Frequently Asked Questions
Which Patients are Most at Risk?
Despite the majority of dialysis treatments being conducted under the supervision of medical staff, the venous needle can still become dislodged. A recent study(1) estimate 414 episodes of venous needle dislodgement annually in the US dialysis population of 350 000 patients. In this study, the mortality estimate range between 10 and 33% which means that the number of fatal incidents in the US may be between 40 and 136.
Low fistula pressure, which is very common, has been proved to increase the risk(2). Traditionally, patients considered as high-risk patients for needle dislodgement have typically been those with a medical condition or behavior which causes restlessness. Some sources estimate an increased risk during the last two hours of dialysis, when some patients become more restless. No, or poor, visibility of access due to the patient occupying single room or receiving nocturnal dialysis in wards with lights out are other factors that may affect the risk.
1 Catastrophic hemorrhage from venous needle
dislodgement during hemodialysis: continued risk of avoidable death and
progress toward a solution” , poster by Stephen Sandroni, MD, Terry
Sherockman, RN, MS, and Kathy Hays-Leight RN, Allegheny General
Hospital, Pittsburgh. Presented at ASN/Renal Week, Philadelphia, US,
November 2008
2 Polaschegg H-D. Venous needle dislodgement: A safety issue.
Possible methods for detection and prevention of major blood loss.
EDTNA/ERCA Conference, Prague, September 2008.