Problematic issues of AV Fistulas
(tab)AV fistulas are the first choice of access for dialysis patients, they come with their share of problems. Fistulas require surgery to join the patient’s own artery and vein. Having less severe problems over other types of accesses, listed below are several issues often faced by patients with AV fistulas.
• Fistula surgery takes four to six weeks to mature and in rare instances can take up to a year.
• “Steal Syndrome” usually the fault of a bad surgical spot, the fistula “steals” too much blood from the hand. Causing poor circulation to the hand, symptoms include numbness and cold in the hand, can also cause pain in the hand.
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• Infection, both patient and caretakers need to watch for redness, swelling, heat of area, sores or pain. See nephrologist if any signs of infection are found before patient can get sepsis. Sepsis is usually caused from inadequately cleansed area and bacteria is forced into the blood stream via the needle. Sepsis can be deadly. (break space) • Very large needles, can damage the walls of the fistula. (break space) • Hematomas, bleeding under the skin, usually caused from removal of needles and pressure not being held long enough to stop bleeding under the needle site. (break space) • Mass blood loss from loose needles, often which go unseen, patients get very cold and cover up, many to where you cannot see the needle site. Stenosis or a narrowing of the blood vessel which can slowly reduce blood flow to fistula causing inadequate dialysis treatment. (break space) • Thrombosis is blood clots caused by scars on the inside of the fistula, normally caused by continuous needle sticks too soon, not allowing site to fully heal. Blood platelets stick to the scars and cause the clot. Warning signs include no thrill (or buzzing like a bee) in the fistula. Clots can also dislodge and move anywhere in the body and can even cause death. Solutions and First Aid for AV fistulas and for your patient (tab)Although many of these solutions have been practiced and used thousands of times. Every patient and caretaker must take it upon themselves to make sure all procedures are followed. As a PCT, nurse or an at home caretaker, you need to be prepared for anything that can happen. These solutions include not only the most often used, but, ones I have had to use myself while taking care of my mom. These solutions and suggestions vary depending on where the patient is located. As a caretaker, keep 911 on speed dial, you will use it, often. Never give a drug not prescribed, something as simple as Tylenol or Imodium can cause extreme danger to a patient with no way to wash those chemicals out of their system. • Strong blood flow …show more content…
Once needles are in place tape needles down so they cannot move. As an at home caretaker, if the vein becomes infiltrated, it gets ugly, similar to a very large bruise and they are painful. Alternate ice and heat for 2 days until the blood is reabsorbed by the …show more content…
Never allow anyone to take blood, start an IV or take blood pressure in the fistula arm. Never carry anything heavy over the fistula or sleep on it, the blood circulation can easily be cut off. I found, if you prop the arm, the patient is less likely to roll over on it.
(break space)
• As the primary at home care taker, learn everything possible about dialysis and what to do in case of emergency. Be the lifeline and don’t be afraid to do what is needed. Become CPR certified and keep first aid materials ready.
Conclusion
(tab)Due to the initiative called Fistula First, more patients have AV Fistulas than any other access. They are more dependable, with fewer hospital stays and far less infections. The goal is to keep it healthy, this is the responsibility of the patient, the staff and the home care takers. Make sure the patient and all at home care takers are educated, on all complications and what to do if one arises. You are now, and always will be, your biggest health advocate. You keep your fistula clean and healthy, feel for the thrill, and your fistula will keep you healthy, for years to
(tab)AV fistulas are the first choice of access for dialysis patients, they come with their share of problems. Fistulas require surgery to join the patient’s own artery and vein. Having less severe problems over other types of accesses, listed below are several issues often faced by patients with AV fistulas.
• Fistula surgery takes four to six weeks to mature and in rare instances can take up to a year.
• “Steal Syndrome” usually the fault of a bad surgical spot, the fistula “steals” too much blood from the hand. Causing poor circulation to the hand, symptoms include numbness and cold in the hand, can also cause pain in the hand.
(break space)
• Infection, both patient and caretakers need to watch for redness, swelling, heat of area, sores or pain. See nephrologist if any signs of infection are found before patient can get sepsis. Sepsis is usually caused from inadequately cleansed area and bacteria is forced into the blood stream via the needle. Sepsis can be deadly. (break space) • Very large needles, can damage the walls of the fistula. (break space) • Hematomas, bleeding under the skin, usually caused from removal of needles and pressure not being held long enough to stop bleeding under the needle site. (break space) • Mass blood loss from loose needles, often which go unseen, patients get very cold and cover up, many to where you cannot see the needle site. Stenosis or a narrowing of the blood vessel which can slowly reduce blood flow to fistula causing inadequate dialysis treatment. (break space) • Thrombosis is blood clots caused by scars on the inside of the fistula, normally caused by continuous needle sticks too soon, not allowing site to fully heal. Blood platelets stick to the scars and cause the clot. Warning signs include no thrill (or buzzing like a bee) in the fistula. Clots can also dislodge and move anywhere in the body and can even cause death. Solutions and First Aid for AV fistulas and for your patient (tab)Although many of these solutions have been practiced and used thousands of times. Every patient and caretaker must take it upon themselves to make sure all procedures are followed. As a PCT, nurse or an at home caretaker, you need to be prepared for anything that can happen. These solutions include not only the most often used, but, ones I have had to use myself while taking care of my mom. These solutions and suggestions vary depending on where the patient is located. As a caretaker, keep 911 on speed dial, you will use it, often. Never give a drug not prescribed, something as simple as Tylenol or Imodium can cause extreme danger to a patient with no way to wash those chemicals out of their system. • Strong blood flow …show more content…
Once needles are in place tape needles down so they cannot move. As an at home caretaker, if the vein becomes infiltrated, it gets ugly, similar to a very large bruise and they are painful. Alternate ice and heat for 2 days until the blood is reabsorbed by the …show more content…
Never allow anyone to take blood, start an IV or take blood pressure in the fistula arm. Never carry anything heavy over the fistula or sleep on it, the blood circulation can easily be cut off. I found, if you prop the arm, the patient is less likely to roll over on it.
(break space)
• As the primary at home care taker, learn everything possible about dialysis and what to do in case of emergency. Be the lifeline and don’t be afraid to do what is needed. Become CPR certified and keep first aid materials ready.
Conclusion
(tab)Due to the initiative called Fistula First, more patients have AV Fistulas than any other access. They are more dependable, with fewer hospital stays and far less infections. The goal is to keep it healthy, this is the responsibility of the patient, the staff and the home care takers. Make sure the patient and all at home care takers are educated, on all complications and what to do if one arises. You are now, and always will be, your biggest health advocate. You keep your fistula clean and healthy, feel for the thrill, and your fistula will keep you healthy, for years to