Port-a-cath needle removal

[tiffy723]

Hi oncology nurses,

I have a desperate question and I was worrying the situation so much that I can't sleep.

I had difficulty to remove a port-a-cath needle yesterday. The needle eventually came out but I'm not sure why I had difficulty. Now I'm scared maybe because I didn't stabilized the port-a-cath enough, and by pulling too hard I may cause damage or dislodgement to the port-a-cath.

So my questions are:

1. What are the chances that the port-a-cath will be damaged or dislodged due to not stabilize it enough when removing the needle or pull the needle too hard?

2. What are the sign on the skin of a damaged or dislodged port-a-cath?

I've worked with port-a-cath before and never have difficulty in removing the needle. I'm not an oncology nurse so I was hoping to have some opinions from the experts. I really really appreciate your input

[CarryThatWeight, BSN]

Was the needle in there properly? Was it flushing well and getting a good blood return before you took it out?

[FlyingScot, RN]

What brand do you use and are you sure it was the needle not the safety mechanism causing the difficulty? I occasionally get one that the safety device sticks making it hard to engage which makes needle removal a little difficult.

[tiffy723]

Hi CarryThatWeight. Yes it flushing well and getting a good blood return the day before. My worry is will it get dislodged or damaged when I pulled it too hard or not stabilize it enough?

Hi FlyingScot, I don't really know what brand it the port-a-cath since the patient got it 3 months ago when she was in oncology unit. Now she is admitted to my unit due to bilateral pleural effusion but we are surgical unit so not so familiar with types of

port-a-cath.

[FlyingScot, RN]

But does it have a safety mechanism? Because if it does, and most do, I can almost guarantee you it was the safety mechanism sticking. Generally this happens if the needle gets a little bent either out of the package or while it was in place.

[tiffy723]

How do I tell if there is safety mechanism? The needle was bent slightly when I looked at it. What are the chances that will the port gets dislodged or damaged when I pulled it too hard or not stabilize it enough?

[FlyingScot, RN]

The safety device covers the needle when you remove it to keep you from getting stuck. While there are still some needles out there that don't have them I highly doubt your facility uses them. You do know that the needle is supposed to be bent at a 90 degree angle? I doubt that you did any damage to the port as they are usually pretty well secured. Have you had any education on ports?

[tiffy723]

Thank for replying me! I meant the tip of the needle there is a little curve, but I do know the needle is supposed to be bent at a 90 degree angle from the top. No the one we are using does not have a safety device cover, just a bare needle. I heard some nurses got their finger stuck when they remove the needle.

Something like this:

Treatment.htm

[FlyingScot, RN]

Okay that helps. The tip of the needle is supposed to have a slight bend in it but the entire needle should not be bent (other than the 90 degree bend) but it sometimes happens in shipping. Soemtimes they stick if they've been in awhile. Sometimes the really small gauge ones will stick too. It's hard to tell what the problem was. I do not think you damaged the port if you didn't stabilize it as well as you think you should have. The symptoms would be an enormous hematoma at the site of the port and your patient would decompensate pretty quickly. on another note you guys should demand a needle with a safety device. What you are using is a nightmare and I'm not surprised people are sticking themselves. The cost of treating an employee for Hepatitis or worse long-term far outweighs the additonal cost of a needle with a safety.

[Littleguccipiggy]

I didn't even know there are still manufacturers out there that don't put safety devices on their needles. That is a huge safety issue. Ports are usually pretty secure where they are, but I also can't imagine taking the needle out without stabilizing it, partially because I use my other hand to hold the safety when I remove the needle. My guess would also be that whoever accessed the port probably put the need in so it was near the edge instead of dead center.

[FlyingScot, RN]

I didn't even know there are still manufacturers out there that don't put safety devices on their needles. That is a huge safety issue. Ports are usually pretty secure where they are, but I also can't imagine taking the needle out without stabilizing it, partially because I use my other hand to hold the safety when I remove the needle. My guess would also be that whoever accessed the port probably put the need in so it was near the edge instead of dead center.

I wouldn't blame them for not wanting to put their hand anywhere near the port with that needle. Yikes!

[tiffy723]

I don't know if it's only my unit has this kind of old fashion needle because we are surgical unit and since we don't have a lot of oncology patients, we only have this kind of needle in stock. So if a damaged port will cause hematoma, the patient must complaint of pain and discomfort on the site right?!