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Survey for Dialysis Staff Using the Endo AVF Vascular Access
Check all that apply and/or comment as needed.
*
1.
Clinic Name (CONFIDENTIAL - Will not be used in any way to identify answers. All information gathered will be shared in summary and not individually.)
(Required.)
2.
Which Endo AVF device do you have cannulation experience with?
WavelinQ by BD Brad
Ellipsys® Vascular Access System by Avenu Medical, Inc.
Both
I don't know
3.
How is the endo AVF identified in your facility?
Procedure record
Communication from the creation physician/center
Patient ID card or wristband
Other (please specify)
4.
Do you receive any training on the endo AVF before having to cannulate the access?
No
Yes
If Yes, Details of your training:
5.
Which surgical AVF is most like the endo AVF?
RC Wrist AVF
Proximal Radial Artery AVF
upper arm AVF (brachiocephalic AVF)
upper arm transposed AVF
Other (please specify)
6.
Is your protocol for first time use of a fistula different for Endo AVF?
No
Yes
If Yes, what is unique for the endo AVF vs. a surgical AVF?
7.
For WavelinQ Device - Refer to image above and select appropriate letter for the common arterial needle placement area (into which part of the endo AVF)?
A
B
C
D
Needle direction Up or Down?
8.
For Ellipsys Device - Refer to images above (note: gray line shows the elbow crease area) and select appropriate letter for the common arterial needle placement area (into which part of the endo AVF)?
A
B
C
D
E
Needle direction Up or Down?
9.
For WavelinQ Device - Refer to image above and select appropriate letter for the common venous needle placement area (into which part of the endo AVF)?
A
B
C
D
Needle direction Up or Down?
10.
For Ellipsys Device - Refer to images above (note: gray line shows the elbow crease area) and select appropriate letter for the common venous needle placement area (into which part of the endo AVF)?
A
B
C
D
E
Needle direction Up or Down?
11.
Do you use a tourniquet for cannulation of the Endo AVF?
No
Yes
12.
Are you part of an expert cannulation team at your facility?
No
Yes
N/A
13.
Are the endo AVF arms marked by the physician before first cannulation?
No
Yes
14.
Did a physician assist with the cannulation?
No
Yes
15.
If YES selected in Question 14 above, what type of physician assisted with cannulation?
Nephrologist
Interventional Nephrologist
Interventional Radiologist
Surgeon
How did they assist?
16.
Do you do anything different when using the One Minute Check for the weekly maturation evaluation?
No
Yes
If Yes, detail the differences:
17.
Do you do anything different when using the One Minute Check for the routine monitoring (before each routine cannulation)?
No
Yes
If Yes, detail the differences:
18.
Needle gauge or blood flow used for the matured endo AVF - any differences from the surgical AVF?
No
Yes
If Yes, detail differences:
19.
If Yes to Question 18 above, please specify any differences from the surgical AVF below:
Needle gauge:
Blood Flow Rate:
20.
Cannulation technique used for the endo AVF cannulation:
rope ladder
buttonhole
area (if this is used why?)
21.
Cannulation zone length any different than a typical surgical AVF?
No
Yes
If Yes, provide details:
22.
Feel when puncturing the endo AVF vessel wall – any differences from a surgical AVF? (peach vs. orange as an example that has been shared or like a venipuncture vs. upper arm high flow AVF cannulation)
No
Yes
If Yes, provide details:
23.
Does your center access either cubital vein within 3-5 cm of the cubital crease (refer to image above - gray line is over cubital crease) for dialysis access?
Yes
No
Never
If No or Never, please provide reason:
24.
If Yes to question 23 above, are any special steps taken with access/needle placement in the cubital/elbow area? (example: arm board used)
No
Yes
If Yes, provide details:
25.
Post needle removal – any special steps taken?
Pull one needle at a time
Pull both needles at the same time
Use of clamps allowed
Use of clamps restricted
26.
Post dressing - any special steps taken? (example tape not around the arm)
No
Yes
If Yes, provide details:
27.
Access surveillance - have you preformed any access surveillance with an endo AVF?
No
Yes
If Yes, Any Issues? Needle placement changed for the measurement day?
28.
Use of any numbing cream or other method to reduce needle cannulation pain? Any different from a surgical AVF?
No
Yes
If Yes, provide details:
Thank you for helping with this effort to better understand cannulation of endo-AVFs. We hope to re-evaluate this information and survey in one year.
