care of a surgically created arteriovenous fistula

Last reviewed 01/2018

The following advice should be given to patients with newly created arteriovenous fistula:

• protect the arm and the fistula from direct trauma for the first few days
• avoid overuse of the arm with the fistula
• avoid driving, and heavy lifting for the first two weeks
• perform strengthening exercises, such as squeezing a rubber ball for 2-3 minutes,  2-3 time each waking hour in the first few weeks

For long term care of the arteriovenous fistula advice patients about the following:

• stress on the importance of maintaining cleanliness of the puncture site and the skin surrounding the fistula
• check for "thrills" and listen for bruit daily
• thrills - a continuous vibration or buzz can be felt when palpating the fistula with at least three fingers or the upper palm of the hand
• a stethoscope can be used to listen to a bruit
• avoid falling asleep on the affected arm
• avoid tight fitting clothes, jewellery, or watches on the affected arm

Healthcare professionals should avoid

• measuring blood pressure in the arm with the fistula
• drawing blood from the arm with the fistula (but blood can be taken from the veins at the back of the hand) (1)

Reference:

• (1) Siddiky A et al. Management of arteriovenous fistulas. BMJ. 2014;349:g6262