Pulling needles.

[Jay72]

I was just wondering, any of you that do home hemo, do you pull both needles at the same time or do you pull one and hold it then pull the other and wait another 10 minutes?  I find by the time I am done I just want to finish, not have to hold for 20 minutes all together.  Please let me know how you go about doing it, and by the way I don't have a clamp I can use.

Thanks for the input,

Jay

[monrein]

I hold both at the same time Jay.  I pull the venous needle and press down with my index finger on it then pull the arterial and press with my middle finger.  I like to make sure I'm not leaking before putting on my bandages.  Ten minutes would be my maximum holding time.  I've never used a clamp and have been strongly advised not to as they can shorten the life of the fistula.  Many do use them however.

I forgot to say that I use a gauze pad to press down with, just in case anyone thought I meant with my bare finger.

[Meinuk]

Jay, we some of this when I was training on NxStage in a post here  http://ihatedialysis.com/forum/index.php?topic=5229.msg83201#msg83201

Currently I:

pull the venous out 1/2 way, then sure seal, then pull the needle completely then wad a 4x4 and tape over the buttonhole & hold

Then do the same with my arterial. 

I actually don't have to hold for very long because I usually clot quite quickly.

[petey]

I pull both of Marvin's needles at the same time...well, not EXACTLY the same time.  I have a folded gauze ready, then pull the venous.  I pull it about 1/2 to 2/3 out then apply pressure with the gauze as I'm totally removing the needle.  Marvin and I "swap" the hold and he puts his thumb on it.  I get another gauze, fold it, and pull the arterial.  (Same quick method of gauze on top, quick pressure.)  Then, we switch again and Marvin holds this site with his index finger (same hand that thumb's holding the other site).  He sits there for about 10 minutes with his thumb and index finger holding the two sites at the same time.  While he's doing this, I "break down" and clean his machine.  When I'm done with clean up, I check first one site and then the other to make sure they've clotted and put band-aids on each.  This method works for us; however, when Marvin had surgery in late July on his other arm (the one he "holds" with), I had to do all the holding for him while his sites clotted.

[G-Ma]

We do venous first on mine and clots rather quickly and a couple min after that we do arterial but it goes on 10 min so don't know if it's because I'm still pressing down on venous or not.  Wish me luck I think I'm going to start self canu tomorrow.....trainer is afraid cuz I REALLY roll.....why didn't the Dr just stitch it in place? 

[Ang]

when  i  trained  for  home  haemo(did'nt  pass) i  used  to  watch  the  people  who  came  in  pull  their  needles  out  with  their  teeth
imagine  it,put the  tube  between  your  teeth,pull  the   needle  and  cover  with  gauze.
   if  you've  never seen  it  before

[del]

I ditto Petey's method!!!  We were also told not to use a clamp because it cam damage the fistula.  Is your wife available to help you pull the needles Jay??  Just takes some practice to do it on your own.

[Bajanne]

I know that this is to do with home hemo, and I am in-center, but we have the choice of both or one at a time (venous always first).  I would love to do both, but I find I never am able to hold both properly.  Sometimes when I am racing against time, the nurse would try to let me hold both, but she usually ends up having to hold one for me.  My venous stops very quickly, but the arterial always takes a long time.  Once a month or so ago, it took over an hour to stop.
They always put a sureseal and then gauze.

[jbeany]

I only do one at a time - doing both tends to get messy.  I've got small hands, and I have a hard time stretching to cover both sites.  My hand ends up cramping up from trying to stretch that far, and then I end up off center and bloody!

[G-Ma]

Well, today I did my own cannulation and pulled the needles, did great on both..yipee...was holding and so proud of myself that I must have loosend my hold and yesireeee bob..........so much for good job......another day tomorrow.

[flip]

Good job, G-Ma.  I'm still working on my clamping technique (when I get a nurse that will let me). You don't have to hold them and you can do both back to back. Much less time.

[G-Ma]

That was the first thing I looked for when I started at NXSt and I was beat soundly with a stick.......I feel a clamp would not be as dangerous as a tourneqet used incorrectly...but who the h_ _ _ am I??   

[del]

Hubby doesn't use a tourneqet since I started needling him.  He just holds his arm with his hand.  He has started putting in his own venous needle with me holding his fistula!! 

[G-Ma]

yahoo dels hubby and del.