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haemodialysis_quality_standards - Rotary International District 3310

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Appendix 9<br />

Date<br />

Type of dialysers<br />

No of Use<br />

Blood Flow Rate<br />

Dialysate Flow Rate<br />

Venous<br />

Pressure<br />

Heparin<br />

Blood<br />

Pressure<br />

Weight (kg)<br />

Target UF<br />

Intra-dialytic<br />

complications<br />

Medication(s)<br />

served<br />

Loading<br />

Dose<br />

Infusion<br />

Pre HD<br />

Intra<br />

Post HD<br />

Dry<br />

Pre HD<br />

Post HD<br />

IDWG *<br />

ESA**<br />

Iron<br />

Calcitriol<br />

DIALYSIS TREATMENT RECORD<br />

MONTH ____________ YEAR __________<br />

*IDWG: Inter-Dialytic Weight Gain. ** ESA: Erythropoiesis Stimulating Agents<br />

Haemodialysis Quality and Standards 45

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