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Christine Thomas
drawing blood from arms with nonfunctioning fistula

  I recently was asked by administration if I agreed with our lab's policy of not drawing blood (not even in the hand) if a patient has history of a fistula that is not functioning.  The lab stated that

they would rather draw from the patient's feet.   Our Manager of Dialysis states that she does not agree with this and thinks it is OK to draw from the arm.  I did not see anything specifically in

INS standards or textbook.  Just to avoid arm with working fistula or planned fistula insertion.   I would appreciate any input on this.

 Thank you,

Chris Thomas

Cleveland

lynncrni
 Have you checked the K-DOQI

 Have you checked the K-DOQI guidelines for any information? My approach would definitely involve direction from the neprologist for each patient. Why is the fistula not working? What happened to it? What is planned for it? Answers to all of these questions would provide information about the safety of using the same arm and allow you to rank the risk of using this arm vs the feet for each patient. Seems to me that the treating neprologist would be the best one to provide this information for each patient. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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