Accessing Ports

Any tips on this. I have a PRN radiology job and at times have to access ports. I would say 3x a month.

I do very well on patients who are slim and the bumps stick out but anyone that is meaty over their port...no.

I used to access ports more frequently in a previous job and did well but I guess I don't get enough practice.
Does your facility have an IV team? You could ask to follow one of the IV nurses for a day or two to get practice and experience. If you don't have an IV team, do you have an oncology unit where you could get some experience?I believe ONS has a CEU on VADs. You should check them out.

If your hospital has an infusion center or oncology lab they would be an excellent resource for you. I train people all of the time.

Thanks to you both for the reply.We do have an IV team and I asked the manager of the team during orientation about a follow along for practice and was told they didn't offer that anymore because it ended up being a waste of time.I'd love to work with a cancer center nurse for half a day just accessing ports if they would allow it. During orientation I start 3 ports without any issue but they were all on prominent ports so the regular nurse signed me off on it.

Palpate, palpate, palpate. That's the key. Before you do anything else feel the heck out of it. Try and grasp it between your fingers. Get a feel for how mobile it is and if it's tilted at all. That's the best tip I can get you. It will get better the more you do.

Mine is difficult to access because it's deep, somewhat tilted , and mobile. I'm very picky about who accesses it. I had someone really botch it, and I had bruising and soreness for about two weeks.

Quote from OCNRN63Mine is difficult to access because it's deep, somewhat tilted , and mobile. I'm very picky about who accesses it. I had someone really botch it, and I had bruising and soreness for about two weeks.

I've had trouble as well with deep or tilted ports. I agree with the advice to palpate. It's tempting to rush, especially when you're busy, but recently I took the time to really feel a port and it paid off. Also, when they are still fresh from being implanted, swelling makes it more difficult to feel where to go. 1 inch needles can be helpful for deep or swollen ones.

Also try and get a feel for the shape of it. Occasionally you might get a triangle one. Have you seen and handled one that wasn't implanted? That helped me to get an idea of how much of a "target" I had to work with and how much border I'm feeling for.

Pretty much what everyone else said. I work in oncology and many of our patients have IVAD's. The key for the ones that are not as prominent is, as someone said above, to palpate the port. If it's a power port, make sure you can feel the 3 small dots. Once you find the dots, aim for the middle of the port. Also, using your index finger and thumb to anchor the port prior to needle access is a good idea. By anchoring the port, you can make the skin taught which can sometimes make the port more prominent. Using a 3/4" needle in an obese patient or a deep port is ambitious, but if that's all you have then you have to work with it.

When you do put the needle in, do it in one swift motion. Don't hesitate once you decide to put it in- commit!

Quote from blondy2061hWhen you do put the needle in, do it in one swift motion. Don't hesitate once you decide to put it in- commit!