Forum topic

Here is the new statement from the 2021 INS SOP

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 (V)

If a PIVC is required and a CVAD is not indicated, choose the side with the least risk and make sure the most skillful inserter does the procedure. Also, obtain patient verbal understanding of the potential risk associated with this although it could be less risk than a CVAD for no real reason.