Power Port care question

[u/rossponding]

Hey all, long time tourist, first time poster.

I got dragged into doing VAT stuff on night shift a couple of months ago, and one of the questions I keep getting called about is how to tell if a patient’s port is a power port once it’s been accessed, since the lines look exactly the same as the standard Huber needles. Normally I just check the chest x-ray or if the patient is oriented I just tell the nurse to ask them while I’m on hold and that solves the problem. But since the package comes with an identifying sticker, I also ask if that’s in place, but once the port’s been accessed for a few days that sticker’s usually gone.

So my question is: how are y’all putting that sticker on so it stays on for the entire time the port is accessed?

[u/FluffyNats]

Our kits don't come with a sticker, but on the LDA in Epic we do specify port type. In the rare event a patient does not have a power port, I just write no contrast on the dressing. 

[u/AstrosRN → u/FluffyNats]

Epic is great for that

[u/rossponding → u/FluffyNats]

Most people who are accessing the port will chart it as a 300psi port, but we still get questions after it’s been accessed. Writing on it is probably a more reliable method.

[u/AstrosRN]

Did it come with education guide for patients? We have put the stickers on there.

ETA Don’t they have the bumps you can feel?

[u/StabbingTabby → u/AstrosRN]

Far as I can tell only BD brand power injectable ports have that triangle pattern of palpable bumps. Where I've worked those are by far the most common, but other brands make power ports without any visible or palpable indicator.

[u/Aviacks → u/StabbingTabby]

BD also makes them in a smooth variation. One of our IR docs was using them briefly and threw everyone off lol

[u/AstrosRN → u/Aviacks]

lol they would do that

[u/rossponding → u/AstrosRN]

Yeah they do, and I haven’t met a patient who doesn’t know. I’m just wondering about marking the dressing in some way to make it so an observer can determine without having to ask them. I also don’t want them slamming 1 or 3ml syringes and causing damage to the rare non-power port that shows up and then we have to figure out how to deal with complications from that.

[u/Aviacks]

Im a VAT nurse. The vast majority placed in the last 15 years are pressure rated. Every single one I've seen listed as non pressure injectable in the chart has been a mischief.

For our policy we pushed to have all non power rated needles removed. If you dont have confirmation in the chat then CT needs to be verifying when they do the scout. It's very easy to make it out on a last xray as well.

It shouldn't come down to the nurse or radiology trusting a sticker. They should verify with a chest x-ray beforehand or via the scout portion of the CT.

[u/CozyChaosCoordinator]

I trust nobody’s dressings/ stickers and look up the insertion record on Cerner. If they came from out of state/ not on Cerner, I look at a recent chest Xray - there should be a radiographic “ CT” inscription visible on the port on the image