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Gary Dangerfield
Central line for a swimmer
We have a Lyme's disease patient who needs VAD for daily infusions of Ceftriaxone.  Pt was recommended a port.  Would he have to deaccess daily when he goes swimming?  Would there be a better recommendation, and how would he occlude the insertion site (or huber needle) when he swims.  Thanks, Gary Dangerfield, Pharm.D. Access I.V. Marina, CA
Robbin George
How long is the

How long is the therapy?--There will be a healing period during which the patient would not be able to shower or swim regardless of catheter type--Shorter term (weeks) the port with daily access/deaccess might be appropriate--But for longer term (months) perhaps a tunneled catheter would be safer and still serve the needs of the patient 

Robbin George RN VA-BC

Gary Dangerfield
They anticipate a year of

They anticipate a year of IVs.  How long is the healing process?  After the scar tissue (Or whatever happens) is formed, how would the pt "wrap" everything up to swim?

Thanks,  Gary

lynncrni
I would agree tha an
I would agree tha an implanted port is the most appropriate device if the patient is willing to learn how to stick the port body every day. There are many long-term parenteral nutrition patients that do this on a daily basis. This is all part of the nursing assessment for the most appropriate device choice. The port body is usually rated to accommodate ~2000 punctures. So daily therapy with a daily stick would only be less than 20% of the useful life of the port body. He would be free to do all activities after the original incision has healed. This time would depend on the patient's healing processes and when his physician said it was healed enough - the same as any other surgical incision. There would not be anything external to wrap up or worry about. Catheter insertion via the jugular vein would be better than the subclavian due to the risk of pinch-off syndrome with the later and swimming requires excessive arm and shoulder movements.  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

Marcia DeRuiter
Are there any concerns with
Are there any concerns with how soon they can go swimming after deaccess?  It does take some time for the hole to close and prevent water and bacteria from entering the hole and maybe starting an infection.
lynn
If the pt goes with a
If the pt goes with a mediport, get a dual lumen. The port can handle 2000 sticks but the skin cannot on a daily basis. This way the "wound" could heal for 24 hours. Every huber is going to try and get in the center, of that port, if it's a single. Itd be llike picking at a scab, no healing.
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