Methods on this page:Per specimen bag for cell count and culture
Per drainage bag for creatinine clearance
- The collection of an effluent specimen is used to analyze the dialysis fluid to:
- do a cell count (find out the number of red and white blood cells): to find out if there is an infection;
- do a liquid culture: to find out if there is an infection and to identify the source (type of bacteria);
- measuring creatinine clearance: to assess the effectiveness of dialysis by analyzing the amount of waste (urea and creatinine) removed by the treatment. Your child’s general condition should also be taken into consideration.
- We suggest a procedure that you can use as a guide; discuss with your healthcare team the specific equipment used for your child.
- This care must be given with strict adherence to the aseptic measures taught by your care team, including basic procedures to be performed before starting.
- Specimen collection can be done “routinely” before appointments with your healthcare team or in an emergency situation at any time, at the request of your healthcare team.
- The collection can be done with a specimen bag or from the drainage bag, depending on the nature of the analysis to be performed and the specifications of your healthcare team.
- For “routine” cell count and culture:
- Specimen collection is always performed during the last drainage of the peritoneal dialysis treatment, after allowing some effluent to drain into the bag, except in emergency situations or if otherwise directed by your healthcare team.
- The specimen can be collected with a specimen bag or directly from the drainage bag, as specified by your healthcare team.
- For “routine” creatinine clearance:
- It is important to program the cycler so that the entire dialysis session is performed with identical solutions.
- When assembling the cycler, when the priming (vacuum) of the lines is completed, the drainage bag must be emptied or changed.
- Specimen collection is always performed at the end of the peritoneal dialysis treatment, directly from the drainage bag, as directed by your healthcare team.
- In emergency situations, collection is done with a specimen bag or directly from the drainage bag, as specified by your healthcare team.
- The amount of effluent to be collected depends on the analysis to be performed and is specified by your healthcare team. In general, here are the quantities required:
- for a cell count: 10 ml,
- for a culture: minimum 50 ml,
- for a routine clearance: minimum 50 ml.
- For “routine” cell count and culture: specimen to be collected each month for appointment with your healthcare team.
- For “routine” creatinine clearance: specimen to be collected monthly or quarterly, as requested by your healthcare team, prior to your appointment.
- In emergency situations, (eg, if there is a possibility of infection): specimen to be collected immediately or after 60 to 90 minutes of dwell, as requested by your healthcare team.
- Small table, desk top or sideboard with a washable surface: for depositing materials
- Hand soap
- Clean paper or towel
- Alcohol or disinfectant wipe (eg, Sani-Cloth® Plus): for surfaces
- 4% chlorhexidine soap solution : for hands
- Alcohol-based antiseptic hand gel (eg, Stérigel®)
- Sterile containers: for all specimens (except for creatinine clearance where the container may not be sterile)
Method by specimen bag:
- Specimen bag
- Disinfectant pads (2% chlorhexidine and 70% alcohol or 70% alcohol only, as directed by your healthcare team): for the specimen bag
- 60 ml syringe
- 23G needles if your child is connected to the cycler or 18G needles if not connected to the cycler
- Sharps container: for needles
Refer to your healthcare team if the materials used or the sequence of steps taught is different from what is described in the method of care.
Depending on your child’s age and condition, always encourage your child’s autonomy in carrying out the method of care.