It was reported via ms&s "we have had several needle dislodgements from the porta cath site due to various reasons.The affected patients are ambulatory pump patients who go home with a 46 hour chemotherapy infusion pump.Two have recently caused a caustic burn to the skin over the port site.Are you aware of any additional securement devices available or measures implemented from other facilities that would help prevent the huber needle dislodgements? we dress each site with tegaderm only." ms&s response "informed we make multiple port access needles with variations in specifications.We have 0.75", 1", and 1.5" needles with and without wings.Port access needles that are too short can fall out of the septum and leak medications onto the skin.The guardiva dressing and biopatch dressing sometimes are used against the skin with needle access.These antimicrobial dressings can keep some of the needle out of the port making it more likely that a short needle could dislodge.I have also seen where if the needle is too long, when placed in the port septum there is excess needle not in the septum.It can be pulled by the tegaderm and the needle pulled out.Port needles that are placed in the septum at an angle other than 90 degrees have a tendency to dislodge.We do sell the sentrinex 3d dressing which may be an option for port needle securement (emailed catalog).I have seen tegaderm dressings taped down with tape strips for additional securement.Patients who have had their ports for longer can have wear and tear to the port septum.This type of damage, usually from larger needles, can cause a septum to not "hold" a port needle in place.Avoid placing the port needle in the exact same area of the septum when accessing.I would have the clinicians drill down on what needle(s) they are using to access which clearvue port(s).Depth of port placement, swelling in the area, and the use of a bio-patch or guardiva at the site will need to be considerations for the clinician accessing the port in determining the appropriate needle length" this report addresses the first of two devices.
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