If one has to be restuck with the original needle left in, where should the new needle go? Must it be above, below or as far as possible away from the original needle so they won't be too close? If the first needle is stuck poorly won't it continue to hurt? What if it completely infiltrated?

Generally, this new needle should go above. If the site is completely infiltrated, then it might require either rescheduling the treatment, or removing the needle, applying compression and ice to take the swelling down, and resuming treatment when possible. If blood flow has ceased throught the 'poor' needle site, the pain should be diminished or stop altogether.

Carol

Carol,
When you say "above", if my arterial site is in my upper arm closer to the direction of my hand than the ven. site (and let's suppose it was the art. stick that was bad), do you mean that the new stick would be past the first stick nearer the direction of my hand? And if the two needles (bad stick and new stick) are near each other, wouldn't they be too close? Seems like they'd have to fit in the vein side by side. (I'm trying to picture this)

Nate:

I understand. I really didn't make myself too clear there.

When I said 'above' I meant 'moving up your arm toward your shoulder'.

In your example, if the arterial needle needed to be replaced, you may need to make the venous needle the arterial site (assume here that this isn't a loop access with arterial flow on one side only). Then, moving toward the shoulder, 'up' the access site, a new needle would need to be placed.

You raise a very valid point about proximity of needles. To help prevent recirculation, they should not be too close together. Generally, one to two inches apart is ideal. I know that in some cases this is hard to achieve, but that is the ideal.

Please let me know if this helps!
Carol