Implanted Ports

Specialties Oncology

Published

Can someone give me some hints on what has worked for you in accessing difficult to access ports? I have three patients that I find it impossible to locate the septum. Please help!

Specializes in Neuro/Med-Surg/Oncology.

A second set of eyes/fingers. Then mark it with something indelible. (Even just the tiniest dot.) Most pt's don't mind since it keeps them from hevign to endure multiple needlesticks.

Try making the patient stand on their head? I almost feel like that's what I'm doing at times. Seriously, I have patients lay on one side then the other, arm up, arm back, supine, upright. You name it I've probably done it. If the port is burried in breast tissue it can be tough, so have the patient hold down the tissue as you palpate. I can not tell you how many ports I hit a day, today alone was 10, so it's a touch that you become familiar with. Sometimes I've had to trace a template in relation to the scar so it can be easily found next time.:monkeydance: (cute monkey)

It just takes practice. I am always amazed how many times the Oncology nurses are asked to access ports on other floors of the hospital because they do not feel comfortable dealing with them.

Do you have the option of choosing the needle length, 3/4 vs 1 inch? I find that the 1 inch saves the day on larger men or women who have ports that are implanted more deeply in the breast tissue.

Specializes in Women's Health, Oncology.

I like the "stand on the head" option...LOL!

We prefer to suspend the patients from the ceiling, at a 90 degree angle....hahahahha

Seriously, it just takes practice and time to really get a feel for accessing ports, just like it does for starting PIV's.

I've always felt that if you keep confident when first trying (keep repeating in your head ..I can DO this!) and not feeling bad if you miss, then you will get it.

Everyone has to learn and doing is learning. Don't be afraid to miss, even experienced nurses know when to call in another nurse if they can't quite get it.

Just don't be afraid to keep trying!

I find when I see new RN's try to access ports that they miss it when they are very tentative. Once you feel it firmly "jab" it in so you hit the back of the port. You will get to feel a dull thump feeling and know you are not in when you dont feel it. It just takes practice.

Ocassionally ports have a hard time "giving up the blood" I wonder if the last person that flushes them does a gentle flush. I think they need a firm flush with saline before the heparin. JMHO:twocents:

Specializes in Women's Health, Oncology.

Beth...ITA!

I've had new nurses tell me they are tenative and scared when doing IV's or port access draws because they might hurt the patient having to do more then one stick.

My answer is that "all needles being used on you hurt". Get over the fact that you're going to inflict pain, because you are.

The goal is to inflict the pain the least amount of times and for the shortest duration.

This can be achieved by being less hesitant and more confident.

Practice makes almost perfect...LOL:w00t:

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