I've been searching for evidence based data about starting peripheral IV's in uncommon areas, ie, breast, chest, etc. I found this same question asked in the past on the forum. I agree with the answers that were provided, but is their any evidence out their to support not using these veins routinely?
I would like to present this scenario to this group of experts: A female patient comes in to the ER that has a chronic condition and is frequently in and out of the hospital. Her condition is stable and not life threatening. She has had multiple central lines (IJ, SC, Femorals and PICCS) and has extinquished all veins appropriate for peripheral access even using ultrasound. She can no longer be accessed for a bedside PICC insertion by the IV Team. It is after hours and she needs access for fluids, antibiotics and pain meds. She insists that the ER nurse start an IV in her breast because that is all that can be obtained in her. The ER physicians do not want to attempt a central line. I'm not sure that an EJ IV was attempted. The IV is started in her R breast and she is admiited in to the hospital which of course after 2 days the R breast IV develops grade 4 phlebitis.
I agree this is dangerous practice and should not be done unless it is a life threatening emergency and used temporarily until the patient becomes stable and can be given better venous access. I also agree that the staff need education in order to change this practice but am unable to find anything to deter it. I would appreciate any help that can be given from this group of experts. I thank you in advance for your time and information.
Below is the posted past forum...