背景:PowerFlow植入式单采静脉端口是一种用于治疗性单采手术的静脉接入装置。在这种情况下,评论文章,我们确定了PowerFlow单采端口与传统端口之间的主要异同。我们还列出了应急部门可以实施的策略,以帮助正确识别港口。
方法:使用案例评审格式,我们描述了一名33岁女性视神经脊髓炎患者的临床表现,该患者在急诊科接受了急性加重评估。她有使用双侧PowerFlow端口的门诊单采手术史。误认为是传统的港口,使用Huber针头而不是适当的针头导管进入右侧PowerFlow端口。在输注静脉输液时,患者出现疼痛和肿胀。最终,端口出现故障,最终被更换。
结果:随后的根本原因分析确定了教育和帮助改善港口识别的机会。为此,使用以下至少两种方法实施适当识别PowerFlow端口的策略:(1)在患者的图表中查看植入式单采静脉端口的记录;(2)检查端口识别卡,手镯,或在插入时发出钥匙扣;(3)触诊端口以寻找圆形顶部和中空凹入口点;和(4)使用X射线或荧光透视来识别不透射线的端口标记。
结论:当具有单采手术史的患者出现植入端口时,应采取措施确保正确的识别和访问。
BACKGROUND: The PowerFlow implantable apheresis intravenous port is a venous access device for therapeutic apheresis procedures. In this
case review article, we identify key similarities and differences between apheresis PowerFlow ports and traditional ports. We also list strategies that emergency departments can implement to aid in correct port identification.
METHODS: Using a
case review format, we describe the clinical presentation of a 33-year-old female with neuromyelitis optica who was evaluated in the emergency department for an acute exacerbation. She had a history of outpatient apheresis procedures that made use of bilateral PowerFlow ports. Mistaken for a conventional port, the right PowerFlow port was accessed with a Huber needle rather than the appropriate catheter-over-needle device. On infusion of intravenous fluids, the patient experienced pain and swelling. Ultimately, the port malfunctioned and was eventually replaced.
RESULTS: A subsequent root cause analysis identified opportunities for education and aids to improve port identification. To this end, strategies were implemented to appropriately identify the PowerFlow port using at least 2 of the following methods: (1) look in the patient\'s chart for record of an implantable apheresis intravenous port; (2) check the port identification card, bracelet, or keychain issued at insertion; (3) palpate the port to look for the rounded top and hollow concave entry point; and (4) use x-ray or fluoroscopy to identify radiopaque port markers.
CONCLUSIONS: When a patient with a history of apheresis procedures presents with an implanted port, steps should be taken to ensure correct identification and access.