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KATHLEENT.MOHN
tatoos

Hi-I teach IV therapy at a local community college. A colleague called me from Louisiana.  She received a question from her Nursing students that stumped me too.  Neither of us could find information to answer these students and their question. The students were told by RNs in their clinical experience not to place IVs in or near tatoos.  The reasoning of the RNs was that the IV would release the tatoo ink into the blood stream of the patient.  This reasoning made no sense to me or my colleague.  Isn't the ink a stain?  My brother, the original Peck's bad boy,  said that American tatoos are surface staining.  The original method of tatoos used by the Japanese and Polynesians releases the ink into much deeper tissues.  Doesn't answer the question but it's interesting insight.  What do you guys say?  Do you have references we can use?  Both of us like this question since so
may men and women today are sporting tatoos.  

Kathy Mohn-Las Vegas

lynncrni
Great question but I have

Great question but I have never seen any studies on this and I just looked at all the PIV studies from 2000. I don't know the techniques for tatooing so can't add anything. But I would still avoid the area of a tatoo. My rationale is that the staining can easily obscure being able to detect changes in color of the skin that can occur from both phlebitis and infiltration. So these complications could easily be overlooked for extended periods. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Roy D.
I attempted to ascertain

I attempted to ascertain information on this subject when asked to place a picc in someone with complete arm tattoos, who ironically needed the picc due to an infection in his latest artwork.  When trying to do researh, which was very limited to non existant, I have had a similar problem posed.  This concerned pregnant women with lower back tatoos and the need for epidurals.  I spoke to anethesia who said he had been confronted with this issue and he and his colleagues did not feel this was a contraindication for an epidural. I attempted to find out if he could provide me with any data/studies, but could not. Much debate arose concerning the type of tattoo, but was unable to get good info concerning the differences in technique/ink.  I agree that if avoidable to stay away, just as Lynn stated.  It could easily camouflage a phlebitis.   I would be very interested in an actual study about this, due to the increase in the numbers of tattoo we are seeing. 

I will follow with interest

Roy

Gwen Irwin
tatoos

WOW!  We really have a lot of tatoos in Austin.

In the days of old (haha), we never thought about the superficial tatoos creating a problem.  We might use the eye of the dragon (or whatever it was) as the target zone for accessing the basilic vein!  The drug users very often used the tatoos to cover their preferred IV sites and hide their tracks.  We never had an issue with choosing those sites and veins by palpation.

To this day, I have never heard of a patient with tatoos having any complication related to having a PICC inserted through at tatoo.  We use ultrasound for insertion and occasionally insert through tatoos.  We still have not had any complication that I now of related to a tatoo.

This is not evidence like a study that could provide evidence in comparison to those without tatoos, but, of the many with tatoos, our experiential information is that there is not an increased risk of going through a tatoo.

I would love to hear anything that supports anything different.

Gwen Irwin

Austin, Texas

lynncrni
Your information supports the

Your information supports the concept that the techniques do not leave significant amounts of dye that can enter the vein and for PICC insertion, superficial signs and symptoms are not the primary type that can occur. But changes in skin color from phlebitis and infiltration with a short peripheral catheter can easily be a problem if the color from the tatoo obscures these changes. I fear this may be one of those issues where the studies will be extremely low on the priorities for funding. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gwen Irwin
Tatoos

I agree that this is not our experential information about peripheral IVs.  However, with PIVs, there has to be more than the visual evaluation of sites through tatoos.  The evaluation needs to include visual inspection and palpation evaluation, as well as the patient's response to the palpation.  Some of the visual evaluation can clearly indicate redness, in spite of superficial tatoo colors.

Gwen Irwin

Austin, Texas

Calebkent
Like everyone else I have had

Like everyone else I have had to resort to using veins obscured by tatoos. I think you all will agree the only "complication" I have experienced with these patients is that they complain more about the needle than any other patient!

Caleb Kent, RN, BSN, CRNI

PICCNurse
Tatoos

Hi Kathy – I agree with Lynn’s comment regarding visual complications being obscured and Gwen’s comment regarding other evaluation methods used. I’ve inserted catheters near or on old tattoos of military veterans. Just depends on the situation. Thanks for the interesting question!

D. Melton

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