If an implanted port is suspected as the source of a BSI, is it acceptable to access it until infection is confirmed?
My thought is that it is the port itself that is potentially infected, so if it is accessed under sterile conditions it does not change what is potentially already present. For many patients, this is their only form of central access which may be necessary to treat the infection.
Please advise!
Depends on the clinical signs and symptoms and why port related BSI is suspected. Fever alone? Use it and obtain a set of blood cultures from the port and another peripheral site at the same time. Port sample will be positive 2 hours before peripheral sample if the port is the source. If there are other problems such as redness, edema, drainage from the port body and surrounding area, then no. "Sterile technique" is a misnomer. We are now using aseptic nontouch technique. Skin is never sterile. If infected, Port BSI is coming from the intraluminal biofilm. Using it will cause more biofilom to break and enter bloodstream, so using it is not advised. Treatment may not require a CVAD. Is the port being used for any infusion currently? What is the current therapy and can it go through a peripheral vein?
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