Risks and benefits of needle use in patients after axillary node surgery.
Lymphoedema may be triggered by any type of injection. This is not just an issue for the cured breast cancer patient but for any patient who has undergone under-arm (axillary) lymph node removal to any degree for any type of cancer. Standard advice given to patients following axillary node removal is to avoid any injection or blood pressure measurement on the ipsilateral arm. The evidence base in this area is severely lacking. Patients have reported frustration that nurses are not informed of contraindications in carrying out such procedures on patients at risk of developing swelling. This article discusses the current evidence available on the subject of non-accidental skin puncture (NASP) relating to the patient at risk of lymphoedema and provides guidelines for any professionals conducting such procedures for patients with a history of cancer. The results from a small audit of the guidelines are cited and they reveal that out of 14 patients who underwent NASP procedures in the at risk arm, no patients reported swelling to that limb within a month of these procedures.
Cole
Tracey
T
Palliative Care, St Christopher's Hospice, Surrey.
D000465:Algorithms; D001132:Arm; D001365:Axilla / Q000033:anatomy & histology; D001795:Blood Pressure Determination / Q000451:nursing; D001943:Breast Neoplasms / Q000453:epidemiology / Q000451:nursing / Q000601:surgery; D000075202:Contraindications; D003663:Decision Trees; D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D007258:Informed Consent; D007267:Injections / Q000451:nursing; D008197:Lymph Node Excision / Q000009:adverse effects*; D008208:Lymphatic System / Q000033:anatomy & histology; D008209:Lymphedema / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015409:Mastectomy, Radical / Q000009:adverse effects*; D009730:Nursing Assessment; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D018962:Phlebotomy / Q000451:nursing; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology