Dialysis Nursing: How to Cannulate the AV FISTULA
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- Опубликовано: 1 июл 2024
- It's finally here! Step by step demonstration on how to cannulate an AV fistula, different ways to tape the needles, and how to remove the needles from the AV Fistula.
I know you have QUESTIONS about DIALYSIS AV FISTULAS.
You may even have CONCERNS.
But you can stop worrying because that's why I created this video about AV FISTULAS.
I want you to be INFORMED.
I also want you to be RELAXED.
So let's address YOUR CONCERNS.
By watching this video, you'll likely have a much better UNDERSTANDING of the ANSWERS to your QUESTIONS about Dialysis AV FISTULAS.
There are exceptions to every rule. This is a simple, easy to follow step by step of what to expect with an AV fistula.
I encourage you to practice and ask for help when learning to cannulate new fistulas.
AV FISTULA REMEMBER:
You FEEL the THRILL
You HEAR A BRUIT
Focus on:
1) Assess for thrill and bruit of the AV Fistula
2) Wash with soap and water
3)Clean site per clinic protocol with Chlorhexidine/Alcohol/Betadine
4)Cannulate AV Fistula
5) Tape
6) Verify needles are correctly in AV Fistula
7) Remove Needles
8) Make sure bleeding has stopped before letting patient leave clinc
AV Grafts: Never Clamp
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00:00 Step By Step AV Fistula Cannulation
01:30 Assess Fistula
02:00 Anastomosis
03:00 Antiseptic Agents
04:00 LET'S CANNULATE
07:00 Verify Needle Placement
10:00 Taping Technique
14:00 Removing Needles
18:45 Lindsey's Dialysis Song
DISCLAIMER: This video is intended for education purposes only and is not intended as medical advice
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Dialysis Nurses Supporting Nurses Facebook Group: facebook.com/groups/215559410197295/
I just got a job at a hemodialysis clinic after i got certified in phlebotomy and i did my first cannulation this week and loved it. Im excited to do more. I had no issues and most importantly, neither did the patient. He was very willing for me to do it. I was able to hit the artery and vein and it all went smoothly. Makes me feel like im in the right job/career now. I wanna do dialysis nursing
Thank u! Yes, keep it going!!
This was way more than i learned at my job .
Thanks for watching Gilly!!
Where do you work? I work at DaVita and there’s loads of training
This channel keeps giving!
Thank u!!! 🤗 🥰
Thank you Lindsey! Just found your channel. I am transitioning to Dialysis RN from being an ICU nurse for a year and I am very excited. Thanks for the great content. Lots to learn!
Thank u!
Love you mam... The best and sincere presentation
Thank you 🥰
Hi Lindsey! Just found your channel and am looking forward to the quality learning. Thanks so much!
Thank u!!
Thank Lindsey you are such a great help I am a dialysis patient and I wanted to learn as much terminology as possible ❤
Ur welcome! Thank u for watching! 🥰🤗
Please please please do a video on per cutaneous AV fistulas
Hi Lindsay, thank you so much for the videos, they are so helpful and fun. My husband is a dialysis patient planning to go on home dialysis and i am to be the nurse😬. I hope i can manage🙏🏼
Love from İstanbul❤️
Yes 🙌 to home dialysis!! U will have a lot of support and autonomy doing home dialysis. Give it a year, and u will be teaching me some things!! 😃
🌹
Where can I get one of those practice arms.
I have a question out of topic but related to dialysis. Does the blood flow rate also contributes with patients having tachycardia during dialysis? Patient has DM and Heart dse.
I always love to feel it with my palm than my finger too. I feel like I can hear it rather than just feeling it.. weird right? But I feel comfortable that way.
a prosedure of 1 minutes we are keeping the needile with saline and flash the needle, and then check with that same syring , no need to use two syrings, its a very easy and strait forward procedure, which I used to do more than 14 years. and we are using to keep cotton under the needle to insure it will be on the same angel all time, instead of folding the wings of the needle which will be so annoying for the patien during 4 hrs of dialysis. but still thank you for your explanation.
Thanks for this video, I had my fistula installed on Apr 25, 2023. Yesterday, Jun 22, 2023, my vascular surgeon said I can start using it for dialysis - it's been healing for about 9 weeks.. So, today, Jun 23 (a Friday,) my dialysis nurse will use it for the first time - and I'm a little apprehensive. They gave me some tubes of Lidocaine and Prilocaine 2.5 % / 2,5 % Cream to rub on 30 minutes prior to dialysis. I guess it's a numbing cream. I've been using a chest catheter since Dec 28, 2022. It has been no problem, but I can't get it wet in a shower - it'll be good taking a shower again. The surgeon said I'll have to use the fistula a while before they can remove the catheter, though - in case there's a problem with the fistula. Hear we go.
Love this!! How did ur first day with needles go?! 💜 thank u so much for sharing 🤗
@@dialysisnurselindsey - I have to wait till Monday, the day my doc approved me for.
Awesome. Keep me posted please! 😃
Hi I always have problem identifying where the fistula ends n tend to go on tissue I can’t feel the thrill towards the end but I try to avoid the sites people have been cannulating.any tips please thank you for your videos
Hi. My question might sound absurd but is there any way to make the hands feel lighter during the cannulation? Patients said something that my hand is quite heavy.
Also, I feel like I always have trouble with the angle of my cannulation. I do it on 20-30 degrees and patients kinda complained that it is painful. I always feel bad for them and there are times that Im a bit afraid to do it because of their reactions.
How do you identify the anastomosis? Is it where the thrill feels the strongest?
It’s the scar where the incision was made for the fistula
Any more tips for needle removal or ideas on how one would practice please!!!!
Practice on real people. U’ll get it!
I'd say: remove the needle at the same angle as during insertion & don't apply pressure to the puncture site too early! Pushing down too early pushes the needle into the vessel and may cause vessel damage and pain.
So useful topic. What’s is the condition of blood transfusion during dialysis? Can we make it fast flow or just as normal?
Fast! , transfuse pre filter. Always have an access 😃
Thank u
Check your institution's policy and procedures. It differs. In my institution, blood is given post-filter since pre-filter is associated with an increased chance of filter clotting (which would also lead to decreased solute removal).
What is the maximum pressure you would dialyze a patient for AP and VP for AVF and AVG?
What is the maximum pressure you would dialyze a patient for CVC?
Besides checking for kinks in the line what other interventions would you do?
Check ur facility protocol 😊
@@dialysisnurselindseygood answer 😅
Thanks!!!
Nice
Thanks!!!
Hi I’m a newer dialysis tech 6 months in and I need assistance on cannulating to avoid high venous/arterial pressures and how to fix air embolisms. Please help!!! 😢
Have you cannulated a WavelinQ endo fístula AV? your point of view will be interested
I have only heard about these! Have u? What’s ur experience been with it?
Lpn here! I have an interview at a dialysis center for a preceptor position. Do you know what’s expected of an lpn at a dialysis center as oppose to RN? I am going back to school for my RN in the fall I love being a nurse ❤
I’m not sure! Lmk! Congrats on going back to school. Keep me posted. Each state has a different scope for their LPNs 😃
Hi! Im a new tech, im wondering how do you know exactly where to stick? Im having issues understanding what to look for and feel when picking my spot for cannulation because sometimes i get no flashback and its very discouraging. Thank you!
U should feel a pulse, see a bulge when u put the tourniquet on. And the spot should feel spongy.
Do you usually position on the side of the arm while cannulating? Is that easier?
Are you talking about the machine? Thanks!
Hi Lindsey, great video. I want to ask that what is the time duration for removing these tapes after dialysis?
24 hours max
@@dialysisnurselindsey Thank you so much for your quick reply. Actually I am recently diagnose with kidney failure and right now I am on dialysis. 😞
Ur doing great! Lots to learn. One day at a time 🤗
@@dialysisnurselindsey Thanks. If I want to ask anything related to dialysis, can you please help me and what is the best way to contact you?
Nurselindseysippl@icloud.com
I must stress I can provide education but not medical advice 👍
Hello! I am starting my Dialysis Tech Training. Where did you get this practice arm? Is there a way I can get one? My ultimate goal is to become a dialysis nurse! I’d like to practice as much as I can. I have tiny veins. I don’t know know if it’s as hard or painful with a fistula but I know painful it can be so I want to have tons of practice!
Honestly, u don’t need the practice arm, u’ll get to try on a patient soon! Keep on going!! 👩🏼⚕️ ur first needle poke will be such a relief…ur doing great!
@@dialysisnurselindsey Thank you! I love your videos. Please keep them coming! 😀
🥰 u betcha!
hello there I wanted to ask you a question. I am working for a small company and am curious how much training and what specific training one needs before they are ready to safely cannulate? I have only seen 2 as I am in acutes but curious if you have any resources so I can better educate myself. Do you think at 5 weeks on training and that being following another nurse, one is ready to start cannulating themselves or should I watch more sticks before actually doing them?
Just go for it! Cannulate everyone u can! Watching is ok, but I 💯 recommend u start cannulating now 😃
I wouldn't cannulate just anyone. Ask experienced nurses to point you towards patients with easy-to-puncture fistulas. Start out there, and gradually work your way up to more difficult fistulas.
We cannulate the arterial needle first?
That’s what I do!
How do you know exactly where the anastomis is?? Always at wrist ??
It’s a scar near the fistula thrill/Bruit. I always look for the scar 😃
@@dialysisnurselindsey thank you
Ur welcome! 🫂
Great demo! But i think your gauze are not enough for the high pressure fistula. It will be soaked! We use the rolled like a ball sterile gauze.
😂
Why are clamps not used on grafts?
Too much pressure. The Fistula can tolerate more direct pressure
Hi...
I'm Rentu Ali
From Bangladesh
Hello ma'am my mom has been doing her dialysis with the fistula it's been a month but the nurse says she must get bump type something.... can you help me regarding this 😅
Buttonhole?
@@dialysisnurselindsey so how can I get that by doing some arm exercises or how please help
Mam, Which needle is first removed? Artery or venous?
Venous
Why mam?
Easier for the patient to hold the site to stop bleeding 🩸
What web site did you get the training kit?
I borrowed it from my clinic. But I think it was on amazon
fun fact, bruit just means noise in French
Omg that is fun!! Now I know a French word!! Thank u so much!!!!!
are those cleaning gloves?
Haha, yes they are! 🤭
Well explained 👏 , are you still working as a dialysis nurse
U betcha 😃
What do you do when you miss?? I’m a tech and It’s always a hit or miss with me
I ask for help. It takes practice!
I still miss!
👏💗🎉
🥰
The issue is skipping the tourniquet.
Hi Lindsey,
I really like your videos because I am a hemodialysis technician student, however I am also a professional hospital clinical Laboratory Assistant/phlebotomist with thirty years of experience and I think your gloves are too big for you and should be a snug fit for better efficiency.
Thank u!
How to avoid cannulating same spot
Rope Ladder Technique 😉
@@kiarahawley2288 thank u for reply but whenever I go up I can’t see the blood coming so cannulation failed
How do you identify the anastomosis? Is it where the thrill feels the strongest?
Omg I thought I replied to this! I’m so sorry. The anastomoses is the scar from the surgery :)
@@dialysisnurselindsey Actually I think you did reply! My comment was posted twice in error lol. I am now 4 weeks into my training so I have had the pleasure of cannulating fistulas now. I don’t really like it. But, I’m not surprised. I didn’t like starting IVs when I worked in the ED. I just do not like sticking people. Anyway, since I am new to dialysis, I will be spending my first few weeks of training with a PCT. I am already a bit tired of this and I am very, very eager to start training with a RN so I can learn that aspect of the job. But, I understand how important it is for me to fully understand the role that the PCTs play in the dialysis clinic before I progress to learning the role of the RN. So, I am trying my best to be patient.
Yes, I remember my first days of training with the techs and being physically and mentally exhausted. Sounds like ur an empath…u feel the pain of the needles going in ❤️ u’ll be in the RN role soon!!