Hi group,
I have searched the history forum on the arm circumference and do not see where anyone has made this a standard again. I am aware of the INS standards not including arm circ. on regular basis as a standard.
Please post on this if your facility is continuing to do this OR not. I am taking the results to the committee that is suggesting bringing this back!
Thanks in advance,
Candee Eisenhart BSN, CRNI, VA-BC
I believe that measuring the arm circumference upon insertion allows you to have a needed baseline if, or when problem arise and this assessment is helpful, but to measure it with each dressing change, or daily isn't appropriate due to the variability of the findings of the assessor. We dropped that requirement too, as INS did.
This idea of measuring arm circumference is based on the theory that arm edema is a sign of several complications and may go undetected by the naked eye. Enlargement of the entire extremity or the upper arm could only be detected if measured and compared to the opposite arm and/or a baseline measurement. This idea came about before ultrasound was a prevalent noninvasive method for detecting vein thrombosis. The issue is - has research proven or supported this theory to improve patient outcomes? Are there any published studies showing a positive or negative aspect of this practice? In the 2011 INS standards document, no such studies could be found, therefore it does not get included. I am not sure what the current reseaerch says but a literature review would located such studies if they exist. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861