Left arm thrombosis

[Zenger Rhonda]

I apologize for not being clear with my question. What I am trying to find out is there any research based information regarding an increased incidence of thrombosis and/or complications when using the left arm for PICC placement. In the past, we would visualize both arms with ultrasound and then choose the arm with the best vein for access. However, I attended a workshop in Kansas City and the speaker reported an increased incidence of thrombosis is associated with using the left arm. He recommended the using the right arm first unless contraindicated and then using the left arm. Now, we use the right arm for PICC placements unless there is a contraindication then we use the left arm. One of our team members continues to use the left arm no matter what the situation is because the CRNAs have informed her it is the easiest and best approach. She also uses a close to the AC approach on the left arm. This makes it very difficult to take care of the PICC due to its location close to the AC. I am trying to change her practice approach, if possible. If anyone has any literature or information to support not using the left arm routinely and not choosing a low AC approach for PICC placements it would be helpful. We use ultrasound with MST. Thanks so much,   Rhonda Zenger, MSN, RN Advanced IV Services Mercy Regional Health Center Manhattan, Kansas 785-323-6835 [EMAIL PROTECTED]