Inserting IV on arm that had I&D done

[mheisey]

Would you insert or attempt to insert an IV in a patients arm when they had an abscess I&D earlier that day above the site of insertion? Why or why not? I attempted a line and was later criticized for doing so and am not sure the rationale.

[offlabel]

Increase risk of phlebitis/thrombus formation perhaps. Wasn't there somewhere else to go?

[mheisey]

Yes but the patient requested in that arm since he would not be using it, and the site in his other arm kept occluding when he was using it (which was most of the time due to the giant bandage on the I&D arm). Apparently later the patient was all upset because I tried to get him in that arm, yet that is where he requested.

[Joanie49]

I would not have attempted or even thought about trying to insert in IV in that same arm as the I&D. If there was a I&D that means there is going to be a draining wound in close proximity to an IV site....not good, and high risk for another infection and possibly sepsis. I would suggest next time using the other arm and if you cant get access ask charge nurse to attempt (they are normally very skilled.) If still not access possibly a midline or PICC would be considered in the other arm considering the patient is most likely on abx it may just work out better in the long run.