Sunday, January 31, 2010

The current practice......(Part 1)

Before we proceed to the use of "blunt AVF needles", we need to revisit the use of sharp AVF needles in haemodialysis. We tend to take many things for granted when we cannulate a patient for haemodialysis treatment.

When a patient with a new AVF (ArterioVenous Fistulae) present him or herself before you for treatment what basic requirements are needed before you can proceed with the cannulation?

1. A order by the attending physician to proceed with the cannulation
2. A trained and competent treatment practitioner with good record of successful first time cannulation shall be assigned to carryout the cannulations.
3. The use of some form of restrain or tourniquet to sufficiently and uniformly engorged the intended vessel to be cannulated.

Having the basic requirements checked, now turn towards allying the patient's fear. Remember, words spoken without much thought may cause more anxiety and fear instead to alleviate it. Be very sensitive and take your time when choosing the appropriate words explaining the procedure.

Do not be in a rush as mistakes can occur when you are in a hurry. Choose the lest busy period of the week and day to introduce a new patient to his/her first haemodialysis treatment.

The first experience has a lasting impression, therefore you may want to use a smaller bore AVF needles for the first time cannulation. The idea of using a size smaller than usual is to ally fear and gives the patient confidence in the treatment pratitioner.

to be contd.....

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