[Is potential equalization in hemodialysis treatments necessary?].
In some cases in haemodialysis blood access is established with a special type of central venous catheter (CVC), sometimes called a central dialysis catheter (CDC), instead of an AV fistula or graft. This central venous catheter tip is placed very close to the heart, increasing the probability of a leakage of electrical current passing through the heart. This may cause arrhythmia or ventricular fibrillation. This current is generally referred to as patient leakage current and has to be kept very low for patient safety. All staff involved in CVC treatments, nursing staff as well as technicians, should be aware of this particular risk to the patient. The purpose of this article is to discuss the background of the above-mentioned safety issue and suggest precautionary measures for minimising this risk. Precautions discussed include potential equalisation, use of separating transformers, periodic maintenance (normally performed by a service technician) and physical placement of the equipment used in the vicinity of the patient (normally the responsibility of the nursing staff).
Wictor
Per-Ola
PO
Gambro Lundia AB, Lund, Schweden. per-ola.wictor@gambro.com
Svensson
Roger
R
D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D004553:Electric Conductivity; D004869:Equipment Safety; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D014693:Ventricular Fibrillation / Q000209:etiology / Q000517:prevention & control