| 5116A | Bicarb pH II Test Kit | 5 bottles of 100 test strips plus control solution / Kit |
Serim Bicarb pH II Test Strips are designed to indicate the pH of bicarbonate concentrate or the pH of the final dialysate solution (a mixture of acid concentrate, bicarbonate concentrate and water).
"Recognition and application of appropriate concentrates to produce the desired dialysate is the responsibility of the operator."3 It is necessary to check the proper composition of the prescribed dialysate after it has been mixed (proportioned) and prior to initiating dialysis. Both the conductivity and pH must be in acceptable ranges before the patient can be dialyzed. Failure to use the correct concentrates with a given machine, or machine setting, can lead to patient injury.1
AAMI Standards for Hemodialysis Systems (RD5) require that manufacturers of dialysate supply systems provide literature containing a warning that the monitors of the dialysate concentration and temperature be checked with an independent method.2
AAMI recognizes that "adequate monitoring does not currently exist to assure that mismatched concentrates will not produce a final dialysate of proper total conductivity but improper composition. The user is cautioned not to rely solely on conductivity measurements to ensure safety, but to consider all relevant factors including pH."3
The instructions for hemodialysis machines with built-in pH monitors require that a manual pH test be run on the dialysate before dialysis is initiated.4 Serim Bicarb pH II Test Strips will provide an estimate of the dialysate pH without the routine calibration and maintenance required by manual pH meters.
Refer to the dialysate manufacturer's instructions to verify the acceptable pH range for the dialysate being used. Common pH limits are 6.9 to 7.6 for bicarbonate dialysate.1 AAMI Standards for
Hemodialysis Concentrates (RD61) state. "The pH of bicarbonate dialysate typically ranges from 7.1 to 7.5. Levels outside this range can indicate a serious misproportioning of concentrate and can result in serious acid/base complications for the patient."5 The standard also requires that the labeling for dialysate concentrates include a statement to test for final dialysate conductivity and pH.6
If powdered bicarbonate is being used, Serim Bicarb pH II Test Strips can be used to test the bicarbonate concentrate once it has been reconstituted. The pH of the bicarbonate solution can also be checked by drawing a sample from the incoming bicarbonate sample port of the hemodialysis machine. To ensure that the pH of the final mixed dialysate proportioned by the dialysis machine is within the proper range, a sample of dialysate can be drawn from the Hansen connector of the sample port connected to the "To Dialyzer" line prior to initiating dialysis.
Use Serim Bicarb pH II Test Strips to test the pH of the freshly prepared bicarbonate concentrate as well as the bicarbonate/acid mixture proportioned by the dialysis machine prior to initiating the dialysis.
References
1. Dialysis Therapy 3 Edition pp 71-73 AR Nissenson. RN Fine Hanley & Belfus Inc Philadelphia PA
2. AAMI Standards and Recommended Practices, Dialysis, 2001 Edition pg 10 3 1 4 2 Association for the Advancement of Medical Instrumentation. Arlington, Virginia.
3. AAMI Standards and Recommended Practices, Dialysis, 2001 Edition pg 24 A3 1 1 Association for the Advancement of Medical Instrumentation. Arlington, Virginia.
4. Dtelyi* Therapy, 3" Edition pg 164 AR Nissenson, RN Fine. Hanley & Belfus, Inc Philadelphia PA.
5. AAMt Standards and Recommended Practices, Dialysis, 2001 Edition pg 61, A5.1,5, Association for the Advancement of Medical Instrumentation Arlington Virginia.
6 AAMI Standaids and Recommended Piactices Dialysis 2001 Edition pg 52, 4.1.1, Association for the Advancement of Medical Instiumentation Ailington Virginia
| 5119 | Blood Leak Test Strips | 2 bottles of 10 test strips / Kit |
Serim Blood Leak Test Strips give a qualitative indication of the presence of blood in dialysate to assist in differentiating an actual blood leak from a false alarm.
The blood leak alarm may be triggered by air in the dialysate flow path, a dirty light source or photoelectric cell or by a malfunctioning detector system as well as an actual blood leak in the dialyzer membrane. Serim Blood Leak Test Strips confirm that the alarm was due to an actual blood leak and avoids unnecessary interruption of the hemodialysis procedure.
AAMI recommends that dialysis machine blood leak detectors on the dialysis machine activate an alarm if blood escapes through the membrane at a rate of 0.35 mL/minute or more.1 This leak rate calculates to a level of 5.5 mg/dL of hemoglobin in the diatysate (assuming a hematocrit of 25% and a dialysate flow of 0,5 L/minute). Serim Blood Leak Test Strips are more sensitive than the AAMI-recommended setting for blood leak detectors: the test strips yield positive readings at 1.5 mg/dL hemoglobin. This increased sensitivity provides a safety margin, thereby protecting the patient against blood loss.
Test the dialysate that exits from the dialyzer or test dialysate waste fluid collected from the dialysate drain line.
Whenever the blood leak detector alarms, use Serim Blood Leak Test Strips to verify the presence of blood in the dialysate.2
Serim Blood Leak Test Strips are supplied in ready-to-use form. When placed in contact with the sample according to the directions for use, the indicator pad changes color in the presence of blood.
References
1. AAMI Standards and Recommended Practices, Dialysis, 2001 Edition, pg. 14. Association for the Advancement of Medical Instrumentation. Arlington. Virginia.
2. NANT Dialysis Technology - A Manual for Dialysis Technicians. 2 Edition (2000), pg 76. National Association of Nephrology Technicians/Technologists, Dayton, OH.