Friday, August 6, 2010

Day 3: Causes of the alarms and how knowing that helps fix the issue

Thiagarajan and I met at around 6 on Wednesday evening to have a session where we would proceed with our discussion. Thiagarajan explained the other types of alarms such as high and low arterial and venous pressure alarms. His explanations were based on first principles which made things very easy to understand. For example, he explained how the arterial and venous pressures were sensed and what caused them to change. This made it easier to figure out what might be the cause of an alarm.

Many people try to fix these alarms without figuring out the cause. They have a list of causes that they have memorized or know from experience and they go about the fix ruling things out one by one. This may result in the alarm being silenced only for a short period of time and return in a few minutes. Alarms can cause a patient to be quite rattled since it is his/her blood that is out of the body! So, it is important to know what the cause is before attempting to fix it.

After a dinner break, we started dialysis. I requested Thiagarajan to allow me to use my style of priming. He readily agreed. I was on dialysis by around 10. The next morning, when dialysis finished, we simulated an air bubble detector alarm and I fixed it on my own. I needed little guidance from the team. I was fairly confident of the technique to do this.

I also closed the dialysis session entirely on my own including closing the sites with one hand.

At this point we decided that we needed just one more session of discussion where we could wrap up the training.

The next day, Thursday, we met at the hospital in the morning around 11. This session was mainly a discussion on any doubts that I had left. I had a few questions which Thiagarajan clarified. I also went through some of the procedures with him one last time to make sure I got them right. The procedures are so similar that it is easy to get confused with which to use for which situation.

The key is to start from first principles. What has happened? What is the cause? What should I then do to fix it? It will all follow if you are clear about the basics. It is striking how many things in life work this way!

I was done with the training!

We took a couple of pictures. I thanked him for all the help he had given me by doing this training. I left for Hyderabad that evening.


IGA Nephropathy said...

Good to read your experiences.

Miriam LB said...

Congratulations, Kamal, and best wishes!