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Dr. Roger N. SmithFACPConsultant Nephrologist & Internist
Emergency Care
KingstonSpanish TownMandevilleVacation DialysisEducationEmergency Intake
HomeEmergency care
Acute Renal Emergency Guidelines

Emergency Kidney Care & Intake.

Guidelines for Acute Kidney Injury (AKI) triage, vascular catheter infections, and emergency dialysis waitlisting pathways in Jamaica — conducted under the oversight of Dr. Roger N. Smith, FACP.

Urgent intake lineAll locations
Acute renal therapy assessment facility, Jamaica

Urgent Intake Triage

Kare KONEC Urgent Care
24/7 Walk-in Emergency Centre
17 Latham Ave, Suite #2, Kingston 6, Jamaica
(Off Old Hope Road, behind El Shaddi Medical Centre)
Public Admissions
Spanish Town Hospital emergency admissions are routed based on strict departmental wait-listed priority codes.
Safety Standards & Infection Control

Clinical Protocols & Survival.

In order to optimize patient survival outcomes and minimize catheter-related morbidity in Jamaican public and private dialysis suites, Dr. Roger Smith co-designed and implemented clinical guidelines, making them part of standard medical training at UHWI and Spanish Town Hospital.

Vascular Access Infection Control

Utilizes the Protocol for Prevention of Catheter and Non-Catheter Related Infection in the Haemodialysis Unit (UHWI):

  • Aseptic catheter care, dressing change guidelines, and exit site inspection.
  • Early clinical recognition of bacteremia and immediate antibiotic lock protocols.

Resource-Scarce Waitlist Protocol

Utilizes the Protocol for Managing Wait-Listed Patients Requiring Dialysis in a Resource-Scarce Setting (Spanish Town Hospital):

  • Provides transparent, risk-stratified criteria for uremic patient triage.
  • Interim conservative medical management guidelines to optimize uremic solute levels.

Acute Kidney Injury (AKI) Triage Pathways

Acute Kidney Injury can present post-operatively or secondary to severe volume depletion, sepsis, or drug toxicity. Dr. Roger Smith has extensively researched post-cardiac surgery renal complications (co-authoring *Acute renal failure post coronary artery bypass grafting at UHWI*). The standard clinical pathway includes:

1. Rapid Volume/Toxin ScreenAssessment of drug nephrotoxicity and fluid status.
2. Solute & Acid-Base TrackingContinuous tracking of serum potassium, creatinine, and arterial pH.
3. Access & Dialysis InitiationStandardized internal jugular catheter setups for acute dialyzer connection.