I think a access coordinator should monitor this site.Lets discuss the fistula first program,and monitoring grafts and fistulas on a monthly basis using transonics,crit-line or any other devices used.We know that catheters are only an expensive item utilized as a temporary gap prior to the fistula or graft.The basic catheter is the same as it was 25yrs ago only the new bugs have evolved,to make this topic temporary conversation at best...

I am the vascular access monitor at our unit. I use the Transonic system and I like it. I have only had it for about 6 months now so I am just getting some trending results. I am also happy to say that our Doc'c are finally starting to trust it. Any help that others may have would be great.

quote:

Originally posted by emtmike:
[qb] I am the vascular access monitor at our unit. I use the Transonic system and I like it. I have only had it for about 6 months now so I am just getting some trending results. I am also happy to say that our Doc'c are finally starting to trust it. Any help that others may have would be great. [/qb]

I too, use the Transonic system for vascular access monitoring. We've had our program for about 4 years now. Glad to hear that your Physicians are on board. What is the frequency of your testing? Are you doing all access types( AVF, AVG, CATH )? Do you follow K/DOQI guidelines or do you set up database based on initial baseline measurements? Sorry for all the questions Just interested in learning how others are utilizing their equip.

It is good to see some conversation about Vascular Access Testing.I too use the Transonics HDO2 the HDO1 works but it takes more time. I currently monitor 500 patients a month.I only monitor Grafts 600ml or below is when I refer to Access Center.5OOml or below for Fistula.I do not monitor catheters.All monitoring takes place every 30 to 45 days and a 2 week follow-up after intervention.In addition I teach and instruct proper cannulation techniques.From the inception of your program you should remember that many of your access problems are because of improper sticking . Also always look at patients chart and observe changes in B/P medications.Kt/v, URR,and any significant problems with accesses.Our patient admission rate for access problems has decreased significantly since I came on board. We are increasing our patient population and adding 3 more technicians.So yes physicians have bought on to Access Testing....

Old School Dialysis writes:
In addition I teach and instruct proper cannulation techniques.From the inception of your program you should remember that many of your access problems are because of improper sticking .

What is your advice on cannulating a fistula? Can you recomend an instructional text?

Wouldn't discard the subject of catheters due to fistula's being recommend. Some patients do not have sufficient veins for a fistula and a catheter is the only choice.

Clearly the benefits of using Transonic for access surveillance and the positive impact of it on quality outcomes is clear. I would like some personal opinions on Transonic and encourage any access coordinator referral for showing the value of Transonic.
www.transonic.com