Management of Life Threatening Bleed from Haemodialysis Fistula or Graft

It is important you know what to do in the event of an unexpected prolonged bleed. Please show this leaflet to family, friends and neighbours so they can assist in an emergency. Please keep it with you at all times, along with the gauze and tape supplied.

Occasionally a fistula may bleed after the dressing is removed at home. If this happens, it should stop quickly when pressure is applied. Apply a folded gauze swab to the bleeding site and apply firm pressure with two fingers for 10 minutes without looking or loosening pressure.

If the bleeding stops after 10 minutes, apply fresh gauze and tape and telephone your dialysis unit for further advice (numbers overleaf). If the bleeding does not stop, or seeps through the gauze despite application of pressure, this is a profuse bleed. Please see below for management.

If unexpected, profuse bleeding occurs from your fistula or graft site between dialysis sessions, this is a medical emergency. You should:

• Seek help urgently from anyone who is around.
• The blood flow can be fast and make you feel faint, so do not delay in seeking help.
• Dial 999 and report ‘excessive bleeding from dialysis fistula/graft’.
• Stay calm, as bleeding can usually be stopped with enough pressure in the right place.
• Apply folded gauze swab to the bleeding site and apply firm pressure with two fingers until help arrives. Do not release pressure to see if the bleeding has stopped. Do not be afraid to press harder than usual if bleeding is not controlled.
• Sit or lay down.
• Raise arm above shoulder if you can, ensuring pressure is maintained.
• Do not use a large dressing; for example a towel will absorb blood and may prevent pressure being applied in the right place.
• If bleeding stops before help arrives, it is important your fistula/graft is still checked urgently, as bleeding should not happen between dialysis sessions.
• You should attend hospital so your fistula can be checked by a vascular surgeon.

Contact numbers for Dialysis Units

Dorchester: 01305 255345
Royal Bournemouth: 01202 704422
Poole: 01202 307430
Yeovil: 01935 847290
KC: 01202 422311

Evenings, nights and Sundays: Please ring the Prince of Wales Ward at DCH on 01305 255139.

About this leaflet

Author: Claire Thompson, Renal Specialist Nurse
Written: January 2019
Approved: August 2020
Review date: August 2023
Edition: 1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk