[rusty55]

Has anyone out there ever had this experience? We have a pt needing regular therapeutic phlebotomies but no veins! Dr. suggests a port but
we've never heard or read anything...please advise

[iluvivt]

Yes we have done this many times. If you choose to do it this way you may have to get a little creative depending upon the type of equipment you have available. We have to get large syringes (60 ml) and use thos to withdraw the blood. We have a standard phlebotomy bag with an attached 16 gauge needle on it. I would not want to use a vacutainer system on a port. Just respect the port...scrub well and perform a good pulsatile flush when you are done and prn to keep the blood coming.
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[rusty55]

Thank you for the info, I didn't get a visual on the phlebotomy bag with needle, how do you transfer blood into bag? We've done a peripheral draw with 60ml syringes and just disposed the syringes. Do you happen to have a written procedure? New to this site so I hope this goes out to the responder...Thanks

[iluvivt]

I am talking about just doing a regular phlebotmy when the patient has no CVC. or even if they do you can still do it this way. In cases where pt has any CVC you are not obligated to use it. The bag is just a standard blood collection bag with a long iv tubing attached...at the end of the IV tubing is a capped 16 gauge needle. So you perform your venipuncture with the stell needle ...tape it down....then open the roller clamp....lower your collection bag....and blood will filll into the bag. there is also a vacutainer method. Yes I can e-mail you our policy if my hospital does not block it. it usually lets me do it/ Send me a private message and I will send you our phlebotomy protocol. Any More questions...ket me know.

[PICC ACE]

You can "unofficially" do a phlebotomy from a CVC,PICC or port by withdrawing the blood using a syringe to do so,but you should be sure to check with your manufacturer first as these devices are not specifically designed for therapeutic phlebotomy. I looked into this a while back and received confirmation from two companies (Bard and Arrow) that doing Ther. Phlebotomy with their devices was "off label" use and as such you do so at your own risk.

[iluvivt]

Yes I know what you are saying but if your back is up against the wall ,what are you going to do.You look at the risk vs the benefit,and clearly if the patient needs the phlebotomy and that is the only way to achieve it ...you go for it. So instead of drawing 10 ml blood for sampling you draw 500 ml off...the procedure is basically the same...just keep the blood moving...and if need be periodically stop and flush.