Pretty good discovery by accident

[cassandra]

so, I am supposed to be using my new fistula by now, but with a very swolen 'old' fistula arm, I find it very difficult to get even just one button hole established (nystagmus to the left corner doesn't help either but......) . So I had to keep using the old ones, which are getting neigh impossible to use. Ridiculously high venous pressures etc. Then I ran out of 15g bh needles for my old fistula. The arterial was in nicely, but the venous didn't want to butch (sp?)


I was going to use a sharp, but thought: why not try a 16g bh needle first as the box with 16g's had just been 'gathering dust'. And it worked!!! 


Just thought it might be helpful for people not wanting to use sharps when a BH doesn't want to go in. Just use a smaller size bh.


   

[kickingandscreaming]

Luckily, you're knowledgable and experienced enough to punt when you need to punt.   

[cassandra]

Luckily, you're knowledgable and experienced enough to punt when you need to punt.   

      Love you

[PrimeTimer]

That's great, Cassandra! Thanks for sharing that tip with us! Also glad to hear of your new fistula...had been wondering. It's great that no matter what you never let anything stop you. You really do have a great attitude. Thanks for the inspiration.

[jambo101]

 Ive been frequently hearing the term "button hole"  mentioned, can some one describe what the term means? thanks

[cassandra]

A button hole in an [size=78%]AV Fistula (Arterio Venous) fistula is made by sticking sharp needles into the same hole, same angle, same needle. When established you can start using blunds (which can't infiltrate the fistula, so you can 'use' your arm too. I found this:[/size]

The buttonhole technique is a way to "cannulate," which means "to insert dialysis needles." Instead of sharp, pointed needles, dull needles are placed into the exact same holes on your fistula every time you have dialysis. Inserting the needles in the same holes creates a "tunneled track" for the needle. - https://www.kidney.org/atoz/content/buttonhole-technique












Sp mod Me

[Simon Dog]

"cannulate,"

Term used because dialysis staff are trained not to use the words "stick" or "puncture".

Just use a smaller size bh.

The downside is the lower bax blood flow rate.  At my clinic it was 450 for 15ga; 350 for 16ga and 250 for 17ga.

[cassandra]

.......

Just use a smaller size bh.

The downside is the lower bax blood flow rate.  At my clinic it was 450 for 15ga; 350 for 16ga and 250 for 17ga.

That's true, but better than no session at all 😇