The history and importance of vascular access are reviewed, including the major types of permanent and temporary vascular access. Use of appropriate needle insertion for arteriovenous fistulae and grafts. Instruction in catheter care and connections. Utilize the four types of anastomosis used for internal arteriovenous fistulae. Management of thrombosis, infection, hematoma, bleeding, steal syndrome, aneurysm, and catheter dislodgment.