Hi,
I would like to know what is the latest evidence based practice on doing PICC's/midlines on mastectomy with lymph node dissection affected limb. Had a strong push from the medical team but declined to insert line on the affected arm.
Hi,
I would like to know what is the latest evidence based practice on doing PICC's/midlines on mastectomy with lymph node dissection affected limb. Had a strong push from the medical team but declined to insert line on the affected arm.
Here is the statement from the 2021 INS SOP supported by 4 references but all are a level 5. I would not do an elective venipuncture of any kind on a limb with lymph node dissection unless it was a life threatening emergency.
Consider restricting venipuncture to
the contralateral upper extremities in patients with
lymphedema and those at increased risk for
lymphedema (eg, axillary surgical dissection or radiation
therapy) based on the risk of decreased perfusion,
impaired immune function, and increased risk
of infection due to compromised axillary drainage.
i. Consider early referral to an infusion nurse/
vascular access specialist.
ii. If emergent vascular access is needed, choose
the most readily accessible vein for access in
either upper extremity, then establish a plan for
ongoing vascular access.52-55
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
Thank you for the reply !!
Eunhee Park