Which sign indicates steal syndrome in a patient with vascular access?

• A. Cold or numb fingers.
• B. Fever.
• C. No thrill.
• D. Redness at site.

Answer: (B)

Steal syndrome occurs when blood is diverted away from the hand by the dialysis access, leading to distal ischemia in the hand. The best sign of this is cold or numb fingers, which reflect reduced distal perfusion and oxygen delivery to the hand. Fever isn’t a typical sign of steal; it points more toward infection. A lack of thrill at the access site suggests a problem with the access itself (like blockage), not the distal ischemia from steal. Redness at the site also points toward infection or inflammation rather than steal. So, cold or numb fingers best indicate steal syndrome because they directly reflect ischemia in the hand caused by the altered blood flow from the vascular access.