Dialysis Access Care and Safety Guide

Dialysis Access Care

Temporary Catheter: Inserted into a large vein in the neck, near the shoulder, or in the thigh.

1. Keep the dressing clean and dry at all times. If it gets wet, visit a hospital or nearby clinic immediately to change the dressing.
2. If the catheter is placed in the thigh, avoid bending or flexing the thigh excessively, as this may kink the catheter, cause blood clots, or affect blood flow.
3. If you experience pain, swelling, fever, or if the catheter appears to move or come loose, seek medical advice immediately.
4. If dialysis is performed once a week, the dressing should be changed every 3 days.

Permanent Access (AV fistula / AV graft): A surgical connection between a vein and an artery, or using a synthetic graft.

Post-operative Phase

1. If there is excessive bleeding or unusual swelling after surgery, consult a doctor immediately.
2. If the wound becomes red, hot, swollen, painful, and is accompanied by fever, infection may be suspected—seek medical care promptly.
3. Keep the arm elevated, especially during the first 2–3 days, to reduce swelling.
4. Perform hand exercises using a small ball (squeeze and release repeatedly) once the pain subsides.
5. Avoid impact or injury to the operated arm.
6. Do not draw blood, measure blood pressure, insert IV fluids, or inject medication in the operated arm or leg, and avoid lying on that side.

During Use

1. Perform regular hand exercises using a small ball (squeeze–release frequently).
2. Avoid trauma from hard or sharp objects to the access arm.
3. Do not draw blood, measure blood pressure, insert needles, or lie on the access side.
4. Clean the area thoroughly with antiseptic soap before each dialysis session.
5. Do not scratch or pick the skin over the access site.
6. Regularly check for redness, swelling, or signs of infection.
7. Check for a “thrill” (vibration) over the access site. If absent, consult a doctor or dialysis nurse immediately.
8. Avoid wearing tight accessories such as watches or bracelets, and do not lift heavy objects with that arm.
9. After dialysis, avoid pressing the needle site too hard when stopping bleeding.
10. If bleeding occurs after returning home, apply gentle pressure with a clean cloth. If bleeding does not stop within 30 minutes, seek medical care immediately.
11. Apply a cold compress and use anti-swelling medication after dialysis. Avoid heat products such as balms.
12. If there are signs of inflammation such as redness, warmth, or fever, go to the hospital immediately.

Proper care of dialysis access is essential for effective treatment. Patients undergoing dialysis must take good care of their vascular access to ensure safe and efficient dialysis.