How to Cannulate Yourself on Dialysis

September 17, 2013
MW 9:30-10:50 How to Essay

How to cannulate yourself on dialysis

Dialysis needles are large not to mention scary as hell. Imagine being stuck with a Capri Sun straw and it staying there for 4 hours. Fear of needles and pain is a reality for most people on dialysis, especially in the beginning. Some have true phobia, and require special techniques and interventions to self-cannulate. All patients, once they become familiar with dialysis, worry about who will put their needles in (and potentially cause access damage that can lead to a hospital stay, surgery, or loss of their lifeline). Some avoid travel because they don’t want an unknown staff person to cannulate them. All of these fears can reduce quality of life. Patients who cannulate themselves learn to overcome these fears—and this task is not as intimidating as it may seem. The following is the button-hole technique for self cannualization.

Here are some things that one should gain knowledge about prior to starting the process:
Four weeks before starting the self cannulation process:
Learn:
 How your access works, fistula vs. graft
 Importance of the blood flow rate
 Size and type of needles used, including gauge; (17, 16, 15, 14), length (3/5", 1”, 1-1/4"); and sharp or blunt ( the smaller the number, the bigger the needle and vice versa)
 How to assess your access before each session: Learn how to check the pulse and thrill, then
 Learn how to recognize problems
 Anything else your clinic feels is important

Cannulating Buttonholes:
 Clean the access site. The fistula must be prepared following established clinic protocol. Remove the scabs covering the tracts from the previous treatment. (This can be done safely in several ways. Choose the way you are most comfortable with)  Hold the tubing behind the needle with your thumb and forefinger, and then curl all four fingers underneath it. Remember hand placement and needle angle.

 Using