Tourniquet...to use or not to use

[kporter85db]

I have come to despise the tourniquet. It pulls my hair both when being put on and taken off. Believe it or not, it has become my least liked part of dialysis. I read on here that someone (Obsidianom, I think) didn't use tourniquets. I had filed this information in the back of my mind and decided to try it once I got more experience putting in needles.

Well, yesterday after I finished putting in needles I realized that we didn't put on a tourniquet. Everything went just fine. So I decided to try it on purpose today, and again, every thing went just fine.

Does anybody else not use a tourniquet when putting in needles? Have you had any problems?

[obsidianom]

I have come to despise the tourniquet. It pulls my hair both when being put on and taken off. Believe it or not, it has become my least liked part of dialysis. I read on here that someone (Obsidianom, I think) didn't use tourniquets. I had filed this information in the back of my mind and decided to try it once I got more experience putting in needles.

Well, yesterday after I finished putting in needles I realized that we didn't put on a tourniquet. Everything went just fine. So I decided to try it on purpose today, and again, every thing went just fine.

Does anybody else not use a tourniquet when putting in needles? Have you had any problems?

We havent used a tourniquet in over a year . No problems at all , 5 days per week. If the fistula is superficial and large it isnt necessary.

[iolaire]

I have come to despise the tourniquet. It pulls my hair both when being put on and taken off. Believe it or not, it has become my least liked part of dialysis.

I shave the area around my access every few days.  The tourniquet don't bother me but I'd much rather pull the tape off of skin rather than hair.

[cattlekid]

After a few months, I was starting to have problems cannulating my access.  One night, in a fit of frustration, I tried it without the tourniquet and never looked back.

[talker]

Hmmn, lets see if I got this right. 
Some here are doing the  cannulating / needle insertion using 'only one hand' .!   

 Also I read that circumstances must be 'just so' in order to perform the task with one hand! 

I have what I facetiously call my 'dancing vein' as it moves / dances around when the dialysis tech, endeavors to 'pin' it.   

To those that nail it with one hand. 

talker

[Zach]

I have what I facetiously call my 'dancing vein' as it moves / dances around when the dialysis tech, endeavors to 'pin' it.   

I let my vein "dance" until it gets tired and then I go in for the "kill."
Works every time.
 

[talker]

I have what I facetiously call my 'dancing vein' as it moves / dances around when the dialysis tech, endeavors to 'pin' it.   

I let my vein "dance" until it gets tired and then I go in for the "kill."
Works every time.
 

                                   

 

        


talker

[cattlekid]

You think cannulating yourself one-handed is bad-ass?   

I also used to pull my needles out at the end of treatment one-handed. 

[obsidianom]

Today my wife "forgot' she was being dialyzed . I turned around to check on her and her arm was "missing' . It wasnt on the pillow where it was supposed to be with the needles and lines there. She had taken it and all the lines and pulled it all to the other side of the chair and was typing away with the arm across her chest to the oposite side. I had a quick heart attack and yelled "where is your arm? " I actually thought for a second it had gone MIA.  Thankfully I tape the needles in very heavily so no damage was done except to my heart. It still hurts.
Monday we are getting our new smaller 16 guage short needles . I decided to try going from 15 to 16 guage to make smaleer holes in the fistula. We only run a blood speed of 340 so hopefully it will work ok. (if she doesnt yank her arm out again)
Speaking of tourniquets, I once left one on for the whole dialysis session . It never effected anything. That was the last time I ever used one . That was over a year and half ago. Real smart. At least her arm didnt fall off or get gangrene.

[kporter85db]

I have come to despise the tourniquet. It pulls my hair both when being put on and taken off. Believe it or not, it has become my least liked part of dialysis.

I shave the area around my access every few days.  The tourniquet don't bother me but I'd much rather pull the tape off of skin rather than hair.

I shave where we put in the needles but didn't really want to go all the way up to my shoulder. I was going to, but now I don't have to.

[kporter85db]

Hmmn, lets see if I got this right. 
Some here are doing the  cannulating / needle insertion using 'only one hand' .!   

 Also I read that circumstances must be 'just so' in order to perform the task with one hand! 

I have what I facetiously call my 'dancing vein' as it moves / dances around when the dialysis tech, endeavors to 'pin' it.   

To those that nail it with one hand. 

talker

Not only do I do it one handed, I also can't bend my pointer finger at the first joint on that hand. And over the last year and a half I have lost about 80% of the strength in my hands and most of the feeling due to neuropathy. Both my wife and my dialysis nurse didn't think I would be able to cannulate myself.

I don't think I would be able to do it if I wasn't using buttonholes. I do a slightly modified version of Stuart Motts touch cannulation.

[amanda100wilson]

I self-cannulate and remove needles myself to.  Pulling the skin taught helps stabilize the vein to some extent.

[cassandra]

I do in and out with my 'wrong' hand too. I
I tape above the top button hole to stabilise the vein, and remove it to do the bottom one.
With the sharps I used a tourniquet

[Maggie and Jeff]

We have not use a tourniquet in 6 or 7 years.  No issues yet. 

We have moved to 340 blood flow and 20 liters dialysate 2:30 hours.  #'s are good and Maggie has more energy.

[Angiepkd]

I did home hemo and didn't need the tourniquet. My fistula was large and near the skin, so it wasn't necessary.  No problems doing it this way for a year.  I inserted and removed my own needles. Good luck!

[JW77]

Stopped using one the last time I had to resite my V needle.  Nurse pointed out that with such a mature fistula I really didn't need it.  If it makes my 20 something old fistula last longer then so much the better:)

[dialysisuser82]

Hi everyone,

I am a newbie on this board and I am a bit nervous...

I never use the tourniquet. I insert both needles in the downward direction. I cultivate the fistula evenly meaning that I use alternate puncture sites so in case of infiltration then I still have other options. 

For the venous site I only use saline solution. The arterial site I take Heparin. New staff members or floaters have difficulty time understanding my method. My reason is that the venous site is crucial because of the blood returning. In case of infiltration I am able to continue to re-stick needles without worrying about bleeding (yes, a few times I had 5 needles inserted in my arm). 

Back on the tourniquet and clamps, I personally feel they are dangerous for the longevity of the fistula. When inserting needle, I pull the skin tight with the last three fingers. I do have Carpal Tunnel on both hands -first three fingers. My fistula is 32 years old, i.e. original, intact (the surgeon was from the John Hopkins Hospital). Both my hands can only bend to 90 degrees.

[obsidianom]

I never use a tourniquet . It Isnt necessary in all cases.