Dialysis Technician Practice Exam

What is a primary complication of "flipping" the needle in AVF cannulation?

1. Infiltration

2. Vascular Occlusion

3. Infection

4. Arterial Thrombosis

The correct answer is: Infiltration

Flipping the needle during arteriovenous fistula (AVF) cannulation can lead to infiltration, which is one of the most common complications associated with this procedure. Infiltration occurs when the needle punctures the wall of the blood vessel and enters the surrounding tissue, causing the dialysis solution or blood to leak into the interstitial space rather than staying within the vessel. This can result in swelling, discomfort for the patient, and potentially compromise future access to the fistula. In terms of clinical practice, maintaining a stable position of the needle during cannulation is crucial. When the needle is flipped, it can alter the direction in which the blood flow is accessed, increasing the risk of perforating the vessel wall. This is particularly important in patients with fragile vascular anatomy or poorly functioning fistulas. Other complications such as vascular occlusion, infections, and arterial thrombosis are also significant concerns in AVF cannulation, but they arise from different issues, such as improper technique, inadequate care of the site, or underlying vascular conditions. Focusing on the risk of infiltration helps highlight the immediate consequences of the specific action of flipping the needle during the cannulation process.