patient report pain and swelling at vascular access site

Infection – Signs of infection include fever, swelling, redness and warmth near your access site, as well as drainage, or pus anywhere along your access arm, catheter or needle site. This should be reported to your physician immediately. Dialysis is a lifesaving treatment and understanding how to take care of your dialysis access is imperative.

Full Answer

What are the symptoms of vascular pain?

There also may be numbness, weakness, or a tingling feeling in the affected area. How is vascular pain treated? Therapies to treat vascular pain can include medications, angioplasty, or bypass surgery. Angioplasty is a procedure to reduce or eliminate blockages in blood vessels.

What is the incidence of vascular access site related complications?

The incidence of vascular access site related complications ranges between 0.8 % to 1.8 % of diagnostic cardiac catheterization and up to 9 % of percutaneous coronary interventions (PCI) [1]. The femoral vessels at the groin are used as the access site for the majority of percutaneous coronary, peri …

How do you assess the patency of a vascular access?

Position the patient's arm so the vascular access is easily visualized. Assess for patency at least every 8 hours. Palpate the vascular access to feel for a thrill or vibration that indicates arterial and venous blood flow and patency. Auscultate the vascular access with a stethoscope to detect a bruit or "swishing" sound that indicates patency.

What are the most common complications of peripheral vascular intervention?

Access site hematomas and pseudoaneurysms are the most frequent complications of peripheral vascular intervention (PVI); however, their incidence and risk factors remain unclear. Methods and Results

What is the most common complication in a vascular access?

Stenosis and infection are the most common complications of the vascular access. DM is an important risk factor for the incidence of infection. Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.

How does the nurse assess a vascular access?

If it's a new vascular access with a wound, don gloves. Position the patient's arm so the vascular access is easily visualized. Assess for patency at least every 8 hours. Palpate the vascular access to feel for a thrill or vibration that indicates arterial and venous blood flow and patency.

What are some signs and symptoms of potential complications that can develop after AV access?

Arteriovenous fistula signs and symptoms may include:Purplish, bulging veins seen through the skin, similar to varicose veins.Swelling in the arms or legs.Decreased blood pressure.Fatigue.Heart failure.

What problems could a vascular access cause?

What problems could a vascular access cause? All three types of vascular access—AV fistula, AV graft, and venous catheter—can cause problems that require further treatment or surgery. The most common problems include access infection and low blood flow due to blood clotting in the access.

How do you care for vascular access?

Caring for your AV fistula or AV graftYou may take showers only after your AV fistula or AV graft has completely healed.Wash your vascular access area gently with antibacterial soap and water every day.Wash your vascular access before every dialysis treatment–your dialysis center has washing stations with soap.

What does a vascular access nurse do?

In general, a Vascular Access Nurse provides access to a patient's circulatory system through the insertion of a small, thin tube called a catheter.

Why is my arm swollen after dialysis?

Swelling can also be caused by edema, or fluid retention, which is common in dialysis patients. However, if edema is the problem, your other hand and arm, and possibly your legs and feet, would also likely be swollen.

What are the two most common complications of a dialysis graft access?

The most common problems you may experience with your dialysis access are infection, clotting that leads to low blood flow and bleeding. These complications can happen with AV fistulas, AV grafts and central venous catheters (CVCs).

How can I reduce swelling in my fistula?

To reduce the swelling, keep your arm up when you are resting or sitting. Put it on 2 pillows at the same level as your heart. Your arm may be cool and numb where the fistula or graft was put in. This lasts a few weeks and is normal.

What is vascular access infection?

Vascular access infection is defined as local signs (pus, redness, or swelling) at the vascular access site or a positive blood culture with no known source other than the vascular access, and hospitalization or receipt of an intravenous antimicrobial [35].

What is vascular access?

Vascular access is a quick, direct method of enabling the entry or removal of a device or chemicals from an individual's bloodstream. This procedure allows medical providers to easily access the veins of a patient's body. Surgeons use a number of different vascular access methods.

Why is my fistula hurting?

This is usually caused by a needle coming out of the vessel into the tissue (called 'bumping') or by not pressing firmly when your needle is removed. Bruising and swelling can also occur if you move your arm around during dialysis, however bruising and swelling is much less likely to occur as the fistula matures.

What is vascular access?

Expand Section. A vascular access is an opening made in your skin and blood vessel during a short operation. When you have dialysis, your blood flows out of the access into the hemodialysis machine. After your blood is filtered in the machine, it flows back through the access into your body.

What are the signs of infection in a catheter?

Signs of infection are redness, swelling, soreness, pain, warmth, pus around the site, and fever. Blood clots may form and block the flow of blood through the access site.

How to clean a fistula before dialysis?

Clean the area around the access with antibacterial soap or rubbing alcohol before your dialysis treatments. Check the flow (also called thrill) in your access every day. Your provider will show you how. Change where the needle goes into your fistula or graft for each dialysis treatment.

How long does it take for a fistula to heal?

A fistula takes from 4 to 6 weeks to heal and mature before it is ready to use. Graft: An artery and a vein in your arm are joined by a U-shaped plastic tube under the skin. Needles are inserted into the graft when you have a dialysis. A graft can be ready to use in 2 to 4 weeks.

How to get rid of swelling in arm after fistula surgery?

If you have a fistula or graft: Prop your arm on pillows and keep your elbow straight to reduce swelling. You can use your arm after you get home from surgery.

How long does it take for a fistula to be inserted into a vein?

There are 3 main types of vascular accesses for hemodialysis. These are described as follows. Fistula: An artery in your forearm or upper arm is sewn to a vein nearby. This allows needles to be inserted into the vein for dialysis treatment. A fistula takes from 4 to 6 weeks ...

How to avoid blood clots on dialysis?

Following these guidelines will help you avoid infection, blood clots, and other problems with your vascular access. Always wash your hands with soap and warm water before and after touching your access. Clean the area around the access with antibacterial soap or rubbing alcohol before your dialysis treatments.

What to avoid when using a vascular access site?

to avoid wearing any clothing or jewelry that restricts the access and to prevent anyone from using the extremity to obtain BP or perform venipuncture. not to use the arm with vascular access to carry heavy objects and not to sleep on the arm. not to use any creams and lotions on the vascular access site.

How often should you assess for vascular access?

Position the patient's arm so the vascular access is easily visualized. Assess for patency at least every 8 hours.

What happens after dialysis?

Patients with end-stage kidney disease are at increased risk of infection. After dialysis, assess the vascular access for any bleeding or hemorrhage. When you move the patient or help with ambulation, avoid trauma to or excessive pressure on the affected arm.

What are the signs of a kidney infection?

Assess the vascular access for signs and symptoms of infection such as redness, warmth, tenderness, purulent drainage, open sores, or swelling. Patients with end-stage kidney disease are at increased risk of infection.

Why monitor fluid status?

Monitor fluid status. Monitor coagulation studies because heparin is used to prevent clotting during dialysis. not to use any creams and lotions on the vascular access site. Document assessment findings, any interventions and patient responses, patient teaching, and the patient's level of understanding.

What to do if you can't feel thrill?

No thrill – Not being able to feel any thrill may indicate that your access has clotted. If you cannot feel a thrill when you place your hand over your access site, contact your doctor or dialysis team immediately.

How long does it take for a dialysis patient to stop bleeding?

Place a clean gauze pad over your access site and apply gentle pressure. If the bleeding doesn’t stop after about 15 minutes , you should call your doctor right away.

What does it mean when you don't hear a sound?

2. No bruit – Not hearing any sound when you place your ear or a stethoscope on your access site could mean that your access is blocked.

Why is my arm swollen?

If you have swelling without redness, drainage or warmth, chances are you do not have an infection. Swelling can also be caused by edema, or fluid retention, which is common in dialysis patients. However, if edema is the problem, your other hand and arm, ...

How long does hemodialysis last?

6. Bleeding – Bleeding from your access site after your hemodialysis treatment is normal, but should only last for about 15-20 minutes. Bleeding for a longer period of time may be an early sign that you may have a stenosis (narrowing) in your fistula or graft.

How to check if your access site is infected?

You can check your access site daily with the simple 3-step process: You need to look to be sure there are no signs of infection; listen for the swishing sound , or bruit; and feel your access to be sure that the thrill, or vibration, is still there and consistent.

Is dialysis a lifesaving treatment?

Dialysis is a lifesaving treatment and understanding how to take care of your dialysis access is imperative. Knowing what signs to look for to determine if something is going wrong is the first step in making sure that your access lasts and functions properly, keeping you healthy for years to come. Sources: