“…Many recommendations have been made in the literature to counter such events, such as proper taping of needles, tightening of connections, or the use of Luer lock devices, loose looping of blood tubing, blood leakage sensors, and heightened surveillance for confused patients. 6,14,[26][27][28] However, as stated, both ANZ and US data confirm that the vast majority of fatal bleeds occur from spontaneous access rupture away from the dialysis facility (most often at home, assisted living, or a nursing home), and it is therefore likely that the family and caregivers are confronting these large bleeds, 29 rather than dialysis unit staff.…”