Portacath question

[Elspeth]

Last week I made a visit to a woman with a PAC (passport) in her upper arm. She's had it for over a yr for chemo, TPN and other prn IV fluids. The family was c/o the PAC not flushing and were afraid it was leaking. Sure enough the needle was completely out. The PCG told me the pt had had a scab in the center of the PAC and the other nurses had been sticking right thru the scab(??). The surrounding area was very reddened and as you know passports are pretty darn small to begin with. Anyway, once I got the old dsg off and cleaned the site to assess for reaccessing the skin over the center of the PAC had completely eroded (I'm guessing where the scab was) and I could see the actual passport(!). Has this happened to any of you before? My supervisor said she'd seen that once before. Needless to say, I did NOT reaccess,cleaned it with betadine/alcohol, put a sterile 2x2 over it , secured it and called the doc and the pt went to have this one removed and a new one inserted.

[renerian, BSN, RN]

I have seen this more in the thin client before. In every case they took it out.

renerian