accessing a port for just one blood draw

Nurses General Nursing

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Would this be worth it? I know that's what the ports are for, but just seemslike unnecessary heparinizing and increased chance of infection over a peripheral stick?

Specializes in ICU.

My son had several ports (for chemo) because nurses weren't careful and they got infected. The cancer center who did his chemo would draw peripherally if he just needed labs and not chemo that day. They always told us to use the port for chemo only, to avoid infection. He was in and out of the hospital a lot, and the nurses there would want to use it for everything. He would tell them to just use his arm, but he had pretty good veins. Personally, I would be more concerned about infection of the port, if you are able to draw peripherally. Also, his oncologist would get upset about nurses sticking in the same hole every time, instead of moving around a little. That would break down the skin over the port. We used saline only, no heparin.

Specializes in ER.

I think it depends. My new job mentioned that the new doctors in the cancer center affiliated with the hospital was upset that the ports weren't being used more often and patients were being stuck. However, I don't know if that was in relation to just drawing labs or if it was for infusing when they came to the hospital/ER.

Specializes in Current: ER Past: Cardiac Tele.

I would ask the patient. I work in the ER and it depends. Sometimes depending on the port we still need a peripheral iv. We don't usually heparinize the port in the ER.

Specializes in Vascular Access.

see below please

Specializes in Vascular Access.
You are right. The purpose of the port is to access easily. Also, please note that the Infusion Nurses Society guidelines recommend NOT using heparin, due to risk of HIT. Normal saline is preferred.

INS does not say that! I've seen your post regarding this before.. And "we" really should be giving correct information to others. Practice standard 45/practice criteria P (page S61 in the latest standard book) states: Before removal of the access needle from an implanted port &/or periodic access and flushing, the device should be locked with HEPARIN LOCK SOLUTION of 100units/ml.

Specializes in Oncology; medical specialty website.
I know ports are better for the patient. I know it's easier on the patient, even it's just one lab.

But darn, it takes longer, it's more trouble for the nurse, and on a really busy shift why can't I just be a little callous and do it the easy way?

I had a patient with a port admitted for OBS. Peripheral site in ER, (they didn't want to access the port either) and one lab before discharge.

Lab didn't want to draw the patient, wanted me to access the port and get the blood. Pressured me. Talked to the patient til the patient asked for a port draw.

A serious waste of my time. Ok, if that makes me self centered and selfish, I'll own it.

It's not about you. It's just 50 shades of wrong to ask why you can't be callous.

If you had a port and veins that were screwed up from chemo, you'd understand. I would do whatever the patient wanted/what was best for the patient.

Specializes in Infusion Nursing, Home Health Infusion.

Thank you IVRUS for the above post (a repeat performance!). The INS even gives very detailed evidence based research with each recommendation. Apparently, the benefit outweighs the risk. Sometimes I will access a port for just one blood draw and sometimes I will not..it just really depends on the clinical scenario and the the quality of the patient's veins.

Specializes in LTC.

To me accessing the port instead of just doing a peripheral draw is worth it if that's what the patient prefers. But then, I had a port put in for chemo last year. My veins were hard to find before chemo, and it's even worse now. And after chemo, it hurts horribly even when the really good lab techs do a peripheral draw. I used to just have them do a peripheral draw until it started getting so painful. I'd rather just have the port accessed and avoid the pain of trying to have a peripheral draw done. I usually try to do lab draws and my scheduled flushes on the same day so everything gets done at once. The cancer center I go to has always encouraged me to have my lab draws done through the port.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
I know ports are better for the patient. I know it's easier on the patient, even it's just one lab.

But darn, it takes longer, it's more trouble for the nurse, and on a really busy shift why can't I just be a little callous and do it the easy way?

I had a patient with a port admitted for OBS. Peripheral site in ER, (they didn't want to access the port either) and one lab before discharge.

Lab didn't want to draw the patient, wanted me to access the port and get the blood. Pressured me. Talked to the patient til the patient asked for a port draw.

A serious waste of my time. Ok, if that makes me self centered and selfish, I'll own it.

I don't even know how to react to this. I am truly stunned.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
My son had several ports (for chemo) because nurses weren't careful and they got infected. The cancer center who did his chemo would draw peripherally if he just needed labs and not chemo that day. They always told us to use the port for chemo only, to avoid infection. He was in and out of the hospital a lot, and the nurses there would want to use it for everything. He would tell them to just use his arm, but he had pretty good veins. Personally, I would be more concerned about infection of the port, if you are able to draw peripherally. Also, his oncologist would get upset about nurses sticking in the same hole every time, instead of moving around a little. That would break down the skin over the port. We used saline only, no heparin.

If the nurses were really the cause of his port infections and they actually caused the skin breakdown then there was truly something horribly wrong with them and they have absolutely no business even touching a port! SMH!

Specializes in LTC Rehab Med/Surg.

It's not about you. It's just 50 shades of wrong to ask why you can't be callous.

If you had a port and veins that were screwed up from chemo, you'd understand. I would do whatever the patient wanted/what was best for the patient.

I know, I know. I said I know.

But saying I have time, and it's all about the patient, puts you in the same category as the manager who expects me to do two jobs in the same amt of time, and deliver cookies and coffee too.

YES, sometimes I want to be callous. Even though I've never refused to access a port when the patient requested it. Will I access if I have a choice? No. Most of us wouldn't for one lab draw.

The OP scenario did not include chemo and bad veins. People have ports for reasons other than CA

Specializes in LTC Rehab Med/Surg.
I don't even know how to react to this. I am truly stunned.

I was honest. One lab draw. A moment of honesty just cracked my nice nurse face.

Sometimes I don't have time. Sometimes the guy in the next room who's about to die comes first. Sometimes I simply can't fit one more thing into the 2 hr I have to do everything. Sometimes I want to do it the easy way.

As I replied to the other poster, I've never refused a patient who wants to use the port for blood draws. But if I have a choice, the lab's going to do it peripherally.

If that really stuns you, you haven't been a nurse very long.

Either that, or you work with saints.

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