I saw this once also, with an added feature. It was at a University
hospital on the pediatric ward. I was doing home IV therapy at the time,
and the surgeon who placed the port had very specific instructions about
accessing the port through the TSM. But he wanted a new TSM placed before
or after every access. So they were accessing through like 5or 6 TSMs when
I saw it. I couldn't believe it. I don't know the outcome as I was there
to see another patient and the nurses ask me about this. I told them I had
never seen or heard of it, (before or since, til now!) Sorry I don't know
what happened after.
Halle Utter RN, BSN
Denver, CO
PS This wasn't in Colorado by the way!
----- Original Message -----
From: "Fritz, Donna" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, March 01, 2006 9:04 AM
Subject: port access through TSM
I did see this once. A pt returned from the OR with newly placed, accessed
port. It had a not-very-esthetic gauze and tape dressing, so we carefully
removed the dressing so we could reprep and put a TSM. Lo and behold, the
TSM was on the patient, with the port needle right through the TSM.
I think the issue of how to dress a newly placed port is important,
however. What I find frequently is that pt returns with steri-strips
covered by TSM WITHOUT needle access. Then we (oncology nurses--usually
me) have to remove part of the TSM, enough to prep and access, but not
pull the TSM off of the steri-strips as strips cannot be removed from the
TSM adhesive. The use subcutaneous sutures with steri-strips for skin
closure. I might be in favor of a small piece of gauze put over the
strips to protect them from TSM adhesive for the first little while.
Donna Fritz, MN, RN, OCN
Oncology/Pain Clinical Nurse Specialist
Cancer Center
St. Mary-Corwin Medical Center
719.560-5215
[EMAIL PROTECTED]
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