"Ouch"......

For haemodialysis dependent patients, an Arterio-Venous Fistulae (AVF) is the "lifeline" to having a good treatment outcome. There are other blood accesses but an AVF is the best. Ever since haemodialysis was introduced in Malaysia, sharp AVF needles has been in used since.

Many patients dread to come for haemodialysis treatment for the very simple reason of the pain involved during cannulation of the AVF needles. Every patient needs two cannulations of the AVF needles per treatment, three times per week and that will result in 312 cannulations over a period of one year. The degree of pain endured during each cannulation varies with patients themselves, site of cannulations and the treatment practitioner who does the cannulation.

Sharp AVF needles themselves can cause untold damages to the AVF and in the hand of unqualified treatment practitioners the damage is unimaginable. Stenosis, thrombosis, haemorrhages, infiltrations and aneurysms are some of the complications.

Many of these complications can arise from the "one site-itis" phenomena.  Many trained and untrained treatment practitioners gave in to the demand of patients for same site cannulations as they are unable to explain the rationale to rotate cannulation sites and choose the easiest way of out of the situation.

Basically there are two methods of cannulations; "the step ladder" method and the "button-hole" method. If properly practiced, these methods can ensure the AVF serving the needs of the patient for many years to come. Due to the abuses and incompetence of qualified and unqualified treatment practitioners, patients suffer physically, emotionally and financially and sometime may lead to their untimely demise.

Over the last 25 years,"blunt AVF needles" has been used in the West with much success. Efforts are underway to introduce them in Malaysia and over the next few postings we shall explore the "blunt AVF needles" method......