IV starts in CVA patients

Nurses General Nursing


Having worked both Medicine and Emergency we usually started IV's in the affected arm of a CVA patient with the idea being, we did not want to further hamper he independence by starting the IV in his good arm. Recently I was orientating a ICU Nurse to Emerg and she couldn't believe we did this. Her rational was that if you put the IV in the affected arm the patient also has decreased sensation therefore he can not tell if the medication like Kcl is burning etc. In ICU she says they always start in the good arm. I do understand there are some drugs that we prefer to go through central lines but I'm talking iv hydration or kvo maybe antibiotics. What is the standard practice you all follow? Would appreciate you input.


25 Posts

Understand I've been away from direct pateint care for some time (own my own biz from home now), but we were even taught in nursing school NOT to use the affected side... primary reasons were circulation & sensation as I remember.... ONLY time I've ever done it is in emergency when there were NO other veins available...

Linda/CMAS, BS, RN

[email protected]


58 Posts

We too were taught (16 years ago) not to place IV's in the affected side. I, for the most part use the non-affected side. I site the iv in the forearm, rather than the hand. When putting an iv in the affected side, hypervigilance is required to observe the site for

redness, swelling.etc. etc.


Do you routinely start IVs in the customer's dominant hand or arm? I do NOT! If I have a choice, I will put the IV in the affected arm of a CVA client. Poor pain sensation, nonuse, and leaving the good arm alone, are the criteria I use. As an ED nurse, if others are upset, then they can switch the peripheral IV themselves. If there is a problem with circulation, I have not seen it in 10 glorious years in this glamorous profession. That's my story and I'm sticking to it.

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