“Arteriovenous internal fistulas are the lifeline of uremic patients.” Therefore, becomes particularly important to correctly use and care for the fistula and prolong the service life of the fistula. Let’s talk about how to care for blood vessels in daily life.

I. Personal hygiene management.

1.Keep your skin clean, and bathe and change underwear regularly.
2.Wash the fistula limb with warm water and soap solution daily, and be careful to avoid the punctured area.
3.Try to wear cotton and soft clothes with loose cuffs. Firstly dress the arm with the fistula, and take off the same arm at last.
4.Do not wear a watch or too tight ornaments on the arm on the fistula side, and do not lift heavy objects.

II. Routine monitoring of internal fistula blood vessel

1.Fistula tremor, pulsation, and murmur are examined daily at special time periods such as after getting up, before eating, and before going to bed, and related records are made.
2.The punctured site of the fistula is observed daily for oozing and swelling. If there is oozing, local hemostasis should be performed by light pressure first. Cold compress with ice packs is given when there is swelling, while hot compress was prohibited within 24 hours after dialysis, and it could be used to detumescence when no oozing is confirmed after 24 hours.

III. Early treatment of abnormalities during dialysis

1.In the state of catching cold, low blood pressure, and hypoglycemia, if the fistula site is painful and the noisy is weakened or disappeared, warmth should be given first, and fist clenching exercise should be performed, and anti-inflammatory, analgesic, and blood-activating ointment bureaus should be used for local kneading. The proximal end of the limb should be intermittently pressurized, and the patient should timely visit the hospital for treatment if the effect was poor.

2.During sleep, especially in cold weather, make sure the limb with fistula placed in the quilt to avoid compression or catching cold, and the warm cuff can be used for protection.
3.If hypotension occurs during dialysis, special attention should be paid to keep the limb with fistula warm after returning home and increase the frequency of fistula monitoring.
4.When diarrhea, high fever, profuse sweating and other conditions occur, it is necessary to monitor whether the internal fistula is abnormal, increase the frequency of internal fistula monitoring to avoid excessive dehydration, and appropriately supplement of fluid is needed when necessary to avoid internal fistula blockage.
5.When doing housework, especially as washing clothes and dishes, be sure to use warm water, and avoid continuous work in cold water.
6.Avoid collision of the limb with internal fistula with hard objects such as table foot, and avoid continuous heavy objects holding.

IV. Fistula care daily

1.Exercise of the limb with fistula  After the arteriovenous fistula surgery is done, local movement of the limb with fistula can be performed on the third day. On the 7th day, the movement of holding the upper arm of the limb with fistula by the healthy limb was started to intermittently prevent blood reflux and increase the pressure of the fistula vessels; during the dialysis period, the exercise of pinching the grip by unaffected can be done regularly, with 4 groups each time and 50 in each group.
2.Local hot-wet compress on the limb with fistula  20-60 minutes after the end of dialysis for internal fistula, the gauze can be removed to see whether there is oozing at the needle site. After 24 hours, the adhesive tape can be removed and ointment is applied twice one day along the perivascular area except the needle site, and after covering with plastic wrap, hot compress the limb with a hot water bag or hot towel for 15 – 20 minutes. The temperature should not be too high to avoid scalding the skin.
3.Keep the limb with fistula warm  Hyperthermia, physiotherapy and other methods can be used to keep the limb with fistula warm, and non-thermal infrared is recommended. X-ray irradiation has the advantages that it will not cause skin burns; infrared ray has strong penetration, which can repair vascular injury, improve peripheral circulation, and enhance vascular elasticity, and it has the best effect especially within 4 hours after vessel injury.