Vascular Access Care

1. VASCULAR ACCESS
CARE
Dialysis Unit, Christian Medical College

2. NEED FOR VASCULAR ACCESS
• To facilitate sufficient and
constant blood flow for dialysis.
• To have effective dialysis.

3. TYPES
TEMPORARY VASCULAR ACCESS
Central venous catheters - uncuffed, non tunneled
double lumen catheters placed into the any of the
central veins of neck, chest or leg, providing access
for dialysis.
Sites
Jugular Venous Catheter - To be removed within
21 days
Femoral Venous Catheter – To be removed in 7
days.

4. Permanent Vascular Access
1. Cuffed tunneled catheter placed into
Jugular vein or subclavian vein
• Can be in place for up to 5yrs.
• Removed early in case of any catheter related
infection
2. Arterio Venous Fistula
3. Arterio Venous Graft

5. CATHETERS
Temporary Jugular Temporary Femoral
Permanent catheter

6. Cost
• Temporary: Jugular venous catheter-RS 6765/-
• femoral venous catheter
• Permanent: Perm cath –RS 17755/-
• Dressing material - RS 240/-
• Mupirocin ointment - RS 105/-

7. WHEN IS A TEMPORARY CATHETER IDEAL TO
HAVE?
• For immediate initiation of dialysis in case of
acute or temporary problems as increase in urea,
creatinine, potassium levels, poisons, toxins,
fluid.
• Until maturation of AV fistula in Kidney Failure.
• Failure of other permanent access options
• Short wait before Renal Transplant

8. BEST VASCULAR ACCESS OPTION
*ARTERIO VENOUS FISTULA
Why…?
• Delivers adequate blood flow for dialysis.
•Reduced chance of infection, sepsis, thrombosis
•Longer survival
WHEN TO PLAN FOR FISTULA
At an early stage of Chronic Kidney Disease (stage 3 or
4 itself)
To create Fistula 6-12 months prior to the anticipated
need

9. COMPLICATIONS OF CATHETER
• Catheter related infections
• Thrombus formation-clot in blood vessel
• Venous Stenosis -Narrowing of vessel
• Displacement of Catheter

10. HOW CAN YOU PREVENT CATHETER
RELATED COMPLICATIONS
• Avoid wetting the catheter site.
• Keep the skin around the catheter site
clean and dry
• Make sure that catheter site dressing
is changed with every dialysis or when
wet.
• Avoid unnecessary handling of the
catheter

11. • Take showers daily (Men- to shave
facial & chest hair)
• While traveling cover the neck with
towel or dupatta.
• Avoid injury or undue pressure over
neck, chest.
REPORT IMMEDIATELY
• Fever pain, bleeding, pus discharge,
redness, loose catheter, Sutures gave
way.