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What is vascular access? What are the different types of accesses for hemodialysis? Does vascular access require surgery? Adina Voiculescu, M.D., FASDIN, General and Interventional Nephrologist at Brigham and Women's Hospital and Assistant Professor at Harvard Medical School, discusses the different types of vascular access, such as AV fistulas and AV grafts, and how to stay healthy while on hemodialysis.
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0:00 - Intro
0:29 - Peritoneal dialysis & Hemodialysis
0:44 - Types of access to perform dialysis
1:48 - Recommendations
About Mass General Brigham:
Mass General Brigham combines the strength of two world-class academic medical centers, five nationally ranked specialty hospitals, 11 community hospitals, and dozens of health centers. Our doctors and researchers accelerate medical breakthroughs and drive innovations in patient care. They are leaders in medical education, serving as Harvard Medical School faculty and training the next generation of physicians. Mass General Brighamโs mission is to deliver the best, affordable health care to patients everywhere. Together, we transform the health of our communities and beyond.
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Hemodialysis: Types of Accesses for Kidney Dialysis and How to Stay Healthy | Mass General Brigham
https://youtu.be/_bxLpudpqnc
Today I will discuss about hemodialysis.
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00:00 Introduction
02:53 Hemodialysis
06:06 Dialysis Apparatus
07:59 Dialysis Mechanism
13:27 Vascular Access
18:55 Nursing Considerations
25:07 Nursing Management for HD
27:57 NCLEX Practice Questions
Hemodialysis is a procedure where a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean your blood.
I will also discuss about hemodialysis procedure, how hemodialysis machine works and its benefits for patients.
If you're interested in learning more about hemodialysis, or if this just seems like something you should know for nursing school or for the NCLEX exam, check out this video!
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Starting dialysis often means creating a new normal for yourself and your family. Thereโs a lot to think about, from choosing a treatment option, to finding new ways to enjoy your favorite activities, to managing a new diet. The FIRST30 program is all about helping you through this period of adjustment.
Find out more at KidneyFund.org/FIRST30.
Dialysis Fistula clip from full video on Dialysis Options
Research from Mayo Clinic finds that half of elderly patients who start dialysis after age 75 will die within one year.
Lead study author and a health care delivery scholar with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Dr. Bjorg Thorsteinsdottir says many elderly patients and their families feel that they have no choice but to start dialysis, with several expressing regret from having initiated therapy.
The findings were presented at the American Society of Nephrology's Kidney Week 2013 in Atlanta.
What is hemodialysis and how does it work? Who needs it? How do you prepare for it? In the United States, over 30 million Americans have kidney disease, and sometimes, kidney disease progresses to kidney failure or end-stage renal disease. When this happens, you cannot survive unless you have a kidney transplant or some form of dialysis. So today we're going to talk about hemodialysis.
Your kidneys are the two kidney bean-shaped organs that are located in your lower back, or in your flanks. And the kidneys are responsible for filtering out or cleaning your blood. They get rid of excess waste, excess toxins, and excess fluids. If your kidneys stop functioning, then you develop renal failure or end-stage renal disease.
What is Hemodialysis?
Hemodialysis, or blood dialysis, is the filtering of your blood outside of your body. So, if your kidneys stop working properly, the hemodialysis acts as a substitute kidney. Now it's important to note that hemodialysis does not actually correct your own kidney function. It does not fix or treat your kidneys.
#hemodialysis #drfrita
What is The Dialyzer?
The dialyzer is actually the filter. It's the main powerhouse of the hemodialysis system, and it is what actually acts as the substitute kidney. In the dialyzer, you have these hollow fibers that run through it, and these fibers are bathed in something called dialysates, or dialysis fluid.
How Often Are Patients Treated With Hemodialysis?
Most patients who are on hemodialysis are on it between three and six hours, about three days a week, especially if they go to a center.
How Does Hemodialysis Work?
So when you are on dialysis, how does your blood get from your body to the hemodialysis machine and then back to your body? Well, it does so through tubes, and those tubes are connected to your access, and we'll talk about access in just a moment. But as far as the tubing, the tubing is connected to your body.
Types Of Hemodialysis Access
Arteriovenous Fistula or AV Fistula
The AV fistula is the gold standard as far as hemodialysis access is concerned because it gives you the most efficient hemodialysis and it is the least likely to be infected.
Arteriovenous Graft or AV Graft
The AV graft is very similar to the AV fistula in that you still have a surgically connected artery and a vein, usually in the arm, but in the case where if you have veins that are rather thin or arteries that are thin and maybe too weak in order to really give you a properly functioning, substantial AV fistula, then the vascular surgeon may opt to add an artificial material in order to make that shunt a little stronger, or little more durable. And so, an AV graft is another option for dialysis access.
Catheter
If you're in a situation where you need temporary dialysis, or if you have acute kidney injury, then you may have a temporary Vascath placed, and it's usually placed in a vein of the neck, the internal jugular vein, or it can be placed in the groin, or in the femoral vein.
Who Needs Hemodialysis Treatment?
How do you know if you need hemodialysis, and when is it time to prepare? Well, if you follow up with your kidney doctor (nephrologist) regularly, he or she will be watching your labs. They'll be able to see those signs of your kidneys not functioning properly.
Eric's Home Dialysis
If you have an active lifestyle or are often on the go with work, travel or family, then peritoneal dialysis at home may be the right choice. Home peritoneal dialysis offers additional freedom and flexibility as a treatment option thatโs closest to natural kidney function and may require fewer dietary restrictions and medications. To learn more about Home PD, visit https://www.FreseniusKidneyCar....e.com/ckd-treatment/
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In this video, I will be sharing simple tests and exercises which will diagnose your knee pain.
These tests will help with the knee pain diagnosis.
In addition, I will share the most effective therapy and exercises with you which you can do from the comfort of your own home.
Time Stamp:
00:00 Introduction
00:59 Anatomy Inside of the Knee
02:19 Test for Pain on Inside of knee (MCL)
03:12 HARM Protocol
03:30 POLICE Protocol
04:44 Home Therapy MCL Sprain
06:06 Home Exercises MCL Sprain
09:21 Test for Pain on Outside of Knee (LCL)
11:11 Renne's Test (ITB Band)
13:39 Symptoms of Meniscus Tear
13:59 Thessaly Test for Meniscus Tear
14:49 Ege's Test for Meniscus Tear
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It depends upon which ligament is injured. If it is medial collateral ligament you feel pain when you walk ,sit and stand and you will be liming as well. If it is anterior cruciate ligament you feel pain when you walk on uneven ground.
How Do I Exercise An Injured Knee?
Bob and Brad discuss how to exercise an injured knee.
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๐ฅPatellar Tendon Pain AKA โJumperโs Kneeโ๐
๐ฅIf you have this, itโs likely because your patellar tendon was over-stressed beyond what it can currently handle (due to loads that are too high or lack of recovery).
๐ Try 5 reps of 45 second holds
๐ 2 min of rest in between each rep
๐ Keep your knees at roughly 60 deg angle
๐ 7/10 intensity
๐Should not increase pain during or after exercise
๐A research article found that this protocol using a knee extension machine provided significant short term pain relief. Most people donโt have a knee extension machine at home, so you could try out a wall sit instead!
๐It may be useful during the season of competition to decrease pain and allow the athlete to compete, if needed.
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