Have a patient that came to our oncology clinic with an infusaport...........said that he only needs flushed every 6 months.   Is that routine for anyone?   I haven't worked with infusaports myself, but from what I read, they are like a port-a-cath...............accessed with a non-coring needle and flushed with NS/heparin.   Can anyone help me out here?

Thank you.

Lesha Seaver RN, Liberty Hospital, Liberty, MO

In my opinion, it is not

In my opinion, it is not safe to infuse through an implanted port that will not produce a brisk blood return. Yes, withdrawal occlusion may be the "most common" reason (would need to look at the data to confirm this) but it is  not the only reason. The need for obtaining a blood return was original driven by case reports of horrible extravasation injuries that can occur from a complete fibrin sheath that caused a retrograde flow and leakage from the venotomy into the port pocket. So if there is no blood return, I would want a dye study. Another approach is to use tPA first to see if that changes anything, but the instillation of tPA is only going to reach what is at the immediate catheter tip. If will do nothing to address the remaining sheath along the catheter walls. You would need a low dose infusion of tPA to get the entire sheath. So in a month if there is not blood return again, you would need to repeat the instillation or dye study. This would be the safest approach. This is your practice and if does not matter what the physicians prefer. If there is an extravasation injury, you or the nurse who made the assessment and gave the drugs will be the ones named in the lawsuit! The physician may or may not be named but I have seen far too many cases where the physician is released and they focus on nursing assessment, judgment and intervention. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

[quote=three

[quote=three eagles]

7-27-07  I would like a response to my question regarding when it is safe to use a infusaport, when you can not get a blood return.  Being an oncology nurse and employed by different oncologists, each has their procedure to follow.

Question: Can the port be used if you do not have a blood return? The most common reason why a VAD will flush but not draw blood is the fibrin tail or sheath. Inability to withdraw 3 mL of blood is considered an occlusion so this line should be treated with Alteplase. ONS guidelines states that there should be brisk blood return to determine patency of the line.

Question:  If, after instilling 250cc of normal saline thru port access without difficulty and still no blood return is it safe to use the port?

Question:  How frequent should the patient with port be checked for patency if no blood return is seen?

[/quote]

7-27-07  I would like a

7-27-07  I would like a response to my question regarding when it is safe to use a infusaport, when you can not get a blood return.  Being an oncology nurse and employed by different oncologists, each has their procedure to follow.

Question: Can the port be used if you do not have a blood return?

Question:  If, after instilling 250cc of normal saline thru port access without difficulty and still no blood return is it safe to use the port?

Question:  How frequent should the patient with port be checked for patency if no blood return is seen?

infusaport flushes

We have an oncologist who writes the order for his patients with ports to only be flushed every 3 months when not being used.   I was concerned when he first started doing this but we have not had any clotting issues or with blood returns  with his patients so far and he has been doing this for almost two years.   We still flush any other ones every month when not being used.  

 Helen Lazeration, CRNI

Fairbank Memorial Hospital

All port manufacturers have

All port manufacturers have instructions stating to flush at least once per month. However, I am aware of some physicians using a valved port (PASV) where they were flushing less often then once per month. I can not recall the frequency and I don't think anything has been published about this. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Infusaport flushes

The standard of care for vascular access port flushing and for heparin to be instilled is once a month (or every 28 days, as stated in some policies). The only difference that I am aware of is that no heparin is used if the port is attached to a Groshong catheter.

I am not familiar with an every 6 month port flushing routine. I'll keep my eyes on this discussion string to see if anyone can provide some insight.