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Placement of gripper needle with PAC access

New INS standards states "Consider orienting the bevel of an implanted port access needle in the opposite direction from the outflow channel where the catheter is attached to the port body.  In vitro testing demonstrates a greater amount of protein is removed when flushing with this bevel orientation.  Pg S58  "greater amount of protein is removed"  Does anyone know what this is referring to?



S Tollerud  RN


 Since I wrote that statement

 Since I wrote that statement, I will try to explain. First, take a look at any brand of implanted port. Find a picture on a Google search or find the instructions for use from the brand in your facility. Notice the stem coming off of the bottom of the side of the port body. This is where the catheter attaches to the port body. Fluid flows from the reservoir out the stem and into the catheter. This is the outflow channel, or where fluid flows through the catheter and into the vein. You can usually palpate the port body and feel where the stem and catheter is located. In some patients you can even see it. The bevel of the port access needle should be positioned so that fluid you inject flows out of the needle in the opposite direction from the outflow channel. Port bodies are known to be the site where blood and drug precipitate can accumulate. When the needle bevel is oriented in the opposite direction from the outflow channel, you create more turbulence and this will remove more of these proteins. This was shown in an in vitro study. We have known for many years that the reservoir can be the site for collection of these proteins, so there is the need to remove as much as possible with each flush. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thank you!  You're such a

Thank you!  You're such a great wealth of knowledge!

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