I would like to get some feedback on this situation: Pt is a 14 year old female with CF, uses her port intermittently for IV antibiotics. In the last 4 months she c/o of feeling the port "higher" than it had been with mild intermittent discomfort. She has not used ther port during this time. Right now she does not c/o of discomfort. The port flushes easliy and can obtain a blood return. A routine x-ray showed port to be positioned "higher" in her chest compared with film on 5/2014 and that there is now a loop, no kink but a nicely configured loop in the port catheter My Question: Would you recommend replacement now or wait until there is evidence of port dysfunction? After talking to her mom last night, I believe a contributing factor for displacement is from her rapid body changes with breast development and breast tissue pushing the port/resevoir upward. I would appreciate to hear any of your thoughts on this.
Thank you.
Linda Tirabassi MN RN CNS
Miller Children's Hospital, Long Beach CA
Any catheter not in the lower third of the SVC near the junction with the right atrium is not corectly positioned. You know there is a loop and this would be considered a malpositioned catheter. What vein is the tip located in? I would say it needs to be repositioned to a correct tip location before she needs it for any infusion. 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
Thanks Lynn, yes the tip is well positioned in the SVC. It is functioning fine at this time, blood return and flushing.
Linda Tirabassi PhD RN CNS CPNP