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rnseb65
unmaintained Port a cath. Can it be used after 2 years of no access?

Recently I was called to ICU regarding a patient with a port that had not been accessed for 2 years. The physician wanted it accessed to see if it had a blood return or not. I did not feel confortable with this as my thinking was that there could be bacteria or old blood that could be entered into the patients system. I felt that it would be best to remove the port. Any thoughts? Sue Boyles RN CRNI

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The company I work for has

The company I work for has decided that if an implanted port has not been accessed in two months, we (the Infusion nurses) will NOT access it.  Since our populi resides in LTC, we do not want a septic storm of bacteria being sent into the system from biofilm.  If however, a doctor wants to do this in a controlled setting, go for it, is what we tell our physicians.  

So, it's been two years... Wow, there is NO way, I'd access it.  I agree with removal.

rnseb65
Thanks for responding. I have

Thanks for responding. I have also started a lit. search on the subject in hopes of finding some evidence out there. I think that even short term non use can cause a septic shower. I have seen what can be found in a disected catheter and it is not anything I would want to send into a patients system. Sue

lynncrni
Regardless of which

Regardless of which professional is accessing the port, the outcome for the patient will be the same. Yes, you can flush in planktonic biofilm when it is flushed but you can also do that when a port is accessed and flushed monthly. The larger question to me is why was this port allowed to remain in place without the needed care for 2 years. It should have been removed when it was no longer needed. Somehow this fell through the cracks in the system. But I think the infusion/VA nurse is the best person to access this rather than a physicain who rarely does this procedure. Lynn

 

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

AshleyM
Unmaintained Port

   I once was called to the ER for a patient that had no access but did have an implanted port from chemo 4 years prior.  She had decided to just "forget" about the port when she was deemed cancer-free.  Since we could not find a peripheral site, I accessed her port, obtained a beautiful blood return and she did fine!  Our thoughts at the time were that if the port had been in for all those years and not caused her any problems, if it was not occluded it would be OK to use.  Evidentally her port had excellent care while it was in use, and served her well a second time!   Marjorie Ashley  CRNI   Fall River, MA

valoriedunn
What about access the port

What about access the port and then aspirating for waste before any type of flushing?  Then you would know if there is blood return.   Would this remove any bacteria that may be present?  Just thinking. :)  Valorie

Valorie Dunn,BSN, RN, CRNI, PLNC

lynncrni
Aspiration would remove some,

Aspiration would remove some, if not all, of the planktonic biofilm, or the free-floating clumps, clusters, or cells that have broken off from the biofilm. It would not remove the sessile biofilm or the biofilm that is attached to the catheter wall. But this is true of any catheter, regardless of whether it was accessed 2 hours ago, or 2 years ago. Lynn

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

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