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How to Button Hole an AV Fistula

My name is Pauline, dialysis access nurse in York Hospital, UK. In this short video I will show you how to buttonhole a fistula. 

A buttonhole is where the needles are inserted in exactly the same place and at the same angle each time you have dialysis.

Buttonholes have been shown to reduce anuersym (bulges in the vein) formation and help preserve integrity of the outflow vein. It also keeps the fistula flatter and improves appearance of the fistula. Patients report that it is less painful and easier to self cannulate.

A training video from 1969 gives us a historical prespective of how patients were trained in the early days of home haemodialysis! My thanks to Home Dialysis Central Discussion group on Facebook for unearthing this video on Youtube