Looking for information on accessing implanted ports that have not been accessed for 2-3 years. MD said to access the port it's a closed system, RN's very concerned about dislodging bacteria with flushing since the port had not been flushed for so long.
We did access the catheter and aspirated a lot of brown sludge then the catheter worked fine with good blood return.
Any reason to be concerned?
When flushed, did the patient spike a temp or have chills? This would be due to a shower of bacteria coming from the biofilm that has been sheared off from the fluid flow. This can happen with any catheter, regardless of whether is thas been through a dormant period or not. I woiuld be concerned about leaving this port in the patient since it is not being used. I know that we typically do not rush to remove implanted ports, but it could not possibly be meeting any medical necessity if it has not been accessed and flushed in several years. The brown sludge could have been coming from the port reservoir or the catheter, but my guess would be the reservoir. What does the patient think about getting it removed? 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
We are in the acute care setting and I am not sure about the details as to why the catheter had not been removed. I did review the chart after the floor nurse accessed the port and found that the patient did not seem to suffer any ill effects...no fever no chills and the cultures of the brown sludge that initially came out of the catheter were negative.
I spoke with a nurse that works in an outpatient oncolgy dept and he said that he has seen patients come in with old ports that have not been flushed and he has utilized them without any difficulties.
Teresa Borunda, RN, BS, CRNI