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PIV in patients with bilateral sentinel nodes dissection

Hi all,

What would be the best practice for PIV placement for a patient that undergone bilateral simple mastectomies with bilateral sentinel (only) nodes disccection.

May we place a PIV in either arm? May we check BP on either arm?

Thank you,


Here is the new statement

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. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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