I have been assigned a home dialysis patient who has a forearm loop graft. It appears all cannulation has occurred near the loop. The patient has excessive tissue similar to one who has lost weight. Even when holding the graft taut between two fingers it tends to move like a rolling vein, except in the area near the loop. I would like to rotate sites along the length of the graft. Any suggestions for stabilizing the graft for cannulation is appreciated. Perhaps this is the reason for prev cannulations near the loop. On my first attempt to cannulate outside that area, I thought I had a section of the graft stabilized. I felt the thrill but when I inserted the needle, I did not enter the graft.

Barbara,
Can you outline the graft from the loop to the arterial and venous anastomoses? The mid sections might be the hardest to palpate. The sections closest to the anastomosis might be easier to start with and then work down towards the loop section as you sucessfully find the graft. It is hard to cannulate the graft when it rolls! Good Luck!
Deborah

Barbara, I don't know how you stabilize the graft before you cannulate, but I have found that if I spread the thumb and index finger (of the hand not holding the needle)and stretch the skin both above and below the area you want to cannulate it tends to help keep the graft from rolling. I put enough tension on it to hold it still but not enough to actually occlude the graft. Others in my unit use their thumb and index finger on either side of the graft where they want to cannulate. Hope this helps! Ruth