As stenosis becomes critical – this sound progresses to low pitch – systolic only bruit
Project – Self Examination of AV Fistula using Stethoscope – 7 STEPS
- Teach patients to identify their type of fistula
- Train them about basic use of stethoscope
- Make them listen the “Continuous Bruit” over a functioning fistula – name it “Continuous Sound”
- Compress fistula distally to mimic upstream stenosis – and make them listen the “Systolic Bruit” over a functioning fistula – name it “Interrupted sound”
- Tell – what to do if sound is “interrupted” ?
- Pre and post evaluation to asceses training success
- Validate their self examination findings with every routine clinical follow up visits.
Consent have been given by patient and relatives to use this video for educational purpose
Point of caution
- In event of low BP – a continuous sound may turn into interrupted sound.
- What to do in case of “interrupted sound”
- Do not panic –fistula is not blocked, it just might be narrow.
- Check BP – if its low – recheck after some time when BP is better
- If interrupted sounds persist – contact AVF surgeon early.
- This Method is made to only detect severe stenosis – mild to moderate stenosis will have “continuous sound”.
- No Sound reflects fistula thrombosis & is an Emergency
