My patient recently had a Bard Power Port placed. I access/de-access the port weekly. She had never had a port before. She continues to complain about pain when I access and de-acess the port. She admits to being a needle phobic. We used emla cream once and she has refused it since then. She did not mention if it was effective (it was placed at least 1 hr. before I arrived). I have also used the diversion techniques recommended. Taking a deep breath while accessing and de-accessing which seemed to work in the beginning.
I had never worked with this particular VAD (Power Port Advantage )before. I will admit when accessing the port it does not "feel the same" as other ports I have accessed. It is not that nice, quick sharp stick, yet there is no problem with flushing or blood drawing.
Does anyone have any suggestions?
Thanks
I have contacted the Bard Rep. (without much luck)
As I mentioned above the patient is terminal. As the situation becomes more and more out of her control the issue of control over things like EMLA cream, time, etc. becomes more and more important. Believe me if you said stand on your head prior to accessing the port I would. Thank you for your input.
Oh okay... If it's just used for a blood draw maybe the patient would prefer you just use a butterfly needle....
I hope you are not serious. A special non coring needle must be used when accessing Ports. Ports are never to be accessed with peripheral iv needles or butterfly needles.
Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
I have a power port, it does hurt each time it is accessed for monthly flushing, the pain is about the same as a peripheral stick for labs, IMO. (my oncologist will not discuss removal until 5 years in remission). I have never had it iced or used emla cream. I do prefer to sit up but some of the nurses prefer flushing it in the recliners (lazy boy chairs) in the chemo room. If you are concerned about placement have it checked out with X-ray as you are the patient advocate.
I hope you are not serious. A special non coring needle must be used when accessing Ports. Ports are never to be accessed with peripheral iv needles or butterfly needles.
I'm fairly confident they meant a butterfly for a peripheral draw, vs using the port at all.
I'm not sure how close to end of life this patient is, but can you perhaps have a discussion with the physician about decreasing frequency of lab draws, if she really is approaching end of life quickly?
Thank you blondy for the advice. I will definitely try the techniques you have suggested. The situation is unusual without getting into specifics as you can probably tell from my comments above.
I hope you are not serious. A special non coring needle must be used when accessing Ports. Ports are never to be accessed with peripheral iv needles or butterfly needles.
Reading the original post you are quoting, I think the poster meant "maybe the patient would prefer a peripheral stick/butterfly needle for a lab draw."
Why is an end of life patient having labs drawn so frequently? If you are accessing her every week is it for a weekly needle change/port is staying accessed all week?
I have a power port, it does hurt each time it is accessed for monthly flushing, the pain is about the same as a peripheral stick for labs, IMO. (my oncologist will not discuss removal until 5 years in remission). I have never had it iced or used emla cream. I do prefer to sit up but some of the nurses prefer flushing it in the recliners (lazy boy chairs) in the chemo room. If you are concerned about placement have it checked out with X-ray as you are the patient advocate.
5 years? I have never heard of leaving a port in for that long and taking on all the risks associated with it. Most ports don't last that long. My pediatric oncology patients have their ports removed within weeks of completing chemo.
Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
5 years? I have never heard of leaving a port in for that long and taking on all the risks associated with it. Most ports don't last that long. My pediatric oncology patients have their ports removed within weeks of completing chemo.
Well you are not my oncologist and you do not know what my cancer is. I leave it up to him as he is the expert and explained how many time he has been "burned" when he has removed ports only to have the cancer return a few months later and now there is scar tissue & other problems in re-inserting a new port. I have had it for 4.5 years, In July I will reach the 5 year survival rate.
Are you suggesting the use of a "butterfly needle in the implanted port? If so, many non-coring needles that access ports will have wings on them, but a true butterfly needle like the ones used to access the peripheral veins for VP/Phlebotomy, can NOT be inserted into the body of a port!
Well you are not my oncologist and you do not know what my cancer is. I leave it up to him as he is the expert and explained how many time he has been "burned" when he has removed ports only to have the cancer return a few months later and now there is scar tissue & other problems in re-inserting a new port. I have had it for 4.5 years, In July I will reach the 5 year survival rate.
I encountered a patient at home with a VAD that had been implanted around 8 years ago and was still functioning fine! It did give a little problems here and there with flushing but it had served the pat well not only for chemo, but also for blood draws and other iv action unrelated to cancer.
On the other hand I have seen somebody who had to get the VAD removed already 3 times due to infection (not implanted for cancer - other dx) within probably 10 years.
I hope you are not serious. A special non coring needle must be used when accessing Ports. Ports are never to be accessed with peripheral iv needles or butterfly needles.
OMG not a butterfly needle in her port that's just stupid! Do a peripheral stick on the patient....
REDDICKD
13 Posts
As I mentioned above the patient is terminal. As the situation becomes more and more out of her control the issue of control over things like EMLA cream, time, etc. becomes more and more important. Believe me if you said stand on your head prior to accessing the port I would. Thank you for your input.