Difficulty Accessing A Port

[REDDICKD]

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)

[iluvivt, BSN, RN]

My husband says that the emla cream takes a full 2 hours to work. While I have a hard time believing that, he's the boss in port matters. Why does your patient refuse it?

Two hours is for deep tissue. One hours is plenty of time for any venipuncture,port access or other minor procedure. Also, it starts to work in 15 minutes and I have found that 30 minutes is highly effective if that is all the time you have. In homecare it will be the first thing I do and while the cream is working I can do other things..get vitals...get forms signed..prepare the flush..etc.

One thing I did not mention is that port access gets easier painwise for the patient as the skin over the port will become desensitized over time with repeated venipuncture. This patient may not have enough time left to experience this

[Ellie G]

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've seen many people have their ports in for several years with no problems.

[greenerpastures]

How often are you doing these blood draws? I'm not sure which state you live in or what your agency suggests, but I know patients that just have their ports left accessed even as outpatients as they are having blood draws/chemo type stuff every other day. The needle and dressing gets changed like they are inpatient, every 7 days. These are patients that are cleared by their doctors after education on NOT accessing their port at home for any reason.

[REDDICKD]

I value your comments because you have a power port. Who could refute your actual experience? The pain is comparable to a peripheral stick as long as it is "done correctly". She is and has been a needle phobic and "procedure phobic" even before having cancer. It has been >10 yrs., painful, and arduous. I am so happy to read you are in remission. I'm with you, if my oncologist (who you obviously trust) said to leave the port in 5 yrs., 2mos. and 1 hr. I'd go with it.

[REDDICKD]

I am so happy you are in remission. And you are absolutely correct about the love/hate relationship with so many circumstances with this patient.

[OCNRN63, RN]

I am so happy you are in remission. And you are absolutely correct about the love/hate relationship with so many circumstances with this patient.

Hey REDDICKD, would you please use the quote function so we know which poster you're responding to? There are several of us here who have power ports.

[NanikRN]

What is that icy spray that you can use you before starting IVs? I bet someone knows. If not I'll find name. Maybe that's an option

I am an onc nurse. You are right the little things sometimes become big things when those are the only things you can control!

Found it--paineaze. Mixed results on PIVs-some say it shrinks veins. But that won't be an issue with a port