I am having surgery for something unrelated to dialysis. I have an arm access and I still have my neck catheter. I don't know how long I am going to have to be in the hospital. It is considered major surgery. I am very nervous thinking about being in pain from the surgery and having to go to dialysis every other day. Can I use my neck catheter for dialysis during the hospital stay, or will that create problems with my arm access? I've kept my neck catheter in as I've been told I can use it as an IV also. I've been told i should never allow needles in my arms which must be saved for future accesses. Can you suggest anything that might help me to be more comfortable in this situation if I am in pain from the surgery and must go to duialysis?

Robin,

Is your arm access a fistula or a graft? Is your neck catheter a tunneled cuffed catheter or an acute non-cuffed catheter? A non-cuffed temporary catheter can easily become infection and may be removed in the hospital prior to surgery or if you develop any signs of infection such as an elevated temperature. Tunneled cuffed catheters are more resistant to infection, but can also be infected with a hospital stay.

The catheter might be used as an IV site during your hospital stay and is based on the specific hospital procedures and policies. Your catheter still needs to be used in the same way as it would with dialysis. The catheter exit site should be examined, properly cleansed and re-dressed every day to every other day. Care must be taken to have the nursing staff mask as well as you mask when the catheter is opened for any reason. The hubs of the catheter ports should be soaked in betadine prior to removal. A proper flush must be administered after each use to prevent clotting within the catheter. The dialysis staff can help answer any of the general floor nurse�s questions. You do not want to get an infection from the catheter while in the hospital.

The catheter can be used for dialysis as well, but your arm access will most likely provide the best dialysis. Good dialysis is very important in your healing process from surgery. If your arm is a graft, there should be no problems with the cannulations. If your arm is a new fistula, the dialysis staff and nephrologist can best assess your vascular access for use or rest with each dialysis session

Make sure other hospital staff never stick an IV, draw blood or even use your vascular access arm for a blood pressure while in the hospital. A sign should be placed above your bed warning of your vascular access arm restrictions. A hospital band can be placed loosely on your access arm that states No IV, BP or Blood Draws in this arm! The arm used for IV and blood draws should avoid the elbow area. Ask the staff to start at your hand (back of the hand can be used) and only work up the arm only as necessary. Tell them you are trying to protect your elbow and upper arm for a future dialysis vascular access and the sticks can scar the veins.

Best wishes for a successful surgery and full recovery.

Deborah