Visual summary
Treat the episode, identify its cause, and prevent the next one through a documented team review.
Text version
Notice the change
Look for dizziness, nausea, cramps, yawning, visual change, weakness, or altered awareness. Compare the blood pressure with baseline and recent treatments; an unexpectedly low reading matters even without symptoms.
Assess immediately
Recheck pressure and assess airway, breathing, pulse, rhythm, perfusion, and access. Reduce or stop ultrafiltration according to the emergency protocol; position safely based on breathing and hemodynamic tolerance.
Look beyond fluid removal
Chest pain, fever, rigors, bleeding, rash, wheeze, air alarms, or symptoms early in treatment suggest additional causes. Do not automatically attribute sudden deterioration to an excessive fluid goal.
Follow the response pathway
Give prescribed rescue measures under the unit protocol and reassess promptly. Persistent instability, neurologic change, concerning chest symptoms, or suspected sepsis or reaction requires urgent clinician and emergency-team involvement.
Review recurrent episodes
Bring target weight, removal rate, session length, meals, medication timing, and dialysate settings to the team. Cooling or prescription changes require an individualized plan; medication holds should be specifically ordered.
Document response and recovery
Record onset, lowest pressure, symptoms, machine findings, interventions, fluid administered, and response. Report the achieved dialysis and removal, discharge safety, and what needs changing before the next session.
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