What Nephrologists Need to Know about Vascular Access Cannulation
Article first published online: 5 MAR 2013
© 2013 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 26, Issue 3, pages 315–322, May–June 2013
How to Cite
Dinwiddie, L. C., Ball, L., Brouwer, D., Doss-McQuitty, S. and Holland, J. (2013), What Nephrologists Need to Know about Vascular Access Cannulation. Seminars in Dialysis, 26: 315–322. doi: 10.1111/sdi.12069
- Issue published online: 17 MAY 2013
- Article first published online: 5 MAR 2013
This article describes cannulation events, especially problems, common and rare, minor and major, to aid the nephrologist (and mid-level providers e.g. nurse practitioner and physician’s assistant) in decision-making to prevent or treat cannulation-related adverse outcomes. The usual management, potential outcomes, nephrologist intervention, and prevention are discussed and include: assessment of arteriovenous (AV) access and readiness for cannulation; initial cannulation of both arteriovenous fistulas and grafts; needle size and adequacy; needle direction and potential for recirculation; limited cannulation sites/buttonhole; pain and fear of pain; prevention of bleeding; management of infiltrations/extravasations; prevention and management of “one-site-itis”; prevention and management of infection. It concludes with the importance of the medical director as the leader of the continuous quality improvement (CQI) team in preventing/reducing cannulation-related adverse events.