Port- a-cath not drawing blood!

[Tolos]

Does any of you infusion nurses have any idea or interventions to make a port-a-cath draw blood? I have a newly revised port that has not drawn blood twice since after the revision but infuses and flushes with no discomfort. I have tried coughing, raising hands and changing positions. Need your input!

[psalm, RN]

Is it midline? Is there an order that it's okay to draw from it? tPA? Let the doc know and get orders for heparin and try in 45 min...or check your facility's protocol.

[iluvivt, BSN, RN]

Th history of the port is the first thing you assess. I have seen them put pediatric size ports in adults. Verify by recent Chest radiograph (CXR) that the tip of the attached catheter is in the Superior Vena Cava as malpostioned CVC's can have withdrawl occlusions. That is the name for what you are describing. If all OK with that ....call MD...request a TPa order...request at least 2mg but I ask for 3mg b/c the priming volume of most ports is approx 2.5 ml. Mix the TPa with 2.2ml sterile water... instill and let sit for at least one hour....I like to leave it in 2 hours especially on ports....once a blood return..withdraw and discard 5-10 ml and flush with NS then whatever heparin concentration you use..let me know if this helps. I have found that if a port is tempermental from the start it tends to stay that way

[vivibae]

I work as an chemo infusion nurse and I encounter more power ports. I am not sure what kind you have. But usually when we do not draw blood when we access the port we ask the patient to deep breath. If that doesnt work we ask them to raise their arm, the side that the port is located. The last thing I can think of is that they did not access the port correctly.