power ports

[schlemj]

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 with giving blood. The majority of our patients (with these power ports) don't give blood. We are having to try all the tricks of the trade, several position changes, having the pt. cough or deep breath, several flushes and eventually cathflo. The patients are frustrated b/c eventually they have to end up getting a peripheral stick for blood test and CT will not use them w/o a blood return anyways-so the whole purpose is defeted. These ports are also difficult to access in some pts. if they are deep. It is impossible at times to find or feel the 3 dots and the area to access is mush smaller, I never miss the port but I have hit the edge many times and I have to reaccess again. I never in all the years of onc nursing have experienced so many problems, I will take the traditional ports any day.

[SamyRN]

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.

[RN813]

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!

[wrongwaydianne]

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:nurse:

[ChristineN, BSN, RN]

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.

[it's hot in phoenix]

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.

[wrongwaydianne]

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

[schlemJM]

I know this is an old post but we only use 20 gauge hubers....