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Accessing a mediport that's not maintained and flushed per protocol.

If a patient has a mediport and isn't flushed monthly, when do you draw the line when accessing it? What is the longest period of time without flushing a port,  would you still access it? 3 months, 7 months, 2 years, or longer? Wouldn't the patient be proned to infection or a blood clot the longer it was not properly maintained? Does anyone know of any data that gives a timeframe? Thanks.

Mel, I'm sure Lynn or

Mel, I'm sure Lynn or someone will offer a literature search on this. In the meantime, I offer my experience. It is a matter of assessment in my mind. If the site has no signs of infection or compromise before accessing, I would take that as a good sign. I would then access it with minimumly a 20g. Huber needle. I would see if blood "easily" came back into the attached syringe. This to me would be the qualifying test. Considering the system is a closed system, you might just get lucky and have an intact system doing what it was designed to do. I would waste the initial blood return before flushing thoroughly. If I had difficulty in getting blood return, I would Cath-Flow the port and return it to optimal function. This, of course, is if there are no signs or symptoms of anything that would require it to be replaced (patient with fever unknown origin, CXR showing line compromise like pinch-off, etc). Some may say if blood return is apparent, do a blood culture of initial blood specimen for documentation.


But, I bow to the gods and goddesses of literature research who can document what really should be done.

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