ER Nurses- Do You Access Mediports?

[blondy2061h]

I work in a hospital that doesn't have it's own ER. As a result, our patients are often filtered through other ERs, and we get patients from a variety of different hospitals. Working in oncology, some of our patients have Mediports, and almost all have central access of some form.

Some hospitals seem to routinely access the Mediport (or use their central line), while others won't touch it and start a peripheral IV.

How do you feel about accessing Mediports in the ED? What if it's a central line with the lumens right there ready for use?

[farmerRN]

I work in the ER and access ports all the time, but I also work part time in a sister facility's outpatient oncology unit and worked several years on an med/oncology unit...so usually my cohorts ask me to access patients with ports when they come in...no one seems to have a problem with it.

[Magsulfate, BSN, RN]

I remember being a new grad, just barely on the floor when I accessed my first portacath. They taught us in school, of course the port was not in the patient. But, it is really easy, you just have to make sure you angle it correctly and have a good grasp ont he port. Also, flush it with heparin just before discontinuing it (according to your facility p&p)

I work at a long term acute care hospital, and there's no policy on xraying central lines, picc's or portacaths when they come in from the other hospital, as long as that hospital followed their own protocol before they started using it. Unless it LOOK like it might be out of place,, like too much line is outside the body, etc.. we'll xray it then.. but otherwise just use it.

[ECKPowers]

If I had a port, I would want it used for everything I needed. I can not imagine having an iv started (i am a VERY hard stick and needle phobic) if I had one

I have a Port. It's a godsend! It can be accessed for any and all uses. My doctors will not allow sticks on me. Darn near impossible stick. And veins are damaged from so many IV's, infusions, blood transfusions, etc. If a nurse or ER refused to access my port, I would call the House supervisor immediately. I am not an ocology patient either. Other diseases sometimes need ports also.

[ChristineN, BSN, RN]

I have a Port. It's a godsend! It can be accessed for any and all uses. My doctors will not allow sticks on me. Darn near impossible stick. And veins are damaged from so many IV's, infusions, blood transfusions, etc. If a nurse or ER refused to access my port, I would call the House supervisor immediately. I am not an ocology patient either. Other diseases sometimes need ports also.

Yes, I see oncology pts, sickle cell, Cystic fibrosis, and any other sort of chronic, frequently hospitalized pt come in with a port.

[Iam46yearsold]

We see mediports all the time. Pts with them come in, we access them routinely without an order to do so. Most pts with them generally if they have labs or need meds iv. Their veins are all shot so the port is your only access. Why wait for an order...

[nuangel1, BSN, RN]

yes we access them in our ed.but regardless of the reason placed there are exceptions to using it.theses thunneled lines and regular central lines cannot be used for cat scans with iv dye .the dye is given at such high pressure it can blow the line .so if md orders a cat scan with dye a peripheral access has to be placed .

[Iam46yearsold]

They are putting the high pressure ones in people now. When you feel the top of the port it has this triangle of bumps on them, those can be used

[FlyingScot, RN]

They are putting the high pressure ones in people now. When you feel the top of the port it has this triangle of bumps on them, those can be used

They are called "Power Ports" or "Power PICCS". The port itself is triangular shaped in addition to having the three reference bumps. The patient should also be wearing a purple wristband. The thing to remember with these is that there is also a special "Power Needle" that must be used if a CT is ordered. If accessing just for labs and/or fluids a regular non-coring needle can be used. The Power PICC's connector is purple to indicate it's presence if the patient forgets to tell you. I now work in an outpatient Hem/Onc clinic and so many of our patients have these that we call our dedicated port draw nurse a "Power Ranger"!

[blondy2061h, MSN, RN]

They are called "Power Ports" or "Power PICCS". The port itself is triangular shaped in addition to having the three reference bumps. The patient should also be wearing a purple wristband. The thing to remember with these is that there is also a special "Power Needle" that must be used if a CT is ordered. If accessing just for labs and/or fluids a regular non-coring needle can be used. The Power PICC's connector is purple to indicate it's presence if the patient forgets to tell you. I now work in an outpatient Hem/Onc clinic and so many of our patients have these that we call our dedicated port draw nurse a "Power Ranger"!

We're not using power PICCs/Ports routinely yet, and I had a patient come from another facility with a power CVC. I had no idea what the "power" part meant, just thinking it was a brand name, and I thought it was cool that it had a purple lumen. Thanks for the explanation. Now I know. A bunch of us commented that we had never seen purple lumens before.

[RNKPCE]

On the floors we never access these we get someone trained to do it. Here is a good reason to only have an expert do it. Someone once accessed a medi port for a dopamine drip and it wasn't accessed correctly she had extravasation of dopamine into her chest. It was horrible as a lot infused before it was caught. She even had to have a plastic surgery consult. Not sure what happened long term.