Your vascular access is your lifeline for dialysis, allowing your blood to be cleaned effectively. Proper care of your access site is essential to prevent infections, clotting, and other complications. Whether you have a fistula, graft, or Tunneled Permanent-Catheter (TPC), following these care tips will help keep your access functioning well.
Types of Vascular Access
1. Arteriovenous (AV) Fistula
- A connection between an artery and a vein, usually in the arm.
- Preferred access type because it lasts longer and has a lower risk of infection.
2. Arteriovenous (AV) Graft
- A synthetic tube connecting an artery and vein.
- Used when veins are too small for a fistula.
3. Tunneled Permanent-Catheter (TPC)
- A tube placed in a large vein (neck, chest, or groin) for temporary dialysis access.
- Has the highest risk of infection.
Daily Care for Your Access
For AV Fistula & AV Graft:
Check for the Thrill & Bruit
- A thrill (vibration) should be felt over the access.
- A bruit (whooshing sound) should be heard with a stethoscope.
- If either is absent, contact your dialysis center immediately.
Keep It Clean & Dry
- Wash the area daily with mild soap and warm water.
- Pat dry with a clean towel.
- Avoid scratching or picking at scabs.
Prevent Infection
- Do not apply lotions, creams, or powders to the site.
- Check for redness, swelling, pain, or pus-signs of infection.
- If you notice these, call your doctor.
Protect from Damage
- DO NOT wear tight clothing or jewelry over your access.
- DO NOT sleep on the arm with the access.
- DO NOT carry heavy objects or put pressure on your access arm.
Rotate Needle Sites
- During dialysis, needle insertion sites should be changed each session to prevent weakening of the vessel.
For Tunnelled Permanent-Catheter (TPC):
Keep It Dry
- Cover the catheter with a waterproof dressing while showering.
- Never remove or touch the dressing yourself-your dialysis team will change it.
Prevent Infection
- Avoid tugging or bending the catheter.
- Never use scissors near the catheter.
- Report fever, chills, redness, or pus at the site immediately.
Warning Signs of Access Problems
Call your doctor or dialysis team if you notice:
- Infection signs: Redness, swelling, warmth, pain, pus, fever.
- Poor blood flow: Cold fingers, numbness, or a weak thrill.
- Bleeding that won’t stop after dialysis.
Additional Tips for Long-Term Access Health
- Exercise your access arm (if approved) to improve blood flow.
- Maintain a healthy diet to support circulation and healing.
- Avoid smoking, as it narrows blood vessels and reduces access longevity.
Taking good care of your vascular access ensures a smoother dialysis experience and fewer complications. Always follow your healthcare team’s advice and report any issues promptly!