What Can You Do To Prevent Peritonitis?

Hand washing should be done: before your PD exchange1 | before your exit-site care1 | after disposing of drained PD bag1

n WASH YOUR HANDS – This is your BEST defense! – Use liquid soapn Dry your hands – Use paper towel or a clean towel (not your clothes)n Do your TwinBag exchange or HomeChoice Cycler set up exactly as your were taughtn Do your exchanges in a clean, dry, well lit area* n Know what is “sterile” and do not touch any of the sterile partsn Turn off fans, close windows and doors*

n Check your drain fluid for cloudiness n Keep pets out of the room when: – setting up – doing an exchange* – while “connected” (all night if on cycler) n Avoid “cross-overs”

n Secure your catheter (so it does not hang freely) n Check and clean your exit site every day, just as you have been taught n Apply antibiotic cream every day as you have been taughtn A wet or dirty dressing must be changed n Call the PD nurse if fluid leaks from your catheter or exit site n Check the titanium adaptor and transfer set connection every dayn Avoid constipation

Before Exchange/Cycler set-up During Exchange/Cycler set-up Daily Care

QUESTION ANSWER

What is peritonitis? Peritonitis is an infection inside the peritoneal cavity. It will not go away without antibiotics.

How do you spot peritonitis? If you see any of these symptoms you may have peritonitis: – cloudy drain fluid – abdominal pain & tenderness – nausea & vomiting – fever & chills

THE PROBLEM WHAT YOU SHOULD DO

Your drain fluid is cloudy. Follow your hospitals instructions on who to call.Call immediately. This CANNOT wait.

You have been on antibiotics for 2-3 days due to peritonitis but your drain fluid is still cloudy.

Follow your hospitals instructions on who to call.Call immediately. This CANNOT wait.

Baxter Corporation Mississauga, ON 1-800-387-8399 www.baxter.ca

Baxter is a trademark of Baxter International Inc. PD-T-13 01/11

References

1. The World Health Organization. WHO guidelines on Hand Hygiene in Healthcare http://whqlibdoc.who.int/publications/2009/9789241597906_eng.pdf2. Li PK, Szeto CC, Piraino B et al. Peritoneal dialysis-related infections recommendations: 2010 update. Peritoneal Dialysis International, Vol. 30, pp. 393–423.3. Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis: best demonstrated practices. Kidney Int Suppl. 2006 Nov;(103):S44-54.

This document is based on published scientific evidence (as of 2009) and clinical practice guidelines from professional societies. It is intended to be used only as one of many factors for managing PD patients, and it does not replace good medical and clinical judgment. Further, individual circumstances of your patients must be taken into account, as well as guidelines of local nephrology societies and other associations. Do not rely on this document alone.

* These instructions refer to both a TwinBag exchange and the HomeChoice cycler set-up.