[sunshineCCRN]

We had a patient for whom mahurkar placement would have been dangerous. Our nephrologist wanted to run CVVH through needles placed in an AV graft. Does anyone have experience with this? Yea or nay?

[km5v6r]

When I worked as an acute dialysis nurse we would run into this periodically. As the dialysis nurses we would come place the needles, use almost a roll of tape securing the silly things, and pray alot. We instructed the ICU nurses on what to watch for and don't try to D'C the needles themselves. If the system came off for some reason flush the needles with saline, cap them and page dialysis. We would also try to insist the pt come off of CRRT for the night shift when dialysis staff was not in-house. Hated doing it. But sometimes we had no choice.