Holding Your Own Gauze After

[PrimeTimer]

This is not really a complaint but does concern me. My husband does home-hemo but because he is very anemic (had a fistula bleeding problem during recent hospital stay), he is having to go in-center for about a month or until his Hemoglobin is back up to an acceptable level. Here's my question: is it standard for a center to have a patient hold their own needle sites after treatment? Would they take offense if I were to ask them to make sure someone holds my husband's needle sites for him? My concern is blood loss. I don't care about blood stains but I am very concerned about his hemoglobin.

[Simon Dog]

Your best bet is to talk to the RN in charge of the clinic when he goes in for processing.

[iolaire]

In my center if you do not hold yourself they use clamps.

[Michael Murphy]

In my center no clamps, studies show use of clamps damages fistulas.  Patients are asked to hold if they are able, one at a time., since if you are having problems two is one to many.  If staff has to hold putting on or taking off has priority so the whole procedure takes longer.  The patients I have seen complain are the ones who try to answer their cell phones while holding.  I have seen more blood then in a slasher movie when that happens.  Realize taking a staff person to hold you means that other patients are not getting the attention they deserve. When a patient that has real problems holding they are scheduled differently to avoid conflicts when staff is tied up.  Not every one can hold, but if you can it's healthier for your fistula and fairer to other patients if you have a real problem then the staff will help.  The need to answer the cell however is not a real problem.

[Vt Big Rig]

And he is anemic. I have no experience in center but I'm told they see a lot of leakage with clamps. In addition to the possible fistula damage.

[iolaire]

My center says clamps are bad but use them if you can not hold.  I'd hate to have to wait for them to hold people's bandages.  When a arrive there usually two or so chairs out of the four with people in clamps (the rest are gone).


RE: Simon Dog's next comment

From a limited sampling I've seen, it appears that Fresenius does not allow techs to use personal cell phones while on duty but it is a way of life at DaVita.  Not sure if this is corporate wide or just what I have seen in a limited sampling.

At my DaVita center they have their phones but do not use them on the floor.  You might hear it ring or beep but they do not use it.  I do think they use it at the nurses station desk and sometimes someone will clean their phone on the floor.  I'm sure the DaVita rules are enforced by the nurse or the center's administrator.

[Simon Dog]

The need to answer the cell however is not a real problem.

Plus, if the staff is holding your sites they cannot answer their cell phones.

From a limited sampling I've seen, it appears that Fresenius does not allow techs to use personal cell phones while on duty but it is a way of life at DaVita.  Not sure if this is corporate wide or just what I have seen in a limited sampling.

[PrimeTimer]

When we are at home I'm the one who pulls the needles and holds the gauze, so he's not use to doing that altho he often asks if I want him to. Maybe it would be a good idea for him to learn just so he can get a feel for it. ??  Takes a while to "get the touch" so to speak and that way, if he ever has to go back in-center like he is having to do right now, he will have a better idea of how to do it. He's not afraid and he's not frustrated over it, I'm the one who is concerned because whether it's a little or a lot, I don't think he can afford to lose any more blood. He lost a lot of blood in the hospital...hemoglobin was 10.5 and went down to a 6. They had to give him 2 units of blood. Blood stains on pants -no big deal. Pants are cheap. It's my husband who is priceless and irreplaceable. 

As for clamps -unless absolutely necessary, I say no way to that. In fact, I've even learned not to "mash down" on his needle sites just to avoid putting unnecessary pressure on his fistula. I think the Australian nephrologist Dr. John Agar once wrote about not flogging the fistula with too high of a blood flow rate or mashing down on it when holding gauze.

[Michael Murphy]

I did not write very clearly, the phone answers every time I have seen it happen were the patients.  Also two of the patients who I saw complained about holding. 

[Simon Dog]

hemoglobin was 10.5 and went down to a 6. They had to give him 2 units of blood.

I've recovered from an HGB of 6.2 twice with no blood.  Fortunately, the head of hematology at the hospital I used understood the reason for avoiding it in my case and worked closely with the docs who were primary on my case to lend his support for "riding it out".

[Hazmat35]

at our center; the patients are encouraged to hold their own sites after the needles are pulled.  However; if they cannot hold them because of some sort of disability or physically unable to do so; then the Tech that takes the needles out; will hold the site until it has clotted and can be tapped up. 

You are the patient (our your husband is) and your in charge of your access; so if YOU want them to HOLD it....it is up to them to follow your directions.  I would say ask them to hold it for your husband. 

[iolaire]

Would they take offense if I were to ask them to make sure someone holds my husband's needle sites for him?

I would hope that they encourage you helping after the needles are pulled... A new pair came in a few months ago and the son has been holding for the mother everyday.

[cassandra]

When we are at home I'm the one who pulls the needles and holds the gauze, so he's not use to doing that altho he often asks if I want him to. Maybe it would be a good idea for him to learn just so he can get a feel for it. ??

Dear PT I would definitely start to let him hold his sites. It's just that little feeling of control, and of helping you too.

Love, Cas