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Any current info as far as literature to venipuncture in the double mastectomy pt.??

We are in the process of updating our policy, which is old!!!, in regards to venipuncture in the double matectomy pt. I would love something current  and possibly published in the U.S. We currently will only stick a pt. if there has been no lymph node removal. There seems to be some debate as to the length of time since the surgery and who is the source saying whether there was node removal or not. This was spurred by the request of a physician to have an iv started in a pt who was  2 wk. s/p double mastectomy coming in with fever and malaise. Unsure of node removal, the nurse declined to start iv in arm but asked if foot was ok for overnight. The MD declined saying he did not want to give vanc that way.

mastectomy patients

Funny this keeps coming up in my practice also. It seems the physicians are  sure we can do this but I cannot find any literature to support it. I find court cases for suits when there is aproblem.... I also find it odd that the physician felt it alright to give the vanc via a mastectomy arm but not the lower extremity. For different reasons I would think both sites would be risky.


Jose Delp RN BSN VA-BC

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