Introduction of Buttonhole Puncture with Blunt Needle

① A sterile towel is placed under the limb of the patient on the side of the internal fistula;

② Reasonable selection of arterial puncture points and venous puncture points according to the patient's vascular conditions;

③ The arterial puncture point should be more than 5cm away from the anastomosis;

④ The venipuncture point should be more than 5cm away from the arterial puncture point;

⑤ Povidone-iodine disinfection around the puncture point is 8-10cm, and the punctureer wears sterile gloves;

⑥ Hold a 16-18G internal fistula needle with the bevel of the needle tip facing upward and at a 25° angle to the skin, insert the needle along the outer edge of the blood vessel, and dive into the blood vessel after a short subcutaneous dive;

⑦ After seeing the blood return, lower the angle, send all the needles into the blood vessels in parallel, and finally fix the puncture needle;

⑧ Buttonhole puncture method, that is, the same punctureer uses a sharp needle to puncture a fixed point of the patient's internal fistula repeatedly at the same angle, so as to form a scar tunnel from the skin to the vein wall after 6-9 punctures , that is, "button eye";

⑨ Once the tunnel is formed, use a blunt needle instead.

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