Covid-19-Hemodialysis

Covid-19-Hemodialysis-Unit-Preparedness-Checklist

 

This checklist contains the guidelines given by the government. This is specifically for various dialysis units across the place. If patients arrive at hospitals with Cocid-19 symptoms, this needs to be followed.

Before The Arrival Of The Patient                                                                Done(Y/N)  Remarks

Things to Assess:

The dialysis staff needs to be educated about:

  • Epidemiology, Testing and Triage of Covi-19.
  • Wearing the PPEs.
  • Etiquettes to be observed while coughing and sneezing.
  • Hand wash and sanitization.

Details related to Stocks:

  • Dialysate, dialysers, tubes, catheters, fistula, needles and heparin.
  • Disinfectants and medication.
  • Stick of PPEs and sanitization materials.

Details related to staff rosters and shifts:

  • Presence of adequate staff members.
  • Detection of Exposure rate of staff members.

Signboards in all languages in the Dialysis unit

Signage asking patients and relatives to report Covid-19 symptoms

Instructions related to reporting of SAR Covid 19 before embarking into the Dialysis area

The Screening Area

Things to Assess:

Presence of an entry and exit for staff members and patients

Presence of a specific area for screening patients before dialysis begins

Adequate space for social distancing in the wards

Availability of Masks

Screening Guidelines in the Screening area:

  • Covid -19 symptoms
  • Thermal screening
  • Contact History
  • Recent Travel History Outside India

 

Presence of adequate and relevant signage on Covid -19.

Sanitizing norms in the wards – hand wash with at least 60% alcohol for hand

wash with liquids disinfectant soaps for 20 seconds

Signing of consent documents with respect to Covid-19

 

The Dialysis Area

Elements To be Assessed

Teaching of Cough Etiquettes to patients

Maintenance of Eating guidelines

Presence of alcohol-based hand sanitizer

Presence of Trash cans

Presence and usage of 3-layer surgical masks

Following of hand hygiene rules

Presence of Questionnaire on Respiratory symptoms of dialysis staff

Social distancing norms maintenance in the unit

Availability and Usage of:

  • Stethoscopes
  • Thermometers
  • Oxygen saturation probes
  • BP cuffs

 

Guidelines for Suspected Patients

Dialysis arrangements for Covid -19 patients:

Needs isolation

Staff division between positive and negative patients

 

Dialysis norms of patients detected for Covid -19 in the last few hours.

Distance of 2 meters maintained between two patients

Usage of PPE for staff caring for Covid-19 infected patients

  • Shoe covers
  • Gown
  • Googles
  • Cap
  • Mask N95 or Triple layer
  • Surgical gloves

Maintenance of usage guidelines of PPEs and disposal

Notification about Covid-19 positive patients to District medical teams

 

Cleaning and Disinfection Process

Cleaning details of dialysis machines and trash cans after each shift

Change of upholstery and bed linen after each shift

Maintenance of gowns and kits and disinfection with 2% hypochlorite solution

Disinfection of furniture – beds, tables, trays, counters, toilets, faucets, taps, bathroom WC.

Presence of dedicated cleaners for wheelchairs and weighing machine

Usage and maintenance of 2 % hypochlorite, 60 % alcohol and other disinfectants

Proper usage and disposal of gloves

RO disinfection procedure maintenance

Kidney Transplant & COVID-19

Kidney Transplant & COVID-19

Kidney Transplant & COVID-19 Patients Guidelines

You must know a few facts about kidney transplant recipients, then only you can understand the implications. These patients are continuously required to take immunosuppressive drugs. Therefore, they have a higher risk of infection from corona virus or any other simple virus, such as cold or flu. To lower the chances of getting the coronavirus, kidney transplant patients should follow the CDC’s guidelines. They know how to avoid catching or spreading viruses. Moreover, they can contact their doctors, if they develop symptoms of COVID-19.

Are post-transplant patients at higher risk from contracting the disease?

Yes, this is a relevant question. If you have just undergone kidney transplant and staying with family members. You should be cautious of members who have contracted the disease. There might be additional sanitization norms for such patients.

How can I get emergency kidney treatment? 

You should keep your dialysis center number handy. In case, you face a situation where you need dialysis, call them up. They will schedule you, if it is urgent or else they will recommend you to the nearest center.

Moreover, during this time, you should have food with low sodium and potassium. It increases the risk all the more.

Do the transplant kidney patients and donors get affected by the virus?

As already told, kidney transplant patients are at a higher risk of contracting Covid -19. However, the risk comes after the surgery. You cannot get the virus from donors. Donors are properly screened. Moreover, living donors are asked to stay in 14 days’ isolation to avoid the contamination themselves.

However, if things go awry then the below symptoms do crop up.

Cold symptoms

Sore Throat

Fever

Less urine generation

Weight imbalance

Pain over transplant area

 

What should I know about medicines and treatments?

As reported worldwide, there is no miracle cure. No patients can be cured overnight. It depends on the patient’s immune system in totality. In fact, research on vaccinations are underway. There has been no concrete success on the same.

 

What are the Prevention tips Kidney Transplant & COVID-19

It is very important, that you take proper care of yourself. You can undergo routine tests. Moreover, you can also get your urine samples checked. If there is no option for home testing, you need to go to the lab to give your samples. All healthcare areas are sanitizing their equipment and machinery before staring tests. So, you can be privy to that. Moreover, they are using PPEs while interacting with customers and patients. You yourself can wear a mask. Also, come back home and wash properly. Use hand sanitizers, wherever possible.  Moreover, you have to be well prepared.

You should buy extra supplies, that includes masks and disposable gloves.  This is to enable you to fight the virus, should you come into contact with someone at a medical center or someone in your locality. Also remember to disinfect touched surfaces such as doorknobs and countertops.

Will there be any drugs supply delays in future?

There is no report on drug supply delays yet. However, if people like you start hoarding drugs and medicines, there might be. The government is aiming at maintain a steady supply of all necessary medicines. Moreover, the Food and Drug Administration is keeping a close watch on drug supply and management. So, you need not worry. Just, buy what has been prescribed to you. Do not change the medicines without speaking to your doctor.

Are you feeling stressed out and depressed?

It is natural for those, who have been diagnosed with chronic kidney diseases to feel scared. Moreover, there are other patients as well, like those on dialysis, kidney transplants patients and donors to feel depressed. The most that you can do in such cases is to maintain the sanitization norms that the government has advised.  WHO has some great ways for helping you to manage your stress and anxiety. They have even started helplines to assist you.

 

Do any of the kidney medications increase the risk from COVID-19?

Yes, it is true. Those who have co-morbidities are at a higher risk of the infection. Cancer patients and those on this drug are at a higher risk. These medicines and drugs reduce the body’s immune system. The immune system becomes powerless. Oral steroids taken as a part of the treatment also reduce the bodies normal immune power. Moreover, if you are taking it for a longer time, it becomes all the more evident.

 

Are other medical conditions responsible for aggravation?

The Covid -19 virus aggravates the satiation even more. The virus that causes the disease infects people of all ages. They are the older people over sixty years old.  Then people with medical conditions such as heart diseases, diabetes, asthma, other respiratory disease, and cancer. The risk of severe disease gradually increases with age starting from midlife. It is important that adults in this group save themselves from the virus. WHO is advising older people to meet people, if necessary without touching. Ask everyone to wash hands for 20 seconds. They should clean their clothes and body regularly with disinfectant soap.

What are various modes of distancing like?

They are self-isolation, quarantine and distancing. The self-isolation refers to separate and stay away in a room or a far off place. You should not talk or interact with anyone. They may be infected.

Quarantine means restricting all your activities. These are people with exposure to Covid conditions. They may not be infected yet but taking precaution. They may carry symptoms.

Physical distancing means distancing norms for normal people. You should follow these norms when visiting markets and other public places.

Can children catch the disease?

Children and teens are also at a higher risk just like older adults and kidney patients. So, you must ensure to keep them well-protected. These groups should follow the same guidelines as followed by other members of the community. Do not allow children to play with other children from the community. This is a prerequisite. So, take care to follow it without fail.

Urinary Tract Infections

Patient education: Urinary tract infections in adults (The Basics)

What is the urinary tract?

The urinary tract is the gathering of organs in the body that handle urine. The urinary tract incorporates the:

  • Bladder, a balloon-formed organ that stores urine
  • Kidneys, 2 bean-formed organs that use to filter the blood for making urine
  • Urethra, the tube that use to carry urine from the bladder towards the outer surface of the body
  • Ureters, 2 tubes which use to carry urine from your kidneys towards the bladder

What are urinary tract infections? 

Urinary tract infections, also named “UTIs,” happen to be infections that change either the kidneys or the bladder:

  • Kidney infections happen when the bacteria travel considerably higher, affecting kidneys. The medical phrase for kidney infections known as “pyelonephritis.”

The symptoms of:

  • Loin pain
  • Fever
  • Hematuria
  • Vomitings
  • Bladder infections are more typical than infections in the kidney. They occur when bacteria enter the urethra and go up into the bladder known as “cystitis”.

Both bladder and kidney infections are more typical in women rather than men.

What are the symptoms of a bladder infection? 

The symptoms include: 

  • A burning feeling or pain when you urinate
  • The need to urinate abruptly or in a rush
  • The need to urinate frequently
  • Blood in the urination

Symptoms of kidney infections

The symptoms of kidney infections acute pyelonephritis can include the symptoms of a bladder infection, yet kidney infections can also cause: 

  • Fever
  • Vomiting or Nausea
  • Back pain or loin pain

How to evaluate if i have a urinary tract infection? 

Consult a kidney specialist. Person can tell in the event that you have a urinary tract infection just by explaining about your complaints.

Your nephrologist may do a straightforward urine routine test. Further urine culture and leukocyte count tests will be done.

How to treat urinary tract infections? 

Most of the urinary tract infections happen to be treated with the help of antibiotics. For bladder infection (cystitis) antibiotics for 3 to 7 days. For kidney infection or acute pyelonephritis antibiotics oral or intravenous for 7 to 21 days. Also may require hospital admission.

Proper antibiotics course to be taken. In recurrent episodes prophylaxis antibiotics therapy is an important planned by a kidney doctor.

For severe bladder pain, bladder analgesics will be given. These drugs ease the pain caused by urinary tract infections. It also reduces the frequency of urination.

What in the event that I get severe bladder infections? 

In the first place, verify with a nephrology doctor to ensure bladder infections. Bladder infection symptoms can be sourced by different things.

In any case, if you are really dealing with recurrent urine infections, there are things you can do to prevent getting more infections. These include: 

  • Drinking more fluid – This can help avert bladder infections.
  • Avoiding spermicides (sperm-murdering creams) – Spermicide is a form of birth control. It appears to increase the danger of bladder infections in certain women, especially when utilized with a diaphragm. If you use spermicide and get a ton of bladder infections, you should have a go at changing to an alternate form of birth control.
  • Urinating directly after sex – Some doctors think this aides, because it assists flush with excursion germs that may get into the bladder during sex. There is no confirmation it works, however it also cannot hurt.
  • Antibiotics – If you get a ton of bladder infections, and the above strategies have not helped, your doctor may give you antibiotics to help avoid infection. Nevertheless, taking antibiotics has downsides, so doctors usually recommend attempting different things first.
  • Vaginal estrogen – In the event that you happen to be a woman already experienced in menopause, your doctor may propose this. Vaginal estrogen arrives in a cream or an adaptable ring that you put into your vagina. It can help counteract bladder infections.

Can cranberry juice or other cranberry products anticipate bladder infections? 

The researchers proposing that cranberry products anticipate bladder infections are not excellent. Different investigations propose that cranberry products don’t avoid bladder infections. In any case, if you want to attempt cranberry products for this reason, there is probably very little harm in doing as such.

Chronic kidney disease

Patient education: Chronic kidney disease (The Basics)

What is chronic kidney disease?

Chronic kidney disease (CKD) is the point at which the kidneys completely quit working just as they should. At the point when they are working normally, the kidneys filter the blood and expel waste and water and overabundance salt.

In individuals with CKD, the kidneys gradually lose the capacity to filter the blood. In time, the kidneys can quit working totally. That is the reason it is so important to prevent CKD from deteriorating.

What are the symptoms of CKD? 

From the start, CKD causes no symptoms. As the disease deteriorates, it can: 

  • Make your ankles, feet, or legs swell (doctors call this “edema”)
  • Give you hypertension
  • Make you tired
  • Damage your bones

Is there anything that can be done preventing your kidneys from deteriorating if I have CKD?

Truly, you can secure your kidneys by: 

  • Taking blood pressure medicines each day.
  • Keeping your blood sugar in a solid range, in the event that you have diabetes
  • Changing your eating routine, if your doctor or nurse says you ought to
  • Quitting smoking, in the event that you smoke
  • Losing weight, in the event that you are overweight
  • Avoiding medicines known as “no steroidal anti-inflammatory drugs,” or NSAIDs. These medicines incorporate ibuprofen (test brand names: Motrin, Advil) and naproxen (test brand name: Aleve). Check with your nurse, doctor, or kidney authority before beginning any new medicines – significantly over-the-counter ones.

What are the treatments for CKD? 

Individuals in the beginning times of CKD can take medicines to prevent the disease from deteriorating. For instance, numerous individuals with CKD should take medicines known as “ACE inhibitors” or “angiotensin receptor blockers.” If your nurse or doctor prescribes these medicines, it is important that you take them consistently as coordinated. If they cause reactions or cost excessively, address your nurse or doctor about it. The person may have answers to offer.

What occurs if my kidneys quit working totally? 

In the event that your kidneys quit working totally, you can pick between 3 unique treatments to assume control over the activity of your kidneys. Your decisions are portrayed beneath.

  • You can have kidney transplant surgery. That way, the new kidney can carry out the responsibility of your own kidneys. If you have a kidney transplant, you should take medicines for a mind-blowing reminder to prevent your body from responding seriously to the new kidney.
  • You can figure out how to utilize an extraordinary liquid that must be channeled all through your belly each day. This treatment is designated “peritoneal dialysis.” If you pick this sort of dialysis, you will require surgery to have a peritoneal dialysis catheter embedded in your belly.
  • You will be able to have your blood cleaned by a machine. This kind of treatment is designated “hemodialysis,” yet numerous individuals call it just “dialysis.” If you pick this methodology, you should be snared to the machine, in any event, each week 3 times. Before you start, you will likewise need to have surgery to set up a blood vessel for connection to the machine.

How would I pick between the distinctive treatments alternatives? 

You and the doctor must work jointly for discovering a treatment that is directly for you. Kidney transplant surgery is generally the best alternative for a great many people. Nevertheless, regularly there are no kidneys accessible for transplant.

Solicit your doctor to clarify all of your alternatives and how they may work for you. At that point talk straightforwardly with the person in question about how you feel pretty much the entirety of the alternatives.

What is COVID-19?

What is COVID-19 all about?

COVID-19 is a type of coronavirus strain. It is a new virus or disease that is contagious. Those who become infected with this virus, will experience mild to severe symptoms. The symptoms are more of the respiratory types. The virus affects aged people more than anyone else. Those who have a history of heart ailments, asthmatic symptoms and diabetes should be more vigilant.

The disease which is caused by this virus Covid-19, has several implications. The Coronavirus disease was first detected in 2019 in Wuhan, China. Therefore, the strain has been named Covid-19, according to the year.  COVID-19 is also known as the “Novel Coronavirus,” which means, it is a new type of coronavirus not previously discovered or identified.

Corona Viruses are a large group of viruses, which have been known to cause illness in humans and animals. It leads to respiratory infections which range from common cold to severe diseases. The various diseases are MERS or Middle East Respiratory Syndrome or SARS, whose full form is Severe Acute Respiratory Syndrome.

What are the various different kinds of symptoms of COVID-19?

The most commonly found symptoms of the coronavirus disease are:

  • Fever
  • Dry Cough and sore throat
  • Shortness of Breath
  • Nasal Congestion
  • Diarrhoea
  • Aches and Pains

If you have the above symptoms, then you should immediately call your healthcare provider. You can acquire information related to the virus and its symptoms from the Ministry of Health & Family Welfare Government of India website.

Why is the entire world so worried about COVID-19 or the Corona Virus disease? 

Till date, we had only heard of pandemics and epidemics. However, the current generation is facing this for the first time. The world has witnessed the small pox epidemic and cholera epidemic. However, this is very new. The world does not even have a vaccine and that is bothering most.

The reasons everyone is so worried about Corona Virus disease are:

  • It is a new virus.
  • There are numerous facts, we don’t know about it.
  • There are no vaccines or medication available as of now.
  • It spreads like fire.

How does COVID-19 spread?

The disease mainly spreads through droplets from coughing and sneezing. You can either get infected through direct contact or through indirect contact. Direct contact means, that you are in close contact with someone, who is suffering from the disease. Indirect contact refers to contamination through cough and sneeze droplets, that survive on the surface for fourteen hours. If someone touches any such surface and touches his or her mouth, contamination can happen.

When is someone with the Novel Virus or COVID-19 contagious?

It can be contagious when someone has or does not have the symptoms. Moreover, it may also spread from people who are already infected, but do not display symptoms. Such people have a strong immune system, however they are at a greater risk of infecting others.

According to the CDC, Corona virus spreads mainly through close contact with infected persons. And through the cough and sneeze droplets from someone who is infected. also it spreads from fomites. People who are infected often have no symptoms or signs of illness. Some people without symptoms may spread the virus, as others are not aware that the incumbent has the disease.

Who is at a risk of contracting the COVID-19?

Covid-19 is a new disease that can affect some people more severely than the others. Older adults and people who have underlying conditions like asthma, cardiac diseases, diabetes, are at a higher risk than normal and younger people.

Do kidney ailments put me at a higher risk of infection?

Yes, people with a chronic kidney disease are at higher risk for more severe illness.

There are people, who are on dialysis. They have weak immune system. Therefore, making it hard for their bodies to fight infections. However, it is important for all to know that such kidney patients need to continue with their treatments and should take precautions as advised by their doctors.

There are people who had a kidney transplant very recently. Such people have not recovered fully and need to take anti-rejection medicines or immunosuppressive medicines. These medicines make the immune system weak, which can make it hard to fight viruses. However, it is still necessary to keep taking these medicines. It is also useful to wash both the hands, maintain good sanitary norms and follow the guidelines from their respective doctors.

Why do you need to wash both your hands and avoid touching the face?

Public health officials are encouraging washing the hands for 20 seconds. The virus lives on various surfaces for a long period of time. Therefore, you have to keep washing hands and eyes. You never know, where the contamination is. Most people have a habit of scratching their faces, biting nails, rubbing their eyes and noses. So, washing hands is really important. The infectious virus enters through the body’s opening.

How do I keep my hands sanitized and clean?

You can keep your hands clean by washing them frequently. It can prevent the virus from entering the body through the orifices in the body. You should wash hands before and after making food, before and after eating, before and after treating wounds, and also on handling various objects. If you have pets at home, you should increase the number of times, you wash the hands. It is advisable to clean hands with any soap, liquid hand wash and a sanitizer containing at least 60% alcohol.

What are the cleaning agents that work against the virus?

The Council recommends that busy and over-used surfaces should be cleaned daily. Apart from cleaning the surfaces with disinfectants, you can clean hands with soap and water. Sodium hypochlorite is a bleach and you can use it as well. The other option is to wash hands with surgical solution. You can use ethanol that is diluted. Or else, you can also use doctor’s spirit. Moreover, you can also use surface wipes and hand sanitizers.

What do you mean by Flattening of – Curve 

Flattening the curve means the aim of slowing the spread of an infectious disease, like Covid -19 in an effort to keep the disease under control.

Certain diseases like COVID-19, can be contagious and can spread from one person to the other person. However, maintain such things as social distancing, which are used to help slow down the spread of the disease and also prevent a rush at hospitals.

The graph from the Centers For Disease Control shows the idea of what a flattening the curve is. The taller the curve, the more severe the outbreak is, with no intervention. The flatter the curve, it shows a possible outbreak with interventions. Flattening the curve can help reduce the pressure on hospitals and other parts of the health system. It gives a chance to respond without becoming pressurized with uncertainties.

Why COVID-19 does not have a medicine or vaccine yet?

COVID-19 is a new form of coronavirus. Therefore, there is no vaccine. Moreover, past research work may speed up the search for Covid-19, however approval process may take 18 months to 2 years.

The potential treatments need to go through a three-phase clinical trial. Then only, the government can release it in the market.

How can we teach social distancing and the importance of social distancing?

There are various reports of people celebrating marriages and birthdays, without fear. In the process, they are contaminating others. There are a lot of young nurses and healthcare professionals working in close contact, are contracting the disease. During these trying times, everybody has to understand, that maintaining distances is the only way to stop the spread of the disease.

People of all age groups who need to be educated, on what this virus can do to them and the people in the family. A few older people are getting bored at home and are venturing outside.

There are researchers who are working day and night to develop a vaccine. The process of research and development are taking new turns and can take many years. When a vaccine is out, it also needs to be examined and checked to make sure it’s working and effective. Moreover, the elderly is over confident. They think, they know more.

Misinformation and stubbornness are the main reasons. Therefore, they have to be explained about the vulnerabilities in details.

How can we find COVID-19 facts from myths?

There are various myths associated with Covid-19. There are myths that high temperature can destroy the virus. However, this not true. Another myth is that, if you expose yourself to the sun, you can kill the virus. Another myth is that steaming, gargling, and bathing in very hot water can protect you against COVID-19. It is not true. Too much of steaming can damage your respiratory channel.

Trustworthy sources

Ministry of Health & Family Welfare Government of India, WHO or the World Health Organization is one of the trustworthy sources for Covid-19 information.

You should only believe in information from reliable sources. You should not pay much heed to news generated by social media. Most of the news bulletins are fake. Use your good judgement, to differentiate between the right and wrong. You should not trust all the sources in the market.

Social media: use caution

Everybody is representing the government today. Therefore, is commenting and distributing facts and figures. The posts on social media can be very misleading. They turn myths into facts under most circumstances and should be given a miss. The best way is to avoid reading them.

You can be part of the solution

You should take care to collect and disseminate proper information. Always make sure to follow the directives from Ministry of Health & Family Welfare Government of India. Moreover, you should also encourage others to follow the directives. If you see that someone is not listening, you can make arrangements to make them follow the government instructions.

How can I make a mask at home?

You can make a mask very easily. The common people do not need three-ply masks or N95. You can make a cloth mask easily at home. Just take a square piece of cloth and attach elastic bands on both ends.

Can COVID-19 cause kidney failure?

There have been reports of kidney failure for patients suffering from Covid-19. However, it is not entirely true, that the virus has caused it. The patient may be having other silent symptoms.

Know the  several kidney ailments

There are two forms of kidney diseases. These are two conditions. They are called acute kidney injury and the other one is called chronic kidney disease, which will lead to chronic kidney failure. The detection of the proteins and blood in urine swabs is an easy way of detecting kidney malfunction in people.

You are a high risk individual, if you are in any of these categories. If you had a kidney transplant, if you are on dialysis, if you are above 70 years and have been taking immune-suppressants. Moreover, if you are suffering from autoimmune conditions, you are in the high risk category.  If you are undergoing dialysis. These people must isolate themselves. Covid-19 is known to aggravate these symptoms, so you have to be careful.