Is it common for shunts....?

chatty-rn · Mar 5, 2008

Does she have a fistula or a graft?

RNinfamily · Mar 5, 2008

Thank you for responding.

She has a fistula.

chatty-rn · Mar 5, 2008

Are the staff rotating sites on the fistula? If they are going in the same area, it could cause a psuedoanuerysm and could get painful. maybe they need to do a fistulogram to check how well it's functoning. If it isn't a long fistula, doesn't have room to rotate, maybe it would be good to buttonhole it. Also, if they don't use lidocaine, maybe she could get an RX for EMLA cream to put on prior to acccessing. Hope some of this helps.

RNinfamily · Mar 5, 2008

Hi! Chatty Rn

They are rotating the sites because she has scarring/hard nodules alone the fistula.

I will have her inquire about using EMLA cream and if the are using buttonhole technique.

Thanks for responding. :nuke:

norcalidiot · Mar 6, 2008

I worked as a PCT in a dialysis center and noticed the pts that used lidocaine injections rather than the cream or the spray had more problems with their fistula.

RNinfamily · Mar 7, 2008

It was suggested she see a dermatologist to "soften" the areas.

Has anyone heard of this and has this worked before?

penem10 · Mar 10, 2008

I would not recomend going to a dermatologist to soften the areas. The scarring, if minimal is protective to an extent. The scar tissue will decrease the pain sensation to some degree.

I would recomend a fistulagram also, this way you know what you are dealing with. She may have a stenois of some sort.

chatty-rn · Mar 12, 2008

Hi, I don't agree with the dermatologist idea, but I think fistulogram to check it out and see if there are any problems that can be fixed before the fistula stops working. Good luck.

RNinfamily · Mar 18, 2008

Thanks Chatty-rn and Penem10 for replying.

We will check in to a fistulogram.