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Cannulation of the Arteriovenous Fistula (AVF)

Cannulation of the Arteriovenous Fistula (AVF). Activity Chair: Lawrence M. Spergel, MD, FACS Clinical Chair, Fistula First National Breakthrough Initiative San Francisco, California Authors:.

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Cannulation of the Arteriovenous Fistula (AVF)

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  1. Cannulation of the Arteriovenous Fistula (AVF) Activity Chair: Lawrence M. Spergel, MD, FACSClinical Chair, Fistula First National Breakthrough InitiativeSan Francisco, California Authors: Lynda K. Ball, RN, BSN, CNNQuality Improvement DirectorNorthwest Renal NetworkSeattle, Washington Deborah Brouwer, RN, CNN Director, Therapeutic & Clinical Programs Renal Solutions, Inc. Warrendale, Pennsylvania

  2. Overview • Cannulation of the Arteriovenous Fistula is designed to help you: • Increase understanding of AV fistulas • Increase knowledge of assessment, cannulation, and protection of new and mature fistulas • Troubleshoot problems during cannulation and dialysis • Communicate effectively with care team members • Encourage your healthcare team to develop a “New AVF Cannulation Protocol”

  3. Overview(cont’d) • Assessment of the New AVF for Maturity • Protocol for New AVF Cannulation • Cannulation Site Selection and Preparation • Cannulation Techniques • Self-Cannulation • Complications

  4. Fact • When Fistula First was initiated in early 2003, it was reported that 80% of prevalent hemodialysis patients in Europe and only 30% of prevalent hemodialysis patients in the United States used an AVF. Fistula First, National Vascular Access Improvement Initiative. Available at: www.fistulafirst.org/professionals/tools.php. Accessed January 11, 2007.

  5. Risks Associated with Poor Cannulation & Improper Care of Fistula • Loss of the fistula • Further hospitalization • Creation of temporary access measures • Inconvenience • Disruption of regular treatment regimen • Higher treatment costs

  6. Mature Arteriovenous Fistula - - Photo courtesy of J. Rowland

  7. Arteriovenous Graft Photo courtesy of J. Rowland

  8. Catheter Used for Dialysis Photo courtesy of J. Rowland

  9. Benefits of Arteriovenous Fistula (AVF) • Benefits of Arteriovenous Fistula (AVF) • Lowest rate of failures and complications • Longevity • Lowest costs Merrill D, et al. Dial Transplant.2005;34:200-208.

  10. Cannulating a Fistula • The formal description of the process of inserting needles into a vascular access Graphic courtesy of Medisystems HemoDYNAMIC Devices™

  11. Program Overview • The new AV fistula: • How to assess for: • Maturity • Complications • Cannulation sites • Correct way to cannulate it • The mature AV fistula: • How to assess • How to select cannulation site • How to prepare cannulation site • How to cannulate site using site rotation and the buttonhole technique

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