So How Long Does the Misery Last?

DeLana_RN, BSN, RN · Jan 3, 2007

Well it can, and has, there were two exsanguinations in the last couple of months in the USA (not sure which states) although they were not from flipping the fistula needle. They were both buttonholes that went all the way through (don't ask me how) and the patients bled out at home. I don't have all the details, but I know it happened, kid ya not! Scary huh?

Indeed... do you have any further info on these cases? A quick Google search turned up nothing (of course it might not).

Of course, arterial bleeding that cannot be stopped (as from a dialysis access that has ruptured, which may very rarely happen during cannulation) is always an emergency. I have also heard of cases where bleeding occurred at home while patients were asleep and/or unable to call 911 and therefore exsanguinated.

DeLana

hemorn1 · Jan 4, 2007

My SW and QI Director were discussing the case. It didn't happen in my network, so I don't have any more details. I've heard a lot of dialysis horror stories, but luckily nothing ever happened in my clinic.... at least that wasn't caught. We had a pts venous needle dislodge and stick in his chair once, the alarms never did go off and it just kept pumping blood into the chair. Luckily the PCT was watching him closely because he tended to squirm around alot, and that was a concern.

DeLana_RN, BSN, RN · Jan 4, 2007

We had a pts venous needle dislodge and stick in his chair once, the alarms never did go off and it just kept pumping blood into the chair. Luckily the PCT was watching him closely because he tended to squirm around alot, and that was a concern.

Wow, that chair must have had good venous pressures... fortunately, if this happens with the arterial needle, the AP alarm should immediately go off - unless it's one of our dinosaur Fresenius H machines with post-pump arterial pressure monitoring - but then again, our acute pts should never be unattended, even briefly.

DeLana

kenzy · Jan 5, 2007

Hope this helps. I can remember when I was in nursing school and did my clinical rotation in the dialysis unit, I was never so sick and horrified aT what I saw. Dont get me wrong I felt that was because of lack of knowledge. I left that rotation swearing there was no way I would or could ever do that for a living. I then graduated from school and was offered many jobs even prior to graduation and turned everyone down because I was so scared and unsure of myself. It was so bad I didn't work for a year. Then one day talking with my family Doc he said you know there's a position at the dialysis unit I think you would be great for it, you should apply. To make him happy I said ok I will, All the time knowing a new LPN would not get the job. At that time there was only 1 other LPN working for the company. Well I got the phone call and when I went to the interview I really was so unsure about the position that I offered to work a day for free to see if I liked it and if they liked me. After A 10 hour shift working with the most amazing RN's talking with patients and gaining more knowledge in that shift then the whole time in school I took the position. To make a long story short I'v been there almost 2 years. I've had a lot of joy and alot of sorrow, but would not trade it in for the world. Other then getting up at 3am and working until sometimes 4:30pm, and when I say work I mean work there is not an aspect about this job I do not like. along with working in the unit I also do Clinic pt with 4 amazing doctors, and am now 6 classes short of my RN, with no plans of working anywhere else. It really does take an amazing person to work in this field and the people you meet pt. and co-workers alike consider yourself lucky!!!!! My advice to you is it is hard, takes a lot of determination and hard work, along with a great understanding about how you yourself feels about death. Please give it sometime. Maybe you like myself will see that this is where you are meant to be!!