I am being asked by physician to place a piv in an arm with a fractured radius and ulna bone. What are the contraindicatins to placing a piv above the fractured wrist.
I'm assuming if he has fractured both the ulna and radius he would be splitted or cast to his AC joint. I don't think there are any "official" contraindications but I wouldn't do it. Why would you need to use a fractured arm to place an IV?
I assessed her left arm and found no veins that would accomodate a piv for any length of time. Her brachial veins were 0.5-1mm in diameter and 2.5cm deep. I recommended RAD for a central line catheter or EJ IV. They were not interested in a RAD placed catheter of any kind. Then I was asked to place a piv to her feet or her fx. right arm. Her right arm had no splint or cast yet and had not been evaluated by an ortho doctor. I said no to both. I know in my heart that this was the right decision but I could not in my brain rationalize why not to place a piv in the upper arm if I could accomplish it without rotating the bones of a broken wrist. I went with my conservative self and did not place an IV access at all. I am looking for reasons to confirm that my decision was right. I want to know what the contraindications are. We put Bier block in arms that are having surgery. Why not broken, before surgery arms? The patient was then placed on PO antibiotics.
I'm assuming if he has fractured both the ulna and radius he would be splitted or cast to his AC joint. I don't think there are any "official" contraindications but I wouldn't do it. Why would you need to use a fractured arm to place an IV?
I would not do it either. What is wrong with the opposite arm?
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I assessed her left arm and found no veins that would accomodate a piv for any length of time. Her brachial veins were 0.5-1mm in diameter and 2.5cm deep. I recommended RAD for a central line catheter or EJ IV. They were not interested in a RAD placed catheter of any kind. Then I was asked to place a piv to her feet or her fx. right arm. Her right arm had no splint or cast yet and had not been evaluated by an ortho doctor. I said no to both. I know in my heart that this was the right decision but I could not in my brain rationalize why not to place a piv in the upper arm if I could accomplish it without rotating the bones of a broken wrist. I went with my conservative self and did not place an IV access at all. I am looking for reasons to confirm that my decision was right. I want to know what the contraindications are. We put Bier block in arms that are having surgery. Why not broken, before surgery arms? The patient was then placed on PO antibiotics.