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mckenzie
IV's in breast, PICC line infecton rate with occluded lumen

 We are  having an increasing number of IV's inserted in the breast in my hospital's  ED department. They are done as "emergent". Sounds and loo ks very painful. Has anyone heard of this practice or any literature out there about extravasation/infection risk from this practice. I have searched and found nothing.

Also, does anyone know of any literature on the risk of infection related to PICC line clot. We have some nurses that are not calling the PICC team when one of the lumens clot, thinking that it is okay b/c they have one or two more lumens working. Would like to do an inservice with literature to back it up.

Thank You in Advance!!

mary ann ferrannini
 Our ED nurses do this
 Our ED nurses do this sometimes and I think as soon as feasable you need to re-site it.       It certainly is an unconventional location. I do not want to imagine an extravasation in this area especially in females. Unfortunately this is where I see it. You might want to contact Genetech and AVA regarding their joint Save that Line Campaign . They have lots of information and will even provide training and education for free. Also read some of Marsha Ryders articles so you have a full grasp of the issue and importance of treating PWOs. I am certain others can link you to other literature as well. You need to educate educate and educate.
Jennifer Schwartz
We used to have a nurse on
We used to have a nurse on our IV team that would put IV'S  in the breast at times which I found very disturbing, as would the patients. First of all I feel that it is a total invasion of privacy and secondly, the vessels that were used were very superficial.  They become irritated very quickly and infiltrations are more prone to go unnoticed because they are covered up and the skin also expands more making the pain from an infiltration less noticable to the patient.  I  would always re-site them as soon as possible.  

Jenn

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