Typically the patient with PHSH will present with persistent bleeding from the access site on the AVF after their hemodialysis run despite direct pressure by healthcare staff.
Life-threatening bleeding for an arteriovenous fistula (AVF) is a different clinical problem and frequently requires systemic hemostatic management including protamine and desmospressin and vascular surgery consultation, in this post we will focus on PHSH. Post-hemodialysis site hemorrhage (PHSH) is often encountered in the emergency department and although apparently a simple problem, sometimes can be quite difficult to stop and require a lot of time, effort and expertise to do so. Author: Cameron Wangsgard, MD and Daniel Cabrera, MD
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