How To Remove The Internal Fistula Needle?

Does the needle bleed or not bleed?

Many patients are very afraid of bleeding after needle removal and even blame nurses for their poor skills. Let’s first understand the position of the internal fistula puncture needle after it is inserted. When our internal fistula puncture needle enters the blood vessel, it will actually produce two needle holes, one is the skin needle entry point, and the other is the blood vessel needle entry point. So, some patients experience bleeding and oozing after getting off the plane. What is the reason?

1. If we only press the needle point of blood vessel and not the needle point of skin when pressing, there will be obvious bleeding, and the patient will often panic and blame the nurse for poor technique. Then, the consequence of this situation is that the patient will lose blood, which will have less impact on the blood vessels of the internal fistula.

2. There is another situation where the patient does not bleed after getting off the machine and removing the needle, but after a while he finds swelling and pain in the blood vessels. This is strange. Why is there bleeding even though the pressure is good? That's because when the nurse pulled out the needle, she only pressed the skin where the needle was inserted, but not the blood vessel where the needle was inserted. The blood vessel entry point will leak blood into the subcutaneous tissue, causing swelling and pain around the blood vessel.

3. When the nurse pulls out the needle, she presses both the blood vessel entry point and the skin needle entry point. However, there is still a small amount of bleeding. This is because there is a time deviation between the left and right hands when pulling out the needle. When the nurse removes the needle, she needs both hands to cooperate. Generally, the needle handle is held in the right hand and the cotton ball is held in the left and right hands. The puncture needle can only be pressed after the puncture needle has been completely pulled out with your right hand. This sounds very simple, but it is actually a little difficult to do. Because what we have to do is not only to remove the needle without bleeding, but also to reduce the damage to the internal fistula blood vessels caused by the puncture needle.

Therefore, when removing the needle, you must press the two needle entry points at the same time to prevent bleeding and reduce damage to the internal fistula. Moreover, you must ensure that after completely pulling out the needle with one hand, press it immediately with the other hand. This coordination requirement is quite high. We hope that patients will not blindly ask for no bleeding as the standard. Responsible nurses will take the least damage to the internal fistula as the principle. After all, it is our lifeline.

Press

Disadvantages of strap compression:

1.The bandage wraps around the arm in a circular shape, which will seriously block the blood flow, reduce the fistula blood flow rate, and increase the risk of fistula obstruction.

2.Patients will relax their vigilance when applying bandage pressure, and the cotton ball will easily shift during activities, causing bleeding.

3.The bandage makes the patient dependent, and it is easy to forget the time to loosen it. Long-term pressure will also affect the internal fistula.

The specific operation of the two-finger pressing method

After the needle is removed after dialysis, the nurse presses the gauze piece vertically with her left thumb, and takes two 2.5cm×20cm 3M pressure-sensitive tape X-shaped diagonal pulls with her right hand to fix the gauze piece for 30 seconds, and then the patient or family member uses the thumb and (or ) Press the puncture point vertically with your index finger, with enough force that there is no blood oozing and the internal fistula tremor can be touched. Observe that there is no bleeding, gradually reduce the pressure until the pressure is completely relieved, and then loosen the tape and gauze.

After learning today’s knowledge, I hope everyone will take action. Let’s learn the point pressure method together to minimize the damage to internal fistulas!

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