CRRT must knows | Everything you need to know about CRRT | Continuous Renal Replacement Therapy

[@MommaNurse]

Are CRRT's 1:1 at your facility?

[@Psalm34v7]

Yes

[@hannahmarshall9526]

Nope

[@tedihollingshead5777]

They’re the only true 1:1’s on my unit now a days!

[@MommaNurse]

We are slowly getting back to this standard but it has been very tight.

[@MGuitarde]

We don't even have 1:1 on ECLS. Here in Germany we tend to never have less then 2 patients. Cause we simply do not have enough Nursing staff... It's not a lot of fun at the moment.

[@margaretmassay5185]

How do you differentiate clotting and clogging?

[@rixita]

@@margaretmassay5185 Just learned this from my instructor this week: cloGGing: Going Great! TMP numbers are increased which is expected when the membrane is clogging from all the particles getting filtered out (from what i understand so far..). Return the blood and change the filter.

[@rixita]

cloTTing: Totally Terrible. Delta P (pressure drop) is increasing, this means that we gotta figure out a better way to avoid clotting again, this is where we can have the MD order anticoags and or increase the PBP/BFR so the blood doesn’t have time to clot. If this is not addressed you’ll have to keep having to replace the filter often which delays the treatment. I’m still learning about crrt but i figured i’d share my notes thus far!

[@thejewelryspot9969]

Thank you for all of this valuable information Momma Nurse!! 😊

[@MommaNurse]

Thanks for watching ❤️

[@elyssafigueroa5177]

Great video! Thank you

[@MommaNurse]

No problem. Glad you enjoyed it.

[@CelestesKingdom]

Can make a video for the calcucations of the number!

[@MommaNurse]

@@CelestesKingdom it’s based on what the doctor orders. So it would honestly be very confusing to protray the calculations in video. But, let me see what I can do

[@pkalpalatha5621]

Nice information thanku

[@rhirhi7260]

Great Video!!! It's 1:1 at my facility. Can you explain how to calculate how much to remove each hour?

[@MommaNurse]

We have a flowsheet that we use. It's rounded to the nearest tens, and based off of the previous hour patient fluid removal.

[@elydiamiles2104]

Nope, paired crrt patients all the time at my facility.

[@MommaNurse]

That’s rough! What State are you in?

[@elydiamiles2104]

@@MommaNurse texas!, I start crrt training in June so I'm nervous about the ratios and how well I catch on😅

[@MommaNurse]

@@elydiamiles2104 hopefully they allow you a preceptor or something for your first one, if they don’t do 1:1 starting out. Praying your training goes well.

[@elydiamiles2104]

@@MommaNurse thanks so much!

[@MommaNurse]

No problem

[@Dasming]

How do you know it’s clogging vs. clotting?

[@MommaNurse]

When it is clogging you will get an increased TMP. It’s typically a good rule of thumb to get ready for a circuit change when your TMP is at about 200.

[@virgiecasanovateambellasyt9260]

thankyou for.sharing mam

[@chaoticofam]

1:1 assignment here.

[@MommaNurse]

😊😊😊

[@emilyraejones7240]

At Cleveland Clinic in CVICU this is not a 1:1 assignment.

[@MommaNurse]

Oh wow! I would have definitely thought it would be 1:1 there. Thanks for sharing.

[@rnsf5169]

We have 1:1 When clogging do you increase or decrease the replacement fluid

[@MommaNurse]

That’s good! When clogging you would want to decrease the replacement fluid rate. Keep in mind this will be just a temporary “hold over” you will eventually need to change out your circuit.

[@rnsf5169]

Got it! Cause less volume = less pressure…. Saving a little time but eventually having to change any way! Thanks for the confirmation!

[@MommaNurse]

Exactly! Blessings on your nursing journey.

[@rnsf5169]

@@MommaNurse thank you! So glad I found your video…subscribed!💛

[@MommaNurse]

Thank you ❤️

[@FF-bf1cw]

How do you differentiate clogging from clotting? You didn't explain

[@MommaNurse]

When it is clogging you will get an increased TMP. It’s typically a good rule of thumb to get ready for a circuit change when your TMP is at about 200. When it is clotting your machine will give you a hard stop alarm instructing you to change your circuit so that the clots do not reach your patient.

[@TravelnurseMercy81]

but you can have intermittent CRRT

[@MommaNurse]

what do you consider intermittent? I have had patients in which we do a trial to see if they can tolerate not being on CRRT but, other than that its been continuous.

[@TravelnurseMercy81]

@@MommaNurse So it's weird because our patients go on CRRT at this hospital for 12hrs then every other day depending on their labs. literally, I come in and have to take them off CRRT on like Monday then they don't have CRRT again Wednesday. I had a patient who even skipped their CRRT because Nephro stated labs were good. eg phos and K not even an improvement in kidney function for an AKI. Seemed to me like they were treating it like "hemodialysis".

[@TravelnurseMercy81]

@@MommaNurse Also at times they do 6, or 12 hrs

[@MommaNurse]

@@TravelnurseMercy81 wow that’s crazy, and very expensive! All those circuit changes. They might as well just do hemodialysis lol. I wonder what their rationale is for doing it that way?

[@MommaNurse]

@@TravelnurseMercy81 I’m shocked. We would only do that short of a treatment if the patient couldn’t tolerate CRRT after adjustments to the settings, adding more pressors, etc.

[@feshawndavisespinosa3165]

Have you ever hear of flushing the filter

[@MommaNurse]

No, I don't believe I have. Would you care to explain?

[@feshawndavisespinosa3165]

As soon as I find out I’ll share, spoke with Gambro they where kinda familiar

[@MommaNurse]

@@feshawndavisespinosa3165 sounds like a plan

[@giegiehelison1554]

hello momma nurse i like to join your valentines giveaway cash Virgie Casanova ❤❤❤

[@pepitobenegas]

Jesus I would never be an ICU nurse 🤮

[@MommaNurse]

@@pepitobenegas lol there’s a specialty for everyone ❤️❤️❤️

[@elezebethsebastian4195]

Useless vedeo. U have demonstrate it. Other wise no use

[@MommaNurse]

I appreciate your input maybe that can be a future video.