PRE - DIALYSIS

Is the patient STABLE or UNSTABLE?

STABLE: STABLE:
UNSTABLE: patient may manifest 1 or more of Normal BP, HR, RR, Temperature
the following signs/symptoms: and Oxygen Saturation
Ambulatory
Extremely high or low – BP, HR, RR, Conscious and coherent
Temperature
Low hemoglobin levels (<8 g/dL)
Oxygen Saturation (<90%)
Shortness/Difficulty of breathing and/or
gasping Proceed with dialysis
Patient has active bleeding
Patient has decreased sensorium

Refer to **POD / Attending Nephrologist for management

Responsive to management?

YES STABLE

NO

What is the patient’s LOC?

CONSCIOUS Private Conduction

Provide photocopies of necessary documents for transfer.

UNCONSCIOUS

Ambulance Transfer
**SEQUENCE OF REFERRAL: if in the event that the occurrence happens during the time of transition/endorseme
OUTGOING POD
INCOMING POD
NEPHROLOGIST
t to the responsible medical representative OFwill
that THE DAY
transfer patient to the hospital
ATTENDING NEPHROLOGIST
MEDICAL DIRECTOR
DR. ARISTIDES PANLILIO
 POST - DIALYSIS

Is the patient STABLE or

UNSTABLE?

STABLE:
UNSTABLE: patient may manifest 1 or more of the
following signs/symptoms:
1. Normal BP, HR, RR,
Temperature and Oxygen
1. Extremely high or low – BP, HR, RR,
Saturation
Temperature
2. Ambulatory
2. Oxygen Saturation (<90%)
3. Conscious and coherent
3. Shortness/Difficulty of breathing
and/or gasping
4. Patient has active bleeding
5. Patient has decreased sensorium or
loss of consciousness May go home
6. Severe/persistent chest pain

Refer to POD / Attending Nephrologist for

management

Responsive to
management?
YES STABLE

NO

What is the patient’s LOC?

CONSCIOUS Private Conduction

Provide photocopies of
necessary documents for
UNCONSCIOUS transfer.

Ambulance Transfer
**SEQUENCE OF REFERRAL: if in the event that the
occurrence happens during the time of
transition/endorsement of Physicians, the first line
Endorse patient to the responsible medical to call is:
representative that will transfer patient to the 1. OUTGOING POD
2. INCOMING POD
hospital 3. NEPHROLOGIST OF THE DAY
4. ATTENDING NEPHROLOGIST
5. MEDICAL DIRECTOR
6. DR. ARISTIDES PANLILIO
 INTRA - DIALYSIS

Is the patient STABLE or

UNSTABLE?

STABLE:
UNSTABLE: patient may manifest 1 or more of the 1. Normal BP, HR, RR,
following signs/symptoms: Temperature and Oxygen
1. Extremely high or low – BP, HR, RR, Saturation
Temperature 2. Normal laboratory result
2. Low hemoglobin levels (<8 g/dL) 3. Conscious and coherent
3. Oxygen Saturation (<90%)
4. Shortness/Difficulty of breathing
and/or gasping
5. Patient has active bleeding
6. Sudden changes in sensorium or loss of
consciousness
Proceed with dialysis
7. Severe/persistent chest pain
8. High or Low laboratory results
9. Persistent leg/abdominal cramps
10. Unrelieved chills
11. Ineffective dialysis access
12. Abnormal ECG tracings

Refer to POD / Attending Nephrologist for

management

Responsive to
management?
YES STABLE

NO

What is the patient’s LOC? Provide

photocopies of
necessary
YES Private Conduction documents for
transfer.

NO **SEQUENCE OF REFERRAL: if in the event that the

occurrence happens during the time of
transition/endorsement of Physicians, the first line
Ambulance Transfer to call is:
1. OUTGOING POD
2. INCOMING POD
Endorse patient to the responsible medical 3. NEPHROLOGIST OF THE DAY
representative that will transfer patient to the 4. ATTENDING NEPHROLOGIST
hospital 5. MEDICAL DIRECTOR
6. DR. ARISTIDES PANLILIO