Taking Care of your Access

Why & how to take care of your Fistula or Graft?

Taking good care of your fistula or graft will help to keep it working properly. There are a few things you can do to help prevent infections, clotting and damage to your access.

Cleanliness is important to keep out infections
Keep your access area clean and free of any trauma. Look for signs of infection, including pain, tenderness, swelling or redness around your access area. Also, be aware of any fever or flu-like symptoms. If you do get an infection and catch it early, it can usually be treated with antibiotics.
Your dialysis care team will teach you how to carefully wash your access arm before each dialysis treatment. Make sure to wash thoroughly and be sure the care team member specially prepares your access site to prevent infection.

Unrestricted Blood Flow Helps Lower the Risk of Clotting
Protect your access from any restriction or trauma:

• Avoid wearing tight clothes, jewellery or anything that may put pressure on your access.
• Don’t sleep on top of or rest you head/arm etc. on your access area.
• Refrain from carrying purses, bags or heavy items across your access area.
• Always request that blood be drawn from your non-access arm.
• Always request that blood pressure be taken from your non-access arm.

How can you assess the health of your Fistula or Graft and prevent it from failing?

Acquaint yourself to the feel of the vibration of blood going through your access and check it several times a day. Call your dialysis care team immediately if the flow stops or changes. This could mean a blood clot. With quick action, many clots can be dissolved or removed.
If it’s possible for you, learn to listen with a stethoscope to the sound (called “bruit”) of blood flowing (“whooshing”) through your access. If the sound of the bruit changes to a higher pitch, like a whistle, it could be an indication that blood vessels are narrowing (call stenosis), which may slow or stop blood flow through your access. If you do not hear the bruit at all, or only your pulse, you may have a blood clot in your access. Call your dialysis care team if you notice any change in your access.

Good Needle Sticks (Cannulation) Can Help Keep Your Access Working Well

To prevent tearing or damage to your access, it’s recommended that you pay attention to the needle stick locations (the place where the needle is inserted in your access) when you’re being put on dialysis.
The arterial and venous needle tips should be at least two inches apart from each other, as well as away from access surgical scars. The new needle stick sites should be at least one-fourth inch from the sites used the time before. Allow about two weeks for healing of previous sites to help maintain the health of the access.
Many people are nervous about having needles placed; however, numbing creams can be used to reduce the pain and fear of needle sticks. Talk to your nephrologist and dialysis care team about ways to decrease pain and to calm anxiety.
After dialysis treatment your needles will be removed and you will need to apply pressure with sterile gauze over your needle sites to stop the bleeding. Your dialysis team will provide you with clean gloves and teach you the proper procedures to stop bleeding as well as prevent infection.

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