the question has come up: if I need to place an access in an arm with a non-functioning AVF or graft, is it better to place the tourniquet below the graft or is it ok to place above it? it does not come up very often but as I see more and more renal patients needing long term access and multiple lab draws, it does not take long to run out of sites. I work in a teaching federal hospital and even the renal docs don't know or won't make a stand.