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Discussion

Huber Needle

I am a new ADON in LTC. My experience with IVs is limited because the facilities I have worked in used IV companies to manage our IVs (they did access, we hung fluids, observed site, etc). We recently had a patient with a porta cath which was accessed with a Huber needle and he was being discharged to another facility. I was asked to quickly inservice the staff on the porta cath before he left and the RN supervisor came in for the inservice and also to deaccess the porta cath. We had difficulty removing the Huber needle from the porta cath and had to work hard to get it out. I have only seen it done before and it wasn't that hard. The next day I mentioned to the DON that the Huber needle was hard to remove and her reply was that the needle was the wrong size and that was probably why it was hard to get out, but that needle size really didn't matter. She said it was the only size available and it was ok. I have only worked in facilities with the highest of standards and we never would have done that. I don't know a lot about Huber needles (but am looking it up), but correct size would seem to be an important factor. Any thoughts and input would be appreciated.

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    depending on how long it had been in place possible fibrinous scar tissue, you have resident/patient take a deep breath and hold it, as you quickly pull huber needle straight out applying small dressing , or bandaid.

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    The Huber needles come in different gauges and lengths, as well as power needles and non-power needles. The size of the needle doesn't sound like it was the problem. For example, if you have a patient that is on the heavier side the port will be a bit deeper than on a slender person, so you would typically use a 1" or longer needle depending on the patient. For someone who is slender and the port is almost visible, a 3/4" needle would suffice. Using a longer needle just means that the needle will have more length showing outside of the skin, and thus make the Tegaderm dressing somewhat more of a challenge to make occlusive (particularly if it's a double port). The Power needles are necessary if the patient needs contrast dye at CT. Like sallyrnrrt said, the needle may have been in place for too long. The needle and dressing should be changed q7d or per institution policy.

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    The needle should not have been in place for longer than 7 days so scar tissue shouldn't have been an issue I don't think. I wonder if the safety mechanism was faulty. I've run into that a time or two. I've gone to de-access and the needle was stubborn but it was a malfunction of the safety device. Scared the bejeezus out of me though and I'm pretty port-savvy.

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    There are several different brands/products for huber needles. Some are harder to remove than others in my opinion. Some have a safety mechanism which is more difficult to engage which makes them harder to remove. I find the lifeguard hubers harder to remove than the Safe Step and Mini Loc ones. Here's a site that shows pictures of all three: ISIPS | International Sharps Injury Prevention Society

    I use all three brands regularly in my job since the products my patients have in their homes depend on what pharmacy delivers their supplies.

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    The type of port that was implanted, it's age and use, anatomical location, the type and gauge of the Huber can all impact how easy or difficult it is to access or de-access a port.

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