Ahlmén J et al. (2008) A new safety device for hemodialysis. Hemodial Int 12: 264–267

Accidental venous needle dislodgement from the arteriovenous fistula or graft can lead to serious and even fatal bleeding in hemodialysis patients. Dislodgement is not detected by the venous pressure meter of the dialysis monitor. Ahlmén et al. have tested an adhesive blood-sensing patch that alerts patients and health-care personnel to blood loss from the venous needle puncture site.

The device was tested in 213 dialysis sessions performed at 5 Swedish dialysis centers in 41 patients with arteriovenous fistulas. This analysis included 200 of the test dialysis sessions. After 129 tests, the device was slightly modified to improve its sensitivity. In 185 (92.5%) tests, either the device correctly detected blood loss (179 tests) or a warning light appeared to indicate failure of the sensor (6 tests). Most (77%) activations of the device were triggered by needle removal at the end of dialysis. In 15 tests, the device failed to activate despite blood loss; of these incidences, 13 occurred with the unmodified device and only 2 occurred with the modified version.

All 10 nurses involved in the trial stated that the device increased their sense of security, and on a scale of 0–5 (5 meaning that the device interfered with their work very much) they gave the device an average rating of 1.0. Patients rated the extent to which routine dialysis was hampered by the device as 0.2 on a scale of 0–5.

Patient supervision at ordinary dialysis centers is the responsibility of a decreasing number of nurses, meaning that the new device could be particularly useful.