We have many patients who are dialysis patients with either a fistula in the arm or a dialysis catheter. Since the affected arm where theÂ fistula is shouldn't be accessed for IV's and the 'good arm' doesn'tÂ have a vein left to stick, Â what are other institutions doing for obtaining IV access. Our ER have at timesÂ placed PIV's on the lowerÂ arm withÂ the fistulaÂ because the ER physician has okay'd this and the renal doc has said it is okay for a limited time. The renal floor of our hospital feels this is not an okay practice. What are others doing for these renal patients when the fistula or dialysis catheter isn't being accessed for infusions? The questionÂ for a plan of care specifically for the renal patient needing IV accessÂ is coming up at a care coucil meeting and if anyone has ideas I would greatly appreciate your input. Thanks.