Dang,it happened again!

[pdpatty]

They put two needles in my arm yesterday for first time. Tech said he didn't understand why the second needle was a 16 but that was what was on paper. Everything went well until the tech started to take me off. She set me up and it was the most horrific pain in my arm and it started to puff up. I told her I was bleeding out or something was leaking out but she said she had stopped the flow. Well arm kept hurting MORE and getting bigger . She just kept saying she had never seen this before. Finally she gets the nurse.
The needle had went thru the vein before she pulled it out.
Arm swelled up to 25 inches around it.
Back on cath for few weeks but I now am scared to death to be stuck again. Arm is swelled from elbow to shoulder and I cannot raise it because of the pain.

[kidney4traci]

OMG!!! How horrible for you.  I have had similar experiences, man I swear you would think she would have yanked that out as soon as the pt was complaining that it hurt and there was swelling. HELLO!! Sorry, but wish you quick healing.   

[kellyt]

OUCH!   That sounds horrific!  Good luck at your next session.     

[migaguiar]

do you guys think the tech should be fired for that?
The flow might have been off but it was obvious you were bleeding inside.
I know if i were to sue or complain about every inncident i wouldnt have anyone to work on me.
And where im at i have nurses working on me not techs.
Its very frustrating.

[twirl]

so sorry

[paris]

I am sorry this happened. It sounds extremely painful! 

[monrein]

That must really hurt.  And for that to be your first needling experience is awful.   

[paddbear0000]

do you guys think the tech should be fired for that?
The flow might have been off but it was obvious you were bleeding inside.
I know if i were to sue or complain about every inncident i wouldnt have anyone to work on me.
And where im at i have nurses working on me not techs.
Its very frustrating.

Geez! I figured out that you were bleeding inside before you even mentioned it! And I'm not even on dialysis! What an idiot. I hope the pain goes away soon. 

[Hemodoc]

Dear pdpatty,

What happened to you is called an “infiltration” where the needle passes through both sides of the fistula and sometimes into the underlying tissues.  I’m sorry, but an experienced tech should have recognized that when it occurred simply by the pain and especially with the swelling.  Once the needle is removed, pressure over the site would have prevented such a large hematoma.  I have only had one infiltration and they do indeed hurt.  Be very careful on how much you move your arm with the needle inside.  Some people have more room to move than others.  My own fistula is a brachiocephalic fistula in the upper arm and I can only bend it a few degrees, but I have learned to keep it still for the most part.

I would strongly advise while your arm is healing that you look into Home Dialysis Central kidney school school and learn what you need to know about your fistula and how to protect it. 

There are three things specifically that you should consider.  First, never use clamps on your fistula.  The amount of pressure needed to stop the bleeding once the needle is removed is actually not much.

Second, the technique for removing the needles that I use is to pull the needle part way out IN THE SAME angle as it was inserted.  You should not feel any pain on removal.  Then place the band aide over the site and free up the needles wings from the band aide.  Then tape in place the folded gauze with a light pressure over the area before you pull the needle out.  I now pull the needles myself and my wife puts pressure on the gauze after the needle is out. (My wife doesn’t have to touch the needles at all which is easier for her to handle)  We get a little bit of bleeding sometimes, but not much.  I do not feel any prick or cutting doing it myself.  Many techs do not pay attention to the angle going out which can damage the fistula as well.

Third, you should be using a small gauge needle until the fistula has developed.  I used 17 ga needles for about 2 months before going to 16 ga and then 15 gauge after 3.5 months.  I had a supreme tech who never missed.  She was simply talented in her job.  I would recommend that you ask around who is the best tech and then insist on using her while you are learning how to do this for yourself.  You must learn to protect yourself.  You may be called difficult or demanding but you live or die on whether you have a mature and well functioning fistula.  Unfortunately, some techs are very talented and others are not.  For your own protection, get the best especially while your fistula is maturing.  The best way to protect your fistula in the long run is to learn how to self cannulate through a buttonhole. The fistula must be mature enough for a 15 ga needle before starting the buttonhole.

May God bless,

Peter

http://www.heartlandkidney.org/community/pat_newsletters/putting_u_in_fistula.pdf

http://www.fistulafirst.org/patients/using_needles.php

http://www.kidneyschool.org/index.html

[thegrammalady]

the first thing i would do is never let that tech near you again. she should have known what had happened. is she new??? second if something like that ever happens with another tech start yelling for the nurse right away. you have rights, use them. it's a good thing you still have your cathetr, they will not be able to use the fistula till the swelling in your arm goes down.

i'm very sorry this happened to you, hope you feel better soon.

[flip]

I feel for you. I had a bad infiltration on my first dialysis visit. Now, I haven't had one in ages (except for the day I let a newbie stick me).

[kidney4traci]

I agree with doc, self canalization is best, and with a buttonhole you really don't have to worry about infultration, the needles have a beveled edge to help prevent those nasty sticks.  Lots of ice and protect your site. 

[okarol]

OUCH! 

[JasonEb]

Yeah, I used to get infilitrated a lot my first six months on dialysis or so (not trying to scare you...I think it was more the people working there than anything wrong with me).  I just started not letting the people who did a bad job stick me anymore.  Eventually I found 2 or 3 that always did a capable job, and just used them.  Even today, I have a couple preferred people that work on me over anyone else.

~Jason E.

[Bajanne]

That was awful!  Thankfully, the nurses listen to us/me.  If I feel the slightest stick when the needle is in, I speak up and they know to pull it back and try another angle.  I have never been badly infiltrated.
By the way, when it comes to taking out, I rate my nurses.  I know the ones that will remove it with no pain at all, those with a little discomfort and those that give me a good hurt as the needle comes out.

[pdpatty]

It has been 5 days now and my arm still hurts just as bad. It feels like it is in a vise. It still has the big tight bump on it. I hurt when I move and when I don't move.
How long will it hurt like this?
I must have bled out a large amount fot it to have swelled up and turned a black as it is.

Wonder if a heating pad(moist heat) would be a good thing to try now.

[Hemodoc]

Yes, most doctors would recommend moist warm heat, caring on keeping it not too hot, and elevation (keeping it above the level of the heart.  Simply placing a couple of pillows under it while sleeping should be enough.)  Sorry to tell you but it will be a good 2 or sometimes three weeks before it resolves.  If you develop numbness below the swelling or pain and weakness in the muscles in the hand or forearm, you need to see your doc right away.  Otherwise, warm packs and elevation is what you should consider doing.

We will pray that you heal soon.  But, yes, once you have blood around the muscle sheaths, then the inflammation it causes is quite painful.  It actually takes only a small amount of blood to do that.

Peter

[jamoman]

Sorry for you, I would use your cath for a week till swelling & pain go down before trying to use fistula again. Same thing just happened to me 2 weeks ago. doesn`t infiltrarion sound so much better than OOPS I missed.

[monrein]

I call it "blowing the vein" and it really hurts sometimes.