The Risk of Blood Clot for Dialysis Patients

Tuesday 2014-02-18

Dialysis patients face many kind of risks, one of which is inappropriate catheter locking.

I saw a blood clot the size of the thumb nail flew out of my artery line at the start of dialysis yesterday. I would very much like to learn about its cause and how to avoid from it happening again. The answer given made me felt even more confused and scared. The rest of the session went without further incident except that after wash back the artery line was reflowed with blood from the catheter outlet down for about 13 cm in length which is a totally different story and should be left for another day.

I’ve seen before for a few times that the lumens dangling in front of my right chest were pink in colour after being locked. None of the times I got a satisfactory answer and I had similar fears back then. Today’s scare was not only more but intense.

Normally before dialysis 3ml of mixed heparin and blood is drown out from each lumen and 10ml of saline pushed back in, then blood starts flowing out. It was at this point the blood clot appeared. How did it come about and where did it come from? I know the catheter out of the body have two outlet, inside the body it appeared as one single line with a divide to make it two individual channels, the blood would be drown from the same blood pool. How come after the saline for both lines were pushed in the clot flew out?

As expected in the end the dialyser was streaky. I was waiting in the past 24 hours if I needed to go to emergency and couldn’t help feeling unsecure and full of anxiety and fear wondering about my venous line which is where the blood going back in. 42 litres of my blood was washed which means the blood had been processed ten times and over, logically I should feel safe.

All I wanted to know was if the clot had anything to do with the way the catheter was locked or perhaps the amount of the heparin used was correct. I deserve a straight and honest answer instead I got garbage and a longwinded excuse.

As I didn’t get a straight answer, being medically illiterate I simply can’t help thinking about the venous line, other dubious locking and other inappropriate practices, doubting the whole medical system. No matter how skilled and careful a person can be, human errors are not totally avoidable. Making error is one thing, not having a procedure to prevent locking procedure not being followed which would endanger patients lives is another. One has to wonder why not such measure not in place already for the safety of patients.