what is the difference between AVF and patient 's own vascular ?

[rain888]

HI dear all :

Can anyone kindly explain what is the difference between created avf and patient 's own vein ,i am thinking sometimes when we have cannulation problem with the vein, then we choose pt "s their own vein , still can going on dialysis, then why they need to be created AVF, they can use their own vascular ,what is the difference?

Thanks for your replay!

[diabo, RN]

An AVF is the patient's own vein. It's just been arteriolized, or toughened up, by being attached to an artery, giving it a pulse with higher prressure. It usually takes six or more weeks before it can be used for dialysis. A normal vein cannot be used for dialysis and should never be attempted. Permanent damage can occur. These folks need all the vein options they can get for future accesses.

[rain888]

:confused:But in our DC ,we already use the uncreated vein ,like brachial vein ,because his radial vein (AVF 's V) can' t be used anymore . anther patient as well ,the brachial V (AVF) failed, no bruit ,so we attempted the radial vein ,use it untill now , what kind of the permanent damage will occur ?

thanks for the direction!!

[pricklypear]

babykitty - you work in a dialysis clinic that allows you to cannulate and perform dialysis through a native vein? I wouldn't think any of the major dialysis providers would have a policy like that.

[traumaRUs, MSN, APRN]

Hmmm - are you talking about using the venous and arterial LIMBS of the fistula?

Surely you are not canulating the pts own (native) vasculature?

[diabo, RN]

First of all, a failed access is considered a medical emergency. The potential for declotting steadily goes down as time goes by so these patients need immediate attention to save the access.

There is a good reason that access arms should never be used for an IV access, or even a glucose finger stick. Blood pressures should never be done in that arm either. So why in the world would anyone assume that it would be ok to stick a fistula needle anywhere but in the graft or fistula? Ask your medical director if it's ok to stick a natural vein. But you better ask and not tell him that you are doing it already or you may get fired. These vessels won't hold up for very long, if at all. When they blow, they can likely be damaged enough that they can never be used for future accesses. That would be considered malpractice by some smart lawyer, especially if it threw a clot that ended up in the lungs. You would be nailed, unless of course you are hiding it and not documenting everything you are doing.

If a doctor told me to stick into an undeveloped native vein, I would refuse and be well within my rights as a dialysis nurse. Heck, why not just stick them in the neck, or groin like they do when they dialyze these million dollar horses.

We must follow the tried and tested methods when we are dealing with lives.

Steven

[rain888]

Sure ,I understood this is very seriou situation, actually , that patient' Vein (fistula Vein) brachial vein can't be cannulated anymore , weak bruit there, arterial side still got brill ,we cannulated one time his radial Vein for the dailysis ,then referred to vascular doctor , but it seems no disagreement from doctor ,we also submit the transonic measurement record report which showing result of 1000ml /mins with the radial using for diaylsis .....

we will stop the inproper methods ...

thanks for the teaching ...