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.
Plus, as previously stated, it was deemed okay to use a safety razor on the chest hair but not the arm.
To place EKG leads, not to insert an IV catheter. I haven't heard of any nosocomial infections linked to EKG lead placement, but many with IVs, so the risk is clearly different.
Potter & Perry Nursing Procedures states NOT to shave over an IV site. I don't have access to CINAHL at home otherwise I'd try a search. Or as someone else mentioned, try the Infusion Nurses Society. Do you have a unit educator who could do a lit search?
And regards to shaving in general- plenty of people have issues with abscesses and infections from shaving faces, legs, and bikini areas. I'm not sure why you want a peer reviewed source on shaving/not shaving for an IV but think citing your experience and your wife's experience as being representative....
So does my wife, PICU, Infant toddler, 15 yrs. She does not see an issue with using a safety razor and feels that the visualization and security of the IV site is more important than worrying about potential infections.
As far as lenght of hair, average hairy guys, we are not talking gorilla hair.
If you dont shave the area the op-site attaches to the hair and you need MORE tape to secure it. When you rip it off you cause more trauma to the skin than if you had shaved it.
Unless I see a good peer reviewed article or a good reason to cease I am going to continue shaving with clippers and ditch the safety razor, though they are cheaper than the dlipper heads.
Sorry, earlier when I said "straight razor" I really meant any type of shaving device with a razor blade (safety or not)... my bad for wording it funny.
I've been taught it's best to clip the hair with scissors because, as others have said, shaving can cause microabrasions and increase the risk of skin infection. Having said that, I've never actually seen any problems from shaving an IV site.
I do think it's almost cruel to apply sticky tape or dressings over hairy male arms though, it makes it harder to get the dressing off and it really does hurt the patient. Unless it's an emergency and you don't have time, just cut or clip the hair.
Like complete unknown, I have never seen any problems with shaving, never a liability issue for any facility I;ve worked at.
Nurse educator says to prep site as appropriate for IV insertion. She was clueless.
We have clippers to use, safety razors are cheaper though.
I still, l don't get the infection/micro-abrasion issue. The site gets cleaned then the skin is penetrated with a needle. What is a greater potential, the needle insertion or the micro-abrads? The needle of course. That is a definate, the m/a are unknown.
Discharge instructions to pts. I say watch site for s/s of infection such as redness. swelling or disxharge and put neosporin or bactracin on and cover with band aid. If worse, contact MD. Standard stuff.
I know that some people on here are afraid to touch a pt. And some go way too far in guarding against the remote: "pt has the potential for a meteor to strike as evidenced by them looking at the stars"
Like complete unknown, I have never seen any problems with shaving, never a liability issue for any facility I;ve worked at.
Nurse educator says to prep site as appropriate for IV insertion. She was clueless.
We have clippers to use, safety razors are cheaper though.
I still, l don't get the infection/micro-abrasion issue. The site gets cleaned then the skin is penetrated with a needle. What is a greater potential, the needle insertion or the micro-abrads? The needle of course. That is a definate, the m/a are unknown.
Discharge instructions to pts. I say watch site for s/s of infection such as redness. swelling or disxharge and put neosporin or bactracin on and cover with band aid. If worse, contact MD. Standard stuff.
I know that some people on here are afraid to touch a pt. And some go way too far in guarding against the remote: "pt has the potential for a meteor to strike as evidenced by them looking at the stars"
Lol!! I must keep that in mind, I love looking at the night sky.
I guess the only two things that i could see wrong with shaving would be nicks and if the pt was taking coumadin or something along those lines. shaving could turn a convenience into a big headache.
Just use common sense. If you cannot see the site, than use a clipper. If you don't have a clipper, than use a razor judiciously. But don't shave if you don't have to.
Pt's HATE to have dressings taken off a hairy IV site, it seems like torture because you have to go slowly.
They WILL get over it, and some things DO hurt.
If that is the only thing my pt.s ever complain about, then I have done well.
hiddencatRN, BSN, RN
3,408 Posts
To place EKG leads, not to insert an IV catheter. I haven't heard of any nosocomial infections linked to EKG lead placement, but many with IVs, so the risk is clearly different.
Potter & Perry Nursing Procedures states NOT to shave over an IV site. I don't have access to CINAHL at home otherwise I'd try a search. Or as someone else mentioned, try the Infusion Nurses Society. Do you have a unit educator who could do a lit search?
And regards to shaving in general- plenty of people have issues with abscesses and infections from shaving faces, legs, and bikini areas. I'm not sure why you want a peer reviewed source on shaving/not shaving for an IV but think citing your experience and your wife's experience as being representative....