Home dialysis patient dialyzing in-center on a trial basis with a new home dialysis machine.The last 10 minutes of therapy, dialysis machine alarmed due to hypotension.Rn went to check on the patient.He was unresponsive to verbal touch.100-200 ml of blood noted on floor.There appeared to be a leak at the junction of the arterial line and the dialyzer.There had not been a leak during the priming.Patient was placed in trendelenburg, blood returned to patient and 300 ml saline bolus was given.Code team was called and patient was transported to ed by ems.Electrolytes were normal.Hb was down to 9.4 mg/dl, from > 10 mg/dl earlier that month.He was kept overnight and discharged the next day.The company is investigating the defect.
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