Published Apr 24, I was hoping to get your opinions, experiences, and any known dangers or contraindications to gaining IV access in not so common spots.
I can't seem to wrap my head around why. No one really has any solid reasons as to the avoidance of alternative sites. Having spent years working with chronically ill children, I've put IVs in all sorts of weird places--in: fingers, bottom of the foot, behind the knee, the thigh, the chest Basically, with kids, if I can see it and stick a line in it, it's all good. But in big people, there are other considerations. I have used foot veins for hydration and blood administration in older patients who had no available upper extremity access, with a doctor's order.
As far as chest area veins, if they're accessible, I don't know of any studies that show they are more prone to DVTs than other sites, but I am not an expert. It comes down to risk assessment vs convenience, I think.
If a nurse can safely place a peripheral line, the MD doesn't have to order or insert a more complex alternative. But it seems that generally, the more unusual the IV, the more likely the complications, so extreme peripheral IV placement should be a last resort if central line placement is somehow contraindicated or seriously inconvenient.
PICC lines, though, done correctly, are a good option for many patients. In any hospital I have worked at, we had to have a doctor's order to use the lower extremities on adults. We were always told it was because of the possibility of blood clots, phlebitis, infection, etc. I guess the rationale is that it is better to lose a hand or arm, rather than a foot or leg. Of course, we were always free to use the lower extremities on pediatric patients.
