AV fistula cannulation and ultrasound guides
The essentials for cannulating the arteriovenous fistula safely, with and without ultrasound: technique, needles, maturation, Doppler and complications. Every guide cites its sources (KDOQI 2019, ESVS, the Spanish GEMAV guideline and the nephrology nursing literature) and links to a simulator case so you can practice it.
Cannulation technique
- AVF cannulation technique, step by stepAssessment, asepsis, tourniquet, site selection, needle direction, first cannulations and hemostasis.
- Ultrasound-guided fistula cannulation: in-plane vs out-of-planeWhen to use ultrasound, long-axis and short-axis approaches, tenting, flashback and the saline flush check.
- AVF needle angle, gauge and spacingAngle by depth, gauge by blood pump speed, needle length and distance between needles.
- Rope ladder vs buttonhole vs area cannulationWhat each technique is, its benefits and risks, and what the guidelines recommend.
Ultrasound assessment
- Rule of 6s and fistula maturationDiameter, depth and flow: when the fistula is ready for its first cannulation.
- AV fistula Doppler ultrasound: flow volume and stenosisHow to measure access flow in the brachial artery and recognize a stenosis by velocities and diameters.
Complications
- Fistula infiltration: prevention and managementWhy needles infiltrate, how to prevent it with ultrasound and saline, and what to do step by step.
- AV fistula aneurysm: cannulation and when to referAneurysm vs pseudoaneurysm, ultrasound findings, where to cannulate and warning signs.
Educational content. It does not replace supervised hands-on training or your unit's protocols.