Caring for Your Hemodialysis Access

It's important to care for and protect your access to help it last. A problem such as an infection or a blood clot may make your access unusable. This may happen more often with an arteriovenous graft than with an arteriovenous fistula. If this occurs, you may need a new access. Follow these guidelines to help protect your access.

Contact your doctor right away if you:

• Can't feel the blood flowing in the access (this sensation is called a thrill).
• Have pain or numbness in your hand or arm.
• Have bleeding, redness, a bluish color, or warmth around your access.
• Notice your access suddenly bulging out more than usual (a slight bulge is normal).
• Have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.

• Wash your hands often.
• Do not wear tight clothes or jewelry around your access.
• Do not sleep on your access area.
• Do not let anyone take your blood pressure on or draw blood from the arm with the access. Also don't let anyone put I.V. (intravenous) lines into it.
• Do not get the area wet. Ask your nurse or doctor how to protect the area around the catheter incision and about using a special protective cover when you shower.
• Protect your access from being scratched, hit, or cut.
• Do not carry anything heavy or do anything that would put pressure on the access.
• Check the area every day for signs of an infection such as redness, pain, and swelling. If you have any of these symptoms, a fever, or flu-like symptoms, call your doctor right away.
• Keep the access area clean.
  
  • Shower only after your AV fistula or AV graft has completely healed.
  • Wash the access area every day with antibacterial soap and water or as advised by your doctor.
• Change the dressing as often as your doctor tells you to. Always keep the dressing clean and dry. Make sure you have plenty of dressing supplies at home in case you need to change it.

If you put your fingers over your access, you should feel the blood rushing through it. This is called a thrill, and it feels like a vibration. Feel for the thrill as often as you're told, usually once or twice a day. If you can't feel it, tell your doctor right away. Blood may not be flowing through your access the way it should.

Write the names and numbers of your health care providers below or have them programmed into your cell phone. That way, you will know how to get in touch with them. Be sure you know how to contact them after office hours and on weekends and holidays, too.

Doctor:

Name ___________________ Phone ___________________

Surgeon:

Name ___________________ Phone ___________________

Dialysis Center:

Name ___________________ Phone ___________________

Many things in your daily life impact your health. This can include transportation, money problems, housing, access to food, and child care. If you can't get to medical appointments, you may not receive the care you need. When money is tight, it may be difficult to pay for medicines. And living far from a grocery store can make it hard to buy healthy food.

If you have concerns in any of these or other areas, talk with your health care team. They may know of local resources to assist you. Or they may have a staff person who can help.