Blood Flow rate (Fistula)

[Amanda From OZ]

Hey

i was wondering what blood flow rate most of you run at??

Interested to know

[angieskidney]

I thought this was already covered in a post? But I can't find it in search ...

Anyway, my fistula is still pretty new (keeps blowing 20 times out of 30) but mine has run max 400.


Oh I found it now!! Here it is!

[scyankee]

My fistula is so fragile that I can only run at 300 on #17 gauge needles. I am coming up to
10 months of dialysis.

[Zach]

What do you folks mean when you say your fistula "Blows"?

I use a pump speed of 425
15 gauge (blue) needle for the arterial (fistula), pressure -250-260 (I stick this one myself)
16 gauge (green) needle for the venous, pressure 260

I guess my pressure numbers are high compared to most of you folks.     

Maybe it's because my hematocrit is 41% ... and of course my preference for a smaller needle in my venous site.

[angieskidney]

What do you folks mean when you say your fistula "Blows"?

well, I am not sured I am using the correct term....

All I know is that they stick me and suddenly I get a huge goose egg... and they have to poke a new spot... and I end up with a nasty bruise sore arm .. 

[Zach]

Yes, I now know what you mean.

That's usually caused by needle displacement or infiltration, in which blood leaks out of the vein under the skin.

Sometimes it happens because the vein is small and not matured.
Sometimes it happens because the patient moves the arm too much.
Sometimes it happens because the needle was inserted incorrectly by the nurse or technician.   

I couple of years ago I started a new venous needle spot.  Almost every dialysis session the technician infiltrated me ( I insert my own arterial needle, but not the venous ).  I went to the vascular surgeon and instead of cutting me open, he looked at the area with a Doppler Sonogram (non-invasive).  The problem was not the vein (although all the technicians claimed it was).  It was just deep and also it would compress easily.  So the surgeon's answer:  Use a tourniquet and angle the needle at 45^o until they "feel" the pop into the vein.  Since doing that way, I've never had an infiltration again!

[angieskidney]

Yes, I now know what you mean.

That's usually caused by needle displacement or infiltration, in which blood leaks out of the vein under the skin.

Sometimes it happens because the vein is small and not matured.
Sometimes it happens because the patient moves the arm too much.
Sometimes it happens because the needle was inserted incorrectly by the nurse or technician.   

I couple of years ago I started a new venous needle spot.  Almost every dialysis session the technician infiltrated me ( I insert my own arterial needle, but not the venous ).  I went to the vascular surgeon and instead of cutting me open, he looked at the area with a Doppler Sonogram (non-invasive).  The problem was not the vein (although all the technicians claimed it was).  It was just deep and also it would compress easily.  So the surgeon's answer:  Use a tourniquet and angle the needle at 45^o until they "feel" the pop into the vein.  Since doing that way, I've never had an infiltration again!

They feel for it and I can even feel the pop and my fistula is near the surface .. I think my problem is just that my fistula is so snakey and also narrows in an awful lot of places It seems to "blow" in the same area .. I am going to tell them today (I have dialysis in an hour and a half) to avoid that area at all costs. I am getting a fistulogram in 1 weeks time. Is a Fistulogram invasive??

[Zach]

I am getting a fistulogram in 1 weeks time. Is a Fistulogram invasive??

I've never had one, but I believe they inject dye into the fistula to see if there is any narrowing of the vein. Many patients at my center have them done, so it's pretty safe.  You shouldn't worry.  But it is considered invasive.

[Bajanne]

There was already a thread on this subject, and it has a poll as well.  check it out - http://ihatedialysis.com/forum/index.php?topic=895.0