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cubeca
Therapeutic Phlebotomy using a Port-A Cath Access Device

I am looking for information about  restrictions or perhaps policies on  nurses performing therapeutic phlebotomy using a port-a cath as opposed to a peripheral line. Thsi is a proposed procedure for our ambulatory care unit. Thanks in advance!!

Donna Fritz
My only experience with this
My only experience with this type of procedure was a lady with late stage ovarian cancer in hospice.  We were using her intraperitoneal port to relieve her ascites when she could not tolerate the abd pressure and dyspnea.  We accessed her port using our usual sterile access procedure and then drained via an evacuated container.  Worked OK.  I think with the distance from the evacuated container to the tip of the catheter on the port, it would require a significant amount of negative pressure to pull blood, which would be thicker than intraperitoneal fluid because of its increased cellular components.  Hopefully, the amt of negative pressure required would not be enough to collapse the catheter.  If you do try this, I would be ready with an intervention to clear the port quickly if the blood is too viscous.
lynncrni
There is another difference

There is another difference - intraperitoneal implanted ports frequently have multiple side holes on the catheter to facilitate drainage. There are no present on a venous implanted port. 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Donna Fritz
Yes, in theory, the
Yes, in theory, the intraperitoneal catheters for use with the ports do have multiple side holes.  However, a GYN oncologist placed an intraperitoneal port on a patient of ours and made the point to say that a venous catheter had been used, as they have fewer problems with these intraperitoneally than the intraperitoneal ones.
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