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Friday, November 5, 2010

Assessing Maturity of a Fistula

Assessing Maturity of a Fistula

Look for signs of infection - redness, drainage or abscess formation
• Look for signs of wound healing of the surgical incision
• Feel for a thrill - it should be continuous and feel like purring or vibration, but not a strong pulsation.
• Feel the diameter of the vessel - it should start growing larger immediately after surgery and the growth should be evident within 2 weeks. Note any flat spots.
• Listen for a bruit - the pitch should be low, and one sound should connect to the next sound.
• After the first week, apply a tourniquet and feel for firmness of the fistula vein; this will tell you that the vessel walls are getting thicker/stronger.
• Dialysis patients should have a post-op visit 4-6 weeks after surgery.
• To cannulate a new AVF, smaller needles (17-gauge) and low blood flows (200-250ml/min) should be used for the first week of treatment.

Wash your hands
• Washing your hands is always the first step before you touch any dialysis access,
• The Occupational Safety and Health Administration (OSHA) requires handwashing and gloves to protect north you and the patient from infections.

Examine the fistula
• You will need to inspect (look), auscultate (listen), and palpate (feel) the access.

Assessing Maturity of a Fistula - Related Hemodialysis Article


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