IVs in the breast

VANurse2010 · Nov 3, 2015

Pssst... not they don't! Apparently you haven't seen an ER physician put in a central line!
Annie

Actually I have, thanks!

Dazglue, ADN, BSN, MSN, RN · Nov 3, 2015

I don't know about evidence, but I have started a couple that were borderline breast/shoulder and I have seen a coworker start one not too far above a nipple before.
I'd say regardless of safety, if you are that desperate for access, the benefits of having access are going to outweigh whatever problems might occur from said access being in the breast.

OUCH!!!!

ThePrincessBride, MSN, RN, NP · Nov 3, 2015

A lady had a IV in her breast at my hospital. The IV extravasated and she ended up losing her breast.

No thanks!

AnnieOaklyRN, BSN, RN, EMT-P · Nov 3, 2015

That's probably true, but PICCs are not available 24/7 at the vast majority of facilities.

And BTW if they can't find a site on an arm for a PIV, how do you suppose they could get a PICC in?!!! If your answer is ultrasound then they best method would be to use the ultrasound and place a peripheral line i that way! It takes a good physician about 20 seconds to find the IJ or the landmarks for a subclavian, not much searching, compared to trying to find a vein for PICC access on a patient with poor peripheral vasculature!

Annie

NotAllWhoWandeRN, ASN, RN · Nov 3, 2015

A lady had a IV in her breast at my hospital. The IV extravasated and she ended up losing her breast.
No thanks!

Legit concern, but I personally find my hands more valuable than my breasts.

blondy2061h, MSN, RN · Nov 3, 2015

Legit concern, but I personally find my hands more valuable than my breasts.

But you're not nearly as likely to lose your hand. An infiltration would be caught more quickly due to the site being readily visible. The vasculature is such that an infiltrate would be unlikely to cause much more than need for a skin graft- which is no doubt serious, but not limb threatening. The breast doesn't have nearly the same venous network. It's a lot of lymph tissue, causing risk for lymphedema.

Karou · Nov 3, 2015

A lady had a IV in her breast at my hospital. The IV extravasated and she ended up losing her breast.
No thanks!

Ouch! Do you know what medication it was? Just curious if it had been a vesicant.

sailornurse · Nov 3, 2015

I put one in once, in the ER. This was before that ultrasound guided/light thing that is used nowadays. She was a hard stick/IVDA hx and we needed a line. The only place I could find a vein was on her right breast. After a couple of hours of fluids, we were able to start a peripheral IV so the breast IV was discontinued.

Lev, MSN, RN, NP · Nov 3, 2015

I drew blood once from somebody's breast. I've also placed an IV (obviously without a tourniquet) in someone's shoulder. There was a great vein there on the surface and he didn't have much else.

VANurse2010 · Nov 3, 2015

And BTW if they can't find a site on an arm for a PIV, how do you suppose they could get a PICC in?!!! If your answer is ultrasound then they best method would be to use the ultrasound and place a peripheral line i that way! It takes a good physician about 20 seconds to find the IJ or the landmarks for a subclavian, not much searching, compared to trying to find a vein for PICC access on a patient with poor peripheral vasculature!
Annie
Annie

Um, really? That was already said by myself and others. And like I said, I'm not arguing with you about this as from my perspective you're ignoring several issues.

ThePrincessBride, MSN, RN, NP · Nov 3, 2015

Legit concern, but I personally find my hands more valuable than my breasts.

You are more likely to feel the burn of an extravasation/see signs and symptoms of infiltration earlier on in the hand than in the breasts though.

I would like to keep both, however.

ThePrincessBride, MSN, RN, NP · Nov 3, 2015

Ouch! Do you know what medication it was? Just curious if it had been a vesicant.

Not sure. I think it was a mycin or chemo. I'm leaning more towards vanco.