Portal cath

[Avu00]

Is anyone know do we need md order to assess the portal cath?

[nynursey_]

​This can be facility dependent, but typically, an order is required to access a port-a-cath just as an order is usually required to place a peripheral IV. Check your facility's requirements.

[SherluckyRN]

Diff hospitals diff protocols. Usually once placement confirmed you just get a dr order before using

[IVRUS, BSN, RN]

Also,

Make sure that you are following your scope of practice for your profession. For instance, in my home state, LPN"s cannot access an implanted port, nor can they deaccess one, but once the RN has accessed it, an LPN can flush it, draw labs from it, and give appropriate medications into it. Now, remember that a Hospital or, the facility that one works for can be more strict than state guidelines and they may have a policy in place which states that THEIR LPN's can not do anything but making sure the infusion is dripping in the drip chamber. And, if you are a RN, make sure you have been assessed as competent to perform this procedure. Just because you have a RN behind your name, doesn't mean your competent, but rather capable. Competency is something that is assessed, usually on a yearly basis.

[nynursey_]

I'd like to clarify that if you're asking if an order is required to access a newly implanted port-a-cath, then the answer is most certainly yes. X-ray will confirm placement (much like a PICC) and then the physician would place an order for the port to be accessed, if it's appropriate.

[ChristineN, BSN, RN]

Is anyone know do we need md order to assess the portal cath?

Please know the correct name. Port-a-cath or Mediport, not portal cath

[Avu00]

Thanks for clarify it. So we need md order to access the port a cath. can we use syringe less than 10 cc or have to be bigger than 10cc

[Avu00]

Can we use smaller syrine to flush the port a cath or have to be 10 cc and larger?

[nynursey_]

Can we use smaller syrine to flush the port a cath or have to be 10 cc and larger?

You need at least a 10mL syringe to flush a port-a-cath and/or a PICC.

[KelRN215, BSN, RN]

I'd like to clarify that if you're asking if an order is required to access a newly implanted port-a-cath, then the answer is most certainly yes. X-ray will confirm placement (much like a PICC) and then the physician would place an order for the port to be accessed, if it's appropriate.

I agree here. If it's a new port, you need to confirm placement and a provider order for "ok to use." If a patient comes in with an existing port, I've never had an MD write an order to "access port-a-cath." If they order labs, fluids, IV meds, accessing the port would be standard- at least everywhere I've worked.

[IVRUS, BSN, RN]

Avu00,

It sounds like there may be a need for some serious education. Do you work for an organization where they have Policies and Procedures in place? If so, all of your questions should be answered within its content of pages. Are you an RN or LPN/LVN?

[msjellybean]

As always, refer to your P&P.

In my facility, if a patient has a port, it is expected that you will access it and use it. Unless the doc suspects it as an infection source. In which case, we generally will access it long enough to draw quantitative blood cultures and then de-access.