Marek Hannan

If your kidneys fail, you will need to start dialysis to do the job of your kidneys unless you receive a kidney transplant. Before you can start dialysis, a surgeon will need to create what is called a vascular access. A vascular access is where the dialysis machine will connect to your bloodstream.

During dialysis treatments, the dialysis machine cleans your blood then moves it back into your body. The three most common types of vascular access for hemodialysis are an artery vein fistula, an artery vein graft and a catheter.

An artery vein fistula (AV fistula) is a connection between your artery and your vein that is created by a surgeon. This surgery creates a large blood vessel that has lots of blood flowing through it.

An AV fistula is usually located in your arm between your wrist and elbow. During dialysis treatments, the technician inserts needles into the AV fistula to get access to your bloodstream.

An artery vein graft (AV graft) is a soft rubbery tube that a surgeon implants (i.e., surgically places) into your arm. An AV graft is usually implanted in your arm but may also be implanted in your leg or chest. During dialysis treatments, the technician inserts needles into the tube to get access to your bloodstream.

A catheter (or venous catheter) is a tube placed into a vein, usually in your neck or upper chest. Catheters are usually temporary and used only for a short time. For example, you may need a catheter if you need dialysis right away and the surgery to create an AV fistula or AV graft is still healing.

AV fistula and AV graft are used for permanent, long-term access to your bloodstream, and can last for years. AV fistulas and grafts are under your skin, so they are less likely to cause infections and blood clots than catheters.

A HeRO (Hemodialysis Reliable Outflow) device is for people on dialysis who have problems with their AV fistula or AV graft. It allows more blood to flow in and out of the body compared to a catheter.

There are other types of vascular access, such as a PICC line or IV, that are not used for dialysis.

AV fistulas are considered the best kind of vascular access because they:

If you are on dialysis, your vascular access allows you to get this lifesaving treatment. Taking care of your vascular access will keep it healthy and free of problems that can disrupt your dialysis treatments–such as infections or blood clots.

Ask your dialysis care team or vascular access nurse (a specialist trained in vascular access care) to teach you how to take care of your vascular access. If you notice any signs of infection (such as redness or swelling) or any problems with your vascular access, contact your doctor, nurse or dialysis center right away.

Here are some tips to help you care for your vascular access:

To keep your AV fistula or graft working well:

Keep it clean at all times

Check it every day

Be careful with it

Use your other arm for medical tests

Your doctor will give you a prescription for supplies you willneed to care for your catheter. You can get these at a pharmacy or medical supply store. To care for your catheter:

Keep it clean, dry and covered

Take care of it

Check it every day

You have graduated from 5-paragraph essays to MLA research papers, so it is time to learn what an MLA heading vs. a header is in MLA format.

Now that you know that each of these is different, explore how an MLA heading and MLA header are used in an MLA paper.

An MLA format heading and title are what you are going to use to start off your paper when you don’t include a title page. Every style guide is a little different. MLA, however, is all about simplicity. Therefore, in your MLA style paper, you can forgo the title page. However, you still do need to have some kind of heading on your first page to give your instructor some inclination of who this paper is from. In the heading of your MLA paper, you need to include a few key details:

Since this is a style guide, MLA headings must be formatted in a specific way. The heading information starts at the 1-inch margin. It’s in the upper left-hand corner of your paper, double spaced, and in a readable font. After your heading, you include the title of your paper, centered in title case.

While a heading is only found on the first page of your MLA paper, an MLA header is included throughout the entire work. An MLA header includes your last name and page number without punctuation or styling elements. The MLA headers work to keep all your pages organized.

Adding a running header in Microsoft Word is pretty easy. Once you’re in the document, just follow these simple steps for a running header.

Not everyone has Word. In that case, you might be creating an MLA running header in Google Docs. This process is just as simple as the Word steps.

When it comes to composing MLA section headings, think freestyle. Why? Because MLA doesn’t have a specific format when it comes to creating section headings in their style guide. All they ask is that whatever you choose to use for your headings, you remain consistent. Therefore, you might have your main section headings bold and centered. Your second-level subheading could then be italicized and centered like:

Main Heading

Subheader

Whatever system you create for your section headers, just remember to use the same format throughout the entire paper. No need to lose points for something so simple. And if you define these in your MLA outline then you’re a step ahead of the game.

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