Feel free to mention any unused central access at any time...

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Specializes in Oncology.

I had a patient last night who was very busy. Several continuous infusions, several IV meds, in constant need of blood products, and overall very sick. He had a double lumen central line and I was having a very hard time keeping up with his meds and avoiding running incompatible drugs together. I kept telling him we may need to add a peripheral IV, but things would clear up just enough that I could avoid it for a few more hours. Finally when he needed his 4th unit of blood for the night I told him I gave up, and he really needed more IV access and I'd be starting a peripheral.

"Can you just use my mediport?" came his response. I hadn't had a chance to read back in his chart much, but when he pulled his gown to the side, yep, sure as the light of day, there it is, a beautiful unused mediport. He said he didn't mind using it at all.

So patients, if your nurses is frazzled trying to keep up with IV meds, feel free to mention any hiding central access you have ;)

And now I get to keep my trend of never starting a peripheral IV.

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Specializes in Neuro ICU and Med Surg.

If anyone wanted to put a line in me and I had a port (port a cath, meid port what ever you want to call it) then I would be letting them know. Seriously, why do patients not want to tell you that? I would rather you use that then poke me for a IV.

And if you are placing a central line in me( and I have said port because I am in need of it and am sick enought for additional access) it better be a triple lumen for the love of God! I just don't understand why if you have the choice for a double lumen or triple lumen that you just wouldn't use the triple. It gives more access and takes the same time and effort to insert.

That to me is the same as when a PICC is inserted. We can have single,double or triple lumen. Why not give me the double or triple? What is the point of the single at this time.

Sorry for the hijack. Off my soapbox now. I truly don't understand why the pt didn't want to make things easy for caregivers and tell them about the port sooner so they could access it.

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Specializes in Oncology.
If anyone wanted to put a line in me and I had a port (port a cath, meid port what ever you want to call it) then I would be letting them know. Seriously, why do patients not want to tell you that? I would rather you use that then poke me for a IV.

And if you are placing a central line in me( and I have said port because I am in need of it and am sick enought for additional access) it better be a triple lumen for the love of God! I just don't understand why if you have the choice for a double lumen or triple lumen that you just wouldn't use the triple. It gives more access and takes the same time and effort to insert.

That to me is the same as when a PICC is inserted. We can have single,double or triple lumen. Why not give me the double or triple? What is the point of the single at this time.

Sorry for the hijack. Off my soapbox now. I truly don't understand why the pt didn't want to make things easy for caregivers and tell them about the port sooner so they could access it.

When I first started we had major issues with not having enough lumens. Now all our allo transplants get 5 lumen central lines. Yes, 5 lumens. It's a beautiful thing. He's an auto, though, and they still put 2 or 3 lumens in them. Occassionaly we'll get patients from other facilities with 2 lumens. I had a post about that rant awhile back.

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Specializes in Neuro ICU and Med Surg.

Once in a while we will have a pt with the alsius (cooling cath) It is a central line with 5 lumens. 2 lumens are dedicated to the cooling, and the other 3 for infusion and monitoring of CVP.

I wish we had lines with 5 lumens. We have occasionally have had to have 2 central lines to have enough access. (This is very rare, but did happen to me a few times.)

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Specializes in ICU, School Nurse, Med/Surg, Psych.

Sorry to be nitpicking but, how did you listen to all fields of lung sound during your assessment and not feel/see the port?

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Great point island40; I was wondering the same thing. :bow:

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Specializes in Oncology.
Sorry to be nitpicking but, how did you listen to all fields of lung sound during your assessment and not feel/see the port?

Patient was sitting up and I listened from back.

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Specializes in Infusion Nursing, Home Health Infusion.

Many ports are what is called a low profile port and thus they do not stick out as far....they can be very tricky and hide especially in large breasted woman. Your scenario has happened many times in our facility. I am called for an IV start and I get there and the patient tells me they have a port. Worse yet...they have told other nurses but no one accessed it or took the initiative to call the IV team. The patient paid the price and that is what I call crappy nursing care. Many patients do not advocate for themselves...so you even have to educate them on how to do this...sad but true!!

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Specializes in Telemetry & Obs.

The whole time I had a Bard PowerPort NOBODY at the hospital would access it!! Not for blood draws, medications, not even for anesthesia! I made sure to tell everybody that would listen that I had a perfectly good access and crappy veins but nobody except the nurses at the oncology center would access it!

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Specializes in Neuro ICU and Med Surg.
The whole time I had a Bard PowerPort NOBODY at the hospital would access it!! Not for blood draws, medications, not even for anesthesia! I made sure to tell everybody that would listen that I had a perfectly good access and crappy veins but nobody except the nurses at the oncology center would access it!

I would have refused any type of peripheral access. That is total crap. It isn't that hard to access a port once you know how. Seriously I would have been demanding they use the port.

I thought the same thing "didn't she feel it?", but then I realized some you don't always feel.

I worked at one facility that you had to call the IV team for access and blood draws. They were always willing to come and access for us no problem. Now where I work we do it ourselves. I don't mind at all. ER will never access them though. I will always access upon admit and use for blood work and med administration. Sometimes that isn't enough access and we will start a IV if necessary, but that isn't too often.

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Specializes in Telemetry & Obs.
I would have refused any type of peripheral access. That is total crap. It isn't that hard to access a port once you know how. Seriously I would have been demanding they use the port.

I thought the same thing "didn't she feel it?", but then I realized some you don't always feel.

I worked at one facility that you had to call the IV team for access and blood draws. They were always willing to come and access for us no problem. Now where I work we do it ourselves. I don't mind at all. ER will never access them though. I will always access upon admit and use for blood work and med administration. Sometimes that isn't enough access and we will start a IV if necessary, but that isn't too often.

They claimed the Bard PP needed "special" access equipment that they didn't have and didn't know how to use...crap! For one of my surgeries the anesthesiologist said he was considering putting in a central line if all they could get was a 22g IV in...I told him I'd refuse to sign surgical consent if he even gave it another thought! WTH?!?

Sooo...I had MAC anesthesias to put the port in and take it out...and it was used a grand total of TWICE. Hmph!

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Sometimes you cant see them.

A lot of times this happens and the pt tells us that the doc told them "it is only for such and such meds"

I do LTC and most of them have 0 access and then you have incomplete histories etc.

btdt

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