port trouble

IVRUS, BSN, RN · Aug 11, 2011

So I do home infusion and been accessing a lot of kids lately. I sometimes don't get a blood return and have to move needle around. Any tips to get better at port access? Also I. Have noticed I have to flush a little then pull back for blood and will get it then. Is this common procedure to flush 1st then pull back for blood then flush rest. Silly question probably.

You have to move the non-coring needle around in the port body? Why?

I would not do that. My first concern would be damaging the port with such movement and the subsequent dislodegment and then infiltration or extravasation depending on the drug. The needle should be such that in is within the septum of the port body with the wings lying flat against the skin. You should never be readjusting the needle. Now if the needle backed out, or accidentally got pulled out some, one should never push it in farther, but rather deaccess and reaccess with a new set up and needle.

As far as getting a blood return, sometimes flushing a little saline in the port and then withdrawing helps, but I'd try other nursing interventions first like: having the pt turn their head and coughing, or repositioning the patient - if they are lying flat, raise the HOB, raise their arm on the affected side etc.