Needling issues

[erinnyk]

I'm new to dialysis (in my sixth week) and have an AV fistula that is 6 months old. Yesterday when they turned on the machine my arm started hurting ALOT and puffed up and got really tight. The nurses said that it was a "hematose" (although the doctor later said that is a made up word). I think that it was the needle ripping the fistula or something like that? Anyway they changed me to single needle for that run. Now my arm is very sore and bruised.

What I am wondering is if what happened with the needle is due to an error by the nurse who needled me, or if it just happens sometimes. I need to know if I should be wary if I am assigned to this nurse in the future. I've had other issues with being needled and have had times where they poked me half a dozen times before getting the needle in properly. I just want things to go as smoothly as possible. Any advice would be greatly appreciated!!

[home28]

sounds like the nurse infiltrated it...thats where the needle went in and went through the back of the vein...it does happen no matter how careful you are... but its your arm and if you dont feel comfortable with that nurse then tell them that

[NatesDad]

Hi Erinnyk, and welcome to the forum.
I suspect that home28 is correct and you were infiltrated. It's going to happen sometimes.

After you get your stick watch your arm closely as they start the pump. If you have any pain or see/feel swelling have them stop the machine and check the stick. Several times I've had to have a needle pulled and get another stick. Twice I have opted to leave and come back the next day after an infiltration because the swelling would make it impossible for the nurse to feel the vein for another try.
If you are infiltrated get the nurses to get you some ice. (at our center they just put a few ice cubes in a rubber glove and tie it off) Apply ice for the first 12 hours then switch to heat.

Skill levels vary between nurses and some skilled nurses just don't get along with some accesses. The charge nurse at our center is a very skilled and experienced sticker but she won't touch me. After several unpleasant episodes she and I have concluded that her method just doesn't get along with my arm.

Here's something I have learned to do that I think has helped a lot with my sticks. The access doctor had required that a tourniquet be used when I'm stuck. different nurses applied it differently and some didn't want to use it at all. Simce my access is in my lower left arm I found that if I applied pressure with my right index finger to the vein up near my elbow in the bend of my arm I could make the vein balloon and thus easier to stick. This pressure also gives the nurse a better flash in the tube when they enter the vein.
Took a while for all this to be figured out and come together and still occassionaly have a problem but not nearly as often as when i started.

Also, as one of my male nurses says. He marked the the trail up my access for the other nurses to follow. As they learn your access things will get better and don't be shy to request a specific nurse to stick you. Out of the 20 at our center I have 4 that I am comfortable with and try to use. Occasionally with days off I'll have to use somebody else but usually at least 1 of the 4 are there.

Hope ths helps!!

[erinnyk]

Thanks for the responses!
I guess I was reluctant to be seen as a trouble maker, but you are absolutely right, it is my arm and I need to be more assertive with what I want. I talked to the charge nurse she assured me that for the next while I will be assigned one of the nurses who has sucessfully needled me in the past.
Hopefully that will reduce some of the anxiety of going there wondering who is going to needle me.