Vascular Access Evaluation and Cannulation Flashcards
Describe each of the 3 pre-treatment access evaluation words
Look: Entire access from inflow back to the heart, observe for healing at sites, observe skin for cleanliness and intactness and drainage, new AVF for signs of maturation
Listen: for bruit- inflow stenosis (water hammer pulse) or outflow stenosis (whistling sound)
Feel: Thrill (vibration) both AVF and AVG should be soft and compressible not hard and raised
When is an AVF considered newly matured?
patient has had post op surgical exam
meets the rules of 6’s
advanced cannulators
When is an AVF considered mature?
AVF is at prescribed BFR with matching needle gauge size
Intermediate teammate can cannulate
When is an AVF considered established?
Been at the Prescribed BFR and max needle size for 2 months
What is the recommended needle gauge and max BFR for a new AVF initial cannulation?
17g and BFR not to exceed 250ml/min
When would you only use one needle for cannulation?
Per physician order, used for arterial pull
Why is there use of a tourniquet during cannulation?
It is used to help engorge fistula and stabilize vessel for cannulation
the tourniquet should not impede overall blood flow to limb
take care when using on individuals with compromised or thinner skin
How do you evaluate the blood flow of the access?
thrill/bruit; look/listen/feel
What do you call the method used for Site rotation? healing time for previous cannulations?
14 days- rope ladder method rotation of sites needed to promote healing
At what angle do you insert the needle for a AVF? AVG?
AVF: 45 degrees,
AVG: 25 degrees
What are possible complications from flipping the needle?
causes coring of access and can lead to increased bleeding and damage to access (scarring)
Distance from anastomosis:
1.5 inches
Distance between needle tips
1.5 Inches
At what angle do you remove a needle?
Same angle as insertion
