power ports

  1. 1 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.
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    Visit  schlemj profile page

    About schlemj

    48 Years Old; Joined Dec '08; Posts: 15; Likes: 14.

    18 Comments so far...

  4. Visit  mtwife profile page
    1
    I have had similar experiences with the power ports. Overall, I like them but we've had several that are quite stingy with blood return, etc. When I spoke to the rep, he stated that most of the problems are related to how the port is placed initially (perhaps they are a bit different than traditional ports on how they are placed-- different technique). Of course, that doesn't help after the fact! I do recall that I had more trouble with a certain surgeon's power port placement than another's. Hopefully the mfr is inservicing those who place the ports!
    hlkight likes this.
  5. Visit  truern profile page
    0
    I only recently had my Bard PowerPort removed and what a pain in the *** it was!!

    NOBODY would use it for blood draws at the hospital..nor would they use it for anesthesia, for CT contrast..heck, I might as well not had it for all the good it did. They would only access it for chemo at the oncologist's office and once did a blood draw there as well.

    Plus it ached always
  6. Visit  blondy2061h profile page
    0
    We don't use them, so I've only seen a power CVC once, on a patient that came with it from another facility. Her's worked well when she had it, but it got pulled with she went septic. We rarely use ports of any kind.
  7. Visit  NurseyBaby'05 profile page
    0
    They don't seem to anchor as well as the traditional ports. I think this makes the needle more likely to worm out of place enough to be a PITA. Some of our pt's have to have them accessed in fluro. Once they get it, we usually don't have additional problems.
    Last edit by NurseyBaby'05 on Jan 4, '09
  8. Visit  iluvivt profile page
    1
    Any port without a blood return should be treated with TPA. Hopefully Bard will reconfigure the next generation of power ports!!!!!
    hlkight likes this.
  9. Visit  schlemj profile page
    1
    Once again this past week with a very busy clinic another patient with a bard power port that would not give blood after several flushes and positon changes cath flo (altaplase) had to be used. Another patient with her power port that was in clinic for treatment had to endure several position changes and finally after several flushes as well a good blood return. Please let me know do you out there have patients with bard power ports? Or are you still seeing the traditional ports ( not compatable with the contrast dye or machines that CT uses)????? Luckily a rep from another co inserviced us on the smart port, another ct comapatable port in which I have used and it was much more user friendly. Please send in any feed back.
    hlkight likes this.
  10. Visit  jazzyday profile page
    2
    Quote from schlemj
    Once again this past week with a very busy clinic another patient with a bard power port that would not give blood after several flushes and positon changes cath flo (altaplase) had to be used. Another patient with her power port that was in clinic for treatment had to endure several position changes and finally after several flushes as well a good blood return. Please let me know do you out there have patients with bard power ports? Or are you still seeing the traditional ports ( not compatable with the contrast dye or machines that CT uses)????? Luckily a rep from another co inserviced us on the smart port, another ct comapatable port in which I have used and it was much more user friendly. Please send in any feed back.
    Thanks for that tidbit... At our hospital we sometimes have the luxury of requesting what sorta PORT we want that particular patient to have. We have have just started asking for the SMART ports, so far so good. But I must say that approx a year ago this particualr surgeon was placing dual POC... That is a nightmare! Both sides had to be accessed... you never knew which side had be accessed last... It was DUAL trouble (smiles). Some patient fail to have their implant card so you might stick in the middle and hit the septum... I'm cringing just thinking about it.
    hlkight and schlemj like this.
  11. Visit  schlemj profile page
    0
    Thank you so much for the imput. We are also requesting smart ports now as well, they are much easier to use, more reliable for blood draws, easier to acess.
  12. Visit  Bob Snow RN profile page
    0
    One question I do have related to the complaint of inability to draw blood from a Bard PowerPort is this? Who placed the port? Was it placed by a Interventional Radiologist or Surgeon? If it was placed by a Surgeon, that may possibly be the problem. It is my experience that my patients have better outcomes all around if the port is placed by Interventional Radiology MD. Port placements by a general surgeon at my facility are few and far inbetween.
    When accessing a PowerPort, keep in mind that the septum is thicker than a standard port. This is to tolerate the high injection pressure of the contrast. I find that I have needed to apply a bit more pressure to the power loc needle when accessing. Other than that, I have had no issues.
  13. Visit  schlemj profile page
    0
    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.
  14. Visit  iluvivt profile page
    0
    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
  15. Visit  SamyRN profile page
    0
    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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