Cannulation Camp

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<strong>Cannulation</strong> Techniques• Site-RotationSite Rotation • Buttonhole– Also known as:• Rope ladder• Rotating sites– Also known as:• Constant-site• Same-site
History of the ButtonholeTechnique• Dr. Twardowski developed the technique in Polandmore than 25 years ago• Dialysis supplies, including AV fistula needles, were verylimited• AV fistula needles were reused for multiple cannulations• The needles became dull after repeated use and wouldnot cut the skin• The “dull” needles would enter smoothly if the exactsame cannulation site was used (same skin entry, sameangle of entry, and same vessel entry depth)• Buttonhole technique was used to successfully solve thedull needle challengeTwardowski Z. Dialysis & Transplantation. 1995;24;559.Peterson P. Nephrol Nurs J. 2002;29:195.Lewis C. Nephrol Nurs J. 2005;32:225.
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Cannulation CampLeighann Sauls RN C
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Do you know this person?
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A Mature Fistula• Vessel diameter
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During AVF Maturation Process• Lo
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TourniquetPhoto courtesy of J. Holl
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Post-Op Follow-up• Communicate as
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Rule of 6’s 6s• Rule of 6’s:
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Is This New AVF Matureand Ready for
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Fistula Maturation• What diagnost
Page 20 and 21:
Maturing FistulaPhysical Exam• Fi
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Best Tool/Technique?Physical Exam!
Page 24 and 25: Look for ComplicationsChanges in Ac
Page 26 and 27: Observe Access Extremityfor Stenosi
Page 28 and 29: Infection• Lower rate with AVF co
Page 30 and 31: “Claw Hand” ContractureFrom Ste
Page 32 and 33: Aneurysm• Localized ballooningPho
Page 34 and 35: PalpationTemperature Change Warmth
Page 36 and 37: AuscultationListen for the Nature o
Page 38 and 39: Requirements for Cannulation• Phy
Page 40 and 41: Best Tool/Technique?Physical Exam!
Page 42 and 43: THE RULES
Page 44 and 45: Cannulation of a New AVF• A “Ne
Page 46 and 47: Recommended Use of aCannulator Rati
Page 48 and 49: Getting Started• Reduce the patie
Page 50 and 51: Getting Started• Use 17-gauge nee
Page 52 and 53: Determine Direction ofAccess FlowCh
Page 54 and 55: Adequacy of Needle Length• Compar
Page 56 and 57: Match Needle Gauge to BloodFlow Rat
Page 58 and 59: Needle Direction• Always cannulat
Page 60 and 61: “Wet” Needle
Page 62 and 63: Clinical Clarification• Whether a
Page 64 and 65: Catheter Removal• Once the patien
Page 66 and 67: CannulationTechniques
Page 68 and 69: Tourniquet Use• The proper use of
Page 70 and 71: Venoussite-rotationcannulationsites
Page 72 and 73: Cannulation Technique• Fistula ne
Page 76 and 77: Buttonhole Technique• Procedure:
Page 78 and 79: Disadvantages• Requires same cann
Page 80 and 81: Major Technique DifferencesWith But
Page 82 and 83: Establishing Buttonhole Sites• On
Page 84 and 85: Needles—Sharp and BluntReprinted
Page 86 and 87: Cannulating Established Sites• Us
Page 88 and 89: Do’s & Don’tsof Scab Removal•
Page 90 and 91: Cannulating Established Sites• Lo
Page 92 and 93: Use of a Buttonhole• If it is imp
Page 94 and 95: Troubleshooting theButtonhole• Bl
Page 96 and 97: Troubleshooting theButtonholeDiffic
Page 98 and 99: Why Offer Self-Cannulation?• Bene
Page 100 and 101: What Are ProfessionalsSaying?• ME
Page 102 and 103: Self Cannulation• The sooner self
Page 104: Questions?• Southeastern KidneyCo
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Cannulation Camp

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