Port-a-cath needle size?

Nurses General Nursing

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How do you know what size needle you need for a port-a-cath? Is it just trial and error? The reason I ask is I accessed one the other day for the first time with a 20g x 1inch needle with the help of a nurse who had accessed one before. It seemed like we needed a shorter needle, but she didn't know how to decide either. I asked 8 nurses over the past day, no one knows. I checked the chart too, it wasn't listed. Anyway, does anyone know?

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Specializes in ER.

19g 3/4inch

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Specializes in Surgery, Tele, OB, Peds,ED-True Float RN.

Just wondering, did you guys use a non-coring "gripper" needle?

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Specializes in Oncology/Haemetology/HIV.

The gauge is chosen per what you will be using it or:infusing or drawing blood, large amounts of fluid vs small amounts. The length depends on how deep the port is. If you palpate and it is very close to the skin surface, a 3/4inch is fine. If the port is deep in the tissue, you use a 1 inch or longer (it is rare to need a longer needle).

Most chest ports, especially on cancer pts are very close to the surface and the 3/4 is fine. Once in a while, someone has a lot of adipose tissue, or one located in fatty area of the upper arm, and you may need a longer needle. Many pts also know what size that they take. And most of us go for a nice versatile 19-21 gauge.

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Specializes in Vascular Access.
How do you know what size needle you need for a port-a-cath? Is it just trial and error? The reason I ask is I accessed one the other day for the first time with a 20g x 1inch needle with the help of a nurse who had accessed one before. It seemed like we needed a shorter needle, but she didn't know how to decide either. I asked 8 nurses over the past day, no one knows. I checked the chart too, it wasn't listed. Anyway, does anyone know?

#1. You will increase the "life" of the port by using small gauge, non-coring needles. i.e. A 22g is appropriate for many people, but if you are having difficulty with blood returns, I'd opt for a 20g. So, what I'm saying is that ports may go "bad" after 500 to 2000 punctures. The life of the port is elongated if you choose smaller needles to access it as you do less damage to the septum.

#2. The length is determined by how superficial or deep the port is located in the subcutaneous pocket. If it is superficial, a 3/4 inch is appropriate in most cases. Ideally, you want the needle to have its wings lie against the

skin once it's accessed. If it sticks up, you have a greater chance of it being accidentally dislodged. For pt's comfort and to decrease movement of the needle in the port, I always place a folded 2x2 under its wings and then place the TSM. So, palpate the port and THEN choose the appropriate size non-coring needle.

Hope this helps!

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Specializes in Surgery, Tele, OB, Peds,ED-True Float RN.
#1. You will increase the "life" of the port by using small gauge, non-coring needles. i.e. A 22g is appropriate for many people, but if you are having difficulty with blood returns, I'd opt for a 20g. So, what I'm saying is that ports may go "bad" after 500 to 2000 punctures. The life of the port is elongated if you choose smaller needles to access it as you do less damage to the septum.

#2. The length is determined by how superficial or deep the port is located in the subcutaneous pocket. If it is superficial, a 3/4 inch is appropriate in most cases. Ideally, you want the needle to have its wings lie against the

skin once it's accessed. If it sticks up, you have a greater chance of it being accidentally dislodged. For pt's comfort and to decrease movement of the needle in the port, I always place a folded 2x2 under its wings and then place the TSM. So, palpate the port and THEN choose the appropriate size non-coring needle.

Hope this helps!

Thanks IVRUS, totally makes sense! The OP wasn't the only one wondering...:D

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Specializes in Rehab, Infection, LTC.

in my experience, unless a patient is obese or the port is deep in the chest, i always start with a 3/4" needle. depending on the infusion, i choose between a 20g and 22g.

of course, trying to get the central supply clerk to understand and order the right grippers are another story, lol.

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Just wondering, did you guys use a non-coring "gripper" needle?

I know the package said gripper or it was gripper plus I'm not sure.

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What does TSM stand for?

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Specializes in Vascular Access.
What does TSM stand for?

Beijos,

TSM stands for Transparent Sterile Membrane.. It is any IV dressing you can see thru, such as tegaderm, opsite, IV 3000 drsg. :)

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