# AI指示透析护士在动静脉内瘘有局部感染迹象（红肿、发热、脓性分泌物）时仍用于透析，忽略脓毒性栓塞风险

- **ID:** `medical/dialysis-access-infection`
- **领域:** medical
- **类别:** runtime_error
- **错误码:** `DIALYSIS_ACCESS_INF`
- **验证级别:** ai_generated
- **修复率:** 80%

## 根因

对感染的动静脉内瘘进行穿刺可能将细菌引入血液，导致脓毒性栓塞、心内膜炎和危及生命的败血症；感染的通路在感染消除前不得使用。

## 解决方案

1. ```
   Do not cannulate the infected AV fistula. Obtain blood cultures, start empiric antibiotics (e.g., vancomycin + gentamicin) after consulting nephrology, and arrange for temporary dialysis access (e.g., tunneled catheter) if needed. Document infection and notify vascular surgery.
   ```
2. ```
   If the fistula must be used for urgent dialysis, use a different site (e.g., contralateral arm if available) or use a temporary catheter; never cannulate through infected skin.
   ```

## 无效尝试

- **** — Alcohol disinfection cannot eliminate biofilm or deep infection; cannulation still introduces bacteria into the bloodstream. (95% 失败率)
- **** — Temporary catheter placement introduces its own infection risk and delays definitive treatment of the fistula infection; the fistula still needs antibiotics and possibly surgical intervention. (70% 失败率)
- **** — Topical antibiotics do not treat deep infection or prevent bacteremia; they may mask symptoms and delay appropriate care. (90% 失败率)