If there is infiltration, where should a new arterial needle be inserted?

When there is infiltration during hemodialysis, the best practice is to insert a new arterial needle below the infiltration site. This is essential because infiltration implies that fluid has escaped into the surrounding tissue, which can lead to swelling and discomfort. By placing the new arterial needle below the affected area, you are allowing for a clear access point to the bloodstream that is not compromised by the infiltration. It also prevents further irritation or damage to the already compromised site.

Inserting a needle at the same site or above the infiltration may exacerbate the infiltration problem and lead to further complications. In contrast, using the opposite arm might not always be feasible due to the presence of existing access or other patient considerations. Therefore, placing the needle below the infiltration guarantees that the new access is effective and minimizes complications.