors (shaking chills) and high fever 20 minutes into hemodialysis. This is most consistent with:

Answer: Pyrogenic reaction from endotoxin contamination in the dialysate or water

Pyrogenic reactions (fever, rigors, hypotension) occurring early in dialysis are caused by bacterial endotoxins or gram-negative bacteria in contaminated water or dialysate. Treatment must be stopped, the water system investigated, and the patient managed supportively.

What is the 'venous pressure alarm' high limit designed to detect in a hemodialysis circuit?

Answer: Obstruction in the venous return line such as a kinked tube, clotted filter, or access stenosis

A high venous pressure alarm indicates resistance to blood returning to the patient. Common causes include a kinked venous line, clotted venous chamber, needle malposition, or access stenosis. It must be investigated promptly to prevent circuit rupture.

When a patient reports sudden severe back pain and difficulty breathing during hemodialysis, the technician should consider:

Answer: Acute hemolysis from a dialysate error, and treatment should be stopped immediately

Sudden back/chest pain with respiratory distress during dialysis should raise concern for acute hemolysis (from hypo-osmolar or overheated dialysate), air embolism, or anaphylaxis. Treatment must be stopped and blood must NOT be returned in hemolysis. Emergency response is required.

The arterial pressure alarm (low limit) on a hemodialysis machine is triggered. What does this most commonly indicate?

Answer: Inadequate blood flow from the access, such as needle malposition, access stenosis, or hypotension

Low arterial pressure indicates the blood pump is not getting enough blood from the access. This may be due to needle malposition, access dysfunction, patient hypotension, or the patient rolling onto the access. It must be corrected to maintain adequate treatment delivery.

What is a 'concentrate alarm' on a hemodialysis machine?

Answer: An alert indicating the acid or bicarbonate concentrate container is empty or improperly connected

Hemodialysis machines mix two concentrates (acid and bicarbonate) with purified water to create dialysate. A concentrate alarm means one or both containers are empty, misconnected, or the conductivity cannot reach target, triggering automatic dialysate bypass to protect the patient.

A patient on hemodialysis suddenly becomes unresponsive. After confirming unresponsiveness, the first action is:

Answer: Activate the emergency response system (call a code) and begin BLS/CPR assessment

An unresponsive patient is a cardiac/medical emergency. The emergency response system must be activated immediately (call a code). While waiting for help, assess airway, breathing, and circulation, and begin CPR if indicated. Dialysis treatment is a secondary concern.