Cannularion

Ask Our Experts Stuart Mott, Cannulation Expert
1

Hi:

I am using a 16 gauge needle 1", filtration fraction of 32, NxStge machine, blood flow rate of 250. We’ve been trying to develop buttonholes for 7 months now and have been very unsuccessful. There are times when my husband can cannulate using the buttonhole needles but most of the time he has difficulty. Questions:

  1. What are the parameters for the arterial and venous problems for a 16 gauge needle? We’re using the parameters for the 15 gauge needle right now since nobody knows what it is (center nurse or tech)

  2. Is there a danger – in using sharp needles – on the same site every time we cannulate?

  3. If the attempt to cannulate using the buttonhole is unsuccessful, can we go back to the site using sharps?? What is the danger of doing this?

2

Ok need to find out some things. Is a upper are lower arm fistulas, how old is your husband and what type of work did he do.this will tell me about the vessel wall thickness that is a problem with buttonholes.Does have his arm in his lap are up on a cushion? Are you only use touch cannulation on buttonholes

  1. 16 g needles should not exceed 300 blood flow and 15g needles should not exceed 500
  2. Using sharps damage the vessel and will cause aneurysm
  3. You can go back to the buttonhole site using sharps but you must use touch cannulation.If you go back to using sharps in the buttonhole site it will in large the site and cause damage to the site and further in crease infevtion
3

Ok need to find out some things. Is a upper are lower arm fistulas, how old is your husband and what type of work did he do.this will tell me about the vessel wall thickness that is a problem with buttonholes.Does have his arm in his lap are up on a cushion? Are you only use touch cannulation on buttonholes

  1. 16 g needles should not exceed 300 blood flow and 15g needles should not exceed 500
  2. Using sharps damage the vessel and will cause aneurysm
  3. You can go back to the buttonhole site using sharps but you must use touch cannulation.If you go back to using sharps in the buttonhole site it will in large the site and cause damage to the site and further in crease infevtion
4

Hi Stuart:

Thank you so much for your reply. I am the patient and my husband is the caregiver.

Reply to your question:

  1. My fistulas are upper arm. I am 64, have had a quadruple bypass, have had 2 strokes, hypertensive and a diabetic. I was a computer programmer/data analyst. My arm is normally on a cushion.

  2. Further question on the 16 g needle – What should be the ranges of the arterial pressure and the venous pressure??

5

Hi Stuart:

Thank you so much for your reply. I am the patient and my husband is the caregiver.

Reply to your question:

  1. My fistulas are upper arm. I am 64, have had a quadruple bypass, have had 2 strokes, hypertensive and a diabetic. I was a computer programmer/data analyst. My arm is normally on a cushion.

  2. Further question on the 16 g needle – What should be the ranges of the arterial pressure and the venous pressure??

6

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Ok next how deep do you go before you reach the vessel. Art pressure 200 to 260, Do you have your arm straight out and make a fist or squeeze a ball when placing the needle in or do you use a tourniquet