Putting in Your Own Dialysis Needles

It won’t come as any surprise to most BigD-ers that there is a group of hardy souls in our club who prefer to needle themselves rather than rely on others to do it for them.

The largest part of this group is of course those who dialyse at home (who else will do it?).  But there are others (like me) who simply prefer the control it gives you, especially when you use the buttonhole method (which relies on a consistent entry angle and technique) or you travel and you don’t know how good the unit’s nurse or technician is at needling.

Chris, our unit manager is a real advocate of DIY needling, so it is a reasonably common practice among BigD-ers in our clinic.  I’ve been needling myself for about 15 years.  I still make the odd mistake, but mostly it has a happy ending.

Syd (not his real name), one of the new guys at our clinic has decided he also wants to put in his own needles too.  So Chris asked me if there was anything on this blog that could help.  There’s lots of good stuff, but nothing dedicated to helping people to needle themselves.

It’s time to fix that, so I am planning a new Briefing Sheet: “Everything you wanted to know about putting in your own dialysis needles but were afraid, to even think about it”.  Or something like that.

But I need help.  I’m hoping some of you DIY needlers out there can add your 2 cents worth to ensure it is a useful document.  Send in your stories, theories, techniques, tricks-of-the-trade, whatever you think will help a first timer.  Style is of no consequence; dot-points or paragraphs.

To get the juices flowing, here are a couple of initial responses when I asked around:

  • For me the first time was the toughest.  I knew the theory, but putting it into practice took more than a bit of moxie
  • Some nurses practice on oranges
  • Confidence is key
  • Much easier and less stressful with blunt (buttonhole) needles

Send staff as comments to this post, or to my email address (see the About page).

I’m hoping to put up a draft within two weeks.

Onward and upward (or downward, or sideways – wherever the fistula flows!)  Greg

7 thoughts on “Putting in Your Own Dialysis Needles

  1. Yes, first time is hardest but it gets better after that. I have
    Bee:-) n on home dialysis f.or about six months and have not had any problem. I find the most important thing is to get the entry angle correct — 45 degrees — then watch for the throb in the line. Once you get a strong ‘bounce’ slide the needle in as parallel to the skin as possible and adjust the angle for a good flow.
    A gauze pad might be needed to maintain the angle.
    Finally, tape down and apply the Tegaderm.
    I have had far fewer problems than when I was in the clinic.


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  3. Oranges went out with the Ark Greg.
    I often used Foam with paper towel over the top to teach needling because you get that pop feeling, slight resistance and then no resistance. if you can get foam with lumps and bumps even better as no fistula is the same.
    Allowing a lot of time 45 min and space (nurses not hovering but just present).
    It’s really hard for people who are using their non dominant hand.
    Taping can be tricky.
    Just some thoughts
    Great topic – I’m a big fan of button holes.

    Cath F


  4. My husband needles himself but as his care partner, a nurse taught me the Buttonhole Method by taping down some skinny clear tubing (like that of the fistula needle) over a block of packing/shipping foam. Then we established a “buttonhole” in the tubing using a sharp and then practiced going down through the “flap” of the buttonhole at the same angle/depth each time, watching (through the tubing) that the needle didn’t “infiltrate” or puncture the tubing.


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