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Hi, everyone this is Magda from utopia, health career Center and I am here today with Koren and I am going to show everyone how to do the 10 seconds assessments on fistulas. We do this only on fistulas and this too to tell if the fistulas has some type of stenosis. So its very simple just takes 10 seconds or less so what we do if we look at her fistula we can see that it its a very great fistula and nice fistula its full look kind of bulky so what we do We tell the patient go ahead and lift your arm and the fistula has to kind of collapse its not its very soft to the touch like that see it collapses and its not, as bulky as it was before then we say lower the arm and there it is back in so you do this to detect to identify if theres any stenosis if you ask the patient to do this type of assessment and the fistula does not collapse or flattens when the arm is up, then you may have a stenosis and this is something that you need to report
