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Dialysis Vascular Access Service

Michigan Dialysis Vascular Access Coordinators

Lorie Crimmins, R.N. and Amy Schemke, R.N. serve as the contact point for the University of Michigan, Dialysis Vascular Access Service.


Coordinated Care:
Interventional Nephrology, Interventional Radiology, Transplant Surgery

The University of Michigan offers a cooperative clinical service involving the Nephrology Division of Internal Medicine, Interventional Radiology Division of Radiology and Transplant Surgery Division of Surgery. The purpose of the program is to meet the increasing demands for responsive vascular access treatment within the dialysis community.

Our Dialysis Access Coordinator team (Lorie Crimmins, R.N. and Amy Schemke, R.N.) serve as a single triage point of contact for referring dialysis units and physicians. The Access Coordinator will direct and coordinate the care plan that involves members from Surgery, Radiology and Nephrology. Whether establishing a new vascular access, placing a peritoneal dialysis catheter, or fixing a dysfunctional or clotted vascular access, the Dialysis Access Coordinator can help quickly establish a plan of action.

The Michigan Dialysis Vascular Access Service is available for full-service operations five days a week to serve dialysis patients. Contact the Dialysis Access Coordinator by phone at 734-936-5646 or toll free at 877-MED-INU4 (877-633-4684) from 7 AM to 3:30 PM Monday through Friday. In addition, fax (734-763-3016) and voicemail are used during off hours to leave referral and contact information. Each morning at 7 AM the Access Coordinator will process fax and voicemail information from the night before or from the weekend and promptly make triage decisions and respond to the patient or dialysis facility to establish a timely evaluation and treatment plan.

Patients with existing vascular access who need urgent declotting, and patients who require fistulogram and possible angioplasty are distributed between Nephrology and Interventional Radiology on a shared basis depending on procedure type and on a rotating schedule. This patient-centered triage plan offers increased responsiveness of the combined manpower from both services and preserves the expertise of the well-developed skill set of each discipline. Surgical cases are triaged based on indication with smooth communication between disciplines.

During evening/night hours and on weekends, messages and referrals may be left on voicemail or by fax for the Dialysis Access Coordinator to respond to in the morning. Urgent dialysis cases will be triaged by the on-call Nephrologist including acute line placement if needed for urgent hemodialysis, and urgent Surgical cases will be triaged by the on-call Surgeon.

Vascular access remains the lifeline for hemodialysis patients. At the University of Michigan, we strive to provide superior Dialysis Vascular Access Service for patients with ESRD.


Instructions for Referring Caregivers

When requesting an appointment for an urgent declot, fistulogram, or fistulogram with possible angioplasty, the following information is needed prior to the procedure:

  • Recent BUN, CRT, Platelets and PT/PTT with INR within 30 days
  • Current list of medications
  • Note of allergy to Seafood/Iodine or Contrast dye
    (If allergic, the referring physician needs to order a Steroid Prep to be taken prior to the procedure. Please call for our protocol.)
  • Outside referrals need all of the above and a written Doctor's Order that includes:
    • Physicians Name and UPIN #
    • Address
    • Phone and Fax numbers

When patients present with a clotted access:

  • Instruct them to remain NPO until further notice
  • Instruct the patient that a driver is needed to bring them home following the procedure
  • If recent blood work is needed, they will be directed to the blood draw station (3rd Floor Taubman Center) for STAT lab work
  • If NO blood work is needed, they will be directed to the appropriate Interventional Unit at the Main Hospital

When patients are referred to Transplant Surgery for operative placement or revision of dialysis access:

  • Please send the most recent venogram films as well as the report from this study.
  • Please explain to patients that the first appointment with Transplant Surgery is for consultation only. Any potential surgical procedures will be scheduled at the time of the consultation for a later date.

To contact us for any procedure, please call 734-936-5646 or 877-633-4684 (toll free), or fax information to 734-763-3016

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