thrill and Bruit

Good question and I wish more non dialysis nurses would ask! The thrill is not a sound, it is felt. You simply lay your hand on a graft or fistula and feel. You should feel what i would describe as a buzzing feeling. This indicates that blood is flowing through the access. It doesn't feel like a pulse, more like a vibration. The bruit is what you hear when you put your stethoscope on a patent fistula or graft. It's a whoosh-whoosh sound that also indicates that blood is flowing through the access. We use this to tell if it is patent as well as to listen for stenosis. If either of these are not present you should notify the clinic or nephrologist as rapid interventions for clotted accesses have the best results. Again, thanks for asking and teach your friends!

You know you are a good dialysis nurse when see one of your patients in grocery store, like I did last week, and you grab her arm and begin stroking it saying, " I can feel your nice thrill." I knew her arm and she knew my touch. We both started laughing, as some of the other customers started backing away from us with strange looks on their faces. :hug:

Steven