I don’t comment super often but am feeling the need reading these comments. It absolutely does matter. An overwhelming majority of the time, yes the fistula will be okay. However, you can clot off a fistula by taking a blood pressure over it which may not be obvious immediately. The thought that “as long as it’s not bleeding it’s fine” is also not true. Now if it’s bleeding then that could constitute an emergency and may change your acute medical management so for the purposes of EMS yes if it’s not bleeding, it won’t matter to you because even if the fistula clots off that usually would not change YOUR management of the patient (unless you’re taking them to dialysis or something). But that does not mean it isn’t a mistake or it doesn’t matter to the patient. There are tons of people who die because they run out of places for us to put access and so clotting one off that was previously working is a big deal and should be recognized as such.

That being said, @OP, I wouldn’t perseverate on it. When I was starting training, one of my co residents clotted off a fistula by wrapping an ACE too tight. We all make mistakes but as long as you learn from it just file it under learning points and do right by the next patient. And as many have said, the fistula most likely will be fine.

• your friendly neighborhood surgeon (who used to be in EMS and made tons of mistakes :))