Preparations at the Hospital
When you arrive, you will change into a hospital gown (sometimes called a "johnny"). A nurse or aid will place your clothing and other personal belongings in a bag, lock the bag in a closet, and return it to you after your surgery when you are ready to go home. Do not bring valuables or large sums of money to the hospital.
Next, your dialysis access team members will prepare you for surgery:
- A nurse will weigh you, take your temperature, pulse, and blood pressure, and count your respirations (breathing rate).
- You will meet with the surgeon and sign a consent form for the operation if one has not already been signed during your clinic visit.
- We will start an intravenous (IV) line in your arm so we can give you any necessary IV medications and IV fluid to prevent you from getting dehydrated. This line and possibly other lines will still be in place when you wake up after your operation.
- We will take blood from your arm to send to the laboratory for necessary tests, including kidney function tests, and red and white blood cell counts.
- On rare occasions, you may need dialysis before surgery if your blood tests show it is necessary.
- We will bring you to the hospital floor called the "anesthesia holding area" or directly to the operating room. Your family can stay with you until that time.
The Anesthesia Holding Area
There is a lot of activity in the anesthesia holding area as medical staff continue to prepare you for surgery:
- The anesthesiologist will ask you to sign a consent form to give you anesthesia.
- Staff may place IV (in the vein) and arterial (in the artery) lines in your arm. These will still be in place when you wake up after the surgery.
- We will also place EKG leads on your chest to monitor your heart.
- You may receive a subcutaneous (under the skin) injection of heparin, a blood thinner used to prevent blood clots from forming in your legs during surgery. You will also receive this after surgery.
- You may receive a dose of intravenous antibiotics before surgery to prevent infections in your surgical incision.
We need to do all of these preparations to perform the dialysis access operation safely. When the preparations are complete, we will wheel you into the operating room on a stretcher for the operation.
Anesthesia to Make You Sleep
The anesthesiologist may give you intravenous medication to make you sleep during the surgery. The anesthesia team monitors your blood pressure, heart rate, breathing, and blood chemistries very closely during the entire operation.
The operation to establish a vascular access takes about 1-2 hours. Following surgery you will go to the post anesthesia care unit (PACU) so nurses can monitor your condition as you awake from the operation. Your doctor will update your support person about your progress. You can expect to be in the PACU area for anywhere from 1-3 hours depending on your recovery from the surgery. When you feel well enough, and provided there are no complications, you will be able to go home with your support person.