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Clotted Fistula Requires Urgent Vas-Cath – Nurse Clinicians in Action – 24

Clotted Fistula Requires Urgent Vas-Cath describes how a Vascular Access clinician placed a Vas Cath, or Temporary Dialysis Catheter, at the bedside in a patient whose fistula clotted off in the middle of dialysis and needed emergent Temporary Dialysis access. Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician, as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.

Clotted Fistula Requires Urgent Vas-Cath

– Clinical Case

This case took place in a Long-Term Acute Care Rehabilitation Hospital (LTACH) where the patient was recovering from major surgery and was also receiving hemodialysis. In the middle of dialysis, the patient’s fistula clotted off, and treatment had to be halted. Because the patient was recovering from recent surgery, transportation to an Emergency Department at another facility to access an Interventional Radiology department and a surgical procedure for a Temporary Dialysis Catheter was contraindicated for many reasons. Not only would transporting the patient to another facility heighten the risk of infection, but it would also require another surgical procedure, causing a longer recovery time, delays in access to much-needed dialysis, and added costs to the LTACH and the patient. The patient’s care team tried other alternatives over the following days but was unsuccessful. With the patient’s health rapidly deteriorating, the demand for dialysis became critical, and the facility needed to find another solution quickly.

Clotted Fistula Requires Urgent Vas-Cath

– Diagnosis and Treatment

With the patient in urgent need of dialysis, the facility contacted Vascular Wellness to place a Vas-Cath or Temporary Dialysis Catheter. A Vascular Wellness nurse clinician trained in this highly advanced procedure arrived at the patient’s bedside within three hours of the call, reviewed the patient’s medical history and labs, and spoke with the patient and his wife about the procedure and their recovery goals. During the conversation, the clinician learned that the patient had experienced significant blood loss during a previous Vas Cath procedure by someone other than Vascular Wellness, and they were nervous about a similar experience happening again. The Vascular Wellness clinician explained that while blood loss is a risk with this type of procedure when done properly, both blood loss and discomfort are minimized. The clinician further shared that he was a Vascular Access Board Certified (VA-BC) clinician who had expertly performed hundreds of advanced lines at the bedside with minimal blood loss, and he assured them that the placement of the Temporary Dialysis Catheter would likely be complete within the hour.

After the procedure, the clinician showed the patient and his wife the intact dressing, and the wife asked if her husband’s sheets had been changed. The nurse clinician replied that new sheets were not needed because the procedure went smoothly, and that blood loss was minimal and contained. The patient’s wife was in disbelief and asked again, “Are you sure you didn’t change his sheets?” The clinician assured her that it was unnecessary, and she proceeded to ask the Vascular Wellness clinician if she could hug him to thank him for taking such expert care of her husband. After the hug, the patient could begin much-needed dialysis without delay.

Vascular Access Experts

– Key Points

This case clearly demonstrates how a Vascular Wellness clinician, a Vascular Access Expert credentialed and skill-verified in the placement of innovative advanced lines, including temporary dialysis, was able to provide immediate vascular access services to an existing client’s patient, resulting in life-saving therapy. Although the facility was not using Vascular Wellness for large bore dialysis catheter placement at the time, they quickly learned that partnering with Vascular Wellness affords a value-added, patient-centered, sustainable solution compared with the potential uncertainty of relying on a separate hospital’s availability to provide similar medical services. The agility of the partnership allowed Vascular Wellness and the hospital to provide prompt treatment improving the patient outcome, reducing the risk of complications, and saving on transportation expenses.

Further, Vascular Wellness takes credentialing very seriously and maintains updated information on every nurse clinician, enabling it to supply the requested credentialing information immediately, or as may be requested by the Joint Commission. Using W-2 nurse employees, Vascular Wellness maintains control over credentialing and skillsets, ensuring quality, reliability, and consistency for every client and patient, providing its clients an advantage over a 1099 contractor model.

In addition, we provide our client partners with a dedicated professional team of vascular access experts who are trained, precepted, and certified in the placement of standard and advanced lines at the patient’s bedside. We arrive onsite, generally within three hours, with all the necessary equipment to perform vascular access procedures, whether it’s placing a standard or advanced line. Our value-added vascular access services support your facility by avoiding unnecessary transportation costs, utilizing your medical resources efficiently, and delivering faster, safer therapy to your patient’s bedside. In addition, we promote teamwork internally and externally by either becoming an extension of your in-house team or operating as your outsourced provider, and all of our services are customized to meet our client’s needs. Superior client services are an essential component of our partnerships, and our expert clinicians function as a bridge among all stakeholders, the patient, their family members, and the medical team, as in this instance.

Because we have earned the trust of many doctors, our Vascular Access Expert Team is frequently contacted by doctors who defer to our recommendations by ordering a “consult” before a specific line which is not done with a typical Mobile PICC Line Services company. Vascular access is an invasive procedure. Patient safety and the preservation of the patient’s vascular anatomy are vital to optimal patient outcomes. That is why we conduct independent, comprehensive evaluations of every patient. You may find other companies asserting that they’re Vascular Access Experts, unfortunately, do not follow the same safety protocol. We deeply care about our patients and strive to develop partnerships that benefit and advance healthcare, which is why, as demonstrated in this case, our client quickly trusted us to evaluate the patient and provide a crucial, invasive, medical procedure, without the typical lengthy administrative process.

If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.  For the latest articles and insights, follow us on LinkedInFacebookTwitterYouTube, and Instagram.

Vascular Wellness Serves North CarolinaSouth Carolina, Virginia, and West Virginia. Expanding to GeorgiaKentuckyOhio, Pennsylvania, and Tennessee.

Vascular Wellness provides:
(1) Comprehensive vascular access services to North CarolinaSouth Carolina, Virginia, and West Virginia;
(2) Customized vascular access services to Tennessee and Georgia; and
(3) Support vascular access services to Pennsylvania, Ohio, and Kentucky


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