Use of portacaths

dawbs · 10-24-2006, 04:18 PM

Has anyone had their portachaths used for anything other than delivery of chemo, blood or iv fluids, say for giving IV contrast for scans, or for the routine taking of blood? Just curious. Everyone always looks at me askance when I try to suggest using it outside the oncology unit!!! All sorts of excuses are usually given, but I suspect the main reason is lack of familiarity. Any experience here?

Vicki

sassy · 10-24-2006, 04:33 PM

I had an unrelated surgery in December and the anesthesiologist used my port. The nurses who did blood work the day before would not use it for the draw. I think medical personnel must be trained in the use of a port and most probably many outside of oncology are not. Just my opinion.
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chrislmelb · 10-24-2006, 04:34 PM

i would just be very careful as it is a sterile procedure to get it going. Other areas are not set up to do it. i know mine will not be used for scans etc as that is what i have been told.

Christine

tousled1 · 10-24-2006, 04:53 PM

In order for anyone to use your port they must have special training. When I go to my oncologist's office for my weekly blood draws they use my port but if I go to my primary physician they have to stick me in the arm. When I had my bilateral mastectomy my port was used for anesthesia but they had to get a nurse from the oncology unit to access it for them.

dawbs · 10-25-2006, 05:44 AM

Thanks everyone for your replies. The occasion I am thinking of was for a CAT scan. I already had the needle and line in situ, having just had chemo, so all that had to be done was to hook up the syringe full of contrast to the line. No needles or technique involved. And there was no concern about needle removal or hep-locking either, as all I had to do was walk next door to the oncology unit to have it removed and hep-locked. The reason I was given in radiology was that the "contrast was too viscous" and that it would ruin the port. But that doesn't make any sense to me as there are plenty of viscous chemo substances given via port.

Has anyone had iv contrast given (or refused) via port.

Vicki

Sandy H · 10-25-2006, 06:02 AM

I use my port as much as I can. To save time and any confusion I go right to oncology get the needle inserted and then I go to get scaned, muga, cat and bone scan. I then go back to oncology and get the needle out. The oncology nurses like doing it, the other departments don't have to go looking for a nurse who has been trained in ports, and I am comfortable having someone I know playing with the port. At first I spent time sitting around different departments while they decided should they accesss or send me to oncology. After 5 years I have a routine figured out that everyone is happy with. God Bless these oncology nurses they are our Angels so lets enjoy them! hugs, Sandy

Nanc · 10-25-2006, 07:09 AM

Hi
Vicki, I am a RN who works with central lines such as port a caths. In the facility I work at we do not use Ports for CTs , the reason is that the contrast is infused in to fast. The thought is that this is too much pressure on the internal part of the port.
Again this is the reasoning where I work.
Take Care
Nancy

Shell · 10-25-2006, 08:36 AM

I have had to be persistent to get them to use my port for CT scans, even bone scans, echos and MRIs, and always for blood draws (that's part of the reason why i got if after all!!) - the reason they do not want to do it is because of the special training involved ...the one hopsital where I was being treated recently did it willingly after I requested it, but the one I'm going back to now it will take more prodding to get it done...

Shell

Dace · 10-25-2006, 09:43 AM

When I had my scan two weeks ago, they did not want to use my port because of the contrast. I think because of the fast infusion and the thickness of the substance. After three sticks they did not have a choice since they could not find my veins. They had to have the nurse come in and manually infuse the contrast, but it worked out okay. So he told me to go to oncology first next time and have them put the needle in and leave it for the scan and just let them know, that is the only way it's going to happen.

SusanV · 10-25-2006, 11:31 AM

I use the port as much as possible. When I need blood work done for WBC counts I arrive early for chemo, and have the blood work done right in the chemo dept.

I think you guys are on to something, as far as going to a chemo nurse to get the job done correctly...

Here is a little story. On Saturday, 5 days after my last chemo I develpoed a fever. At the suggestion of the on call oncology nurse I proceeded to the hospital for blood work and a urine sample. An obviously inexperienced ER nurse accessed the port,(She had another nurse in the room and kept asking her questions to clarify that she was doing it correctly) and was very aggressive in her technique. (I told her in those exact words by the way) I was very sore afterwards.

I did that day however receive anti-nausua meds through the port, as well as have a billion (seemed like it at the time) tubes of blood drawn. The port did clog before I left, and they had to take the whole deal out, and re-access the port again just to flush it out before I left. The onc nurses are much better at the whole port access deal. Just my 2 cents !

TriciaK · 10-26-2006, 02:07 PM

WHen I had triple bypass heart surgery in May the surgery intake nurse didn't want to use the port--in fact acted shocked that I would suggest it---I said "Fine, Give me back my clothes and I'll go home." Then she really was shocked! (Actually I surprised myself, too!) Fortunately she checked with the cardiologist and he said "Absolutely use the port---that's why Tricia has one!" So they used the port for everything. I went for many years with angonizing blood draws before my port, almost as hard on the nurses as on me. Now I go to the chemo lab first for everything possible. For the yearly PET/CT scans they don't use the port but those nurses seem to be really adept at what they do. I do not have any blood drawn or any other procedure without the port, except for a couple of times I had to call EMT's. (I have one little vein in my right forearm I save just for them!) I have been off herceptin nearly a year now, but have the port flushed every month and do not intend to let it be taken out unless there is some serious problem with it. If a port is as much a blessing for you as it is for me, stand firm and insist it be used! Hugs, Tricia

bmuenks · 10-28-2006, 07:13 AM

I was able to have mine used for anesthesia but they called a nurse from oncology to put it in. BERTA

Sandy H · 10-28-2006, 09:21 AM

I am with Tricia use my port! This fishing to find a vein is no fun been there done it and all done doing it!! hugs, Sandy

AlaskaAngel · 10-28-2006, 10:57 AM

My portacath hasn't been used for treatment for 4 years, but it made sense to me as a HER2+++ to keep it.

I get blood draws every 4 months now that I pay for the nurse in my PCP's office to draw, as my effort to continue in 2 clinical trials that use the blood to try to find better markers for breast cancer and ovarian cancer. If I go to my internist's office in Alaska for the draws it also provides the chance to have the portacath flushed to keep it working.

But if I need a lab drawn at the hospital the lab techs are not qualified by training to access it. And if I happen to be at the office for the clinical trial in Seattle instead for a draw, the people doing the draw for the clinical trial won't use it either, and I am not too happy about that.

AlaskaAngel

Christine · 10-28-2006, 11:05 AM

Vicki
Port-Caths are usually put in for 2 reasons. First to protect your veins from harm from the more toxic chemos, but also to have easy access to get the vein for blood tests prior to chemo infusion. Difficulty in finding your veins make it an easy for both you and the nure tto get the job done, usually w/o problems.
Hope you are doing well.
Hugs, Christine

sassy · 10-28-2006, 08:14 PM

When I had CT scan and bone scan, they did not use port. As I said in previous post, they did use it for anesthesia during surgery and also for antibiotics and fluids when I was hospitilized for staph infection.
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margo · 10-30-2006, 11:10 AM

I was told that my Port could not be used for MRI and CT Scans, because a power-pump is utilized for the infusion process. The increased pressure, volume, and type of contrast used can damage the port.

dawbs · 10-31-2006, 12:41 AM

Thanks everyone. I think I've pieced it together. The problem with giving iv contrast is that it needs to be delivered in a rapid bolus to provide a rapid concentration in the organs and therefore good pictures. A peripheral vein can expand to accomodate to that, but the narrow rigid tubing in a portacath cannot do that. So I gather that contrast given through a port is delivered more slowly than is preferred and then diluted by all the blood in the superior vena cava where the tubing exits. Also the pressure of delivering the thinckened substance of iv contrast (especially if given by a machine) may risk damaging/separating/tearing the tubing.

So for those of you who have had iv contrast given through your port, how did the pictures turn out?

Cheers to all, and many thanks
Vicki