What needs to be felt for during the assessment of a fistula or graft?

In the assessment of a fistula or graft, feeling for a pulse and a thrill is essential. The thrill is a vibration felt over the site of the fistula or graft due to the turbulent blood flow created by the anastomosis of the artery and vein. This is a key indicator of the patency and functionality of the fistula or graft, as a strong thrill suggests adequate blood flow, whereas a weak or absent thrill can indicate potential issues such as thrombosis or stenosis.

Assessing the pulse is also critical because it provides information about the arterial blood flow to the extremity. An abnormal pulse or lack of pulse might indicate complications related to the access site that could impact dialysis treatment. Monitoring both the thrill and pulse is a standard practice for ensuring that the vascular access is working effectively.