When Your AV Graft becomes an AV Fistula

I sat today gazing at this tore up AV graft, it had been in Pt. X for about six years, he had psuedo aneurysm that frankly worried me.  His arm was lumpy and there wasn’t a straight peice of graft to stick to save your life.  Sticking him had become increasingly difficult and they had given him to me to try to get a treatment in before they put a cath in him.

The doctor had already rounded and the old time ICU nurse stood behind me, tapping her foot.  I looked back at her, my face shield cocked up.  We were about two minutes away from sending him off to interventional radiology and calling it a day.

The nurse told me to try one more thing, she pulled up the sleeve of his plaid button down and we stared at something so magnificent.  Yes, I said magnificent, somethings are magnificient.  I grabbed a tourniquet and kelly clamp and occluded his arm, a thick pen size vein popped up completely straight.  It felt awesome, plump and juicy.

I smiled at the nurse and she grinned back, two seconds later she was on the phone calling the doctor and getting the approval to stick this magnificently awesome vein. 

A 17 guage needle later and we were off.  This thing was perfect.  Surgery is scheduled for next week to convert the vein into a AV fistula.

Evil dialysis gods: 0, healthcare team: 1.

Somedays I get immense satisfaction from this job.


~ by Kim on July 24, 2008.

One Response to “When Your AV Graft becomes an AV Fistula”

  1. SWEEEET!!!!

    Nothing more beautiful than those thick pen sized veins 🙂

    Well, there are a few things, but had I been in your position, I would have squealed and wet myself.

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