How to do priming

1. BY,
Jamizan bt. Jeemaun
Program Coordinator PBRN

2.  Define what is priming.
 Explain the purpose of priming.
 Differentiate the new and reuse dialyzer
priming.
 State the component parts of the dialyzer and
blood lines.
 Describe the pre, during and post priming.
 Describe nursing responsibilities during
priming.

3. What is priming?

4. To remove air from the blood lines and the
dialyzer as well as to remove possible
fragments of remaining sterilising agents or
other residuals from the disposables
elements, such as bloodlines and dialyzers
that form the extracorporeal circuit before
the patient is connected.
(using normal saline, albumin)

5.  New dialyzer
 Reuse dialyzer

6. DIALYZER

8. Feature
 Medical grade PVC tubing.
 Guarded access ports reduce infection risks.
 All parts are of superior quality, unique
design and high performance.
 Male/ female lure locks are in compliance
with the related international specification.
 100% tests for each blood line sets.

10. Preparation of machine
 anticoagulant
disposable

11. Turn on water and switch on power suply for the
dialysis machine.
Set the machine to rinse at least 10 min or
according to operator manual (optional).
Insert
‘A’ pick up tube to solution ‘A’ concentrate
‘B’ pick up to tube to ‘B’ concentrate.
Wait till temperature light is off and conductivity
stabilize
Machine is ready to priming

12. Withdraw 2 mls (5000units/ ml) of heparin from
heparin vial (pure)
Dilute with 8mls of normal saline = 1000units/
ml of haeparinized saline and mark the syringe
with ‘X’.
Inject 1ml of heparin (1000units/ml) into a bottle
of 500mls of normal saline and mark ‘X’ on label
– 1000units/ 500ml normal saline.

13. Bloodlines
Normal saline 0.9% x 3 bottles
IV drip line
Transducer
Alcohol swab
Dialyzer
Sterilant test strip
Syringes 20mls x 2

14. NEW DIALYZER (refer to Clinical Performance Book)
• Secure dialyzer in its holder with arterial inlet
upright.
• Put up a bag or bottle normal saline, spike
the IV set into the bag/ bottle.
• Connect IV set to arterial needle end of the
bloodline.
• Set up arterial blood line onto the machine
with arterial chamber inverted and ensure
clamps are close except the main clamp.

15. • Start blood pump (100-200mls/min) to prime
the arterial blood line with normal saline.
• Stop blood pump.
• Connect arterial blood line to arterial inlet of
dialyzer and then invert dialyzer with arterial
inlet facing down.
• Connect venous blood line (chamber inverted)
to venous outlet of dialyzer and ensure the
venous pressure monitoring line is close.

16. • Place needle end of venous bloodline into a
receiver.
• Needle end of venous blood line should be
left hanging inside the receiver.
• Restart blood pump
• Continue priming dialyzer and blood line with
the remaining normal saline. Stop blood
pump and clamp venous needle end.

17. • Connect the dialysate hose to dialyzer.
• Allow the dialysate to fill up and rinse the
dialysate compartment of the dialyzer.
• Hang heparinised saline and flush infusion
line, hep. Line, arterial and venous pressure
monitoring line and lastly venous needle end.
• Change to a new bag/ bottle of normal saline.

18. • Turn both arterial and venous chambers
upright
• Lower the fluid level of both chambers (3/4
full with fluid)
• Clamp arterial and venous bloodlines. Clamp
IV line and disconnect from the arterial
needle end and connect to infuse line.
• Wipe venous needle end with alcohol swab
and join to arterial needle end.

19. • Unclamp both bloodlines and on blood pump
with a speed of 150-200mls/min for
recirculation procedure.
• Ready to use.

20. REUSED DIALYZER (refer to Clinical Performance
Book)
 Secure dialyzer in its holder with arterial end
upright.
 Connect dialysate line to a dialyzer and allow
dialysate fill up and rinse the dialysate
compartment.
 Start priming (same as new dialyzer).
 Flush all the small line but for the venous
pressure monitoring line, test for the
presence of residual sterilant (also test at the
venous needle end)

21.  Continue priming until completed the
procedure.
 On blood pump 250-300mls/min for
recirculation procedure.
 Ready for treatment.

22.  Adherence to the priming protocol (single use
and reuse dialyzer)
 To prepare the all necessary disposable
items.
 To ensure the reuse dialyzer is checked (free
from residual disinfectant agents)

24. THANK YOU