Anyone know the theory behind having a pt take in a deep breath during the accessing of the infusaport? I have been taking my husband to a cancer treatment center and when they access his port they have him take in a deep breath.
some access during inhalation and some access during holding breath. He says when they stick him while inhaling it doesnt hurt.
Anyone familiar with the theory with this? I have been doing ports for many years and have never been taught this.
Also.....sometimes if blood return in slow they have him cough? He does have pinch off and when we lay him flat we get excellent blood return but...coughing??? does the changes in intrathoracic pressure somehow help with blood return in a port??
thank you in advance
I do not see any benefit to the deep breath when accessing or deaccessing an implanted port. I have never seen instructions including this step either. If there is diagnosed pinch off syndrome, this catheter should be removed and replaced. Pinch off syndrome can lead to catheter fracture and embolization. I would much rather take this one out and insert in another vein, preferably IJ insertion than to have to go through a radiology procedure or even surgery to retrieve a broken catheter. Coughing would not have anything to do with obstruction due to pinch off syndrome. Coughing could change to the position of the catheter tip. For instance if it is lying against the vein wall rather than in the center of the vein lumen. 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
First of all, I hope your husband has good outcomes. Second, I smiled when I read this...my mom taught me this trick. But after so many years, it is hard to remember. She informed me that "Gina" the oncology nurse didn't hurt her when she accessed and told me she had her take a deep breath. If I recall, she inserted the needle with the breath held. Like you, I have never figured out the rationale. The only thing I can imagine is one of 2 things (1) it takes the patients mind off what we are doing, or (2) maybe it brings the port into a steadier position for the stick. Either way, she believed in it, and I try to do it 'when I remember." Again, good luck to you and hubby. And yes, I agree with Lynn....if they know he has pinch off, that port should be removed before the catheter breaks off.
Ann Williams RN CRNI
Infusion Specialist
Deaconess Home Services
Evansville, IN
We use for years already the "take-a-deep-breath-method" for our patients with ports. The rationale behind is exactely as described below already:
Your patient has to focus on the act of taking a deep breath at the moment they were asked about. As a consequence they are not longer surprised or worried when you will place the needle, they know they can be relaxed till they hear the "take-a-deep-breath" order and they also can't "pull away their thorax" because they have to hold their thorax in the position of inspiration, this makes the needle placement easier for the nurse.
At the time we were changing to this method we asked patients about their experiences and those who could compare the before and after they told us the feeling of the needle stick is less when you were asked to take a deep breath.
Unfortunately, no study has be done to support this practice.