Are there any articles about not using the volar surface of the wrist for IVs. If so please coontact Jackie Tropp with the information. Thanks in advance, [email protected]
Type in; peripheral iv flexion, in a Google search.
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.
There are numerous articles of case reports of nerve injuries associated with venipuncture, peripheral and central catheters. In the extremity, the damage primiarly is reported at the wrist and antecubital fossa. A literature search on PubMed using the terms "venipuncture and nerve injury" will pull up numerous publications.
Venipuncture on the volar aspect of the wrist is painful, and dangerous. The median nerve is very superficial at this location, causing excessive pain. This nerve can also be damaged from venipuncture. There is a cadaveric study from France dissecting the lower forearm and finding that the sensory branch of the radial nerve can intersect with the cephalic vein up to 3 times within the short distance of about 3 to 4 inches from the origin of the cephalic vein up the arm. All of these studies can easily be found in a lit search. Also in my A&P chapter in the INS textbook, I have discussed these risk in all three editions.
Finally there are several publications on nerve injuries from Sue Masoorli in Nursing and JIN that are not actual studies but review articles of this problem. So while you might not specifically locate an article about the volar aspect of the wrist for venipuncture, you will find numerous articles describing nerve injuries in the hand and wrist.
Hope this helps, Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
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