Peritoneal Dialysis – CAPD and CCPD

BEST PERITONEAL DIALYSIS DELHI NCR AND GURGAON

CAPD or Peritoneal dialysis is a safe and effective method of dialysis, and is an excellent alternative to hemodialysis. Dr Vijayant Govinda Gupta, Urologist and laparoscoic surgeon, located in Delhi NCR, India has vast experience in placing peritoneal dialysis catheter/CAPD catheter insertion.

You can contact me for a free e consult via email at vijayantgovinda@gmail.com or drop a message below.

capd catheter insertion-capd-peritoneal dialysis-dialysis

Peritoneal Dialysis/ CAPD/Continuous automated peritoneal dialysis/CCPD/Continuous cycler peritoneal dialysis

As a patient of kidney failure, you require some mechanism of replacing your lost kidneys. The kidneys are basically very efficient filters that clean the blood of all toxic materials. They act like a filter through which blood passes, and due to many biological processes, the kidney removes all waste material, which comes out as urine.

As the kidneys fail, urine output falls, and the toxic metabolites accumulate in the body such as potassium, phosphate, sodium and excess water. These toxic metabolites are the basis of all symptoms that chronic kidney patients face.

With kidney failure, all patients will require some form of dialysis if they havent received a transplant.

Conventionally most patients will proceed to hemodialysis, which is basically the process in which the patient is attached to a machine, in which the patients blood is cleaned. Though comfortable, there are certain disadvantages of hemodialysis.

  1. Recurrent punctures to draw blood
  2. risk of HIV/AIDS/Hepatitis B
  3. Spending 4 to 5 hours thrice a week going to the hospital.
  4. Low or High Blood pressure
  5. Blood infections
  6. Need for an attendant

These disadvantages can be significant for somebody living a healthy and independant lifestyle.

The alternative to hemodialysis is peritoneal dialysis/continuous ambulatory peritoneal dialysis or CAPD. In peritoneal dialysis/CAPD, a tube or a soft catheter (CAPD catheter insertion) is placed inside your abdominal cavity, Trough this tube (capd catheter insertion), fluid is poured inside the peritoneal cavitythree times a day. It requires 15 to 20 minutes to do this process. Then the fluid remain inside, and the patient goes about with his daily chores and activities.

After 4 to 5 hours the fluid is removed and fresh fluid is put inside. By, doing this peritoneal dialysis or CAPD goes on while the patient is busy doing his daily work.

How peritoneal dialysis works is that, the abdomen is lined by a thin silky layer called peritoneum. The fluid that is put inside absorbs all the waste product from the blood via this lining and then when it is removed, it takes with it all the waste products.

The advantages of peritoneal dialysis or CAPD or CCPD are

  1. Time saving - 30 minutes thrice a day = 1.5 hours every day. Over a week it is 10 hours.
  2. Comfort of home - No need to go to the hospital
  3. Own convenience - Dialysis timings can be set according to own convenience.
  4. Painless
  5. No pin pricks/no Risk of HIV
  6. Patients have better control of BP and fewer medications
  7. Healthy active lifestyle - Apart from intense running, cycling and swimming, you can pursue all other daily activities, even exercise.

 

THIS IS A VIDEO TUTORIAL DESCRIBING THE TECHNICAL POINTS TO PERFORM PERITONEAL DIALYSIS FROM A PATIENTS PERPSECTIVE

READ THE COMPLETE TRANSCRIPT AT THE END OF THE ARTICLE.

Peritoneal Dialysis (CAPD) Catheter Insertion/Peritoneal Dialysis (CAPD) Catheter Placement

The advantages of peritoneal dialysis or CAPD can only work if the cathete is placed correctly and without complications. There are many methods of capd catheter insertion, but there is mounting evidence that open or laparoscopic capd catheter insertion is the best method.

The success of the capd catheter placement/capd catheter insertion is judged on the following parameters.

  1. Function - The capd catheter should function after placement
  2. Early Failure - Failure to put and remove fluid within 30 days of capd catheter placement.
  3. Late Failure - After 30 days of capd catheter insertion.
  4. Infections and complications.

There is enough evidence that shows laparpscopic and open methods are better on all parameters studies. Percutaneous capd catheter insertion under ultrasound guidance is a common method, but it is much inferior to open and laparoscopic capd catheter insertion.

What to expect?

Peritoneal dialysis catheter placement/insertion or CAPD catheter placement/insertion is done under anesthesia to prevent pain. I prefer local anesthesia and open capd catheter placement in delhi, gurgaon, faridabad, india .

You will have a 4 cm incision near your umbilicus and approximately 4 stitches. You will have to stay overnight for observation and dressing. We will test your capd catheter for function after a week and start your CAPD in 14 days. You will require training for peritoneal dialysis and CAPD, the training can be done at home or at my centre according to your wishes.

For any further questions you can leave me a message.

TRANSCRIPT OF THE VIDEO

ALSO AVAILABLE ON YOUTUBE

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HELLO FRIENDS, DRVIJAYANTGOVINDA.COM, PATIENT

DISCLAIMER, THIS VIDEO DEPICTS A MEDICAL PROCEDURE

 

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WITH ASOCIATED SERIOUS POTENTIALLY LIFETHREATENING

COMPLICATIONS, IF NOT DONE WITH QUALIFIED

 

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MEDICAL PROFESSIONAL, KINDLY TAKE THE ADVICE

OF YOUR DOCTOR, THIS CONTENT IS PROTECTED

 

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UNDER COPYRIGHT LAWS WRITTEN EXPRESS PERMISSION

IS REQUIRED BEFORE REUSING THIS CONTENT FOR

 

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COMMERCIAL PURPOSES,

WHAT IS PERITONEAL DIALYSIS, PERITONEAL DIALYSIS

 

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IS A SAFE AND EFFECTIVE METHOD OF DIALYSIS,

IT IS AN EXCELLENT ALTERNATIVE TO HEMODIALYSIS.

 

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A SOFT CATHETR IS PLACED INSIDE YOUR ABDOMINAL

CAVITY, THROUGH THIS TUBE FLUID IS POURED

 

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INSIDE THE PERITONEAL CAVITY THREE TIMES A

DAY, THEN THE FLUID REMAINS ISIDE AND THE

 

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PATIENT GOES ABOUT HIS DIALY LIFE, AFTER 4

TO 5 HOURS THE FLUID IS REMOVED AND FRESH

 

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FLUID IS PUT INSIDE.

 

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THE FLUID ABSORBS THE EXTRA WATER AND TOXIC

METABOLITES.

 

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THE DIALYSIS HAPPENS WHILE THE FLUID IS INSIDE

THE PATIENTS ABDOMEN.AS YOU CAN SEE IN THIS,

 

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THE FLUID, INSIDE THE ABDOMEN OVER A PERIOD

OF 4 TO 5 HOURS WILL ABSORB CREATININE UREA

 

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WATER AND OTHER TOXIC METABOLITES.

 

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THE MAIN ADVANTAGE OF PERITONEAL DIALYSIS

IS THAT THE PATIENT DOES NOT HAVE TO VISIT

 

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THE HOSPITAL.

 

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NO PUNCTURES, IS NEEDED, AND IT IS COMPLETELY

BLOODLESS, THE PATIENT CAN MAINTAIN AN ACTIVE

 

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LIFESTYLE, EXCEPT SWIMMING.

 

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WHO IS PERITONEAL DIALYSIS FOR?

 

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PERITONEAL DIALYSIS IS IDEALLY SUITED FOR

PATIENTS

 

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WITH ACTIVE LIFESTYLE, PATIENTS WHO ARE STILL

PASSING SOME AMOUNT OF URINE, PATIENTS WHO

 

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HAVE HAD NO SURGERIES IN THE PAST, AND PATIENTS

WHO CAN MAINTAIN THEIR OWN SELF HYGIENE?

 

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WHAT ARE THE TYPES OF PERITONEAL DIALYSIS?

 

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ONE IS CAPD WHICH WE WILL SHOW IN THE VIDEO,

WHICH IS ALSO CALLED AS CONTINUOUS AMBULATORY

 

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PERITONEAL DIALYSIS, FLUID IS FILLED IN THE

ABDOMINAL CAVITY 3 TIMES A DAY AND ONCE AT

 

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NIGHT, THE ENTIRE PROCESS IS MANUAL, BUT REQUIRES

TOUCHING THE CATHETER 9 TIMES A DAY.

 

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THIS CAN INCREASE THE CHANCES OF INFECTION.

 

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THE OTHER IS CCPD, ALSO CALLED AS CONTINUOUS

CYCLING PERITONEAL DIALYSIS, FLUID IS FILLED

 

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IN THE BADOMINAL CAVITY ONLY AT NIGHT, AUTOMATIC

MACHINE CYCLES THE FLUID THROUGHOUT THE NIGHT,

 

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IT REQUIRES TOUCHING THE CATHETER ONLY 2 TIMES

A DAY.

 

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WHICH CAN SIGNIFICANTLY REDUCE CHANCES OF

INFECTION.

 

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IN THIS TABLE, WE CAN SEE A COMPARISON BETWEEN

CCPD AND CAPD, IN TERMS OF EXPENSE, MORE OR

 

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LESS THEY ARE EQUIVALENT, BUT CCPD WILL BE

A LITTLE MORE COSTLY.

 

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THE CHANCES OF INFECTION,

WHT ARE THE TYPES OF PERITONEAL DIALYSIS FLUID?

 

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ONE ARE THE DEXTROSE BASED FLUID, THESEA RE

CHEAPER, THEY REMOVE MORE METABOLIC WASTE,

 

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THAN WATER, BUT IN DIABETIC PATIENTS THEY

CAN CREATE PROBLEM BY PROVIDING MORE SUGAR

 

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THAN THE BODY CAN HANDLE, OR THEY MAY CAUSE

DAMAGE TO THE PERITONEAL MEMBRANE.

 

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LEADING OVERTIME TO THE FAILURE OR MALFUNCTION

OF CAPD.

 

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A BETTER OPTION TODAY IS ICO DEXTRIN.

 

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THESE FLUIDS ARE EXPENSIVE THEY REMOVE MORE

WATER, BUT THEY CAN ONLY BE USED ONCE A DAY,

 

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SAFER IN THE PERITONEUM, MOST IMPORTANTLY

ICO DEXTRIN EVEN THOUGH IS NOT METOBOLISED

 

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SUGAR, CAN CAUSE FALSE READINGS IN THE GLUCOMETER

SO SPECIALLY DESIGNED GLUCOMETER THAT CAN

 

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DETECT ICODEXTRIN ARE INDICATED.

 

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ICO DEXTRIN SOLUTIONS ARE MOSTLY MEANT FOR

NIGHT OR IN CCPD FLUID.

 

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WHAT ARE THE ACTIVITES THAT A PATIENT CAN

OR CANNOT DO ON PERITONEAL DIALYSIS.

 

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CAUTION HAS TO BE EXERCISED WHILE USING WATER

BECAUSE THERE IS A TUBE GOING INSIDE THE STOMACH,

 

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AND INFECTION IS THE MOST IMPORTANT COMPLICATION

OF PERITONEAL DIALYSIS.

 

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SWIMMING ESPECIALLY IN PUBLIC POOLS, TAKING

PUBLIC BATHS, HOT TUB BATHS USING PUBLIC BATHROOMS,

 

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TAKING LONG HOT TUB BATHS, OR DOING CYCLING

ESPECIALLY STRENOUS CYCLING ARE CONTRINDICATED.

 

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BUT AS IN INDIA, WHERE MOST PEOPLE HAVE A

BATH WITH BUCKET IT IS ALLOWED.

 

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YOU CAN ALSO SHOWER, UNTIL UNLESS YOU ARE

NOT USING STORED WATER BUT BEST PART IS ON

 

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PERITONEAL DIALYSIS, PATIENTS CAN INDULGE

IN RUNNING, WEIGHT TRAINING, TREKKING, YOGA

 

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MASSAGE, STEAM AND SAUNA.

 

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BUT MOST IMPORTANTLY, YOU ARE STILL A PATIENT

WITH NON FUNCTIONAL KIDNEYS SO YOU HAVE TO

 

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AVOID DEHYDRATION AT ALL COSTS.

 

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HOW DO WE PLACE PERITONEAL DIALYSI CATHETER

OR PERITONEAL DIALYSIS CATHETER PLACEMENT.

 

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THSI IS A LADY SHOWING HER PERITONEAL DIALYSIS

CATHETER.

 

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AND THE ENTRY SITE ON THE STOMACH.

 

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THSIBANDAGE IS COVERING THE ENTRY SITE BUT

IT IS ADVISABEL TO PUT THE BANDAGE TO PREVENT

 

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INFECTION A CAPD CATHETER IS BASICALLY NOTHING

BUT A SOFT SILASTIC SILICON TUBE WHICH IS

 

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PLACED INSIDE THE PERITONEAL CAVITY.

 

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THE END OUTSIDE THAT YOU CAN SEE IS USED TO

PUT AND REMOVE FLUID A CYCLE OF PUTTING AND

 

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REMOVINF FLUID IS CALLED A FLUID EXCHANGE.

 

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THE CAPD CATHETER PLACEMENT HAS 3 MAIN PROBLEMS,

1 IS MALFUNCTION, WHAT IS MALFUNCTION - IDEALLY

 

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IF WE PUT IN 3 LITRES OF FLUID, WE SHOULD

BE ABLE TO REMOVE 2 LITRES, BUT DUE TO THE

 

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PROBLEMS IN THE CATHETER LIKE CLOGGING OR

PROTEIN OR IT GETTING STUCK YOU MAY KEEP PUTTING

 

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FLUID BUT NOTHING WILL COME OUT, THAT IS CALLED

A CATHETER MALFUNCTION, SECOND BECAUSE A CATHETER

 

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IS A DIRECT ENTRY SITE, FROM THE OUTSIDE TO

THE INSIDE, THE BODY, IT CAN ALWAYS GET INFECTED.

 

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AND OTHE RIMPORTANT INJURY IS WHILE PUTTING

THE CATHETER, THE CATHETER MAY GO AND INJURE

 

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ANY OF THE ORGANS INSIDE LIKE THE LIVER OR

THE INTESTINE OR THE BLADDER.

 

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THERE ARE THREE WAYS TO PUT A CAPD CATHETER,

ONE IS PERCUTANEOUS, THIS IS USUALLY OUTDATED.

 

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IT HAS THE HIGHEST RATES OF COMPLICATION,

AND MALFUNCTION BECAUSE IT IS BASICALLY A

 

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BLIND PROCEDURE, THE OTHER TWO ARE OPENA DN

LAPAROSCOPIC.

 

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ALL OVER THE WORLD, THE LAPAROSCOPIC METHOD

IS THE MOST PREFERRED BECAUSE IT HAS THE LOWEST

 

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RATES OF INJURY AND MALFUNCTION BECAUSE THE

ENTIRE PROCEDURE IS DONE UNDER EXCELLENT VISION.

 

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DR VIJAYANT GOVINDA IS A SPECIALIST IN CAPD

CATHETER PLACEMENT.

 

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YOU CAN VISIT MY WEBSITE DR VIJAYANT GOVINDA.COM

FOR THE BEST CAPD CATHETER SURGERY IN DELHI

 

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NCR AND INDIA.

 

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PERITONEAL DIALYSIS HOW TO DO.

 

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THE NEXT VIDEO SESSION WILL SHOW YOU A EXAMPLE

OF DOING CONTINUOUS AMBULATORY PERITONEAL

 

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DIALYSIS.

 

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THE THINGS THAT ARE NEEDE ARE FIRST WE NEED

LIQUID SOAP, WE NEED SPIRIT TO CLEAN OUR SURFACES,

 

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WE NEED A HAND RUB, TO CLEAN OUR HANDS, WE

NEED GAUZE, AS DEMONSTRATED LATER, AND WE

 

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WILL NEED 8 HANDKERCHIEFS OR TOWELS.

 

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THEN WE WILL NEED DIALYSIS FLUID, MOST IMPORTANTLY

THE DIALYSI FLUID HAS TO BE CHECKED FOR CLARITY

 

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IT SHOULD BE COMPLETELY CLEAR AND WE SHOULD

BE ABLE TO SEE ACROSS THE FLUID EASILY.

 

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THERE SHOULD NOT BE ANY CLOUDINESS OR PARTICLES,

IN THE FLUID.

 

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THE EXPIRY DATE HAS TO BE CHECKED.

 

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IT HAS TO BE CHECKED FOR THE CONCENTRATION

OF THE FLUID BEING USED IS THE ONE ADVISED

 

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BY YOUR PHYSICIAN, AND THE PRESCRIBED AMOUNT

IS ACCORDING TO YOUR PRESCRIPTION.

 

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THIS SHOWS THE BAG, DIALYSIS FLUID, APART

FROM THAT WE NEED CATHEER CAPS WHICH ARE SHOWN

 

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IN THE WHITE PACKETS, AND WE ALSO NEED CLAMPS

TO CLAMP THE OUTLET AND INLET WHICH ARE THE

 

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BLUE CLAMPS THAT CAN BE SEEN.

 

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IN ALL THREE WE HAVE TO CHECK THE PACKET FOR

EXPIRY.

 

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THE MOST IMPORTANT THING REQUIREMNT FOR A

GOOD CAPD IS A CLEAN ISOLATED ROOM A ROOM

 

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NEEDS TO BE AIRY SPACIOUS AND IT NEED TO HAVE

SUNLIGHT.

 

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IT SHOULD EB CLEANED WITH A ANTISPETIC FLOOR

CLEANER EVERYDAY.

 

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THERRE SHOULD BE AN ATTACHED TOILET PREFERABY

YO DISPOSE OF THE FLUID.

 

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A WATER FAUCET WITH ELBOW OPERATED TURN OFF

KNOB IS REQUIRED TO WASH THE HANDS, THIS ROOM

 

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SHOULD BE CLOSED OFF TO ALL UNREQUIRED PEOPLE,

IT SHOULD NOT BE A THOROUGHWAY.

 

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FOOTWEAR NEEDS TO BE REMOVED OUTSIDE, ALL

PEOPLE ENTERING THE ROOM NEED TO WEAR A FACE

 

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MASK, AND YOU HAVE TO SWITCH OFF THE FANS

WHEN DOING CAPD.

 

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APART FROM THESE WE NEED A HANGER FOR HANGING

THE FLUID A IV STAND, WE NEED A UPRIGHT CHAIR

 

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FOR THE PATIENT AND THE ATTENDANT TO SIT,

AND WE NEED A AUTOCLAVE BOX, WITH PRESSURE

 

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COOKER IN THIS PHOTO WE CAN SEE A COMMON AUTOCLAVE

BOX WHICH CAN ACCOMODATE 8 HANDKERCHIEFS,

 

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ONE OR TWO PLATES FOR HOLDING OUR SOLUTION

AND SOME GAUZE.

 

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THIS BOX CAN THEN BE CLOSED AND PUT INSIDE

A COOKER AND COOKED FOR 10 TO 15 MINUTES MAKING

 

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THE CONTENTS INSIDE COMPLETELY STERILE AND

FREE OF ANY INFECTION.

 

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BEFORE WE START CAPD THERE IS STEP 0.

 

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THE ROOM NEEDS TO BE CLEANED, THE TABLE CHAIR

HAS TO BE CLEANED WITHT HE SPIRIT.

 

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ALL THE BAGS AND CAPS HAVE TO BE CHECKED FOR

EXPIRY AND CLOUDINESS.

 

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AND IN THE MORNING WE USE THE AUTOCLAVE AND

PREPARE OUR KERCHIEFS AND GAUZE.

 

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IDEALLY WE WOULD REQUIRE 3 KERCHIEFS AND 3

GAUZE FOR EACH CYCLE OF CAPD.

 

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SO IN THSI PHOTO WE CANS EE THE TABLE HAS

BEEN CLEANED WITH SPIRIT AND THE AUTOCLAVE

 

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BOX IS READY, WE CAN SEE THA TOUR BAG IS NOT

CLOUDY AND WE CAN SEE WE HAVE CHECKED THE

 

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EXPIRY, THEN REMOVE ALL FOOTWEAR ENTER THE

ROOM PUT OFF THE FAN, WEAR YOUR FACE MASK,

 

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WASH AHNDS AND OPEN THE FLUID COVERING AND

EXPOSE THE INNER PACKET.

 

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FIRST STEP IS TO WASH THE HANDS.

 

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WSHING HANDS BY THE CAREGIVER IS THE MOST

IMPORTANT STEP TO PREVENT INFECTION.

 

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WE HAVE TO REMOVE ALL RINGS AND JEWELLERY

THEN AFTER THAT WE HAVE TO WASH HAND WITH

 

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LIQUID SOAP IN 6 STEPS.

 

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EACH OF THESE STEPS IS TO BE DONE FOR APPROXIAMTEL

5 TO 10 SECONDS, AND NONE OF THESE STEPS HAS

 

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TO BE MISSED.

 

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NOW YOU CAN SEE IN THE VIDEO, ALL THE 6 STEPS

BEING PERFORMED.

 

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STEP 1 THEN SREP 2 3 4 AND SO ON.

 

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IT IS HIGHLY ESSENTIAL FOR ANYBODY TO PERFORM

THESE 6 STEPS TO ALLOW THE HANDS TO BECOME

 

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COMPLETELY CLEAN AND REMOVE ALL BACTERIA.

 

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MISSING CAN CAUSE AN INLET FOR THE BACTERIA

TO ENTER.

 

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AND CAUSE INFECTION.

 

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THE ONES TEP THAT IS MANY TIMES MISSED IS

IF AFTER WASHING THE HANDS WE USE THE SAME

 

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DIRTY HANDS OR THESAME HANDS TO CLOSE THE

FAUCET, TE ENTIRE PROCEDURE IS A WASTE.

 

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SO AN ELBOW OPERATED FAUCET IS REQUIRED SO

AFTER WASHING WITH THE ELBOW THE FAUCET CAN

 

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JUST BE CLOSED.

 

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AFTER THE WASHING HAS BEEN COMPLETED WE DRY

OUR HANDS, WITH ONE STERILISED KERCHIEF,

 

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AFTER THIS THE HANDS ARE DRIED, A SECOND COAT

IS APPLIED WITHA ALCOHOL RUB, IT IS ESSENTAIL

 

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THAT THE ALCOHOL HAND RUB IS SQUEEZED WITH

THE ELBOW AND NOT PRESSED WITH THE HANDS,

 

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AS IT DEFEATS THE ENTIRE PURPOSE OF OUR WASH,

BECAUSE IF WE SQUEEZE WITH OUR HANDS WE ARE

 

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AGAIN ALLOWING GERMS TO GET IN.

 

139

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BUT ONCE THE HANDS HAVE BEEN DRIED, IT IS

HIGHLY ESSENTIAL to not to USE THE HANDS AGAIN

 

140

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TO SQUUEZE THE BOTTLE OR TO REMOVE THE MEDICATION.

 

141

00:14:51,450 --> 00:14:52,920

LET THE HANDRUB DRY.

 

142

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IT IS ESSENTIAL FOR THE HANDRUB TO DRY, BECAUSE

IF IT HAS NOT DRIED, IT IS NOT GOING TO KILL

 

143

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ALL THE GERMS, AND THAT IS THE MOST ESSENTIAL

STEP.

 

144

00:15:03,590 --> 00:15:09,780

AFTER THIS WE REMOVE THE FLUID PACKET FROM

INSIDE THE ITS OUTER COVERING, IN THE PREVIOUS

 

145

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STEP YOU HAD ALREADY OPENED THE OUTER COVERING

AND LET THE STERILE BAG INSIDE TO STAY.

 

146

00:15:15,830 --> 00:15:23,640

WE TKAE THE BAG, AND WE HANG IT ON THE IV

STAND, THE BAG USED HAS ITS DRAINAGE BAG STUK

 

147

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TO IT, WHICH IS PEELED AWAY, AND THEN LET

THE EMPTY PACKET DROP TO THE FLOOR, WE DONT

 

148

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HAVE TO TOUCH THE FLOOR WE DONT HAVE TO DO

ANYTHING, JUST LET IT DROP TO THE FLOOR, THEN

 

149

00:15:36,220 --> 00:15:41,600

WE REMOVE THE CAPD CATHETER FROM THE CAPD

BELT AND KEEP IT ON A CLEAN KERCHIEF, WE KEEP

 

150

00:15:41,600 --> 00:15:44,880

IT ON THE STERILE KERCHIEF AND THEN WE DONT

HANDLE IT, WE DONT TOUCH IT, WE JUST KEEP

 

151

00:15:44,880 --> 00:15:47,240

IT, THERE AND LET IT THERE.

 

152

00:15:47,240 --> 00:15:52,250

AFTER THIS WE TAKE THE TUBING, AND WE TAKE

THA CAPD CATHETER, AND KEEP THEM ON A KERCHIEF

 

153

00:15:52,250 --> 00:16:00,190

NEAR EACH OTHER, AND THEN AFTER THAT WE GO

AHEAD AND CLAMP THE INLET VALVE, OF THE FLUID

 

154

00:16:00,190 --> 00:16:05,120

BAG THIS PREVENTS THE FLUID FROM ENTERING

INSIDE THE BODY WHILE THE PREVIOUS FLUID HAS

 

155

00:16:05,120 --> 00:16:06,120

NOT BEEN REMOVED.

 

156

00:16:06,120 --> 00:16:10,510

SO CLAMPING IT IS ESSENTIAL.

 

157

00:16:10,510 --> 00:16:13,280

AFTER THIS WE OPEN THE CAPD CATHETER CAP.

 

158

00:16:13,280 --> 00:16:15,740

IT IS THE WHITE CAP AT THE END OF THE BLUE

CAP.

 

159

00:16:15,740 --> 00:16:17,810

THAT CSN BE SEEN IN THE VIDEO.

 

160

00:16:17,810 --> 00:16:19,770

AND WE CONNECT THE TUBING OF THE BAG.

 

161

00:16:19,770 --> 00:16:22,120

TO THE CAPD CATHETER.

 

162

00:16:22,120 --> 00:16:23,120

CAP.

 

163

00:16:23,120 --> 00:16:29,350

AFTER CONNECTING IT, WE HAVE ALREADY CLOSED

THE INLET VALVE, SO WE OPEN THE OUTLET VALVE,

 

164

00:16:29,350 --> 00:16:31,810

OF THE BAG LYING ON THE FLOOR.

 

165

00:16:31,810 --> 00:16:38,040

AFTER THIS WE OPEN, THE CAPD CATHETER.

 

166

00:16:38,040 --> 00:16:40,010

LET HR FLUID DRAIN INTO THE EMPTY BAG.

 

167

00:16:40,010 --> 00:16:42,070

IT WILL DRAIN ON ITS OWN AUTOMATICALLY.

 

168

00:16:42,070 --> 00:16:43,590

IT DOESNT NEED TO BE TOUCHED.

 

169

00:16:43,590 --> 00:16:49,790

DOESNT NEED TO BE HANDLES, IT WILL TAKE APPROX

10 MINUTES AND DURING THIS PERIOD, THE CAREGIVER

 

170

00:16:49,790 --> 00:16:55,660

AND THE PATIENT CAN INDUGLE IN LIGHT BANTER,

OR MAYBE SIT AND READ A MAGAZINE OR LISTEN

 

171

00:16:55,660 --> 00:16:57,800

TO SOME MUSIC.

 

172

00:16:57,800 --> 00:17:03,880

HURRYING UP DURING THIS STEP, WILL NOT ALLOW

THE ENTIRE CONTENTS TO DRAIN OUT. AND THIS

 

173

00:17:03,880 --> 00:17:09,990

MAY ALLOW SOME AMOUNT OF FLUID TO REMAIN INSIDE

THE BAG, WHICH COULD BE HARMFUL.AT THE END

 

174

00:17:09,990 --> 00:17:14,470

OF THE PROCEDURE WE CHECK FOR AIR BUBBLES,

IN THE TUBING, AND ONCE WE CAN SEE THE AIR

 

175

00:17:14,470 --> 00:17:20,220

BUBBLES, WE ARE SURE THAT THE ABDOMEN IS COMPLETELY

EMPTY.

 

176

00:17:20,220 --> 00:17:25,790

NOW WE CLOSE THE OUTLET VALVE, OPEN THE INLET

VALVE.

 

177

00:17:25,790 --> 00:17:28,870

AND LET THE CAPD FLUID GO IN.

 

178

00:17:28,870 --> 00:17:32,750

NOW THIS PROCEDURE OF GOING IN, SHOULD BE

PAINLESS.

 

179

00:17:32,750 --> 00:17:39,380

IF THERE IS PAIN, THEN IT SHOULD BE STOPPED

AND DOCTOR SHOULD BE CALLED, ITS IS SIGN OF

 

180

00:17:39,380 --> 00:17:40,970

CAPD MALFUNCTION.

 

181

00:17:40,970 --> 00:17:46,000

THIS STEP OF THE INLET WILL AGAIN TAKE 10

MINUTES.

 

182

00:17:46,000 --> 00:17:47,510

DO NOT, HURRY.

 

183

00:17:47,510 --> 00:17:52,740

THESE 25 MINUTES INVESTED, OR GOING TO KEEP

YOU HEALTHY AND THE CAPD CATHETER FUNCTIONAL

 

184

00:17:52,740 --> 00:17:58,230

FOR A LONG TIME, ARRANGE SOME MUSIC, OR SOME

LIGHT TAK.

 

185

00:17:58,230 --> 00:18:04,370

DONOT USE YOUR HANDS DURING THESE 25 MINUTES

TO READ A BOOK, OR SWITCH CHANNELS, OR TO

 

186

00:18:04,370 --> 00:18:05,370

TOUCH ANYTHING.

 

187

00:18:05,370 --> 00:18:08,730

YOU NEED TO REMAIN COMPLETELY STERILE WHILE

DURING THIS 20 MINUTES.

 

188

00:18:08,730 --> 00:18:15,280

FINALLY WE WAIT FOR THE BUBBLES IN THE INLET

TUBE TO CONFIRM THA THTE FILL HAS BEEN COMPLETE.

 

189

00:18:15,280 --> 00:18:17,970

AND THE ENTIRE FLUID IS IN.

 

190

00:18:17,970 --> 00:18:21,980

CLOSE THE INLET CHANNEL, DISCONECT THE TUBE.

 

191

00:18:21,980 --> 00:18:27,641

AFTER DISCONNECTING THE TUBE, WE KEEP THE

NEW CATHETER CAP ON THE KERCHIEF, WE OPEN

 

192

00:18:27,641 --> 00:18:28,700

IT.

 

193

00:18:28,700 --> 00:18:34,410

THE NEW CATHETER CAP IS REMOVED AND MOST IMPORTANTLY

IT IS CHECKED FOR THE BETDINE GAUZE INSIDE.

 

194

00:18:34,410 --> 00:18:42,470

IF THE BETADINE GAUZE, IS NOT INSIDE THE CAP,

IT IS BETTER TO DISCARD IT.

 

195

00:18:42,470 --> 00:18:47,780

WE CLOSE THE CATHETER WITH THIS NEW CAP. AND

WE THROW TH OLD CAP AWAY.

 

196

00:18:47,780 --> 00:18:52,710

YOUR CAPD PROVIDOR WILL PROVIDE YOU FRESH

CAPS FOR EACH EXCHANGE.

 

197

00:18:52,710 --> 00:18:58,210

THE CAPS ARE USUALY INXPENSIVE, COST AROUND

20 TO 30 RUPEES, SO THEY WILL COST YOU A 100

 

198

00:18:58,210 --> 00:19:02,550

RUPEES A DAY BUT WILL KEEP YOU FREE OF INFECTIONS.

 

199

00:19:02,550 --> 00:19:09,710

AFTER DOING THIS THE CAPD CATHETER IS PALCD

BACK IN THE CAPD BELT.

 

200

00:19:09,710 --> 00:19:17,180

AFTER THIS THE FLUID IS TAKEN AND WEIGHED

LIKE IN THIS EXAMPLE, 2.25 KG OF FLUID HAS

 

201

00:19:17,180 --> 00:19:24,100

COME OUT, WHICH MEANS THAT 2 KILOS OF FLUID

PLUS 250 ML OF FREE WATER HAS BEEN REMOVED,

 

202

00:19:24,100 --> 00:19:29,061

THIS READING IS ENTERED IN THE DIARY, THE

FLUID IS DISCARDED IN THE TOILET, AND ALL

 

203

00:19:29,061 --> 00:19:31,910

TH WASTE IS DISCARDED IN THE WASTE BASKET.

 

204

00:19:31,910 --> 00:19:33,530

BUT THE WORK IS NOT OVER.

 

205

00:19:33,530 --> 00:19:39,020

WE HAVE TO CLEAN THE WORK AREA, WASH OUR HANDS

AGIAN, EXIT THE ROOM AND THEN GET THE ROOM

 

206

00:19:39,020 --> 00:19:44,820

CLEANED AGAIN BECAUSE TO PREPARE FOR THE NEXT

CYXLE.

 

207

00:19:44,820 --> 00:19:49,020

TOTAL TIME FOR ONE EXCAHNGE IS 20 TO 25 MINUTES.

 

208

00:19:49,020 --> 00:19:50,060

CAUTION.

 

209

00:19:50,060 --> 00:19:57,780

AVOID MISSING EXCHANGS, AVOID DOING EXCHANGES

ON FULL STOMACH, NOW IF YOU CAN LOOK AT IT

 

210

00:19:57,780 --> 00:20:03,500

IN COMPARISON TO HEMODIALYSIS, HEMODIALYSIS

WOULD TAKE 5 TO 6 HOURS OF YOUR DAY AND THREE

 

211

00:20:03,500 --> 00:20:08,500

TIMES A WEEK AND THE MOMENT YOU GOT O THE

HOSPITAL AND COME BACK YOUR DAY IS FINISHED.

 

212

00:20:08,500 --> 00:20:16,240

I CAPD AND CCPD, BY INVESTING 1 HOUR OF YOUR

ENTIRE DAY YOUR OWN HEALTH, KEEPS YOU ACTIVE

 

213

00:20:16,240 --> 00:20:19,390

AND AVOIDS HOSPITAL, AND IS CONVENEIENT.

 

214

00:20:19,390 --> 00:20:27,160

SO CAPD IS THE PREFERABLE MODALITY OF DIALYSIS

FOR PATIENTS WITH RESIDUAL URINE AND ACTIVE

 

215

00:20:27,160 --> 00:20:29,240

LIFESTYLE.

 

216

00:20:29,240 --> 00:20:40,110

FOR CAPD CATHETER PLACEMENETS COTACT DRVIJAYANTGOVINDA.COM

FOR THE BEST CAPD CATHETER SURGERY IN DELHI

 

217

00:20:40,110 --> 00:20:42,530

NCR AND INDIA.

 

218

00:20:42,530 --> 00:20:48,740

YOU CAN ALSO BUY ACCESSORIES IN DELHI NCR

LIKE CAPD BELT CAPD BATH BELT AND AUTOCLAVE

 

219

00:20:48,740 --> 00:20:54,000

WITH COOKER, THEN AGAIN LEAVE A MESSAGE WITH

DRVIAJAYNTGOVINDA.COM.

 

220

00:20:54,000 --> 00:21:02,059

WE ALSO ARE IN THE PROCESS OF PROVIDING CAPD

NURSES AT VERY ECONOMICAL RATES TO DO CAPD

 

221

00:21:02,059 --> 00:21:05,090

FOR PATIENTS WHO DO NOT HAVE ANY CAREGIVERS.

 

222

00:21:05,090 --> 00:21:10,360

YOU CAN AGAIN CONTACT ME ON MY WEBSITE FOR

THE BEST PERITONEAL DIALYSIS CARE IN DELHI

 

223

00:21:10,360 --> 00:21:11,360

NCR.

 

224

00:21:11,360 --> 00:21:12,870

THANK YOU.