Question: access flow test with blunts in buttonholes

[angieskidney]

Question: access flow test with blunts in buttonholes

I have always gotten good results with the monthly Access Flow Test they do on the fresenius 2008K HD machines in my dialysis unit, but this month was the first time with me using blunts in my buttonholes.

The arterial kept alarming even when we flipped the needle! She had to turn the pump speed down below 300 that the test asks for it to run at. The nurse said that it was the reverse test that it didn't like. So I have good flow normal but when they reverse the lines for the test it freaks out.

Can anyone elaborate on this some as I am still tryin to learn about allt his.

I usually get over 900 access flow rate when I had sharps in and wasn't doing buttonholes.








EDITED: Thread moved to proper section. The section this was originally in was "Dialysis: Centers" that section is for threads about dialysis centers. - IHD Moderator

[Epoman]

Sounds like it was just a case of positioning that is all. I get good flow rates. In fact I even hooked up my lines reversed one time by mistake and ran my whole treatment and didn't even realize until at the end of the treatments. I got the usual flow rates. On my last flow test I scored 900+ as well, however I used to score 1,200+  But again several factors come into play with those tests, INCLUDING operator error.

The needle being "Blunt" is not going to affect the flow pressures, are you using the same gauge needles? For example did you used to use 15g sharps, and now are using 15g blunts. They are the same needle however one is sharp and one is not.

- Epoman

[angieskidney]

Sounds like it was just a case of positioning that is all. I get good flow rates. In fact I even hooked up my lines reversed one time by mistake and ran my whole treatment and didn't even realize until at the end of the treatments. I got the usual flow rates. On my last flow test I scored 900+ as well, however I used to score 1,200+  But again several factors come into play with those tests, INCLUDING operator error.

The needle being "Blunt" is not going to affect the flow pressures, are you using the same gauge needles? For example did you used to use 15g sharps, and now are using 15g blunts. They are the same needle however one is sharp and one is not.

- Epoman

Yes I am using 15gauge blunts. We even flipped the arterial blunt but that didn't help. A 15g sharp in the blunt gave good results last month. That is why I was wondering why the blunt would make a difference. Do you think maybe I have scar tissue in the way?

I have also noticed that where the needles sit in my fistula it is bigger (the fistula) where as the rest of the fistula is all small. Why is that? Does that affect flow?

[jedimaster]

Same here as EPOMAN...once I switched the accesses by mistake, no problem. It has to do with the needle's position...some days is excellent and some days is not...then the alarms drive you crazy...but nothing else....don't worry that much...you are almost there!

[angieskidney]

Same here as EPOMAN...once I switched the accesses by mistake, no problem. It has to do with the needle's position...some days is excellent and some days is not...then the alarms drive you crazy...but nothing else....don't worry that much...you are almost there!

Even if this only happens during the access flow test in the 2nd half of it when they reverse it? That is the only time it kept alarming over and over. Had to turn the pump speed below 300 when my normal speed every other day is 400.

[Epoman]

Same here as EPOMAN...once I switched the accesses by mistake, no problem. It has to do with the needle's position...some days is excellent and some days is not...then the alarms drive you crazy...but nothing else....don't worry that much...you are almost there!

Even if this only happens during the access flow test in the 2nd half of it when they reverse it? That is the only time it kept alarming over and over. Had to turn the pump speed below 300 when my normal speed every other day is 400.

It could have been operator error, the connection of the sensors are very sensitive. I will say it again, the needle tips being "blunt" have nothing to do with the outcome of the test. See what the results are next month and if there is still a problem then worry. 

- Epoman

[angieskidney]

Same here as EPOMAN...once I switched the accesses by mistake, no problem. It has to do with the needle's position...some days is excellent and some days is not...then the alarms drive you crazy...but nothing else....don't worry that much...you are almost there!

Even if this only happens during the access flow test in the 2nd half of it when they reverse it? That is the only time it kept alarming over and over. Had to turn the pump speed below 300 when my normal speed every other day is 400.

It could have been operator error, the connection of the sensors are very sensitive. I will say it again, the needle tips being "blunt" have nothing to do with the outcome of the test. See what the results are next month and if there is still a problem then worry. 

- Epoman

OKay thanks

I didn't think them being blunts mattered but I was wondering more about the flow .. so yes placement does make sense. But since they are buttonholes they will be placed the same most likely next month as well right? Any suggestions for next month? How do I know how to rectify this problem (if it even is a problem - the nurse said my numbers will still good).