Had an incident on Monday where a 28 y.o. pt with medulloblastoma had his port accessed. (He's had it for four months.) Flushed and he had pain in his chest, about 4 inches superior to his port. Minimal pinkish return upon withdrawal attempt. RN reaccessed it. Same issue, however with no pink. When they flushed (it flushed easily), they noted that the catheter could be seen more easily, kind of bulging. I was called over to evaluate it. Well, in my way of thinking, if this is the first time he is having pain with each flush (no pain at access point), must be something wrong with the port system. Sent him to interventional radiology and, lo and behold, they saw a large catheter fragment in the right chambers of his heart. It was removed with a snare and a new port placed in the IJ.  In follow-up with RNs, he is a weight lifter--it's his whole life. I suspect all those bench presses and more contributed to some compression of the catheter between the clavicle and 1st rib. Any other thoughts?
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
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
Kathy Kokotis
Bard Access Systems
pinch off? Did they have trouble with blood return on the port unless he raised his arm?
Kathy Kokotis
Bard Access Systems
I am looking for evidence-based journal articles that support verifying port function with a blood return. And if no blood return, then a dye study is needed.