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hemodialysis water treatment.pptx
This document discusses the treatment of reverse osmosis (RO) water for a hemodialysis unit. It outlines the various stages of pre-treatment, primary treatment, and disinfection required to produce ultrapure dialysis water. The pre-treatment process removes particles, chlorine, and hardness. Primary treatment includes softening, carbon filtration, and RO to remove inorganic contaminants. Disinfection is done through chemical methods like peracetic acid or non-chemical UV light and hot water to kill bacteria and prevent endotoxins from entering the dialysate. Proper water treatment and disinfection is crucial to reduce inflammation and improve patient outcomes on hemodialysis.
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hemodialysis water treatment.pptx
- 1. TREATMENT OF ROWATER FOR HEMODIALYSIS UNIT PRESENTED BY: PANKAJ RANA NURSE PRACTITIONER
- 2. OVERVIEW • Introduction • Designinga water treatment system • Pre- treatment process • Primary treatment • Secondary treatment • Disinfection • Maintenance
- 3. Introduction • Standard 4hrs HD session exposes the patient to 120-160 lit. of water. • In the normal population the gut forms an effective barrier to contaminants in the water. • The barrier for Dialysis patient is non- selective semipermable membrane, providing a direct route for any contaminates into the blood stream. • Many of the permitted levels of contaminates in drinking water have the potential to cause problem in Dialysis patients.
- 4. In QB 200= 200 x 60 = 12000 ml (12 l) 1 hr (48 l) = 4hr 250X60 = 15 lit. In 1 hr 60 lit in 4 hr
- 5. Ne of watertreatment
- 6. Ultrapure dialysis solution •Low level of endotoxins and endotoxin fragments in dialysis solutions contribute to a chronic inflamentary response that associated with long term morbidity in dialysis pt. • Ultra pure dialysis solution is characterized by a bacteria level and endo toxin level.
- 7. Advantage of ultrapure solution • Decrease plasma level of C- reactive protein . • Better nutrition - increase plasma albumin value and higher estimated dry body weight. • A slower loss of residual renal function.
- 8. Sources of feedwater Surface water- It contains various degree of silt , mud , dirt. Ground water- It contains more in organic materials, salts .
- 9. Pre-treatment process • 1-Partical removal Chlorine removal Hardness removal • 2- Optimum operating pressure and temperature
- 10. Pre- treatment component 1.Mash filter :- 50 micron It is used to remove air from Feed water before it is supplied To the rest system
- 11. Booster pump It provideadequate pressure for optimal operation of the water treatment system.
- 12. Particle filter • Removalof large particles of > 10 microns such as dirt . • To prevent loss of performance filter are back washed everyday.
- 13.
- 14. Multimedia depth filter (multigratedmedia filter)
- 15. Carbon filter • Activatedcarbon filter removing chlorine and chloramine because it cause haemolysis. • Smell also removed into this.
- 16. Exchange carbon filterrotation
- 17. Softener • Softener principle:-form of de - ionizer = calcium and magnesium ions are exchange from sodium ions.
- 18.
- 19. Dual Softener It isused before RO to improve life expectancy of RO.
- 20.
- 21. Distribution system • Thedistribution system must be capable of delivering the treated water to its point of use without recontamination. • There are 2 basic design – direct and indirect
- 22. Advantage DIRECT– 1 bacterial controlis easier . INDIRECT – 1. it helpful when water system failure occurs. 2. Pressure in the indirect feed can be increased
- 23. DISINFECTION • Chemical disinfection •Non chemical disinfection • Chemical disinfection : sodium hypochlorite (Bleach) • A Mixture of peracetic acid and hydrogen peroxide. • It should be perform at least quarterly.
- 24. Citrosteril/ Peracetic acid •600-800ml : Time duration of suction 5min. • CIRCULATION : 1 to 10 min. • Dwell time 1 : 10 to 30 min. • Mandatory rinse : 100 liter. • Dwell time 2 : 10 to 30 min. • Mandatory rinse :100 liter. • Then rinse 100 liter for 2 time .
- 25. Disadvantage • Lengthy periodof rinsing required to remove residual disinfection. • Hence difficult to implement on frequent basis.
- 26. NON CHEMICAL DISINFECTION •METHOD : Hot Water Ozone . UV Light HOT WATER : 85 degree Celsius is used.
- 27. Ozone • A machinerelease ozone in water. It oxidize bacterial cell wall. DISADVANTAGE • Costly • Irritating and toxic • Not effective in poorly treated water.
- 28. UV Light • Itproduced by mercury vapor from which the treated water passes. Wavelength of light is 254 nm. • UV light kill bacteria that produce endotoxins which is followed by endotoxin filter or RO.