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)
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!
No kidding. No I wasn't at all I was saying just use the patients arm if the port is so painful for the patient!
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?
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.
Our oncology patients can leave them in forever. Peds is a different world than adults
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.
My husband's port is going on 8 years. Still going strong.
My husband's port is going on 8 years. Still going strong.
Most ports can withstand 500-2000 punctures before they go bad, and the larger non-coring needles decrease the life of the port, vs the smaller gauge ones.
Some people just don't do well with ports. When I had my power port, I hated it. It always hurt to be accessed, but I am very, very, very sensitive to pain. My port also migrated during treatment and I had to have it surgically fixed.
My port and I had a love/hate relationship. I know I needed it, and it always worked well in regards to flushing, chemo, IVs, etc., but it hurt like hell. I had my port placed in June 2008 and I finished chemo in December 2008. My cancer went away after just 4 cycles (out of 12) of ABVD so my oncologist signed off completely when I had my port removed on January 19th, 2009. I loved/hated that thing so much I remember the exact date!
You do the math - 8 years later and I'm still cancer free! I am friends with a few people who had cancer and I've had a few patients over the years with ports. Some remove them immediately, some wait a year, others wait three years, and the longest I've seen in is waiting for his 5 year mark in 6 months. To each their own - if you maintain it then it shouldn't be an issue!
Specializes in Oncology; medical specialty website.
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.
My port has been in for almost 5 years. I have had 2 different oncologists; neither one has said I had to have my port removed because it was nearly 5 years old. I have very little pain when it's being accessed. I do make sure that certain people are available to access it; some people have trouble with it because it's a little tipped to one side.
I worked in outpatient oncology and saw patients who had ports that were in for much longer than 5 years. The docs I worked with all said that as long as the port is functioning appropriately there is no need to remove it. They said much the same things your doc said.
There's a big difference between pediatric oncology and adult oncology.
Specializes in Infusion Nursing, Home Health Infusion.
Honestly, it does not sound as if there is anything wrong with this port. Are you using a power loc non-coring needle? I find the power lock needles to be very dull so you could try switching to a different non-coring needle if that is an option. You can use any non-coring needle in a power injectable capable port if you are NOT going to have to power inject through it. If you DO NOT have an option to switch to a different product please try a smaller gauge ( 22) and see if that reduces the patient discomfort upon accessing!
sweetlilwolf
179 Posts
No kidding. No I wasn't at all I was saying just use the patients arm if the port is so painful for the patient!
I'm not a moron thank you.