Hemiparesis and line placement

[Justice4all]

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There is no consensus on placement of lines s/p stroke even if residual. Some are adamant to avoid the extremity while others say no harm. What's your point of view?

 

[deleted87051]

It depends on whether you want to risk messing up the good limb or the bad limb. What is the rationale for avoiding a paralyzed extremity?

 

[deleted875186]

I would use the paralyzed limb, no chance they’ll move during placement 🙂

 

[Beeftenderloin]

There’s already little to no good evidence to support avoidance of BP cuff or IV placement in patients who are post axillary lymph node dissection, (let alone just a Sentinel node Bx or simple mastectomy) but here we are... Let’s not go looking to create another problem where there isn’t one.

 

[woopedazz]

If their paralyzed limb has enough metabolic activity to maintain decent blood flow and a big enough vein, then I go there.

 

[coffeebythelake]

I have no problem going for the paralyzed side.

 

[Arch Guillotti]

There is no consensus on placement of lines s/p stroke even if residual. Some are adamant to avoid the extremity while others say no harm. What's your point of view?

ELI5. What’s the concern?

 

[IMGASMD]

ELI5. What’s the concern?

It no moving, bad.
It no feeling, bad.
You pokey pokey, hurty, bad.
bad+bad+bad= bad bad bad.

 

[Tramadeezy]

Why are these bad? Youre potentially stabbing a big peripheral nerve or something?

 

[woopedazz]

I presume it's needle + stasis +/- altered sensorium = potential VTE risk?

 

[deleted875186]

devils advocate. Patient doesn’t want a line in the one arm they depend on to
function with while awake.

 

[anbuitachi]

if they have good veins, i prefer the arm that doesnt move!

 

[deleted697535]

Some people are way ott. why would anyone care about this? Put the sharp thing into a bleedy thing and move on