‘Save the vein’ initiative aims to preserve veins in children with kidney disease

The UC Davis pediatric nephrology team launched an initiative this month to help preserve the veins of children with chronic kidney disease and end-stage kidney disease. The effort is called ‘Save the Vein.’  It asks the medical team to use the dominant arm for lab draws and IV placement, while preserving the veins of the non-dominant arm.

According to the Centers for Disease Control and Prevention, almost 10,000 children and adolescents in the U.S. are living with end-stage kidney disease. For those who have experienced kidney failure since childhood, healthy veins serve as their lifeline. Repeated IV placements and blood draws can cause damage to the veins.

“Our goal is to preserve veins for future venous access for dialysis in children who may need them in the future,” said Maha Haddad, pediatric nephrologist at UC Davis Children’s Hospital. “Save a vein, save a life!”

Haddad led the project with pediatric nephrology nurses Olivia Johl, Bertha Ramirez-Preciado and Rodrigo Almirol.

The Save the Vein campaign will target:

• Children on dialysis
• Children with chronic kidney disease, stage 3 to 5
• Children presenting with acute kidney injury who are unlikely to recover kidney function
• Children who are kidney transplant recipients

Nurses are asked to choose:

• The veins in the back of the hand
• Rotate veins in the forearm
• Internal jugular veins for central venous access

In the hospital, patients will receive a “save the vein” arm band to identify the patient’s non-dominant arm.

Nurses should avoid taking blood or inserting IV lines in:

• Antecubital veins (elbow crease) for veripuncture (puncturing the vein for a blood draw) and IV access
• Cephalic veins (the superficial veins of the upper arm)
• Peripherally inserted central catheter (PICC) line and midline placement
• Subclavian veins (wrist veins)

These patients will also be identified in the electronic medical record. Best practice advisories, which appear as pop-up alerts, will display for phlebotomy, inpatient providers, ambulator providers and ambulatory nurses. They will remind them to minimize blood draws and attempt to preserve the non-dominant arm veins for future vein access for these patients.