Is it contraindicated to draw labs from the same arm that pt has had a mastectomy on that siade or has a upper arm diaylsis catheter in? If so why? If there isn't is there any documentation that state so?
Debra Rivie
Long Beach Memorial Medical Center
Long Beach, CA 90806
Yes venipuncture in the arm with sentinel node dissection and the presence of a fistula or graft is contraindicated. And yes, there are many publications to support this. A literature search should pull these up for you. 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
lynn,
Can you direct me to some site so I can pull up some literature on venipuncture and PIV insertion being contraindicated in arm with sentinel node dissection. Our facility surgeon feels there is no data on this . Our policy is not to place a PIV in arm with any node dissection. This is an ongoing battle esp. with bilateral mastectomies. What is your recommendation for bil. mastectomy with 1 arm having node dissection and the other having sentinel node <4 dissection. The Oncologist feels that less than 5 nodes is not a problem and the arm can be used for venipuncture and b/p this backed up by surgeon and anesthesiologist. the surgeon now wants this issue taken to surgical quality meeting next mont where they will make a recommendation to revise our policy. I would very much like to have some information to present on why this is not a good idea.
Cathy Lessard RN,CRNI
The biggest risk is lymphedema. This oncology nurse is squirming right now!
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
There is not a lot of research, however the standard of care remains the same due to other evidence. See this article:
1. Fu MR. Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management. World J Clin Oncol. 2014;5(3):241-247.
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