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AV Fistula Precautions — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementAV Fistula PrecautionsORE Part 1

A patient on chronic haemodialysis has an arteriovenous (AV) fistula in the left arm. What is the key precaution when taking blood pressure or using a tourniquet?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: ENever take blood pressure on the arm with the AV fistula; use the opposite arm

The correct answer is E. UK NHS guidance explicitly states that blood pressure must never be taken on the arm with an AV fistula because the cuff compression interrupts critical blood flow through the fistula, risking thrombosis and permanent loss of vascular access—the patient's lifeline for haemodialysis. Blood pressure should always be measured on the opposite (non-fistula) arm. Option A is dangerous (reverses the rule). Option D ignores the serious risk of fistula failure. Option C is unnecessarily restrictive; measurement on the contralateral arm is safe. Option B incorrectly implies that gentler pressure is protective; any occlusion risks thrombosis regardless of pressure magnitude.

Reference: Cambridge University Hospitals NHS Trust. Arterio Venous Fistula (AVF) as an access for haemodialysis. Patient Information Sheet. https://www.cuh.nhs.uk/patient-information/arterio-venous-fistula-avf-as-an-access-for-haemodialysis/