We have this problem often at our hospital. What is recommended to place if able to place at all. We normally as a team do not place or recommend any lines in the arms. We have some patients that don't know if they had lymph removal at all and others that have had lymph removal to both h or just one side. What is the best practice for this and thank you
The question is not the mastectomy. It is whether axillary lymph node dissection was done. If bilateral, which side had the least number dissected? A venipuncture for a short PIVC might be the type of least risk, depends on patient and all factors. Also what is the purpose and type of therapy prescribed. Does that indicate need for a CVAD? If you must do a short PIVC on the side with the least number of nodes dissected, the insertion should be the smallest catheter possilbe inserted by the most skilled clinicains with USG AND the patient MUST be involved with this decision. She msut be informed of the risk and give her consent to allow this. She is taking the risk of lymphedema and would have to live with it. So this decision belongs to the patient, not the providers. If a CVAD is needed, that should be an IJ in the low position. I would not use a PICC or a midline in an arm with node dissection.
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861