The other night a middle-aged dialysis patient came in with a bleeding fistula. I've seen plenty of fistulas before, but this one was bleeding so heavily that it soaked through every dressing we applied in a matter of seconds, resulting in a good 45 minutes of me applying direct pressure while waiting for the consult to arrive. Even though I was tightly clamping down on the arm, the force of the blood pumping through was enough to push my hand back. Luckily, the gentleman was a nice guy and we made small talk to pass the time while making sure he didn't bleed out.
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