We are in the process of writing P&P for PAC. A lengthy discussion about frequency of CXR for portacaths ended in a stalemate. How often is a CXR needed to check tip postion of PAC? Does the patient have to get a CXR on each admission prior to use of port? Is a prescan CXR necessary to identify a Power port prior to power injection of contrast?
Good morning,
When you say "port a cath" are your referring to an infusaport? a surgically implanted port where the catheter tip that is attatached to the port resides in the distal superior vena cava? If so:
When a patient arrives to us for treatment with a port a cath ;
#1 We inquire with the patient the hx; when was device placed, type of port ( power or not power), does pt get it flushed monthly, any issues with blood return etc....
#2 Power Port verififaction; must be done by several means; pt shows id card/band of power port, palpating port for power port distinct markings ( if from Bard)of triangle shape as well as palpable nobs on each side of port, and or if it is visible when magnfying in on a cxr to see the etching of "CT" on port. Not all ports have those distinct markings, they are manufacturer specific so thorough investigation is key. Must have several identifying factors not just one.
#3 The only time we do a CXR for an infusaport is when we are trouble shooting. We do not to any routine cxrs on pts with ports.
#4 accessing the port easily with good flow and good blood return in key. If there is difficulty with any, or pt has any complaints of issues; burning pressure or pain on instillation, feeling or hearing gurgling in ears, feels "something weird" or different on the port side, above port or other side of chest, then.........I usually go look at any old/recent cxrs to see what the port and its catheter look like. Then from their I usually would see if we could get a dye study on the port to assess the device for patency, damage to catheter etc.. Once again , this is trouble shooting , not routine care.
Hope it helps, Gina Ward R.N.
Gina Ward R.N., VA-BC
Port-a-cath, Infusaport are all trade names. Generically speaking these are implanted ports. Any written policy will apply to all brands. Power-injectable Implanted ports would be the other way to label these when they are labeled for power injection. 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