Download Dialysis education Poster

Atrium PTFE Vascular Graft
Dialysis Education
Ask, Look, Listen: Before Cannulation
1 Ask the patient if they have noticed any unusual symptoms concerning their access site or
physical changes to their health such as dizziness or a high temperature.
2Conduct a visual exam of the access site. Report any signs of infection, such as redness,
swelling, pain, fever or any drainage issues to the patients’ doctor.
3Feel for the thrill (vibration) and listen for the bruit with a stethoscope since grafts are generally
thicker than native fistulas. Sometimes a thrill may not always be detectable.
Upper Extremity Straight
Prosthetic AV Accesses
Upper Extremity Loop
Prosthetic AV Accesses
Thigh Prosthetic
AV Accesses
DOQI Guidelines for
Proper Needle Cannulation*
Post Cannulation Care of
Synthetic Graft*
• A clean, sterile technique should be used for all cannulation procedures.
• Be sure to rotate cannulation sites. Avoid sticking the graft in the same
location twice to reduce the risk of graft damage and possible
pseudoaneurysm formation.
• When stopping the bleeding at the needle site
post dialysis, apply only enough pressure to
stop the blood flow. Too much pressure may
cause the graft to clot or block-off.
• Make sure that the skin is stretched tight in the opposite direction of the
needle insertion. This will help to stabilize the graft when cannulating.
• Be sure to properly clean the access site after
and between dialysis sessions.
• Use a 45 degree angle of insertion for the synthetic graft. Note that this
degree is different if you are cannulating a fistula. The 45 degree angle
is necessary when cannulating a synthetic graft because it reduces the
possible risk of tearing the graft. It also helps to prevent backwall
sticking. Once the graft is punctured, advance the needle slowly with the
cutting edge facing the top of the vessel. DO NOT ROTATE AXIS WHEN
INSERTING THE NEEDLE.
• Educate the patient on proper care of the
access site and graft. For example, not to allow
blood pressures to be taken on the arm with the
graft, avoid carrying heavy packages, purses or
a young child and to avoid constrictive clothing
or jewelry as these may restrict blood flow
through the graft and possibly cause it to clot.
• Once the needle is in the desired position, it is safe to rotate the needle
180 degrees. Waiting to rotate avoids unnecessary damage to the top of
the graft.
• Remind them to take their medications as
prescribed by their doctor as well as to follow
their diet and exercise regimens. Also stress
the importance of attending each dialysis
session.
• Once the needle is correctly placed, tape it at the same angle or one
similar to the angle of insertion. Avoid pressing the needle shaft flat
against the skin as this moves the needle tip from the desired position.
Proper Needle Cannulation
Proper Compression Technique
Exceptional Strength, Handling and Durability
Superior Kink and Compression Resistance
The No Weep Guarantee™
Advancing Vascular Repair
*National Kidney Foundation, DOQI Clinical Guidelines
© Atrium Medical Corporation 2008. All Rights Reserved. Part # 0174. Printed in USA 9/08
www.atriummed.com