Where should the second venous needle be stuck after an infiltration?

After an infiltration occurs during dialysis, the second venous needle should be inserted above the infiltration site. This is done to minimize the complications associated with the infiltration, such as tissue damage or swelling, and to ensure proper blood flow.

By placing the second needle above the infiltration, you are effectively utilizing the healthy and unaffected vein segment that is still functional and capable of providing adequate blood access. This approach helps maintain the efficiency of the treatment while avoiding the compromised area, which may still be experiencing issues from the infiltration.

In contrast, placing a needle at the same site could exacerbate the infiltration or cause additional harm to the already affected area, while inserting a needle below the infiltration site may not provide sufficient blood flow because the compromised area could still disrupt circulation dynamics. Sticking the needle in the opposite arm might not be practical or feasible in all cases, especially if the patient's access is primarily in one arm. Therefore, the best practice is to insert the second needle above the infiltration.