No Venus bloodflow with buttonholes

Having a problem.

When I went to stick my venus vein, the needle goes in, but no blood flow. When I take the needle out, the site does bleed. I have tried over 10 times and every time, the needle goes in fine, but no blood return. any ideas or suggestions? I do have buttonholes.

Hi anonymous. It sounds to me like you’re somehow missing the channel with the venous needle. Blood will come out if you poke around anywhere, but you won’t get a flashback unless it’s in the right place. Sometimes folks have said that they need to use sharps a time or two to reestablish the channel.

SInce it’s Easter, things may be a bit slow here. You might search the message boards for “Buttonhole,” because I’m pretty sure others have had this problem and it’s been discussed. Something that’s been talked about before might help you now.

She is absolutely right you are not in. Try using a tourniquet(sp) or have your partner apply some pressure for you -close your eyes and try to follow the direction of the blood flow (since you cant see it anyway closing your eyes will relive some of the stress you are having in trying to get it) once you think you have found it stop open your eyes take a deep breath and go for it. works for me!

If you aren’t getting blood you are not in the vein. Sometimes I have to apply pressure to the needle to g it in the vein. I can feel th vein pulsing but the nedle won’t penetrate(not right in the tract). Sometimes have to give up and us a sharp. Usualy works fine the next time.

It’s obvious you’re not in the track. However, you must remember that everybody’s access is different, and what works for one person may not work for another. SOme may have better fistulas, or some may even have a graft. You didn’t mention whether this is a new buttonhole or not, and how long you’ve been using it. I had some problems in the beginning and actually ended up starting a new venous buttonhole myself. In fact, I’ve done it twice in the last year. The first buttonholes were started by a nurse without any consideration of whether the angle was comfortable for me. It’s easy for another person to stick you when they aren’t constrained by only using one hand and standing above you – it’s differnt if you need to self-cannulate. So I did my own taking in consideration what was best for me. There also have been a few times when I’ve needed to use a sharp – more out of frustration - I’m sure I would have eventually found it. But usually I’m in the first try. Learn your bruit and follow your thrill. Once you get comfortable, you’ll never trust anybody else to stick you. Even when I’ve been in the hospital (once for major surgery), I wouldn’t let any of the dialysis nurses touch me, and these were people who had stuck me before. Only one person will get to know your buttonhole accesses, and that’s you. Be patient, it’ll come to you.

Rich Berkowitz

NxStage 2/06
In-center 3/03

Great points, Rich. But just to prevent confusion, the Buttonhole technique is only for fistulas, not for grafts. (Of course, someone could still self-cannulate a graft using the rope-ladder method–and self-cannulation is always best!).