Finger Stick in Arm Alert AV Fistula

[RN Questions]

Hello,

Some facilities allow finger sticks in "arm alert" fistula arms and others do not. I have been told the evidence is not there to prove finger sticks in a AV fistula/mastectomy arm are harmful. Can anyone speak to this and/or does anyone have any good articles on the subject to support the practice of not finger sticking "arm alert" fingers.

Thank you.

[PeakRN]

For something like a glucose check I don't understand why you would really need to use the limb alert arm.

In the unit we stick patients every hour when on IV insulin, often (repeatedly) on the finger of their choosing.

[brownbook]

It makes no sense to me how poking a finger in a patient with an AV fistula could what???? Maybe lead to an infection? Somehow compromise their AV fistula in their forearm?

When there are no reasonable options we've started IV's, for same day surgery, below the fistula with doctor and anesthesia approval. Of course we know these are only going to be in place 3 - 6 hours or so.

Do the finger stick as "clean" as possible, and you should be fine. But you'd to that for every patient.

Sure if both hands, all fingers, are available why not to use the non AV hand.

Our surgeon, who runs the Cancer Center and who's focus is breast cancer, does mastectomies 4 - 8 times a week, told us we could start the IV in the same arm as an old, healed, mastectomy. Of course if the other arm was available, use it. Just be sure the whole process is as clean as possible, as you would for every patient.

She said a clean IV start in the arm of a mastectomy is not an issue. A "dirty" wound, scratch, infection, the patient might get at home could be trouble.