What is the proper way to assess a fistula for patency?

The proper way to assess a fistula for patency is by palpating for a thrill and auscultating for a bruit. A fistula, created for hemodialysis access, should have a continuous turbulent blood flow, which can be felt as a vibration (thrill) upon palpation and heard as a whooshing sound (bruit) through a stethoscope when auscultated. This method evaluates the blood flow and functionality of the fistula effectively, ensuring it is patent and can be used for dialysis treatments.

Other assessment methods, such as using imaging studies, may provide information about the fistula but are typically not the first line in a routine patency assessment. Observing for swelling in the arm can indicate complications but does not directly assess patency. Checking the patient's blood pressure is essential for overall health monitoring but is not an indicator of fistula function. Therefore, palpation and auscultation are the most direct and effective means of assessing the patency of a fistula.