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  • Possible Infiltration?

    Hello,

    How can you tell if your graft or fistula has been infiltratrated? Today at dialysis I had my fourth diderent tech since I started. This is my fourth day. She positioned the needle down unstead of up like everyone else had done. It hurted immediatly, and I felt pain thourghout the treatment. She also had to keep checking the position of the needle cause the alarm kept going off. Now at home my arm is sore. Did not feel like this after other treatments.

  • #2
    Re: Possible Infiltration?

    If the alarm kept going off then yes most likely the needles was positioned wrong against the vessel.

    However, if your arm/fistula is not swelled, black/blueish then its not infilrated. Infiltration occurs when the needles fully punctures through the vessel to the outer side of the vessel causing blood to leak out into your arm, causing swell and blueish coloration.




    Originally posted by denise1040 View Post
    Hello,

    How can you tell if your graft or fistula has been infiltratrated? Today at dialysis I had my fourth diderent tech since I started. This is my fourth day. She positioned the needle down unstead of up like everyone else had done. It hurted immediatly, and I felt pain thourghout the treatment. She also had to keep checking the position of the needle cause the alarm kept going off. Now at home my arm is sore. Did not feel like this after other treatments.
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    • #3
      Re: Possible Infiltration?

      Sounds like just a bad stick to me. Sometimes it helps if you flip the needle so the bevel side is facing down. I actually like the up and down stick and I think I get better dialysis.

      When I get a bad stick like that, I make them restick rather than spend the whole session trying to adjust their mistake.
      Whatever does not kill me makes me stronger...Neitzsche
      Flip

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      • #4
        Re: Possible Infiltration?

        Pretty soon you will be able to tell the techs when they are in the right place because you will develop a feel for it. That having been said, your fistula was probably not infiltrated if your arm is not swollen and black and blue and really sore. I agree with Flip that it was probably just a bad stick. If it had been infiltrated you would not have been able to stand the amount of pain involved in a full treatment. BTW; you should feel free to tell a tech or nurse who hasn't worked on you before about the characteristics of your access. For example, mine is shallow and snaky and goes off at a sort of odd angle.
        To the stars through difficulty!

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        • #5
          Re: Possible Infiltration?

          Thanks for the info. I guess its not infiltrated. But it sure felt like it. Just real sore. Hopefully by wednesday it will feel better. I know everyone uses the emla cream, but what do you think of the ethyl choride spray?

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          • #6
            Re: Possible Infiltration?

            I have never used the ethyl chloride spray. If your arm is still sore, try putting warm (not hot) packs on it 3 or 4 times a day for about 15 minutes each time. You will be surprised at how much better your arm feels. You might also try putting a warm pack on your fistula just before you put on your EMLA cream. The warm pack will make the fistula dilate and it will be easier to stick.
            To the stars through difficulty!

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            • #7
              Re: Possible Infiltration?

              Thanks chefnancy, I had tried ice. Thinking that would help take down the swelling. It did swell up, especially around the needle stick site. It seems better today not so sore but still slightly swollen. Will post tomorrow after dialysis and let you know if things went better. Oh, and by the way I have a upper arm graft.

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              • #8
                Re: Possible Infiltration?

                The best rule of thumb is ice intermittently for the first 24 hours and use warm packs after that. Your injury occurred more than 24 hours ago, so I was recommending the warm packs. If this happens again, get some ice on it right away. Then start warm packs the next day.
                To the stars through difficulty!

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                • #9
                  Re: Possible Infiltration?

                  Hey ya'll, I'm new to this blogging thing but not to dialysis. I noticed some talking about that cream you put on before treatment. Well, just from my experience... I've been on hemo for about 3 years now (again being that I had a kidney transplant once already and dialysis before that) and been using the cream until about a week ago. Apparently, this cream thins out the skin and eventually you develop problems with leaking from the needle entrance point among other problems. Last week, I had a leak and they ended up having to remove the needle and re-stick me during treatment, which caused an immediate massive infiltration... Needless to say HUGE PAIN. My arm is still swollen, black and blue and I still have sooooo much pain. I just ordered the Ethyl Chloride spray to see if it's effective. According to the nephrologist, this will not cause your skin to thin out. Good luck to ya'll with everthing and hope this helps.

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                  • #10
                    The tech at Davita infiltrated my fistula this morning 10/16, I wasn't able to get treatment today after they tried moving the needle around to fix it.
                    I then told the tech to take them both out because my arm/fistula had become sore and tender feeling, I had plenty techs stick my fistula with ease and this person is my regular tech and always needs to tie my arm up with a glove to see the fistula better, but other techs in the past do it without tying off my arm.
                    I told him I think him tying my arm up makes it easier to infiltrate, I am not happy with having to go through this every few weeks it seems, I have a very healthy and strong flowing fistula, Maybe I need to request another tech?

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                    • #11
                      Originally posted by denise1040 View Post
                      Hello,

                      How can you tell if your graft or fistula has been infiltratrated? Today at dialysis I had my fourth diderent tech since I started. This is my fourth day. She positioned the needle down unstead of up like everyone else had done. It hurted immediatly, and I felt pain thourghout the treatment. She also had to keep checking the position of the needle cause the alarm kept going off. Now at home my arm is sore. Did not feel like this after other treatments.
                      denise,

                      They should not be using the needle facing downward. This was a practice many many years ago, but have long since moved away. Doing this can cause aneurysms. I would speak to your nephrologist about this. Are you at a DaVita center?
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                      • #12
                        You can demand to have another tech stick you. And don't let them tell you different. They are there to help you ... nitcause more problems.
                        My hisband in on Hemo and several of the techs at his DaVita can't stick him. Plus they can;'t pull the needles out correctly. He has had two infiltrations in the last month and a half ... and now next Tuesday we have to go back to the doctor for a fistulagram They will never take the blame for what they do ... it's always "you must have done something" !!! Even though he has two HUGH bumps on this arm where they had stuck him.
                        If they give you any grief ... call the 800 number that they have to have posted for complaints ... IT DOES HELP.
                        My husband was getting the run around about getting on PD home diaylsis ... we emailed one of the heads of DaVita in this area ... we had the surgery scheduled the NEXT DAY !!!!

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