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Daily access care before and after dialysis

Spend one minute each day looking at and feeling your access. Check for redness, discharge, unusual bleeding and the familiar thrill.

Clinical Education

Do not allow blood-pressure cuffs or blood draws on the access arm, and avoid tight sleeves or prolonged pressure.

  • Look for redness, discharge or bleeding
  • Feel for the familiar thrill
  • Notice swelling, cold fingers or pain

Three daily checks

  • Look: check for redness, discharge, wounds or unusual bleeding.
  • Feel: confirm that the familiar thrill is still present.
  • Listen to your body: notice sudden arm swelling or cold, painful fingers.

What should the access arm avoid?

  • No blood-pressure measurements or blood draws.
  • Avoid tight sleeves.
  • Avoid heavy pressure or sleeping on the arm.
  • Follow your dialysis unit's advice about lifting.

Daily access care

SituationWhat you can doWhen to ask for help
Every dayLook, feel and check the thrillReport anything different
After needle removalApply pressure as instructedReport longer bleeding
Redness or dischargeKeep clean; do not squeezeSeek prompt assessment
No thrillDo not massage itContact dialysis or vascular care immediately

Note: An absent thrill, sudden swelling, cold painful fingers or possible infection needs prompt medical assessment.

References

  1. Sidawy AN, et al. J Vasc Surg. 2008;48(5 Suppl):2S–25S. View source
  2. Schmidli J, et al. Eur J Vasc Endovasc Surg. 2018;55(6):757–818. View source

Related Clinical Education

This article is for health education only and does not replace individual medical assessment. Seek urgent care for acute symptoms.

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Begin with a careful assessment.

Symptoms, examination and ultrasound findings are considered before treatment options are discussed.

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Dr LiangVascularFemale Vascular Surgeon

Website content is for medical education only and does not replace individual diagnosis or medical advice.

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