Giving IV Contrast thru a Power Port with NO blood return

I've had no trouble getting a blood return on a power port. If I did not get a blood return I would not inject no matter how sure I was that I had accessed it correctly.

Hi - I would never give anything thru a port without a blood flow - where is that tip? is it a clot or fibrin sheath, get a flow study - and then fix the problem -- where could that drug end up if the catheter has broken, or come apart. Good luck.

Are you talking about a chest port? You should never give anything through a port unless you get a blood return . The first thing I would do is re-access it. One common thing I see is nurses who select a 22 gauge as an option to decrease pain to the patient. I always access a patient in the hospital or if I need to get a brisk blood return with at least a 20 gauge and sometomes a 19 gauge (ie Blood administration). I cannot tell you how many times I de-accessed a 22 gauge with no blood return or a sluggish one and re-accessed with a larger one and then got a great blood return. Also try position changes,especially abducting the same side arm. Also try a 10-20ml pulsatile flush...leave that same syringe attached and then immediately attempt a blood return. If all troubleshooting fails and you believe you are in the portal chamber and you are able to easily instill...you probably have a withdrawl occlusion. This will require the use of Tpa to treat the fibrin build-up. After all trouble shooting and several doses of Tpa and still no blood return the pt will require more testing such as a catheterogram to verify the integrity of the line. As you may know contrast media is considered a vesicant and may cause severe tissue damage if extravasated so you should not take a no blood return finding lightly.

Hi there, I am not a nurse but a cancer patient who has just had a Power Port inserted for the administration of chemotherapy. I just wanted to say that, even though the swelling has now subsided, my oncology nurse cannot gain access and get a blood return by using a 3/4" needle and has to use a 1". This has happened more than once and now she just uses the 1". Thank you to all nurses everywhere!

Yes I believe that ...you need a length that will allow you to get through the portal septum and reach the back wall of the portal chamber. Each pts body is a bit different and each pocket is unique....so an assessment needs to be done to select the most appopriate gauge and length.