Emla thank you for your questions thankful I can answer them
Fear of needles is common problem with all dialysis patents attached is Tap Cannualtion a article that is waiting publication, in the ANNA journal.
Use touch cannualtion when starting and continue with buttonhole cannualtion. It was developed by me to save the tunnel tracks.
The use of the 3/5 cannualtion needle I have been a great support for 15 years the reason infiltration is almost unheard of the article and venous pressure drop of 40 to 80 mg. save the access. Less pressure decrease in aneurysm.
Go to home dialysis center and watch my videos this will help understand what I’m talking about.
Please call me at 573-826-8237 if you need any thing else
DPR:
Hello Stuart -
My husband has been on home hemodialysis for 9 years. We’ve been using buttonholes for most of that time. He’s severely needle phobic so I (wife) do the cannulation. Recently, we lost both his buttonholes and were having issues with his fistula infiltrating and other problems. So he currently has a femoral tunneled catheter while we rested the fistula. Why femoral? Well he has a pacemaker on one side and a powerport in the other side of his chest. His fistula is in upper arm on his dominant hand. No good veins elsewhere. While his fistula is in the upper arm, it isn’t all that deep or long. We are getting ready to make new buttonholes so he can have the permcath out. I need some guidance. First question:
When using the touch cannulation technique, do you use that with the sharps also while forming the buttonhole or only AFTER the buttonhole is formed and you are cannulating with blunts. I often have difficulty seeing the flash when I hold the wings of the needle. I have used the touch technique with blunts, but wonder if it also is appropriate to use while cannulating with sharps and making the buttonholes?
when using the teardrop technique, you have a full saline syringe attached to the cannulation needle…once the needles are in…don’t you need to draw first before flushing? I am a bit confused as to the sequence if you already have a full saline flush attached to the line.
I also have a question about using 3/5 needles. You said those are primarily for forearm fistulas. Should I consider requesting them also if my husband’s brachial fistula is not very deep. Previously, with his old buttonholes, I did notice we got high pressures, so high that it caused the machine to stop if I didn’t pull the needles part way out. Of course, that did not happen until the buttonholes had been in use for quite some time. He has a short fistula and I need his buttonholes to work well and stay patent for a long time.
I am really eager to get these buttonholes going and working well so the catheter can come out. My husband is less eager. He really feels he needs emla, but I also read that emla can be contributing to his problems with cannulation. His needle phobia is severe and is more related to the feeling of the needle in his vein than a fear of the pain.
I would really appreciate any support you can offer.