Blood what......?

Blood access is a passage to the blood circulatory system of the human body. It may be a temporary or permanent in nature.

Intravenous line is a form of temporary access where intravenous fluid such as Normal Saline or medication can be introduced into the blood circulatory system. An access by a catheter (a tube-like) may be of a temporary or long term usage and this has many uses in the many disciplines in medical practice.

However, in haemodialysis a blood access is basically of a long term nature. It has to be repeatedly used again and again, day after day to gain access to good blood flow in order to carryout treatment.

Blood access for haemodialysis can be divided in 3 basic types;
1. catheter
2. arteriovenous (AV) graft
3. arteriovenous (AV) fistula

The catheter is a tube insert into one of the selected major veins and can be used as a short-term measure and in some case as a permanent access. It has a greater tendency to get infected therefore limiting its usage. Cleanliness is of utmost importance. No needles required.

The arterioveous (AV) graft is a tube surgically inserted to connect an artery to a vein. This method is employed under certain circumstances such as where veins are small and not able to sustain a good blood flow sufficient for haemodialysis treatment. The cost of having an AV graft is costly and needed qualified and experienced staff to handle it. Needling is required.

Arteriovenous (AV) fistula is surgically created by making a passage between an artery and a vein. This method is commonly employed for the simple reason that is the best and cheapest. This method has been described as the “Gold Standard” of blood access in haemodialysis. Needling is required.

Care of a blood access is crucial in haemodialysis as it is the “lifeline” to staying alive for the patient. A good needling practice is pertinent in ensuring a good and lasting AV graft or AV fistula. Basically there are two methods for needling; "step ladder" method and "buttonhole" method. Both methods has its own advantages and disadvantages, the point is whichever method is employed it must serve to the best interest of the patient and provide the best outcome.