Forum topic

3 posts / 0 new
Last post
Eunhee Park
Line insertion on the side of lymph node dissection


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

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


Office Phone 770-358-7861

Eunhee Park
Thank you for the reply !!

Thank you for the reply !!

Eunhee Park

Log in or register to post comments