Placing IVs in shoulder, breast, upper chest

[paphgrl]

When I have encontered patients with difficult IV access I have placed IVs in shoulders and sometimes in veins of the breast. I have had good success with these sites. I have not seen other nurses do this. Has anyone ever utilized there peripheral veins? Are there any contraindications that prevent RNs from utilizing these sites?

Your input is valued,

PG

[twinmommy+2, ADN, BSN, MSN]

I've started a more than two breast IVs, shoulder IVs and many in the upper arm. 1. I would not start a breast IV unless it was a large enough vein to handle a decent sized IV. The ones I've started were 20's easily with room to go bigger. 2. as a previous poster said, as long as they are used for short term only. there shouldn't be a problem just watch the site. Of course we aren't talking about dopamine or Phenergan, just fluids maybe some pain relief.

[veinwhisper]

I always use 22g no matter the large size of the vessel. There IS evidence that the small catheter has decreased thrombophlebitis due to increased blood flow around the catheter which causes a dilutional effect. I don't start then for pain Meds alone as these could be given IM with less risk. I agree also that it can be urgent for fluids, insulin drips, and 1st dose antibiotics especially.