Questions accessing passports

FUNRN · Nov 8, 2004

How about some informational websites?

I really need your HELP.:uhoh21:

Thanks

tridil2000, MSN, RN · Nov 9, 2004

How about some informational websites?
I really need your HELP.:uhoh21:
Thanks

i think what you're describing is what we call a portacath... the little disc under the chest wall??

if so, they come in single port and double ports. they are about the size of a nickle. you always have to use a 'huber needle' for these. they are a needle that is a right angle. in an adult, i use a 19g that is about 1/2 " deep. since this is a central line, you must prep your work area as a sterile place. usually central line dressing kits work well. i open the kit. after that i flush my huber needle, which has a little extension tube on it, with sterile saline, making sure to not touch the actual needle, and place it on the side of the sterile field... still on the paper, just off, bc the tubing i just prepped isn't all sterile. then i prepare the pt. sometimes you can use emla cream that helps numb the area. imo, it doesn't work well. people still complained with it, so now i don't bother. but regardless, prep the pt emotionally for access. then don your sterile gloves. clean the disc area from inner to outer in circles. toss the used betadine swab to the side since it isn't sterile any more. repeat this cleaning motion. if there are alcohol qtip swabs, then do them last. let air dry a minute. now hold the disc with your nondominant hand so it doesn't wiggle. quickly push the huber needle into the disc. you will feel a hard stop bc you hit the back wall of the disc. gently aspirate back for blood. remember, you're in a large vein, prabably the subclavian, so don't inject air. if you don't get any blood at all, have the patient lift the opposite arm in the air while aspirating. once you see blood, slowly inject the saline in the extension and watch for swelling. there should be none if you're in. now, you can draw labs. remember to waste the first tube or 8cc in a syringe bc of the mixed saline etc. after that, you should flush again with some saline and hook up your iv. secure your huber needle with a strile 2x2 under it and dress like any central line.

hope that helps... hope i described this right too!:)

good luck!

FUNRN · Nov 9, 2004

Thank you so much. You make it sound so much easier than the books. I really appreciate your help. The passport is a portacath but on the arm but it is basically the same concept.