Shave long arm hair before IV start

Sun0408, ASN, RN · May 10, 2011

I can't help much because I have not seen anyone clip arm hair for an IV..

starfishlpn · May 10, 2011

As a student I am taught it is a no no, cause it is unnecessary and can cause nicks and skin irritation... teacher says it is old school, did it 15 years ago but generally thought to be a bad idea. The other difference is likely your environment, I have seen a lot of stuff in ER that wouldn't fly in other departments, just because of the convenence or urgency to get something done in the ED... Clip if needed then scrub the heck out of the still hairy area, that's what I was told.

Turd Ferguson · May 10, 2011

I think the general consensus nowadays is that straight razors are avoided unless absolutely necessary- as for removing the hair with clippers, I don't think there would be anything wrong with it

Double-Helix, BSN, RN · May 10, 2011

From what I was taught, shaving is avoided because it creates cuts, irritation and a portal to infection. Even electric razors are avoided.

I can see where it would be helpful to visualize the vein and secure the IV in place.

FLVARN · May 10, 2011

Thank you for your comments. I did a quick ebsco search for journal articles but everything I came up with was dealing with surgical clipping such as prior to episeotomy, vasectomy, etc. and even that is now old school for infection purposes. There was nothing about shaving over an intended IV site. As far as using a straight razor, OMG are you thinking I am using a straight razor!! No, I am using a safety razor, like millions use eace day on their face.

The same nurse who said I was wrong to do this proceded to shave the guy's chest hair for the ECG tele pads! So it is apparently okay to shave for that but not for better vein visualization and op-site adherance.

One nurse I asked said to not use op-sites but use ko-ban to wrap the site. Duh! then you cannot see the insertiion site.

Seems to be a lot of variation on this issue.

IVRUS, BSN, RN · May 10, 2011

We are having a debate at work (VA outpatient center) When I start IVs I always go for the forearm first as my patients get moderate sedation and they frequently clutch the side rail and could dislodge an IV placed in the top of the hand. Often, our male patients are very hairy so I take a safety razor and shave a small patch over the vein. This provided a good place for the op-site to stick and is less painful when it is removed. I have done this for 15 years as an ER and ICU nurse and no-one ever had a problem with it.
Today, another nurse stated this was not correct and that a patient should never be shaved for IV start no matter how hairy they are. She stated info about clipping surgical sites, which I feel is different from an IV start.
Mosby's, our clinical guide at the VA, does not say you can or that you cannot.
I believe that it is all a matter of what you were taught at nursing school.
What is the general consensus out there?

For years, Infusion Nurses Society(INS) has adopted the standard of never shaving before IV placement as one already said so appropriately as it causes microabrasions and subsequent staph infections. It is only acceptable to clip the hair over the proposed site. If you were sued because a patient was harmed by shaving, you wouldn't have a "leg" to stand on.

Hope this helps. :)

merlee · May 10, 2011

A safety razor is still a BLADE, and can cause nicks. And of course there is the added expense of a new razor for each pt who needs to be shaved. There are infection control issues here as well.

I remember some very hairy arms - - not much you can do. That being said, my groin was shaved prior to both of my cardiac caths, and I am not particularly hairy there!

What do the main IV associations have to say about this?

royhanosn · May 10, 2011

depends on how long the LONG hair is! ifs a bush, as some cultures tend to grow long arm hair, a safety razor to prevent infection. It will grow back.

FLVARN · May 10, 2011

Okay, I am open to using clippers instead of a razor though I do not see how using a safety razor to clear a small place on an arm opens the patient, esp. an outpatient in good health, to staph infections. Someone said it was an infection control issue. HOW? I am cleaning the site after I clear the hair away. I shave my face every day with a razor just like this and my wife shaves her legs and I am not worried about staph infections! That just does not make sense. Micro-abrasions will not bloom into raging infections in a normal patient. Whould I do this in a chemo unit with compromised immune systems. Absolutely not.

Plus, as previously stated, it was deemed okay to use a safety razor on the chest hair but not the arm.

Still looking for peer reviewed articles but there is nothing out there about this. Also, ANA does not have a position either. So it seems to be more a matter of what you feel comfortable with and the situation.

Soounds like some do not see a problem with it and some do.

NicuGal, MSN, RN · May 10, 2011

For what it is worth, we shave babies heads when we use the scalp veins, better visualization and better stability of the site. I guess it would depend on how hairy that arm was lol

casi, ASN, RN · May 11, 2011

See if your facility can invest in clippers. I've only ever used clippers on people for IVs and telepatches. This also makes the process of hte hair growing back less painful/itchy/'n stuff.