Why do we rotate needle sites on a fistula?

Why do we rotate needle sites on a fistula?

6 The needle bevel is rotated to help prevent a “back wall” or posterior wall infiltration, which can occur if the needle’s bevel tip accidentally punctures the bottom of the graft or fistula (see the discussion under “Cannulation Problem Solving”).

Which complication is associated with flipping or over manipulation of needles?

An improper needle flip or taping procedure can cause an infiltration. If the fistula is infiltrated, it is best to rest the fistula for at least 1 treatment.

What is the treatment for needle infiltration?

Place a warm wash cloth on the area for 20 minutes. Do this 6 to 8 times a day for the next 24 hours to promote healing. You only need the warm compress to cover the affected area. The dialysis nurses will check your fistula or graft each dialysis treatment after you have an infiltration.

How is a dialysis needle inserted?

Pull the skin taut and insert the needle into the same place, at the same angle and at the same depth each time. Watch for a flashback of blood in the tube connected to the needle. When you see the flashback of blood, lower the angle and continue to slide the needle into the fistula. Tape the needle in place.

What is the Kdoqi rule of 6?

The KDOQI “Rule of 6s” suggests that a fistula can be used when it is at least 6 mm in diameter, < 6 mm deep, and has a blood flow > 600 mL/min. However, with maturation failure rates as high as 60%,4 a greater understanding of what it takes to make an AVF useable is necessary.

When Cannulating an AVF AVG Do not insert the needles closer than?

If possible, aneurysmal areas should be avoided. 9) Needle sites should be positioned at least 5cm apart, if possible, to avoid recirculation. 10) A tourniquet should be used for all needle insertions into AV fistulae, unless the AV fistula is aneurysmal. A tourniquet is not needed for AV grafts.

What are the complications of hemodialysis?


  • Low blood pressure (hypotension). A drop in blood pressure is a common side effect of hemodialysis.
  • Muscle cramps. Although the cause is not clear, muscle cramps during hemodialysis are common.
  • Itching.
  • Sleep problems.
  • Anemia.
  • Bone diseases.
  • High blood pressure (hypertension).
  • Fluid overload.

How can I reduce swelling in my fistula?

To reduce the swelling, keep your arm up when you are resting or sitting. Put it on 2 pillows at the same level as your heart. Your arm may be cool and numb where the fistula or graft was put in. This lasts a few weeks and is normal.

Do dialysis needles hurt?

Dialysis itself does not hurt. In hemodialysis the needles may hurt going in, but they should stop hurting after that. You can ask for numbing medicine before you get the needle sticks if they bother you. Many people get used to the needles in time.

Where is the needle inserted for dialysis?

When you receive dialysis through a fistula, two needles will be placed in your arm that will connect to the dialysis system through tubing. Your blood flows from your body through the hemodialysis system.

What are the rules of 6 in dialysis?

1. “Rule of six” in fistula assessment — at six weeks post-creation the diameter of the body of the fistula should be at least 6mm and the depth no more than 0.6cm. The blood-flow rate should be 600mL/min or more by this time. The length of the fistula should be 6cm to allow for a successful two-needle dialysis.

How are the needles connected to the dialysis circuit?

In this case, noting the venous pressure and pre-pump arterial pressure may assist in determining the bloodflow direction. To accomplish this, the needles are connected to the dialysis circuit, a 200 mL/min bloodflow is achieved, and the mid-graft region is lightly compressed.

Are there sharp metal needles for nocturnal dialysis?

Sharp metal needles for nocturnal dialysis are not preferred due to the potential for needle infiltration during treatment. If sharp metal needles are used however, it is critical that they be well secured.20 SUMMARY

What happens when a dialysis needle is punctured?

It is more likely to need hospital “tune-ups” to remove clots, and more prone to infection. When your access is infiltrated (the needle punctures both walls of the access), blood leaks into the tissues and causes swelling, and often a painful bruise. The escaped blood can compress your access.

What do you need for self cannulation in dialysis?

Here are the basic steps: Gather your supplies. You’ll need needles, gauze pads, tape (you’ll tear a number of pieces to length), a tourniquet, a cleanser for your access, clean gloves, alcohol wipes, Band-aids, a sharps container (to dispose of used needles or syringes), etc.