Complication with accessing a porta cath
- 0Nov 10, '12 by RN-BSN2006My patient has a new porta cath placed 3 weeks ago for vanc infusions. The order is to change huber needle every 3 days. I attempted to access porta cath and I get a beautiful blood return, however, when I flush the site begins to rise significantly. I have been unable to access this. Patient was sent to radiology for a study. He was told he had a hematoma and was sent home with a new access in place. Could the issue I had be due to my technique or a complication with his port??
- 0Nov 11, '12 by NBMom1225Was the Huber needle you were using the right length? I've seen various lengths ranging from 1/2 inch to 2 inches. When you inserted the Huber, did you 'feel' the needle hit the base of the port?
I'm curious about the order to change the Huber every 3 days, I've worked oncology at a couple facilities and policy has always been to change the Huber every 7 days or as needed...though I am only familiar with mediports, perhaps they're different than porta caths?
I'll take accessing a mediport over getting a peripheral IV any day, my IV skills aren't the best after dealing with mediports for my first few years as a nurse...no longer in oncology now, co-workers on my current floor are a bit intimidated by the occasional mediport we'll get, so we trade: I'll access their port, they get my peripheral, lol
- 0Nov 11, '12 by RN-BSN2006LolI have tried from 3/4 in to 1 1/2 inch and they have resulted in the same complication. I was only able to access this once since he's had it. Yes I couldn't believe the order for q 3 days. I even called to verify this as well because every PAC I've ever had has been for q 7 days. I'm a home health nurse. My associates have both tried to access him as well and have gotten the same result as me. We are all at our ends wits with this. I just can't figure out why the radiology dept was able to access it and then when I tried I had the same problem as before.
- 1Nov 13, '12 by iluvivtI need to know a few things and I can then give you a few suggestions. So far it sounds like you are just having an issue with accessing the septal chamber of the port with the non-coring needle. You should NEVER use a 1/2 inch needle length to access a chest port,that length can only be used fro a peripherally placed port b/c on all port designs and sizes you barely get through the septum and it can easily pop out and infiltrate or extravasate. I have some tips for you but want to be more specific and if it is that tricky to access I would implore the MD to change the order to reaccess q 7 days as that is the current standard of care. This will also extend the life of the port and decrease her risk for a potential drug leakage pathway.
1. What side is the port on?
2. Does it have a low profile?
3. Can you easily palpate the septum or is it hard to do so b/c of breast tissue or rotation of the port?
4, How long has it been in place now,did you say it was a new port?
5 where is the port pocket exactly in relation to the clavicle?
6 What gauge needle have you been using?