HemoDialysis Access

A hemodialysis access, also known as a vascular access, is a method of reaching the blood for hemodialysis. The access lets blood to flow through soft tubes to the dialysis machine, where it is cleansed by passing through a specific filter known as a dialyzer. A small operation is used to insert an access. As a hemodialysis patient, you have one of the following options:

1. Fistula an access obtained by connecting an artery and vein in your arm.
2. Graft an access obtained by placing a piece of soft tube to connect an artery and vein in your arm 
3. Catheter a soft tube placed in a large vein, typically in your neck. 

If you have a fistula or graft access, your nurse or technician will insert two needles into the access at the start of each treatment. These needles are linked to soft tubing that connects to a dialysis machine. Your blood enters the machine via one of the tubes, is cleansed in the dialyzer, and then returned to you via the other tube. If you have a catheter, you can attach it directly to the dialysis tubes without using needles.

A fistula is the best option for your access since it lasts longer and has fewer complications such as infections and clotting. Some individuals, however, may be unable to obtain a fistula because their blood vessels are insufficiently robust. A graft is considered the second best option for gaining access. Catheters are often used for temporary access, although they can also be used permanently. It is sometimes attainable to transition from another form of access to a fistula. whether you do not have a fistula, ask your dialysis care team whether you may switch.’

Fistula or Graft 

1. Before and after dialysis, wash with an antibacterial soap each day
2. Do not scratch or pick at the scab 
3. Be aware of redness, feelings of intense warmth, or the beginning of a pimple on the area of your access. 
4. Ask your care team to rotate the needles while performing dialysis treatment

Catherer 

1. Make sure your catheter dressing is clean and dry 
2. Be sure the area of access is sanitary and the dressing should be changed each dialysis session 
3. Always have an emergency dressing kit at home
4. Never expose your catheter to the air

1. Check your blood flow frequently every day. You can do this by checking for a pulse. If you do not feel this, call your dialysis center immediately. 
2. Wear loose clothes and jewelry on your access arms. Avoid anything tight-fitting. 
3. Never sleep on your access arm. Be sure your head is not resting on it while asleep. 
4. Never let anyone use a blood pressure cuff on your access arm 
5. Never let anyone draw blood from your access arm 
6. If you start bleeding after dialysis, apply gentle pressure to the needle site and clean with gauze or a clean towel. If it does not stop within 30 minutes, call your dialysis center immediately.