Care and Cannulation


Catalog excerpts

Care and Cannulation - 1

Techniques for the Care and Cannulation of A-V Prosthetic Grafts PERFORMANCE through innovation

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Techniques for the Care and Cannulation of A-VProsthetic Grafts The quality of life for hemodialysis patients can be directly related to the life expectancy of their arteriovenous (A-V) grafts. Which is why we recommend the following guidelines for the safe and efficient cannulation of GORE® Vascular Grafts implanted as an A-V hemodialysis access. Taken from the combined experiences of major dialysis centers, we have identified certain techniques that have proven to be of benefit through the years. Through the consistent use of these techniques, you will help cannulation proceed faster and...

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About Gore Vascular Grafts The GORE® ACUSEAL Vascular Graft FOR MORE THAN 40 YEARS MEETING THE MOST DEMANDING PROCEDURES The GORE® ACUSEAL Vascular Graft is a multilayer vascular graft which includes: Tri-Layer Construction of a GORE® ACUSEAL Vascular Graft • An elastomer membrane between the inner and outer layers of expanded polytetrafluoroethylene (ePTFE) Recognized by renowned surgeons worldwide for exceptional performance and quality, our vascular grafts are available in a wide range of configurations: Abluminal layer: ePTFE graft • A luminal CBAS Heparin Surface • Stretch and...

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Evaluating the A-V Prosthetic Graft Evaluating the A-V Prosthetic Graft 2. CHECKING THE FLOW IN THE GRAFT Initial inspection of the access site should be part of every hemodialysis session, especially after the patient’s graft has healed. Infections, hematomas, and pseudoaneurysms can present problems, making cannulation difficult, even dangerous. Early detection of such problems and prompt referral to the patient’s physician may save the graft and perhaps the patient’s life. The most serious complications are: It is important to check for blood flow in the graft because reduced blood flow...

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Evaluating the A-V Prosthetic Graft Aseptic Preparation 4. ASSESS PUNCTURE SITE It is important to know what graft sites have been used during the course of hemodialysis in order to avoid “one-site-itis.” To track this history, keep a chart to map the position and date of puncture. Use the following to evaluate the efficacy of a puncture site. • You may choose to wear sterile gloves, depending on procedures followed in your dialysis center. Avoid touching a disinfected puncture site with unprotected hands, non-sterile gloves or instruments, or dialysis equipment. HOW TO EVALUATE THE...

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Cannulation Technique After Dialysis is Completed NEEDLE DIRECTION AND BLOOD FLOW: Please note that during all phases of needle insertion, care must be taken not to contaminate the disinfected area around the puncture site. Investigate unusual resistance or pain occurring during cannulation. Once the needle is fully inserted and the wings taped, the patient should not experience discomfort. Persistent pain may indicate needle puncture of the back wall of the graft. In this condition, flow will often be sluggish and erratic upon aspiration. Correct such problems before continuing dialysis. •...

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Special Consideration for Early Cannulation of the GORE® ACUSEAL Vascular Graft In selected cases, a physician may decide that a patient must undergo hemodialysis shortly after the vascular access graft has been implanted. Extra precautions must be taken with these patients because the danger of venous outflow damage, hematoma formation, and infection is great. Postoperative swelling may make it difficult to locate the graft and place the needle. A misplaced needle may damage the graft or puncture the back wall. Gentle digital pressure can be used to temporarily displace GORE® ACUSEAL...

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References and Bibliography Davidson I, Munschauer C. Preliminary experience with a new intrawall radially supported ePTFE graft. Abstract presented at the 8th Biannual Symposium on Dialysis Access. Vascular Access for Hemodialysis VIII; May 9-10, 2002; Rancho Mirage, CA. Page 23. REFERENCES 1. National Kidney Foundation, Inc. NKF KDOQI Guidelines. Clinical Practice Guidelines and Clinical Practice Recommendations. Guideline 6. Treatment of arteriovenous graft complications. Graft Degeneration and Pseudoaneurysm Formation (CPG 6.2, CPG 6.3)....

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W. L. Gore & Associates, Inc. Flagstaff, AZ 86004 +65.67332882 (Asia Pacific) 00800.6334.4673 (Europe) 800.437.8181 (United States) 928.779.2771 (United States) Products listed may not be available in all markets. GORE®, GORE-TEX®, ACUSEAL, PERFORMANCE THROUGH INNOVATION, and designs are trademarks of W. L. Gore & Associates. CBAS is a trademark of Carmeda AB, a wholly owned subsidiary of W. L. Gore & Associates, Inc. © 2011 – 2016 W. L. Gore & Associates, Inc.  AP0064-EN5  JANUAR

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