How To Do ATwin Bag Exchange

2012

Illustrations: Used with permission from Baxter Health CarePrepared by: Home Dialysis Unit Nursing Staff

Designed and Printed by: CH Audio Visual and Printing Departments

The information in this brochure is provided for information and education purposes only. The information is not intended to be and does not constitute healthcareor medical advice. If you have any questions, please ask your healthcare provider.

WQ85-0633 Revised Jan.2012The information in this pamphlet is to be updated every 3 years.

Looking for more health information?Contact your local public library for books, videos, magazine articles and online health information. For a list of public libraries in Nova Scotia go to www.publiclibraries.ns.ca

Capital Health promotes a smoke-free and scent-free environment.Please do not use perfumed products. Thank you!

Capital Health, Nova Scotia

How To Do A Twin Bag Exchange

Important things to remember

Masks

Handwashing

Checking Your Supplies

Connection Points

Checking the Drained Fluid

Checking Your Surroundings

1

MECHANICAL PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Transfer set contaminated with Put mini cap on for 5 minutes - thenroller clamp closed. remove and put on another new mini cap.

2. Did not close roller clamp on Close roller clamp on transfer set - puttransfer set when disconnecting mini cap on - 5 minutes then remove andfrom Twin Bag. put on another mini cap.

3. Drain bag has a hole. Close roller clamp on transfer set - clampdrain line. Put mini cap on transfer set.

Take out new Twin Bag system andcontinue with dialysis exchange.

4. Hole in dianel bag. Clamp roller clamp on transfer set. Clamp fill line. Put mini cap on transfer set, call Home

Dialysis Unit IMMEDIATELY. [This is adialysis emergency.]

5. Your tubing separates from your Use emergency kit. Put catheter clampcatheter. on your catheter next to the exit site. connection points not tight Put cap on end of your catheter. pulling on catheter and tubing Call the Home Dialysis Unit IMMEDIATELY.

[This is a dialysis emergency.]

6. Needle goes through port of Change to new twin bag set and new new bag. syringe and needle.

Draw up new medication.

7. New fluid goes in drained bag. Do another bag exchange.

8. Contaminated Twin Bag Discard the set.Connector. Check and prepare a new set.

6

Open TwinBag overpouchand dry bag.

Check full bag for leaks. Check medication ports. Check empty bag. Check pull ring, green seal and Y area.

DRAIN Open roller clamp to drain.

After draining,close roller clamp ontransfer set.

Place clamp on drain line. Place drain bag on the table to check it.

Mask and wash hands. Assemble supplies on a clean surface. Check Twin Bag for: solution strength, bag

size, expiry date and calcium. Check Minicap expiry date.

SOAP

MASK

MINICAP

CLAMPS

2

TAPE

Hang fill bag and place drain bag downon the pole.

Mask and wash hands with gel. Tape tubing to the table at the Y. Expose transfer set and check that clamp is

closed. Remove the pull ring.

Remove Minicap from tranfer set. Immedicately attach Twin Bag connector

to transfer set.

5

FILL PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Roller Clamp Is it open? Check under roller clamp for

pinched tubing.

2. Kink in Tubing Check around dressing. Check along tubing.

3. Green Seal Not Broken Break green seal - space betweenbroken seal.

4. Body Position Bend back and forth. Stand up or press on abdomen. Cough.

5. Fibrin Wrap tubing tightly around penciland release (repeat).

Inject heparin in fill bag. Squeeze bag. Raise pole.

6. Constipation Increase laxatives.

7. Defective Bag Change to a new set.

Check drainedfluid for:- clear: if cloudy, call Home Unit- fibrin: add heparin- blood: if with pain, call Home Unit.

Unscrew Twin Bag connector from transferset. Keep the transfer set in your hand.

Check roller clampis closed.

FLUSH Break green seal. Open blue clamp on

drain line for 3 seconds. Close blue clamp on drain line.

Immediately apply new Minicap totransfer set.

3

MINICAP

Ensure mask is on. Wash hands with gel. Open Minicap package.

FILL Open roller clamp to fill.

After filling: Close roller clamp

on transfer set. Place clamp on fill line. Check that all 3 clamps are closed.

4

DRAIN PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Roller Clamp Is it open? Check under roller clamp for pinched

tubing.

2. Kink in Tubing Check around dressing. Check along drain line. Check tape on pole.

3. Fibrin Wrap tubing tightly around penciland release (repeat).

4. Constipation Take more laxatives.

5. Body Position Bend back and forth. Stand up or press on abdomen. Cough Make sure the drain bag is lower

than abdomen.

6. Air Lock Wrap tubing tightly around penciland release (repeat).

7. Defective Bag Change set.

Check drainedfluid for:- clear: if cloudy, call Home Unit- fibrin: add heparin- blood: if with pain, call Home Unit.

Unscrew Twin Bag connector from transferset. Keep the transfer set in your hand.

Check roller clampis closed.

FLUSH Break green seal. Open blue clamp on

drain line for 3 seconds. Close blue clamp on drain line.

Immediately apply new Minicap totransfer set.

3

MINICAP

Ensure mask is on. Wash hands with gel. Open Minicap package.

FILL Open roller clamp to fill.

After filling: Close roller clamp

on transfer set. Place clamp on fill line. Check that all 3 clamps are closed.

4

DRAIN PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Roller Clamp Is it open? Check under roller clamp for pinched

tubing.

2. Kink in Tubing Check around dressing. Check along drain line. Check tape on pole.

3. Fibrin Wrap tubing tightly around penciland release (repeat).

4. Constipation Take more laxatives.

5. Body Position Bend back and forth. Stand up or press on abdomen. Cough Make sure the drain bag is lower

than abdomen.

6. Air Lock Wrap tubing tightly around penciland release (repeat).

7. Defective Bag Change set.

Open TwinBag overpouchand dry bag.

Check full bag for leaks. Check medication ports. Check empty bag. Check pull ring, green seal and Y area.

DRAIN Open roller clamp to drain.

After draining,close roller clamp ontransfer set.

Place clamp on drain line. Place drain bag on the table to check it.

Mask and wash hands. Assemble supplies on a clean surface. Check Twin Bag for: solution strength, bag

size, expiry date and calcium. Check Minicap expiry date.

SOAP

MASK

MINICAP

CLAMPS

2

TAPE

Hang fill bag and place drain bag downon the pole.

Mask and wash hands with gel. Tape tubing to the table at the Y. Expose transfer set and check that clamp is

closed. Remove the pull ring.

Remove Minicap from tranfer set. Immedicately attach Twin Bag connector

to transfer set.

5

FILL PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Roller Clamp Is it open? Check under roller clamp for

pinched tubing.

2. Kink in Tubing Check around dressing. Check along tubing.

3. Green Seal Not Broken Break green seal - space betweenbroken seal.

4. Body Position Bend back and forth. Stand up or press on abdomen. Cough.

5. Fibrin Wrap tubing tightly around penciland release (repeat).

Inject heparin in fill bag. Squeeze bag. Raise pole.

6. Constipation Increase laxatives.

7. Defective Bag Change to a new set.

How To Do A Twin Bag Exchange

Important things to remember

Masks

Handwashing

Checking Your Supplies

Connection Points

Checking the Drained Fluid

Checking Your Surroundings

1

MECHANICAL PROBLEMS - TWIN BAG

Problem/Cause What I Should Do

1. Transfer set contaminated with Put mini cap on for 5 minutes - thenroller clamp closed. remove and put on another new mini cap.

2. Did not close roller clamp on Close roller clamp on transfer set - puttransfer set when disconnecting mini cap on - 5 minutes then remove andfrom Twin Bag. put on another mini cap.

3. Drain bag has a hole. Close roller clamp on transfer set - clampdrain line. Put mini cap on transfer set.

Take out new Twin Bag system andcontinue with dialysis exchange.

4. Hole in dianel bag. Clamp roller clamp on transfer set. Clamp fill line. Put mini cap on transfer set, call Home

Dialysis Unit IMMEDIATELY. [This is adialysis emergency.]

5. Your tubing separates from your Use emergency kit. Put catheter clampcatheter. on your catheter next to the exit site. connection points not tight Put cap on end of your catheter. pulling on catheter and tubing Call the Home Dialysis Unit IMMEDIATELY.

[This is a dialysis emergency.]

6. Needle goes through port of Change to new twin bag set and new new bag. syringe and needle.

Draw up new medication.

7. New fluid goes in drained bag. Do another bag exchange.

8. Contaminated Twin Bag Discard the set.Connector. Check and prepare a new set.

6

How To Do ATwin Bag Exchange

2012

Illustrations: Used with permission from Baxter Health CarePrepared by: Home Dialysis Unit Nursing Staff

Designed and Printed by: CH Audio Visual and Printing Departments

The information in this brochure is provided for information and education purposes only. The information is not intended to be and does not constitute healthcareor medical advice. If you have any questions, please ask your healthcare provider.

WQ85-0633 Revised Jan.2012The information in this pamphlet is to be updated every 3 years.

Looking for more health information?Contact your local public library for books, videos, magazine articles and online health information. For a list of public libraries in Nova Scotia go to www.publiclibraries.ns.ca

Capital Health promotes a smoke-free and scent-free environment.Please do not use perfumed products. Thank you!

Capital Health, Nova Scotia

0633,f0633,10633,20633,30633,40633,50633,60633, b