ER nurse accessing Dialysis Cath in Emergency

[Huachuca]

I am a nurse working in an emergency department. I had a patient last week that came in with a dialysis cath in her left chest wall. First of all let me say that I know to NEVER touch them. But here is the problem, the patient was most likely septic, 80 some years old. We needed to get a fluid bolus into her. there was absolutely no access....even the doc couldn't get an EJ started. They were just going for a central line when the little old lady died. So my question, would it ever be acceptable to access the dialysis cath and if so ..HOW to do it with the supplies on hand in the ER.

thanks

Huachuca

[jnette, ASN, EMT-I]

IMO, every ER nurse and EMT should be trained on basic access and care of HD accesses. In a life threatening situation, better to use it and save a life, regardless of the old "nobody touches it but dialysis staff" addage.

Agree wholeheartedly.

We would often have to send a pt. to the ED and none of the nurses there would know how to pull the needle and/or even hold the site. One of our (usually "short") staff would always have to leave the clinic and go to the ER with the pt. merely to hold the site.

Doesn't make sense.