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fistula needle size
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<old school>
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I would like for anyone to show me where it is documented (not needle manufacturer)that you cannot increase QB to 400 using 16 ga needles on Fistulas.
 
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<RN>
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Its not about needle gauge and blood flow, its about the damage that can be done if the pre-pum arterial pressure is too high which can cause hemolysis and possible damage to the vessel. You probably could get the blood flow up to 400, but what do the pressures look when its that high with a smaller gauge needle?
 
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<old school>
posted
Sorry I left out 1. arterial pressures averaged -240mmg and venous pressures averaged + 250mmg with QB at 400 cc/mn. 2. Also these patients had fewer access related problems than the rest of the clinic population.
 
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old school,

Keep in mind that the more negative the arterial pressure is, the further the actual delivered blood flow is from the set value.

I will send you a spreadsheet of measurements I did about 10 years ago. The measurements were done using NSS at room temperature so the results with blood at body temperature would be even worse.

Chuck


DISCLAIMER : My opinions and views are mine and may not be the same as my employer.
 
Posts: 1787 | Location: Baltimore, MD USA | Registered: 24 October 2001Report This Post
<old school>
posted
Chuck Whats up.I have also done a study which compared Fistulas cannulated with 15ga needles VS 16ga nnedles RESULTS I saw a 64% decrease of referrals to access center for interventions with the 16 ga needles.We have always been taught the bigger the needle,the higher the QB the higher the QD THE BETTER CLEARANCES WE WILL GET.All of the 16ga needle patients passed KT/V and URR EVERY MONTH.Also patients had less complaints with smaller needle
 
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