Clogged PORT-A-CATH

Ma's PORT-A-CATH got clogged last Wednesday while she was still at Doctors Medical Center. The nurses had been flushing her port with 3 ml saline after every use. It turns out that was not nearly enough. A nurse from the Cancer Center came over and injected TPA into the port to clear it. TPA is supposedly stronger than Heparin for dissolving blood clots. It took 2 hours to unclog the port. This is the procedure the oncology nurse recommends each time the port is used:

1. Flush with 20-30 ml saline.
2. Follow-up with 5 ml (100 units) Heparin

I wrote down the instructions for the nurses at Summit. They have a better protocol that they follow compared to Doctors Medical, but I nag them anyway, just in case. I also remind every new nurse not to use Ma's left arm and that she has a port. I don't know if they do it at Summit, but at Doctors they rotate the nurses. Ma would always end up with a new nurse who's not familiar with her requirements. Even though there's a sheet in the room saying not to use her left arm, the nurse doesn't always notice the sign. I've had to stop more than one person from using her left arm.

Update 07/20/08: I added clarification that 5ml Heparin = 100 units. Also, if the patient is on a saline drip, the Heparin can be skipped till the saline is discontinued. The saline drip should be at 30 ml/hr.