Article

Postoperative Care for Vascular Access

1. In the days following surgery, mild swelling may occur at the access site. Patients can elevate the limb with a pillow to aid in reducing swelling.
2. Post-surgery, it is important to regularly check for the "thrill" or vibration of the vascular access. If the pulse weakens or the thrill is lost, report it immediately to the nephrology center.
3. Monitor the temperature of the access site; if it becomes cold, numb, or swollen, report it to the nephrology center immediately.
4. After surgery, observe the dressing for any signs of bleeding or excessive tightness, and carry sterile gauze for pressure bandaging.
5. If the wound bleeds or shows signs of inflammation (pain, redness, heat, pus, or hardness), notify the nephrology center promptly.
6. The stitches in the wound are typically removed 10 to 14 days after surgery.
    

Daily Care for Vascular Access

1. Avoid tight clothing and wear warm clothes in winter.
2. Do not measure blood pressure, draw blood, or perform venipuncture on the limb with vascular access.
3. Be cautious with water temperature while bathing; avoid extremes of hot or cold.
4. Avoid putting direct pressure on the limb with vascular access while sleeping.
5. After each dialysis session, cover the access site with a bandage until the next day.
6. Avoid bumping the access site. If injured and bleeding occurs, apply sterile gauze for pressure and notify the nephrology center.
7. Check the vascular access site daily for pulse and throbbing. If the pulse weakens, contact the nephrology nurse or go to the emergency room immediately.
    

Possible Complications of Hemodialysis

Complications may include narrowing of the access, leading to reduced blood flow or thrombosis, ischemia and swelling of the access, aneurysms, pseudoaneurysms, access infections, or heart failure.
 

Purpose of Subcutaneous Venous Catheter Placement

To provide vascular access for hemodialysis, catheters are placed in the subclavian, groin, or jugular veins. These catheters can be temporary or semi-permanent, with semi-permanent generally being more comfortable.
 

Care for Subcutaneous Venous Catheter

1. Monitor daily for signs of bleeding or inflammation (redness, pain, heat, pus, etc.).
2. If the catheter is placed in the jugular or subclavian area, wear loose-fitting, button-up clothing.
3. Keep the dressing over the catheter dry; avoid getting it wet while bathing or washing hair.
4. If the catheter is in the groin, avoid excessive leg movement and keep the area clean; notify staff if it becomes soiled.

5. In the event of an emergency, such as the catheter becoming dislodged and bleeding, apply pressure with gauze or clothing and seek immediate medical attention or call for an ambulance.

    

Possible Complications of Hemodialysis

1. Low blood pressure
2. Muscle cramps
3. Nausea and vomiting
4. Headaches
5. Chest pain, including angina
6. Back pain
7. Fever and chills

8. Bleeding tendencies

    

• Doctors will provide appropriate treatment based on your reactions.
• Other uncommon but serious complications include dialysis disequilibrium syndrome, allergic reactions to the artificial kidney, arrhythmias, cerebral hemorrhage, and seizures.
• Rare complications may include hemolysis, air embolism, and cardiac arrest.