Power port question

[rn undisclosed name]

I recently had a pt with a power port that was accessed with a non power port huber needle in the ER and the pt went for a ct with contrast. I suspected that the port was used for the contrast and I confirmed with CT they did actually use the port. Somehow CT didn't question that it wasn't accessed with a power port huber needle. I did some research and found that the needle can burst and damage the port. Everything appears to be ok except for a sluggish blood return but this appears to be the norm for the pt. I let the hem-onc doc know and their response was "so what?" I was flabbergasted by her response and would think she would have been upset. Am I missing something?

I did speak with my educator and the oncology educator. I also completed an incident report so hopefully this doesn't happen in the future.

[SoldierNurse22, BSN, RN]

You did the right thing. You're right--if the Huber needle isn't rated to be used as a powerport needle, it shouldn't be used as such. However, it sounds as if the patient came through things well and (thankfully) didn't suffer any consequences from this oversight. Documenting and passing on in report what happened with the patient so that other nurses know what to watch for are both good moves.

CT and other services should be looking for that kind of thing, but as you well know, they won't always do that. Make a mental note to check that kind of thing on your patients so that next time, you can make sure another patient isn't put at risk.

[iluvivt, BSN, RN]

Yes...... you are absolutely correct and do not expect the Oncologist to know the details of the proper types of non-coring needles to use for power injection and the consequences for not doing it properly. The buck stops with the tech or RN checking the port and administering the power injection. They do a scout scan before the CT and can check for the port type and also need to check to see if it has been accessed with a power loc needle. So it is the radiology department that needs the education. There is a sticker that you can peel off the package of the power loc needle that wraps around the tubing of the power loc so if that is not there and they cannot prove it is a power loc in the power port than it should be reaccessed.

This is what I do to prevent this: I always access and re-access a power port with a power loc needle. We made a poster for radiogy with all the acceptable products that are rated for power injections. That includes IV cannulas as all are not rated for power injection. I made an issue of this where I work so it can be prevented.

I would send the ISMP practice alert and the FDA alert about the dangers of power injection if not done correctly. let me know if you need help to find these.

[summerly]

Always label the dressing with the power port sticker that comes on the packaging as well! Our CT techs won't use the port unless it's labeled by us and the patient has their ID card from the surgeon confirming a power port was placed.

[iluvivt, BSN, RN]

Yes I said that.