What good are power injectable infuse-a-ports, if we are unable to radiographically identify them? Some patients do not have a card or bracelet to identify them, and not all of them are palpably identified.
What good are power injectable infuse-a-ports, if we are unable to radiographically identify them? Some patients do not have a card or bracelet to identify them, and not all of them are palpably identified.
I thought that every implanted port on the market now had a radiopaque "CT" marker on the reservoir. This should be visible with xray. Correct me if I'm wrong, please. Also this is information that should be included in the insertion note, just like I would expect to find the internal trim length of a PICC line in the patient's record before I go to remove it. I don't like the cards or bracelets.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
OK, I'm reading through all the different IFUs I can find. B. Braun's Celcite line of implanted ports do not have the radiopaque engraving or print to indicate power injection safety. I think the safest way to handle this situation, because power-injectable ports definitely have a important role, is to know your institution's port brand, know the IFU, and ensure the power injectability is clearly documented in the patient's record. In the hopefully rare circumstance in which you will encounter a patient with a port placed at another facility, try to obtain documentation of the ports IFU. If not available and you can't find the tell-tale "bumps" (Bard) or if you run a scout scan and can't see the "CT" etching that almost every brand of port has, then you have to place an IV. I'm sure this will be a very rare occurrence. As I'm writing this I am realizing the importance of treating each individual patient as unique. Not everyone who walks into my clinic will fall into the exact same category with the exact same needs. I know that every port placed at my hospital in the last five years is a power port, so it's a no-brainer. But if someone comes in from an outside hospital, transfers care to us, it is my job as the nurse case manager to ensure my treatment team knows exactly what that patient has implanted in his/her body and what its capabilities are.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
As Keith states, if it was implanted at your own hospital, it's easy to find model numbers and brands in the op record somewhere. You can google that and see exactly what the specs are. I usually look at a CXR or CT Thorax first as it takes less time. Usually, the "CT" is quite apparent. I was unaware that ANY brand of CT injectable power port did NOT have this designation visible on imaging. B.Braun better get up to speed! Just this week, we had a patient come from another institution where a different brand was used. Looked on CT; "CT" was visible. Then looked up the brand and model number. It seems the documenting person had transposed some of the lettering in the model. When I found it on the internet, it stated it was a powerport, but had a SILICONE catheter. I have never seen this before and my understanding is that silicone catheters cannot withstand power injectors which is why we don't use tunneled Groshongs for CT scans. Emailed the company's clinical support that day and asked for an ASAP response as the patient was going for a CT scan later that day. There was no phone number to call (I think this is ridiculous for clinical support!!!!), only email. I haven't heard back from them yet and we're going on the third day. Patient opted to get a PIV for his CT scan.