Implanted ports, computed tomography, power injectors, and catheter rupture.

Patients with cancer often require computed tomography (CT) examinations to monitor the status of their disease. To enhance CT images, radiology personnel use power injectors to administer radiopaque contrast media at high pressures and controlled rates. If power injectors are used with implanted ports that are not designed to withstand pressures generated by the injectors, catheter ruptures can occur. Catheter rupture can lead to extravasation of vesicant contrast dye, catheter fragment emboli in the right atrium or pulmonary artery, and the need for port removal and replacement (U.S. Food and Drug Administration [FDA], 2006). Several vascular access manufacturers have recently developed implanted ports that are safe for power injection. For patients who may already have poor peripheral venous access, the ability to use their port to inject contrast media decreases discomfort from venipuncture and helps lower the risk for extravasation of vesicant contrast media. Although power injectable ports have many benefits, serious adverse events can occur if safety processes are not developed and implemented. Oncology nurses can prevent catheter rupture by accurately identifying a port that is a power injectable port; using the correct power injectable, pressure-tested port needle to access the port; communicating with radiology personnel; and educating the patient about port safety issues.