care of a surgically created arteriovenous fistulas
The following advice should be given to patients with newly created arteriovenous fistula:
- protect the arm and the fistula from direct trauma for the first few days
- avoid overuse of the arm with the fistula
- avoid driving, and heavy lifting for the first two weeks
- perform strengthening exercises, such as squeezing a rubber ball for 2-3 minutes, 2-3 time each waking hour in the first few weeks
For long term care of the arteriovenous fistula advice patients about the following:
- stress on the importance of maintaining cleanliness of the puncture site and the skin surrounding the fistula
- check for "thrills" and listen for bruit daily
- thrills - a continuous vibration or buzz can be felt when palpating the fistula with at least three fingers or the upper palm of the hand
- a stethoscope can be used to listen to a bruit
- avoid falling asleep on the affected arm
- avoid tight fitting clothes, jewellery, or watches on the affected arm
Healthcare professionals should avoid
- measuring blood pressure in the arm with the fistula
- drawing blood from the arm with the fistula (but blood can be taken from the veins at the back of the hand) (1)
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