How does anyone feel about using clamps to hold pressure after treatment?

Takes away the "quality" time with the patient, breaking down the communication and the relationships.
also allows for more "accidents" to occur from not being there when the clamp has slid off, popped off, got bumped off.... anyway it came off...

Clamps should not be used unless absolutely necessary, (too much pressure can clot off and or damage the access) and should adjustable so too much pressure will not be used. The fistula first concept guidelines suggest if a clamp must be used, that they be used one at at time. Remove the first needle, apply the clamp and check for a bruit and thrill. Once hemostasis has occurred, remove the clamp (apply bandage) and then remove the second needle and apply the clamp, again checking for bruit and thrill. Patients can be taught to hold thier sites too. For more information check out the fistula first website at http://www.fistulafirst.org/

While not a fan of the use of clamps, they have become a necesary evil in today's marketplace.If the ratio was lower than 4-5:1 or 5-6:1, if anyone calls off, the use would be lower. Maybe 50% of pts. could hold their own sites but 51% of that number will refuse { I can't, I don't feel good, I'm not doing your job, etc.}. While most of the recomendations of fistula first program Are sound, remember they are made sitting behind a desk not standing beside a machine.

Its time for dialysis professionals to quit making excuses and do what is right for the patient. This move 'em in and move 'em out attitude dehuminizes us all.

What if it were you or your family member? Wouldn't you want them to get the best care?

the guest must come out of the bubble she lives in.

There are inherent dangers of clotting an access with the use of clamps. But with the increasing age and disability of dialysis patients, this is a risk that must be faced. The proper use of these clamps will reduce the adverse risk of access damage. I usually use the clamps on the patients who cant hold their own sites. I remove them in a timely manner to reduce the time of restricted flow. We rarely experience clotted access at our clinic. The few that do occur are dispersed between clamp use and non-clamp use, so the data here does not show a correlation between clamp use and clotted accesses.

I haven't seen clamps used in at least 8 years in 3 different units and different companies as well. Thank GOD we have good pt to staff ratios at my clinic

Our unit has used clamps for the seven and a half years I have worked here. Our numbers for fistula/graft thrombosis compare to the numbers for our state. There is not a correlation between clamp use and thrombosis at our unit.
In this "evidence based' environment has anyone seen any research evidence that "There are inherent dangers of clotting an access with the use of clamps"? I reviewed the Fistula First bibliography and found nothing that referred to arm clamps.

we just get the patients to 'hold off' their own spots, this gives more independence back to the patients.
For patients with high pressures we use as calcium alginate pad under some gauze to help coagulation