**1.2 Same day evaluation**

Most procedures done to establish hemodialysis access are outpatient procedures with patients arriving a few hours prior to the planned procedure. The pre-anesthesia evaluation in the preoperative holding area is one of the most important phases

in preparing the patient for the administration of anesthesia. The anesthesia team should confirm that the patient's general condition has not changed since they are evaluated in pre-anesthesia clinic. The site of intravenous access and blood pressure measurement must be avoided in the arteriovenous (AV) access arm. Establishing peripheral intravenous access may be challenging, and an ultrasound-guided method may be helpful to identify an appropriate vein. In cases where a patient has an existing indwelling catheter, consideration can be taken to gain access. However, this is generally avoided due to fear of increased infectious complications. Routine airway examination should be done at the same time even if general anesthesia is not planned.
