accessing a port for just one blood draw

  1. 0
    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?
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  3. 49 Comments so far...

  4. 0
    What's the lab? I feel like I would just go for a peripheral stick as well, depending on what the lab was. We have lots of labs that by policy aren't to be drawn from a port or a central line, even when they are already accessed - which sucks, but they are necessary evils.
  5. 5
    When I worked in oncology I would always ask the pt their preference. Some of them don't want to be stuck in the peripheral, and some have really bad IV access, so why wouldn't you use the port? A port needs to be accessed and flushed every 8 weeks or so, so if it would coincide with the lab draw, you would just get 2 things done at once. And on the flip side, some didn't want their port used because it took too long or what have you, and that was fine as long as it wasn't "scheduled" to be flushed. And I'm thinking that as long as it is done as a sterile procedure, you should be ok infection wise. (My opinion as somewhat of a still newbie nurse)
    psu_213, canoehead, OCNRN63, and 2 others like this.
  6. 2
    I do this pretty much every day. Most of my patients (children) have ports because they're oncology patients. When we draw their labs at home, we access their ports to do so. I'm not doing a peripheral stick on a baby who sits still and claps through getting her port accessed. The only lab that I regularly draw that I KNOW can't be drawn via PAC is a lovenox level.
    gvrn13 and SoldierNurse22 like this.
  7. 1
    Quote from KelRN215
    I do this pretty much every day. Most of my patients (children) have ports because they're oncology patients. When we draw their labs at home, we access their ports to do so. I'm not doing a peripheral stick on a baby who sits still and claps through getting her port accessed. The only lab that I regularly draw that I KNOW can't be drawn via PAC is a lovenox level.
    We have lots of ABX peaks and troughs that can't be drawn via a port... which really sucks when the kid is all accessed and hooked up anyway.

    Obviously if they are a super hard stick or there is another reason you can't stick peripherally the port is of course the easier option (well, most of them - we had one girl who had a port under about forty pounds of breast tissue, it was like playing a bad game of darts to access that thing) - but for most of my kids a port access is more panic inducing than a lab draw! And they are all old hats with them!
    sallyrnrrt likes this.
  8. 3
    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.
  9. 0
    Quote from classicdame
    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.
    Never?
    I'd love to see a copy of these recommendations and the evidence behind them. I always feel like we use too much heparin. (We lock every central line with heparin PRN - on top of our flushing protocols when not infusing fluids.)
  10. 0
    Not sure if you can access the information from their website but you can try. I bought the Standards for my hospital's use. Cost is about $50, I think. Helps me create policies, etc. There are times when heparin is ok, of course, but not routinely and not for every patient. The reference list for flushing standards is four page columns, so I cannot address here.

    www.ins1.org
  11. 7
    Chemo has left my veins difficult to access, so I would much rather have a draw from my port than have someone digging around in my arm.
    Muser69, Christy1019, vintagemother, and 4 others like this.
  12. 0
    Quote from classicdame
    Not sure if you can access the information from their website but you can try. I bought the Standards for my hospital's use. Cost is about $50, I think. Helps me create policies, etc. There are times when heparin is ok, of course, but not routinely and not for every patient. The reference list for flushing standards is four page columns, so I cannot address here.

    www.ins1.org
    2 IV RNs stated this was untrue in another thread: http://allnurses.com/nursing-patient...831-page2.html

    I have never worked anywhere where we didn't flush ports with heparin at all times. 500 units with deaccessing and 50 units if left accessed.

    It won't let me link directly to it but if you click the first link here, it says heparin is recommended: https://www.google.com/#q=infusion%2...ng%20protocols
    Last edit by KelRN215 on Jul 15


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