Consider this. In less than seven-and-a-half minutes an average-sized man receiving a dialysis treatment can lose more than 40 percent of his blood volume1 from an undetected venous needle dislodgement. An average size woman can lose more than 40 percent of her blood volume1 in less than five minutes. It is considered a Class IV Hemorrhage, and it can be fatal without a rapid response.1
Hemodialysis is a complex treatment requiring a team of trained professionals who are responsible for delivering safe and effective care to the patient.
Before a dialysis treatment can actually begin, vascular access must be established. If the treatment is short-term, or it is necessary to allow a more permanent access route time to mature, a catheter may be used. Another type of venous access is called the arteriovenous fistula (AV), and is preferred for patients who require long-term hemodialysis. The AV fistula is surgically created and provides a long-lasting access site where blood can be removed and returned during hemodialysis. It is used to connect the patient to a dialysis machine, and has to heal for weeks or months before it is ready to be used for the dialysis treatments. A vein and artery are joined under the skin. Over time the vein becomes larger and stronger, creating the fistula that provides vascular access. The skin over the fistula stretches and bulges over the area allowing needles to be used to gain access to the patient’s blood. Two needles are commonly used to puncture the skin to gain access to the patient’s blood supply. The arterial needle removes the blood, and the venous needle is used to return the cleansed blood to the patient.
Complications
Complications associated with dialysis may arise from machine malfunctions, poor design, defective products, adverse reactions to medications, alteration in the patient’s level of consciousness/condition, and human error/inattention. Venous needle dislodgement (VND) is a complication of hemodialysis that can range from minor blood loss to exsanguination (bleeding to death). VND occurs when the needle delivering the cleansed blood from the machine back into the patient either partially or completely pulls out of the access site. Instead of the blood being pumped back into the patient’s bloodstream, it is pumped onto the bed, chair and even the floor. If the dialysis machine is set at a rate of 300mL/min and the venous needle is completely dislodged, the patient’s blood will be pumped out of the machine at 300mL/min. Blood flow rates generally range from vary from 300-500mL/min, so the time it takes for a patient to lose blood will vary.