Port o cath help

unknown99, BSN, RN · Jul 15, 2005

Not hard at all. Just remove the Huber needle, then hold pressure over the site for 5 minutes. Chances are you won't even have to hold pressure, but that is just a safety precaution, in case any of the little capillaries break surrounding the port. My only concern is that they say you do not have to flush it prior to de-accessing it. Typically, I flush with 5cc normal Saline and 3cc Heparin. The heparin stays in the port in order to keep it from clotting.

ERNURSE4MS · Jul 16, 2005

deaccessing a port a cath is not difficult but i am concerned that you will not be flushing it. most places have a policy that when an infusion is dicontinued or completed the port is flushed with 10cc normal saline then 5cc hep-lock, the the huber needle is removed and a dressing applied. this is done so that 1- the infusion is not left sitting in the port where it could cause a reaction to anything else that is infused afterwards and 2 the hep-lock maintains patency of the port a cath for future uses- (he only thing i can come up with is that the port is going to be reaccessed the next day?) i would question the dicharge nurse regarding this. btw i commend you for being the for your grandfather and offering to do this. i'm sure this will make him have some time to rest. any extra rest some one in his state can get is a help. my prayers are with you and your grandfather. :)

Home Health Columnist / Guide · Jul 16, 2005

chemo often administered at home using cadd pump device size of portable radio --smaller than today's cd player. portacath is implantable under the skin iv devicewith tip in superior vena cava. it is accessed with a huber needle which is bent at 90 degrees . pharmacist prepares chemotherapy and inserts in cassesste--size of playing cards. homecare infusion rn sets up pump and teaches family how to flush and deacess port port's can be accessed 2-3,000 times before wearing out and have low infection rates.

don't forget to wear gloves when disconnecting iv and must flush with 10cc saline then heparin to clear site of chemo and prevent clotting--just like flushing regular iv line. dispose of supplies in chemo sharps container.

i''ve taught 12 year old kids how to do this. if you have concerns re flushing, please call the iv company; they have 24 hour support!

some portacath links for you.

http://www.mededcon.com/cvc11.htm

http://en.wikipedia.org/wiki/port-a-cath

flushing: http://www.apria.com/resources/aw_resources_showdiscussion/1,2727,47-12-337,00.html

BSN74 · Aug 6, 2009

I have a new chemo port.

When they need blood, they just disconnect my tubing, ask me to hold one end of it. Attach a syringe and get all the blood. Then they just reconnect every things. No sterile gloves, no sterile techniche.

Is this OK?

Also, since 2 weeks befor dx, rwo months ago, my legs have been covered in hundreds if bug bites infected with staph. Been to two dermo guys. Regular one home and one up here. I follow their instructions to the letter. I am staying at Amnerican Cancer Society hope house during the week.

The nurse was in a big hurry last time when she accessed my port and kept looking at something on the other side of the room. She was moving around too fast and I wound with this "window thing" pulling at my skin. This was monday. Here on Wednesday, it was itching so pad I pulled a little of the adhesive back. There were red bumps, yellowish blisters, probably the spreading staph

Sometimes the adhesive part of a bandaid will cause me to have blisters after about 3 days.

I am having my whole colon removed and also orifice and rectum about 6 weeks after chemo. Had one week of chemo at this point. I want all this staph cleared by my surgery date. I feel in am just infiltrated with staph everyday.

What should I do? The Derm. (really great guy) up here did a culture and sensitivity. No result yet. Should I ask to be put in the hospital and treated with IV antibiotics?

scma · Aug 15, 2009

The box you are speaking of sounds like a Ambulatory Pump for 5FU infusion. It typically infusses for 46 hours. When you discontinue the pump once the infusion is complete you will need to flush the huber line with 10cc Normal Saline and then Heparin. We use 100u/ml Heparin, so we use a total of 500u or 5cc. If I were you I would check with the hospital to make sure you don't need to flush is line before removing the huber needle.

blondy2061h, MSN, RN · Aug 19, 2009

I have a new chemo port.
When they need blood, they just disconnect my tubing, ask me to hold one end of it. Attach a syringe and get all the blood. Then they just reconnect every things. No sterile gloves, no sterile techniche.
Is this OK?
Also, since 2 weeks befor dx, rwo months ago, my legs have been covered in hundreds if bug bites infected with staph. Been to two dermo guys. Regular one home and one up here. I follow their instructions to the letter. I am staying at Amnerican Cancer Society hope house during the week.
The nurse was in a big hurry last time when she accessed my port and kept looking at something on the other side of the room. She was moving around too fast and I wound with this "window thing" pulling at my skin. This was monday. Here on Wednesday, it was itching so pad I pulled a little of the adhesive back. There were red bumps, yellowish blisters, probably the spreading staph
Sometimes the adhesive part of a bandaid will cause me to have blisters after about 3 days.
I am having my whole colon removed and also orifice and rectum about 6 weeks after chemo. Had one week of chemo at this point. I want all this staph cleared by my surgery date. I feel in am just infiltrated with staph everyday.
What should I do? The Derm. (really great guy) up here did a culture and sensitivity. No result yet. Should I ask to be put in the hospital and treated with IV antibiotics?

Drawing blood off the port once it's already accessed, and presumably has a dressing over it, does not need to be a sterile procedure. They should be wearing clean gloves prior to accessing the port- for their protection and should be washing their hands prior- for your protection.

Our port-a-cath access tubing has a y-site type connection where you can run fluids on one side then to draw blood clamp it and use the other side. This is preferable to outright disconnecting the tubing. If chemo is running through the line I sure hope they are wearing full chemo PPE before disconnecting the line. if they do have to disconnect the tubing it's also preferable to cap the tubing end than have someone hold it, though probably not necessary. Given that I work with BMT patients I tend to be more cautious.

To draw the blood they should be be flushing the port, drawing a waste, drawing blood for the tests, swabbing the lumen w/ alcohol, flushing again, then reconnecting the tubing.

If you're having issues with the dressing over the port you may be able to ask them to try a different brand.

We really can't give medical advice here, but there's some general comments.

AylanRose · Sep 14, 2009

Just a note about the blisters around/under your dressings. I work at an Office/Outpatient Chemo infusion area and we have found that if we use the product Cavilon by 3M it almost eliminates all sensitivity to dressings - even those with all-over EGF rashes. Its a product your hosital can request from the Ostomy team. It has been a wonder for us. Good luck to you in your journey!

ylong · Sep 16, 2009

I've a question about the Chemo Port. My dad have colon cancer and his cancer spread to his lever. He had a Chemo Port installed. Yesterday, we found out that the nurse forgot to flush the port and removed some gadgets. He's having the Chemo now and they'll turn off the pump tomorrow. Could anybody tell me the correct procedures for turn off the pump? I'm afraid that they'll forget something again. Thank you.

AylanRose · Sep 18, 2009

I am sorry that you have had problems with the port disconnection. After the nurse turns off the pump(each on is a little different), she should have gloves on and disconnect the chemo tubing from the port valve. Then the port should be flushed with at least 10cc of Normal saline followed by 500units of heparin. Once the port is flushed then the needle can be removed and a small gauze pad or dressing applied. I hope this helps and good luck to you and your father on his journey.

vivibae · Dec 13, 2011

I am a new grad working at a outpatient cancer center. I have been working there for 2 months. I have accessed several ports and there has been times where I didnt access it properly. Those times are the ones that I constantly go over my head what went wrong. I am having anxiety and losing sleep over this. I am trying to adjust my technique but I am not even sure what I am doing wrong. Can anyone give me advice on my hand/finger placement to ensure that I access the port in the correct area? I am right handed so I hold the Huber needle in this hand. Any advice is greatly appreciated.

DavidFR, BSN, MSN, RN · Dec 13, 2011

I am a new grad working at a outpatient cancer center. I have been working there for 2 months. I have accessed several ports and there has been times where I didnt access it properly. Those times are the ones that I constantly go over my head what went wrong. I am having anxiety and losing sleep over this. I am trying to adjust my technique but I am not even sure what I am doing wrong. Can anyone give me advice on my hand/finger placement to ensure that I access the port in the correct area? I am right handed so I hold the Huber needle in this hand. Any advice is greatly appreciated.

Ask an experienced nurse to watch you. Sometimes it's not your technique but a Port-a-cath that's already blocked, buckled over, damaged etc. I personally think they are more trouble than they're worth and prefer patients with standard central catheters. I yearn for the old days when Hickmans and Groshongs were the norm - they were so much easier to handle! Most of all don't stress - you will gain confidence in time.