Week 11 - Dialysis Access Scanning Flashcards
What are 4 types of dialysis access?
Peritoneal Dialysis
Dialysis Catheter
AVF
AVG
What is Peritoneal Dialysis and what is a complication?
Catheter in stomach, Dialysis each night or daily
Complication = infection
What is a Dialysis Catheter and what is a complication?
Catheter into prox IJV, used for < 3 mo, venous blood out / cleansed blood into artery
Complication = infection
Define a fistula
direct connection between artery and vein with one anastomosis
What is the name of the fistula made between the radial artery and cephalic vein at the wrist?
Brescia-Cimino Fistula
Define a Graft
2 anastomoses: arterial anastomosis and venous anastomosis with the graft between them
Transposed vein or PTFE
Dialysis takes _______ pressure arterial blood out and puts blood back into _______ pressure vein.
high, low
Name 4 AV graft configurations
- Forearm loop graft (Brachial artery to basilic or cephalic vein)
- Brachial to axillary graft
- Axillary loop graft
- Femoral loop graft
Primary patency rates of ________ are better than ________.
AVF’s, AVG’s
What is expected when doing a physical exam of a fistula?
Palpable thrill
If the graft feels _________ with no thrill, may have an ____________.
pulsatile, obstruction
What does it mean if the hand temperature on the access side is colder than the other hand?
AVF may be stealing blood from the hand
What are some important things to remember when scanning an access site?
- Scan the entire inflow artery
- Scan the entire outflow vein to most proximal point
- DO NOT take pressure over graft
What three things should you document at each scan point?
Size, Depth, and Velocity
What are the characteristics of a normal AVF flow pattern?
- Very Turbulent ( no turbulence in abnormal)
- Low Pulsatility (high is abnormal)
- Very low resistance (high is abn)
- High velocities near AVF that decrease with distal flow
- Change in Velocity with diameter change
