This is an e-mail I sent to the nephrologists at our hospital. I amy get better answers here;o) thanks
We are looking for some expert guidance for our practice and procedure of placing and maintaining peripheral IV access in our CRF patients with active and non-functioning HD fistulas. We recognize preservation of functioning fistulas is of paramount importance to these folks. We would not place an IV in a functional fistula arm unless a life threatening emergency (cardiac arrest). Occasionally, we get patients with a failed fistula arm and a functional fistula arm. In the past, we required an order from nephrologists to use the non-functional fistula arm. Currently, our procedure reads, " Unless life threatening emergency, with no alternative access, extremities with functioning or non-functioning A/V fistulas and lymph node dissection/lymph edema are NOT to be used for IV insertion." This is even more restrictive.