Hi all....I have a pt who has a severe nickel allergy and has required multiple lengthy courses of antibiotics via PICC line--usually continuous infusions of Vanco and Pip/Taz. She would like to have a port installed but with her nickel allergy, having a classic Huber in situ for weeks is not an option.
Has anyone heard of an alternative material for Hubers or another type of access device? (the only metal she is not allergic to is pure silver)
Thanks!
Peggy Pearce, Nanaimo, BC, Canada
This issue seems to be prominant now. I was just looking at this literature. Nickel is a common allergy. Also remember that nitinol used in stylet and gudewires for PICCs contains nickel. Has she reacted to those? Stainless steel is used for most port access needles and does contain nickel. However the nickel is bonded to the other metals and may not cause a problem. I am not aware of any other materials used to make the port needles. Choices for the material in the port body are stainless steel, plastic or titanium. Has this nickel allergy been confirmed by an allergist? Before insertion of a surgically inserted VAD, maybe she should be patch tested to determine what other allergies may be present. 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
Thanks Lynn--yes it is a confirmed allergy---she has rejected every single knee replacment due to metal allergies. Poor woman- it has been a nightmare for her. Transient exposure seems to be fine (i.e. the nickel in PICC guide wires is not an issue). It is the long dwell exposure that triggers a severe inflammatory response.
Thanks for your info.
Peggy Pearce, Nanaimo
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Since my first reply, I have learned that stainless steel for port bodies is gone so now there is plastic, usually polysulfone, titanium (also a form of metal) and silicone for the entire body. But that does not solve the problem with a needle. have not found anything other than metal. Many years ago, there was a plastic catheter designed to access ports but it was not successful and is no longer made. Seems like the only other option is a tunneled cuffed CVAD, but then she has to care for it, flushing, etc.
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
I have a nickel allergy and found that I can still use my port if I deafness for a day to give my port a break from the Huber needle. My allergist called the manufacturer and there is only one type of Huber needle....and it does contain nickel. I am on my 6th port in 2 yrs tho. Found out about nickel allergy afterwards.
Now there is a new type of port used for apheresis, meaning it will allow for more rapid flow. It is accessed with a traditional over the needle catheter and not a metal needle. But the over the needle catheter may still have a very small bracket inside made of nickel as this is used to attached the catheter to the hub. May be worth checking out for a severe nickel allergy
https://www.bd.com/en-us/products-and-solutions/products/product-familie...
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