Safety recommendation
HSIB recommends that the Medicines and Healthcare products Regulatory Agency amends its 2022 ‘Dialysis guidance’ to include the safety risk of air emboli associated with unclamped haemodialysis catheters.
Response:
We have considered HSIB’s investigation report relating to the safety risk of air embolus associated with central venous catheters used for haemodialysis treatment and noted the specific recommendation made to us.
Air ingress due to unclamped catheters is an avoidable safety risk and further communication may help reducing the number of occurrences; we have therefore updated the MHRA Dialysis Guidance to raise awareness of the importance of clamping and capping central venous catheters.
Action carried out to deliver safety recommendation response:
Update of the MHRA Dialysis Guidance (2022) in quarter 2, 2023, to include risk of air embolus associated with unclamped haemodialysis catheters.
Response received on 18 July 2023.