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Hello- I Get Monthly IVIG Infusions And Have Received Different
Question: Hello-
I get monthly IVIG infusions and have received different inputs regarding which veins are safest to use on a regular basis. So far, it's been 4 years getting IVIG. One of my prior nurses rarely used the anterior veins (where blood is typically drawn in arm/elbow area) and would always look for ones by my wrists or other locations on my arm, alternating sites between infusions. Part of it is that I work the 4 hours on my computer and my pump will beep if in an unacceptable area where I may occlude the line, bend my arm. This latest nurse has been trying alternate sites, but is having more trouble getting the IV in and has lately been going into the anterior veins which are generally much easier to insert to administer. Is there any protocol on this- vein selection for regular infusions? I worry about overall vein health as my condition, CIDP is chronic.
I get monthly IVIG infusions and have received different inputs regarding which veins are safest to use on a regular basis. So far, it's been 4 years getting IVIG. One of my prior nurses rarely used the anterior veins (where blood is typically drawn in arm/elbow area) and would always look for ones by my wrists or other locations on my arm, alternating sites between infusions. Part of it is that I work the 4 hours on my computer and my pump will beep if in an unacceptable area where I may occlude the line, bend my arm. This latest nurse has been trying alternate sites, but is having more trouble getting the IV in and has lately been going into the anterior veins which are generally much easier to insert to administer. Is there any protocol on this- vein selection for regular infusions? I worry about overall vein health as my condition, CIDP is chronic.
Brief Answer:
the veins of the back of the hand are preferable
Detailed Answer:
Hello,
choosing the vein to cannulate does not follow strict rules. We usually prefer the most distal veins i.e. the dorsal hand veins. We try to avoid the joint areas because it may be difficult to keep the cannula patent at all times as you've already pointed out. Alternating sites is important to give time to previously cannulated veins to recover.
Obviously, the larger and more straight veins are easier to cannulate. Cannulating the central part of a vein is easier than cannulating the distal one. On the other hand the peripheral (and smaller and harder to cannulate) part is preferable because it allows for more cannulation attempts/choices. If - for example - trying to cannulate the vein at its most distal part fails, the cannulation can be attempted again at a more central location of the same vein. If the nurse had chosen the central part right from the start then the distal part could not have been an option after a failed cannulation attempt. This is because the vein usually breaks after the failed attempt.
Too many cannulations usually result in broken veins everywhere and difficult prospective cannulations.
I hope I've answered your question. Please let me know if you need further assistance.
Kind Regards,
Dr Panagiotis Zografakis
Internal Medicine Specialist
the veins of the back of the hand are preferable
Detailed Answer:
Hello,
choosing the vein to cannulate does not follow strict rules. We usually prefer the most distal veins i.e. the dorsal hand veins. We try to avoid the joint areas because it may be difficult to keep the cannula patent at all times as you've already pointed out. Alternating sites is important to give time to previously cannulated veins to recover.
Obviously, the larger and more straight veins are easier to cannulate. Cannulating the central part of a vein is easier than cannulating the distal one. On the other hand the peripheral (and smaller and harder to cannulate) part is preferable because it allows for more cannulation attempts/choices. If - for example - trying to cannulate the vein at its most distal part fails, the cannulation can be attempted again at a more central location of the same vein. If the nurse had chosen the central part right from the start then the distal part could not have been an option after a failed cannulation attempt. This is because the vein usually breaks after the failed attempt.
Too many cannulations usually result in broken veins everywhere and difficult prospective cannulations.
I hope I've answered your question. Please let me know if you need further assistance.
Kind Regards,
Dr Panagiotis Zografakis
Internal Medicine Specialist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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