Flssh dies out


#1

Hi Stuart,
I’m having trouble with my venous buttonhole in my lower arm fistula. I get a flashback but then it stops pumping, often before I’ve had a chance to level out. My other problem is that I get into the channel but won’t get a flashback. Any ideas? I’m going to an IR this week to see what’s going on. I have a good thrill at my elbow and wrist and can hear my bruit.
Thanks for you help, I’m stumped on this one.
Gretchen


#2

Need some help with your problem, are you using 15g one inch needles?, when you are not getting the flashback is this when you are cannualting and have the needle say 1/2 inch in? or how far is the needle in before the flash back stops? And what is your blood pressure run? this is a important fact in reference to a flash back.Is there any curves in the access are drop offs ?AND ONE LAST QUSTION HOW DEEP ARE YOUR TUNNEL TRACKS>


#3

I had a similar problem. When inserting the 15g buttonhole needles one day there was no flashback on either one after the needles were completly in. My moms fistula is farily close to the surface (not deep at all). We then inserted sharps and everything was fine. I called our nurse and she did not know why that happened. Was wondering if you had any insight on that??


#4

Did both of you feel a pop when you slid the needle in are did it5 just go in easily?


#5

We did not feel the pop on either one but they went in very easy.


#6

Ok what happen is that you cannualted along side of the vessel. If you don’t feel a pop and you know the deep of your access i.e. 1/4 deep and you go in 1/2 inch you know that you are cannualted along side.to help have your partner hold the vessel with there thumb 1/2 inch below the buttonhole entrance. this will stop the vessel from moving as you cannualted. I stated this back in 2004 because when I try to cannualted the buttonholes on the fore arm the vessel would move because the needle is so blunt. If you can’t cannualted with the buttonhole needle it is go to use a sharp but you must use the “Touch Cannualtion technique”.I hope this answer your problem