We are seeing these IV's more and more and it is very new to alot of us. We are trying to find the standard practice for starting themin the breast area.

Kim Springer

Educator

 This site is not an

 This site is not an acceptable location and is not listed in the INS standards of practice. There are numerous reasons for this. Visible veins on the chest wall are usually caused by some problem or issue. Venous distention to make them visible could be due to some type of obstruction to venous blood flow. What you are seeing could be collateral circulation that developed due to this obstruction. You can not stablize this site for safe insertion and to maintain the site. There are no studies on using any site in the chest wall. A complication at this site such as extravaation could easily mean the need for mastectomy. I have had legal cases due to extravasation from an implanted port access needle and I think it could easily happen with a peripheral catheter in this aberrant location. There are several alternatives to avoid this dangerous site on the chest wall and that is now the standard of practice due to do many published studies about use of this technology. The first is use of ultrasound of finding superfical veins in the upper extremity and second is the use of infrared light devices for the same purpose. Those are the standard instead of using veins on the chest wall. 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