Strategies and Techniques for Optimal Cannulation

A hemodialysis fistula or graft is considered functional once the access can support repeated cannulations with the needle gauge required to deliver the chronic hemodialysis prescription, including the blood flow rate and treatment time. Cannulation technique will impact the success of the cannulation while minimizing potential cannulation complications. Proper cannulation can also affect the lifespan of the vascular access and should be detailed in the ESKD Life Plan and Supporting Access Plans for any individual requiring hemodialysis. Successful cannulation includes proper assessment, skin preparation and infection control techniques, needle characteristics, insertion technique, needle securing, troubleshooting, needle removal and achievement of hemostasis, and proper documentation. Detailed policy and procedures should be in place, which will differ according to access type. With proper care, the lifespan of any access will be lengthened.