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Patti Jo Carruth
Port standards of care

Please help me clarify this issue, I can't put my hands on my INS standards right now....for port usage, after accessing and no blood return. 

Start with repositioning pt, deep breathe, cough, re-accessing; do you:

 a.  If pt reports no blood return, but port functions, call MD and obtain order to use.

 b.  Call MD to get order for tPA and attempt to clear line.

 c.  If no blood return remains, call MD and get order for dye study to determine catheter placement and device functionality.

We are having a discussion about this because in Oncology we do #'s b and c.; on the floors it seems they do # a. I feel we should change the practice to b and c....any input please to [email protected]

thank you!

The INS standards do not
The INS standards do not have procedure-specific information such as this. But the ONS Chemo Guidelines specifically states that if there is no blood return to hold all infusion, teach the patient about the risk of infusion without a blood return, and to either get a dye study or treat with fibrinolytic. There are no specific standards or guidelines about which is the most appropriate to do first. But the main thing is not to use any catheter, especially an implanted port when you can not get a blood return. There are far too many things that could be wrong even if you can inject through it. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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