RE: Left arm thrombosis

[MidWest Vascular Access]

All thrombi are a concern, but thrombus in the subclavian, innominate, or SVC of either side have much greater consequences, generally, than that of the basilic, brachial, or cephalic veins.  A clot in the left arm is no worse than a clot in the right arm.  There is simply a greater risk for thrombus formation with left sided approaches because of the longer line length and the increase in turns, thus more contact of the line on the vessel wall.   We also try to encourage the patient to allow right-sided placement if there is no clinical contraindication.  With that said, if the patient feels very strongly about not using their right arm, we will place the line on the left without a fight.   Hope that helps, Michelle Followell, RN, CNN, CRNI   MidWest Vascular Access, LLC P.O. Box 7061 Shawnee Mission, KS  66207 913-593-9557 [EMAIL PROTECTED]   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Zenger Rhonda Sent: Wednesday, August 16, 2006 7:43 AM To: [EMAIL PROTECTED] Subject: Left arm thrombosis   At first I was concerned about an increased risk of thrombosis with using the left arm because of the additional length of the catheter which means more vessel irritation ect. However, upon reviewing x-rays, the left arm approach catheter placement looks “very funny” a lot of sharp angles and turns. If we have to use the left arm then that is okay. I just don’t want it to become the first choice. And if it is the first choice, then to document the rationale as to why the left arm was chosen for placement. Such as, if the patient has had a recent right mastectomy, major trauma to right shoulder, etc. I guess I am not worried about thrombosis in other vessels on the left arm, just the basilic vein. Should I be?   Rhonda Zenger, MSN, RN Advanced IV Services Mercy Regional Health Center Manhattan, Kansas 785-323-6835 [EMAIL PROTECTED]   __________ NOD32 1.1208 (20050902) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com