Hi all,
What would be the best practice for PIV placement for a patient that undergone bilateral simple mastectomies with bilateral sentinel (only) nodes disccection.
May we place a PIV in either arm? May we check BP on either arm?
Thank you,
Janna
Here is the new statement from the 2021 INS SOP
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 (V)
If a PIVC is required and a CVAD is not indicated, choose the side with the least risk and make sure the most skillful inserter does the procedure. Also, obtain patient verbal understanding of the potential risk associated with this although it could be less risk than a CVAD for no real reason.
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