title: What nephrologists need to know about vascular access cannulation.
abstract: This article describes cannulation events, especially problems, common and rare, minor and major, to aid the nephrologist (and mid-level providers e.g. nurse practitioner and physician's assistant) in decision-making to prevent or treat cannulation-related adverse outcomes. The usual management, potential outcomes, nephrologist intervention, and prevention are discussed and include: assessment of arteriovenous (AV) access and readiness for cannulation; initial cannulation of both arteriovenous fistulas and grafts; needle size and adequacy; needle direction and potential for recirculation; limited cannulation sites/buttonhole; pain and fear of pain; prevention of bleeding; management of infiltrations/extravasations; prevention and management of "one-site-itis"; prevention and management of infection. It concludes with the importance of the medical director as the leader of the continuous quality improvement (CQI) team in preventing/reducing cannulation-related adverse events.
authors: Nephrology Nurse & Vascular Access Consultant, Cary, North Carolina 27518, USA. lesleyd@nc.rr.com
authors: Lesley C
authors: LC
authors: Dinwiddie
authors: Lynda
authors: L
authors: Ball
authors: Deborah
authors: D
authors: Brouwer
authors: Sheila
authors: S
authors: Doss-McQuitty
authors: Janet
authors: J
authors: Holland
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D003657:Decision Making; D004282:Documentation; D006801:Humans; D059408:Pain Management; D011183:Postoperative Complications / Q000517:prevention & control; D006435:Renal Dialysis; D014654:Vascular Patency