ED Shunt Dialysis Fistula Bleeding

Hemodialysis Access Bleeding

You have a hemodialysis access in your arm, either an arteriovenous (AV) fistula or an artery to vein graft. It has been bleeding. Blood needs to flow freely through the fistula or graft. As part of your treatment, you are also taking medication that thins your blood. This makes you bleed more easily. It is important to stop your fistula or graft from bleeding as soon as possible-you can quickly bleed to death from a rapidly bleeding hemodialysis access.

Home care

If your fistula or graft site is bleeding:

  • If it is bleeding quickly, immediately put pressure right on the spot that is bleeding with a gauze or cloth. Push hard till it stops. Then, get medical help right away.
  • If it is just oozing a small amount of blood, follow these directions:
  • Wash your hands. Dry them on a clean towel.
  • Put a small piece of sterile gauze on the area that is bleeding.
  • Press gently with your fingertips only on the area that is bleeding. Hold your fingers there for 30 minutes. Do not press on the whole forearm. Do not wrap anything around the wrist or arm, including bandages.
  • After 30 minutes, take your fingers off the area that was bleeding.
  • Wash and dry your hands again.
  • If it is still bleeding, call your doctor or go to a hospital emergency department.

General access site care

The following guidelines will help you care for your access site:

  • Wash your hands often. Keep the access site clean.
  • Check the fistula or graft for the pulsing feeling ("thrill") every morning and night.
  • Do not:
    • Let anyone take your blood pressure on your hemodialysis access arm.
    • Let anyone take blood from or inject medication into the arm.
    • Wear jewelry or tight sleeves over the access site.
    • Wiggle the fistula or graft, or pick at your skin near the access.
    • Carry anything over the arm or lift heavy objects with that arm.
    • Sleep on your arm with the access site.

Follow-up care

Follow up as advised by the doctor or our staff.

When to seek medical care

Get prompt medical attention if you have any of the following:

  • Fever of 100.4?F (38?C) or higher
  • Red, hot, or swollen area around the access site
  • Light-colored fluid coming from the area around the access site
  • Pain or hardness around the access site
  • Loss of pulsing feeling ("thrill") over the fistula or graft
  • Pain, cold, or numbness in the hand that won't go away
  • Pale color of the hand that won't go back to pink
  • Any major bleeding, or minor bleeding from the access site that won't stop