Hemorrhage of AV fistula - Revision history

Elcatracho: /* Management */

2020-12-31T04:50:59Z

Management

← Older revision		Revision as of 04:50, 31 December 2020
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	*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>		*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>
	[[File:purse string.jpg\|thumbnail]]		[[File:purse string.jpg\|thumbnail]]
	*Figure-of-8 stitch with 3-0 ~~nylong~~ or 5-0 prolene		*Figure-of-8 stitch with 3-0 nylon or 5-0 prolene
	*Can attempt desmopressin acetate 0.3 mcg/kg IV<ref>Calvert JH, Cline DM. End-stage renal disease. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. New York, NY: McGraw-Hill; 2020:(Ch) 90.</ref>		*Can attempt desmopressin acetate 0.3 mcg/kg IV<ref>Calvert JH, Cline DM. End-stage renal disease. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. New York, NY: McGraw-Hill; 2020:(Ch) 90.</ref>
	*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.		*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.

Elcatracho: /* External Links */

2020-12-22T21:58:40Z

External Links

← Older revision		Revision as of 21:58, 22 December 2020
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	==External Links==		==External Links==
			https://www.youtube.com/watch?v=toFiGSfesZk&feature=youtu.be

	==References==		==References==

Elcatracho: /* Management */

2020-12-22T21:57:41Z

Management

← Older revision		Revision as of 21:57, 22 December 2020
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	[[File:purse string.jpg\|thumbnail]]		[[File:purse string.jpg\|thumbnail]]
	*Figure-of-8 stitch with 3-0 nylong or 5-0 prolene		*Figure-of-8 stitch with 3-0 nylong or 5-0 prolene
			*Can attempt desmopressin acetate 0.3 mcg/kg IV<ref>Calvert JH, Cline DM. End-stage renal disease. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. New York, NY: McGraw-Hill; 2020:(Ch) 90.</ref>
	*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.		*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.

Elcatracho: /* Management */

2020-12-22T21:56:56Z

Management

← Older revision		Revision as of 21:56, 22 December 2020
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	*QuikClot or similar product application		*QuikClot or similar product application
	*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>		*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>
	[[File:purse string.jpg\|thumbnail]] ~~or figure~~-of-8 stitch with 3-0 nylong or 5-0 prolene		[[File:purse string.jpg\|thumbnail]]
			*Figure-of-8 stitch with 3-0 nylong or 5-0 prolene
	*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.		*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.

Elcatracho: /* Management */

2020-12-22T21:55:12Z

Management

← Older revision		Revision as of 21:55, 22 December 2020
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	*QuikClot or similar product application		*QuikClot or similar product application
	*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>		*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>
	[[File:purse string.jpg\|thumbnail]]		[[File:purse string.jpg\|thumbnail]] or figure-of-8 stitch with 3-0 nylong or 5-0 prolene
	*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.		*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.

ClaireLewis at 16:55, 16 October 2019

2019-10-16T16:55:05Z

← Older revision		Revision as of 16:55, 16 October 2019
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	==Evaluation==		==Evaluation==
	*Consider Doppler US		*Consider Doppler [[ultrasound\|US]]

	==Management==		==Management==
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	**Utilize fistula clamp to apply small focus of direct pressure		**Utilize fistula clamp to apply small focus of direct pressure
	**Bulky dressing with allow for continued bleeding		**Bulky dressing with allow for continued bleeding
	*Correct coagulopathy		*Correct [[coagulopathy]]
	**Protamine sulfate for severe [[Unfractionated heparin reversal]]		**[[Protamine]] sulfate for severe [[Unfractionated heparin reversal]]
	**DDAVP for [[Uremic bleeding syndrome]]		**[[DDAVP]] for [[Uremic bleeding syndrome]]
	*Topical thrombin		*Topical thrombin
	*QuikClot or similar product application		*QuikClot or similar product application
	*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>		*Purse string suture with 3-0 nylon suture<ref>Vesely TM. Use of a Purse String Suture to Close a Percutaneous Access Site After Hemodialysis Graft Interventions. JVIR 1998; 9:447-450. http://www.vascularaccessdoc.com/pdf/22.pdf.</ref>
	[[File:purse string.jpg\|thumbnail]]		[[File:purse string.jpg\|thumbnail]]
	*If can not be stopped with above measures, place upper extremity ~~tourinquet~~ and consult vascular surgeon vs IR.		*If can not be stopped with above measures, place upper extremity [[tourniquet]] and consult vascular surgeon vs IR.

	==Disposition==		==Disposition==

Rossdonaldson1: Text replacement - " US " to " ultrasound "

2016-11-13T19:05:53Z

Text replacement - " US " to " ultrasound "

← Older revision		Revision as of 19:05, 13 November 2016
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	**Bleeding from puncture site is usually controlled by digital pressure or subq suture (if placed deep will often ruin shunt)		**Bleeding from puncture site is usually controlled by digital pressure or subq suture (if placed deep will often ruin shunt)
	**Consider vascular surgery consultation for continued bleeding or infection		**Consider vascular surgery consultation for continued bleeding or infection
	**Arterial Doppler US studies can identify the aneurysm or pseudoaneurysm		**Arterial Doppler [[ultrasound]] studies can identify the aneurysm or pseudoaneurysm

	==Clinical Features==		==Clinical Features==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T12:04:22Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 12:04, 23 July 2016
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	{{AV shunt complications DDX}}		{{AV shunt complications DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Consider Doppler US		*Consider Doppler US

Rossdonaldson1: Text replacement - "w/ " to "with "

2016-07-14T05:56:41Z

Text replacement - "w/ " to "with "

← Older revision		Revision as of 05:56, 14 July 2016
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	==Management==		==Management==
	*Control bleeding w/ pressure applied to puncture site for 5-10min; observe for 1-2hr		*Control bleeding with pressure applied to puncture site for 5-10min; observe for 1-2hr
	**Utilize fistula clamp to apply small focus of direct pressure		**Utilize fistula clamp to apply small focus of direct pressure
	**Bulky dressing with allow for continued bleeding		**Bulky dressing with allow for continued bleeding

Ostermayer: Text replacement - "Category:Nephro" to "Category:Renal"

2016-03-22T14:08:28Z

Text replacement - "Category:Nephro" to "Category:Renal"

← Older revision		Revision as of 14:08, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Nephro~~]]		[[Category:Renal]]
	[[Category:Vascular]]		[[Category:Vascular]]