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Akses :

Pembuluh darahyang digunakan

untuk masukdan keluarnyadarah daritubuh dalam

proses dialisis

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CDL

Fistula

cimino/AV shunt

graft

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CDL

TEMPORARY

SUBCLAVIAN/JUGULARIS

FEMORALIS

PERMANENT SUBCLAVIAN

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Check doctors order

Identify your patient

Assemble/prepare

your equipment fordressing

Wash your hand

Wear unsterile gloves

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Remove oldplaster/hipafix(tape) from outer

to inner Throw to medical

waste togetherwith unsterile

gloves Wash your hand

Wear sterile

gloves n removegauze sterile

Put green eyesheet sterile

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Start to clean CDLfrom inner to outer (exit port) by iodine 10

% , wait till dry or for 4mins

Wipe with alcohol

70% start from inner toouter and wait till dry

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Throw to medicalwaste together with

unsterile gloves

Wash your hand

Wear sterile gloves

n remove gauzesterile

Put green eye sheet

sterile Fix with tape

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Withdraw heparinfrom both lumen ofcatheter and flush

with 10 ml saline eachlumen. While doingthis u r checking flow

of access

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Patient ready toconnect to machine forHD

If patient not for HD Put Hep Lock as

manufactures order

Cover catether

Wrap with sterile gauzenicely

Fix with hipafix or tape

Return equipment Throw your gloves

Wash your hand

Document

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Specialconsideration

1. Check any sign ofinfection

2. Check fixation ofcatheter

3. Check flow ofaccess

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Check doctors

order

Indentify your

patient Prepare equipment

Wash your hand

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Wear sterile gloves

Wipe with iodine 10 %wait till dry or for 4

mins

Wipe with alcohol70% wait till dry

Put sterile gauze

Fix with tape

Doen gloves

Wash your hand

Document

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NOT LIGHTING HEAVY OBJECT or PUTTING PRESSURE ON ACCESS ARM

Check bruits daily Not to bump or cut access

NOT TO WEAR TIGHT JEWELRY or CLOTHING NEAR THE ACCESS

Dont take BP on access arm Using access only for HD

SLEEPING ON THEACCESS ARM FREE/NOT UNDER HEAD or BODY

Makesure working well Keep clean all the time

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THANK YOU AND GOOD LUCK