The National Association of Nephrology Technicians/Technologists (NANT) recognizes two types of dialysis technicians: nephrology clinical technicians and nephrology biomedical technologists. Nephrology clinical technicians work directly with patients. They prepare the patient for dialysis, monitor the procedure, and respond to any emergencies that occur during the treatment. Before dialysis, the technician measures the patient's vital signs (including weight, pulse, blood pressure, and temperature) and obtains blood samples and specimens as required. The technician then inserts tubes into access routes, such as a vein or a catheter, which will exchange blood between the patient and the artificial kidney machine throughout the dialysis session.
While monitoring the process of dialysis, the technician must be attentive, precise, and alert. He or she measures and adjusts blood-flow rates as well as checks and rechecks the patient's vital signs. All of this information is carefully recorded in a log. In addition, the technician must respond to any alarms that occur during the procedure and make appropriate adjustments to the dialysis machine. Should an emergency occur during the session, the technician must be able to administer cardiopulmonary resuscitation (CPR) or other life-saving techniques.
Nephrology biomedical technologists maintain and repair the dialysis machines. Dialyzer reuse technicians care for the dialyzers—the apparatus through which the blood is filtered. Each one must be cleaned and bleached after use, then sterilized by filling it with formaldehyde overnight so that it is ready to be used again for the patient's next treatment. To prevent contamination, a dialyzer may only be reused with the same patient, so accurate records must be kept. Some dialysis units reuse plastic tubing as well; this, too, must be carefully sterilized.
While most hemodialysis takes place in a hospital or special dialysis centers, the use of dialysis in the patient's home is becoming more common. In these cases, nephrology clinical technicians travel to patients' homes to carry out the dialysis procedures or to instruct family members in assisting with the process.
In many dialysis facilities the duties described above overlap. The dialysis technician's role is determined by a number of factors: the dialysis facility's management plan, the facility's leadership and staff, the technician's skills and background, the unit's equipment and facilities, and the long-term care plans for patients. However, all dialysis technicians work under the supervision of physicians or registered nurses.
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