How often should fistulas be assessed for patency (thrill/bruit)?

• A. At least daily or per unit protocol by checking for a continuous thrill and audible bruit
• B. Once a week
• C. Only when there is pain
• D. Monthly

Answer: (A)

Regular monitoring of fistula patency is essential to catch problems early before thrombosis occurs. The thrill is the palpable vibration and the bruit is the audible sound of flowing blood; when these signs are present continuously, they indicate good flow through the fistula. Checking for these signs at least daily or per unit protocol allows rapid detection of any decline in flow and enables timely intervention, helping preserve the access. Waiting longer, such as weekly or monthly checks, or relying on pain to signal a problem, is not reliable because issues like stenosis can develop quietly and progress quickly, risking loss of the fistula if not identified promptly.