I am sooooo mad
I had to vent! Have you ever heard of such a thing??. We have a new pt (6 weeks on dialysis) had a fistula and tunneled cath placed 6 weeks ago. Had a hypoglycemic episode that sent her to ER and after trying
to find an access the nurses told her they would have
to use her fistula. Fortunately, her son is an RN and told them they most deffinately would NOT
use her fistula. The son left his mom briefly and when he returned, the ER doc had started an IV in her fistula!!!
The son was livid and immediately DC'd the IV and told them to try again elsewhere! Then low and behold they WERE ABLE
to start the IV in her other
arm! ARRRGHH!!! The fistula is not even
mature yet and this guy(idiot) has threatened her life line!
How do you handle these situations in a professional manner when you would love to choke these people?!
I apologize for my harsh words in advance, but I have seen tooo many infections, dead grafts in pt's I have grown to love as family. I know too that all of you dialysis staff have seen it too!
Apr 17, '04
Well, if... IF
it's a life threatening situation, and no other means is working to establish a line, use any and everything. If not, then leave it alone !!!
Six weeks is usually good enough to start using a fistula.. (at dialysis).. should be about mature by then... the average is about six weeks.
My question is did they know which end of the fistula to access... the upper part (venous)..? If they cannulated into the lower arterial site (and how would someone not familiar with dialysis know where in a fistula to stick, right?)... then that tiny gauge needle could well have been blown right back out by the pressure of the fistula itself ! Can you see it? Needle, blood flying everywhere... :uhoh21:
I prefer them to use the fistula than mess with their cath, however.
At our ER up the road from our clinic, if we have to send them one of our pts. for an emergency, of course we leave the lines in, attach a syringe on one to cap the end, and leave saline running in the other... well, when the patient has stabilized in ER, they always call one of US to drive up there and pull the needles and hold the sites... they say they don't know how.......????
So no matter how busy we are at the time, one of us has to go up there and perform this majorly difficult task..
I understand the protectiveness, though. I feel the same way about my patients and I always hope when they're in the hospital for anything, that their lifeline is still intact, and they remain infection free.
Last edit by jnette on Apr 17, '04