Cardiac Arrest in Hemodialysis at Dialysis Unit, Sunpasitthiprasong Hospital

Abstract

Cardiac arrest is the most common complication of hemodialysis leading to death in patients with hemodialysis. Because no cause showed, reviewing the indication was concerned. The purposes of the study were to know incident and cause of dialysis unit-based cardiac arrest during hemodialysis. The descriptive study was applied by reviewing medication record about Dialysis unit-based cardiac arrest at hemodialysis, Sunpasit Unit, Sunpasitthiprasong Hospital between October 1, 2015 and September 30, 2017. Instrument following review literature of care from important event included two parts: 1) record form about general data and 2) record form about dialysis unit-based cardiac arrest. The instrument was accepted by three experts. The results showed that there were 28 patients with dialysis unit-based cardiac arrest at the hemodialysis. Most patients were females, 70-90 years of age mean, and AKI disease more than ESRD disease. Most comorbidity was cardiovascular disease and septic shock respectively. They were treated with ventilator. Moreover, their conscious had more drowsiness. Early symptoms of the cardiac arrest were hypotension and arrhythmia. When investigating with EKG, it showed pulseless electrical activity, asystole, and ventricular tachycardia respectively. Time of hemodialysis to present the cardiac arrest was first time and more than three times of hemodialysis respectively. Most rate of water to remove (UF volume) in an hour for the dialysis run were 500-1,000 ml/hr and lower than 500 ml/hr respectively. The cardiac arrest was found during dialysis in 5-60 minuses. After cardiopulmonary resuscitation, all patients had vital sign. For role of registered nurses, there was lack of knowledge to assess the patients before dialysis and before discharge. The review suggested that the information was basic data and analysis to find a guideline of nursing to prevent or decrease the cardiac arrest at the hemodialysis. The guideline may be alternative way to develop a guideline of nursing for risk patients that may be good outcome for patients and organization in the future.