PORT-A-CATHETER
OBSTRUCTION AND INTERVENTION
Zhang, B-H; Shen, L;
Gu, J-X
Shanghai Children’s
Medical Center, Shanghai, China
Objective: Central venous line device
Port-A-Catheter is convenience for oncology children to receive
chemotherapy. Daily intravenous administration through Port-A-Catheter
reduces stress on children and family. However, the usage of
Port-A-Catheter requires nurses to follow a meticulous sterilized
procedure; otherwise, catheter infection and obstruction could occur. The
purpose of this paper is to describe process of preventing and solving
Port-A-Catheter obstruction.
Methods: To solve the obstruction of the
Port-A-Catheter, a detail nursing policy and procedure are developed, and
all nursing and medical staffs who will work with oncology children attend
a haft day meeting related to Port-A-Catheter problem solving. Urokinase,
an anit-cloting agent, is introduced to all staffs to ensure the proper way
of administration of Urokinase.
Results: A total of 39 oncology children
received Port-A-Catheter placement.
Only 3 children (7.6%) had catheter occlusion. Two catheters
obstruction were solved by administrating Urokinase (5,000 unit/ml; 1,5ml
each dose). Port-A-Catheter
obstruction caused by blood clot were able be solved by repeat Urokinase administration.
One case whose catheter was kinked received a minor surgery to replace the
catheter.
Conclusion: Port-A-Catheter is a useful
medical device for children to receive long-term chemotherapy. However, it
has a small chamber and catheter lumen. Oncology children use the catheter not only for
chemotherapy but also for perenteral nutrition and antibiotic administration. Therefore, it is necessary to
follow the nursing policy and procedure to ensure the safety of using
Port-A-Catheter.