Patient
CARE
At Dialysis Access Center of Boardman, our unwavering commitment is to prioritize our patients above all else. This dedicated section is crafted to provide valuable care information and resources tailored to enhance the well-being of those under our care. Your health and comfort are our foremost priorities.
Access Care Instructions
It is important that you take care of your access so that it can give you the best
dialysis treatments
possible.
Warning Signs
to Watch For
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Your dialysis caregivers are having difficulty inserting the dialysis needles into your access
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Frequent machine alarms during your treatment
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Increased bleeding time after dialysis or bleeding that restarts after it has stopped
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Development and/or increase in the size of localized bumps on the skin surface over your access
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Decrease or loss of the buzzing that you feel when you place your hand on your access
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Swelling of or increased pain in your access arm
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Pain or cold feeling in your hand or fingers
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Signs or symptoms of infection, including redness, swelling or drainage
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If you detect any these changes in your access, please notify your kidney doctor and/or dialysis caregivers.
Daily Access Check
Three Easy Steps!
(For Fistula and Graft)
LOOK
LOOK at your access for signs of infection or skin changes.
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See that the access is not red or swollen and that there is no drainage.
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Be sure that the skin is not thin or shiny over aneurysms (bumps), if any are present.
FEEL
FEEL your access by placing your fingertips over the access.
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The pulsation is called the THRILL. It should have a soft running feel.
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if it feels hard or beating, it is not normal and may mean there is pressure inside the access.
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LISTEN
LISTEN to your access using a stethoscope.
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The "whooshing" sound you hear is called a BRUIT (broo-ee). It should be a low-pitched, continuous sound.
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A high-pitched sound or whistling noise is not normal and may mean there is a narrowed area in your acess.
Notify your kidney doctor and/or dialysis caregivers
if you detect any changes in your access.
Daily Access Check
(For Catheter)
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Ensure your catheter dressing is intact, clean and dry at all times.
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Be careful not to snag the catheter on clothing or other objects because it can be pulled out
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Thoroughly wash your hands before touching your catheter and dressing
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If your catheter moves around or becomes caught in clothing use tape to attach it to your skin
The signs and symptoms of a catheter infection include:
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Fever of 110.5 or greater, or chills
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Drainage from the catheter exit site
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Redness or tenderness around the catheter exit site
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Do not remove any stitches (sutures).
Your dialysis team knows when to remove to make sure that the catheter is secure.
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Call your Nephrologist (kidney doctor) or dialysis unit if you see any sign of infection. Signs and symptoms of a catheter infection include fever, chills, drainage, redness or tenderness around the catheter exit site. Also report dry skin, rash, or irritation at the site.
What to Expect
A Visit to the Access Center
The early detection and timely intervention of access dysfunction is critical to access preservation. Dysfunction can occur in any type of access. One could experience infection, inadequate flow, unacceptable arterial and/or venous pressures, stenosis (a narrowing in an access), thrombosis (clotting) or an aneurysm (a bulging or "bump" in the access).
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The following procedures are done in the access center to maintain optimal access function when an indication for evaluation is detected:
An angiogram is a picture of the inside of the fistula or graft using x-rays. A local anesthetic is used.
A small needle is inserted and dye is injected while x-ray pictures are observed to identify whether an additional procedure is needed.
An angioplasty is performed if a stenosis was observed on the angiogram. A local anesthetic and possibly IV sedation are used. A small catheter with a balloon at the tip is inserted and inflated to stretch the narrowed area. The balloon is removed at the end of the procedure. Sometimes a stent
(a metal piece of mesh) is needed to support the vessel walls to keep the access open. The stent will remain inside the fistula or graft and does not move.
A thrombectomy is the procedure performed to restore blood flow to a clotted access. A local anesthetic and IV sedation are usually used. The physician may use medications or devices to break up clots and to sweep and suction the clots away.
A catheter placement is the insertion of a tunneled cuffed hemodialysis catheter. A local anesthetic and IV sedation are used. The catheter is placed in a vein in the neck (sometimes in the groin) to obtain access to the bloodstream. A tunnel is created under the skin and leads up to the point where the catheter exits the body.
A catheter exchange is performed to improve blood flow or when there is an infection present. A local anesthetic and possibly IV sedation are used. The cuff is loosened and a wire is advanced through the catheter. The old catheter is removed and a new one is placed over the wire.
A catheter removal is performed when the catheter is no longer needed. The catheter exit site area is numbed using a local anesthetic. Once the cuff is freed from the tissue, the catheter slides out of the tunnel and removal is complete.
Vessel mapping is performed prior to fistula or graft placement. This procedure measures and evaluates arteries and veins for successful vascular access creation. Testing may include an ultrasound and venogram (IV x-ray of veins). A venogram requires insertion of an IV and injection of a small amount of dye.
Your dialysis access is often called your lifeline. A well-functioning access is necessary for effective and efficient hemodialysis treatment. The doctors at Dialysis Access Center are dedicated to helping you maintain a healthy vascular access.
AV Fistula
A fistula is a natural type of vascular access where your own vein is surgically connected to an artery. The increased blood flow through this connection causes the vein to enlarge and the vein walls to strengthen.
General Rules of Access Care:
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Keep the skin over your access clean
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Avoid sleeping on your access arm
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Protect your arm from injury
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Don't put pressure on your access arm
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Don't let anyone take your blood pressure in your access arm
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Don't let anyone draw blood or start an IV in your access
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Wear loose clothing and avoid jewelry over your access
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Only use your access for dialysis
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Apply gentle pressure to your access after dialysis needles are removed (too much pressure can stop the blood flowing through the access)
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Check your access daily
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Your dialysis access is often called your lifeline. A well-functioning access is necessary for effective and efficient hemodialysis treatment. The doctors at Dialysis Access Center are dedicated to helping you maintain a healthy vascular access.
Graft
A Graft is usually a soft synthetic tubing with one end surgically connected to your artery and the other end to your vein. A graft acts like a vein allowing blood to flow through it.
General Rules of Access Care:
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Keep the skin over your access clean
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Avoid sleeping on your access arm
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Protect your arm from injury
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Don't put pressure on your access arm
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Don't let anyone take your blood pressure in your access arm
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Don't let anyone draw blood or start an IV in your access
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Wear loose clothing and avoid jewelry over your access
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Only use your access for dialysis
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Apply gentle pressure to your access after dialysis needles are removed (too much pressure can stop the blood flowing through the access)
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Check your access daily
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Your dialysis access is often called your lifeline. A well-functioning access is necessary for effective and efficient hemodialysis treatment. The doctors at Dialysis Access Center are dedicated to helping you maintain a healthy vascular access.
Catheter
A catheter is a hollow tube that allows blood to flow in and out of your body. It's inserted into a large vein, usually in the neck or groin. Part of the catheter lies outside of the body. The internal tip floats in the top chamber of your heart.
Caring for Your Dialysis Catheter
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Do not shower or get the catheter wet.
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When bathing or coming in contact with water, cover with plastic wrap and tape to create a strong seal.
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Do not submerge in water (swimming pools, hot tubs) until the catheter is removed and the skin has healed.
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Only healthcare professionals should touch the dressing or catheter device​
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Do not pull, bend, poke, or pinch the catheter
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Do not remove the dressing.
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Do not remove any stitches (sutures) . Your dialysis team knows when to remove to make sure the catheter is secure.
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Do not take the caps off.
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Do not use sharp objects around the catheter (scissors and knives)
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Do not let pets and small children near the catheter service area.
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Do not ever inject anything into the catheter/catheter tubing. It is for dialysis only. This could be fatal.
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Do not touch the open end of the catheter when the caps have been removed by a nurse or dialysis technician.
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Call your Nephrologist (kidney doctor) or dialysis unit if you see any sign of infection. Signs and symptoms of a catheter infection include fever, chills, drainage, redness or tenderness around the catheter exit site. Also report dry skin, rash, or irritation at the site.
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Note: There may be some oozing of blood from the site for several days after the catheter placement. If there is a lot of blood, or if the site keeps bleeding, call the doctor.
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*If alternate instructions have been provided for your particular catheter, refer to those directions and instructions.
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IMPORTANT!
If Your Catheter Dressing Gets Wet, Loose, or Soiled
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Keep an Emergency Kit:
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Clean gloves (several pairs)
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Large individually wrapped alcohol wipes
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A transparent dressing, individually packaged sterile gauze and/or large bandage (individually wrapped)
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A roll of medical tape (silk, paper, or transparent)
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Other supplies as needed:
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Before touching the dressing, wash your hands for 15 seconds with liquid antibacterial soap. Dry thoroughly using paper towels. If the problem is just a partially loose dressing, do not remove it. Place a large bandage or sterile gauze over a loosened dressing. Secure with tape.
If your dressing is wet, dirty, or is coming off, carefully remove it and:
1. Clean the area in question with alcohol wipes.
a) Cleanse vigorously, in sections 4 x 5 inches in size, for 30 seconds using an up-and-down or side-to-side motion.
2. Allow the area to dry for 30 seconds.
Inspect the area around the site for any sign of infection (redness, swelling, drainage, tenderness, warmth, or odor).
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Check the entire chest area for new or prominent veins, rash, change in color, or swelling.
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Cover the site with large bandage or sterile gauze and secure with tape as needed
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Tape the catheter tubing to your skin to prevent the catheter from dangling or catching on loose clothing
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Go to your dialysis center as soon as possible.
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