Buttonhole Cannulation of Arteriovenous Fistulas: a Dialysis Nurse's Perspective.

Abstract

Patients with ESKD who choose a hemodialysis modality are burdened with the reality that their life is now tied to a dialysis machine 3–6 days weekly. The effect on their medical, social, and psychologic well being is dramatic. One of the biggest fears patients have expressed to us (nurses) regarding hemodialysis is having to be “stuck with big needles” at each treatment. The average patient on in-center hemodialysis is stuck with large bore needles six times per week or 312 times per year, barring any “missed sticks” or infiltrations. The patient on home hemodialysis increases that number to about ten times per week, or >500 times annually. Understanding that the average person recoils from the thought of needles and that 25% of adults present with a real clinical diagnosis of trypanophobia, or “needle phobia” (1), it seems only fitting that we seek out options that would reduce this burden. Buttonhole cannulation, a technique that entails same-site (constant) cannulation of the arteriovenous fistula (AVF) with a blunt needle, …