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KLHodge
Implanted Port with no blood return

A patient has an implanted port that has been in place for 20 years. Patient states unable to aspirate blood return for 5 years. Quadrapalegic, chronis urinary infections, currently has MRSA. Is it appropriate to refuse to access port? Should a PICC be placed because there is no blood aspiration?

lynncrni
There is definitely a

There is definitely a poroblem with this port and I would want to know what I was dealing with before infusing anything through this port. It has been in so long, I would imagine a very hard calcified sheath around the catheter. It is probably so old that a fibrinolytic drug will not work. I would want a dye study through the catheter to know for sure what was happening inside the vein regarding retrograde flow. Getting this would have to be balanced against the challenges with getting this patient to the Radiology dept. I would assess what drugs were prescribed, their vesicant nature, etc. This patient may not be able to notice any burning or pain associated with extravasation if it were occuring. So this leaves the nurse with even more greater responsibilty to confirm patency before using this port. A PICC is not the answser either due to the paralysis in the arms and the subsequent alterations in blood flow that would add to the risk of venous thrombosis. If the port must be replaced, you should consider another port or a tunneled catheter. Lynn

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Theresa-CRNI
It is absolutely appropriate

It is absolutely appropriate to refuse to access this port. It has been in a long time and there could be multiple problems involved as to why there is no blood return. It may even beyond the recommended age of the manufacturer and need replacing. I would not take that risk.

 

Theresa Strunk, RN, CRNI

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