power ports - page 2

by schlemj | 21,868 Views | 18 Comments

Hoping for some opinions regarding power mediports (I think bard makes them) as I am all for our patients to have a port that can be used for contrast dye for CT but my collegeus and I are finding they can be very tempermental... Read More


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    Thank you so much for the feedback. I do see what you mean about the thicker septum, I too have needed to use more force when accessing the power ports. We have several oncologists in our practice, so who puts them in depends on what doc's patient it is. One of the docs will only use the vascular surgeons one doc uses the radiologist, and another uses general surgeon. I do agree that certain surgeons that are used seem to be more difficult but again there are just so many that won't give blood, even early on. I think the power ports are more difficult toaccess if they are deep compared to the traditional counterparts. We are having much better success with the smart ports (angiodynamics) wich are CT comapatable as well.
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    Also use at least a 20 gauge power loc needle...rarely will use a 22 gauge..even on a regular port....b/c they do not draw as well.....I can not tell you how many x I got NO blood return or a sluggish one and de-accessed and re-accessed with a larger gauge and magically got a blood return...also a pre flush may help
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    About 1 year ago my facility switched from regular conventional port-a-caths to the power port. We have n-e-v-e-r had problems with any ports like we do with these! On average, we loose blood return on the power ports in the first two uses. We have used cathflo after fluro proves fibrin sheath. We may get the blood return back for a use or two, but then start all over again with the one way valve effect of fibrin sheaths. We flush by all the rules, using pulsatile technique, clamping during last 0.5ml of hep., etc. We have even left cathflo set in the port overnight, with little success. We have had more cracks and fractures in the last 6-8 months than we have had in the last 10 years! I feel fairly certain it is not due to change on technique or carelessness on the nurses part... why would we only have begun experiencing problems after initiating use of powerport?!?

    Our surgeon refuses to place powerports now. We have gone back to the good old fashioned ports.
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    I don't see many power ports but I find the double ports quite useful for the patient needing chemo, IVF, ABX, transfusion. Or for the patient needing pain meds every 2-3 hours during an infusion!
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    I've been a PACU/critical care/trauma/GI and now IR on the weekends nurse. I don't do IR much so I don't experience too many placements. My sister moved from AZ to NJ recently and has a power port for her scleroderma, which was put in mostly because her venous access in nearly impossible and she needs IV iron and frequent blood draws, so she's between medical insurance's and asked me to look into flushing these catheters. I did a IVC permcath placement and asked to radiologist what he thought, and he recommened she go to an ER and have placement checked and so forth. I know nothing about flushing these ports and will not harm my own sister. The label she gave me that Bard gave her gives the recommended flushing times if not used as q 4 weeks with heparinized saline, but what concentration? After reading the posts here, I'm just going to recommend that she go to the ED and explain her situation. I cannot believe the problems these things have, but I hope they can iron out the kinks for the patient's sakes. Thank you for listening. Thank God there's a place for nurses to talk to other nurses. Dianne
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    The facilities I currently work at don't use Power ports, but I used to work somewhere that did. I don't recall any of us having major issues frequently except for one pt. That particular pt had her power port place "pre-puberty" and once she started to get breasts it was near impossible to get a blood return. TPA did nothing to her line, and even positioning was often ineffective.
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    We use only power ports and love them, no heparin though and I use to use the 3/4 inch needle and would have an issue sometimes with blood retrn, but when I changed to the 1 inch needle, problem has been solved.
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    I appreciate any replies to this, and I saw my sister yesterday. Her port is planted in the right subclavian and you can actually see the 3 dots. She is hoping to get into this nilotinib study at HSS in NY this year, and her port will be accessed use during the study. I just read all the side efffects of this drug and am leary about those, but at this point, she doesn't have much choice and she may not even be a candidate for the study because of her preexisting anemia and severe GI involvement. Time will tell. I hope to God this drug will help her and not harm her if she gets into the program. The drug has very nasty and numerous side effects. So I pray. Thanks all, Dianne
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    I know this is an old post but we only use 20 gauge hubers....


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