Cannulation Camp

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Use of a Buttonhole• If it is impossible to have only 1 cannulator,additional buttonhole sites can be developed atthe same time using a second cannulator• If your patient is hospitalized and the acutehospital renal team does not know how toaccess a buttonhole, they can:– Rotate sites using standard sharp needles as long asthey stay ¾″ away from the buttonhole tracks, or– Have the patient self-cannulate (if the patient hasbeen trained and is able)
Using a Buttonhole• Plan outreach to the acute team and educate regardingbuttonhole technique• Continue access monitoring and surveillance, even ifpatient is dialyzing at home• Inform patients that laminated procedure cards andvideos are available• If the patient travels, provide instructions to receivingp p gfacility to rotate sites unless the patient is able to selfcannulate
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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
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Maturing FistulaPhysical Exam• Fi
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Best Tool/Technique?Physical Exam!
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Look for ComplicationsChanges in Ac
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Observe Access Extremityfor Stenosi
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Infection• Lower rate with AVF co
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“Claw Hand” ContractureFrom Ste
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Aneurysm• Localized ballooningPho
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PalpationTemperature Change Warmth
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AuscultationListen for the Nature o
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Requirements for Cannulation• Phy
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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 74 and 75: Cannulation Techniques• Site-Rota
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 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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