posted
Can anyone speak to the advantages of each--port vs PICC line--if the patient is to have IV Rocephin 5-7 days per week (for an unknown period of time but at least 2 months)? For our family member, this will require infusion in a clinic setting, not at home, to get insurance coverage.
Is there discomfort with the needle change in the port? Does this outweigh the dicomfort of having blood drawn weekly (I know the port means you can draw blood there rather than having an additional blood stick. Our family member has difficult veins, making labrwork--sticks in the arm--a real problem, usually.
Any help with these questions will be so appreciated!
Posts: 19 | From St Augustine, FL | Registered: Mar 2006
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
A few notes:
A port is much more expensive than a picc
A port is designed for periodic access, not access every day. If it is accessed for long periods of time you have the same problem you have with a Picc, that is posibility of infection. Both the port and the picc require that the skin barrier be pierced and thereby provide a pathway for infection.
If you de-access the port every day, this is bad, the rubber cover on the port can only be pierced so many time before is starts to degrade. With a Picc line the access part gets changed once a week.
The main use of a port is for cancer chemo therapy where the infusion is done every few days or weeks follwed by a de-access.
The Picc line cannot get wet, a Port, when deaccessed does not have this problem. While the port is accessed, the problem is the same.
The picc line skin penetration part stays in and can get infected, For a port, the skin penetration part gets changed on every access. HOWEVER, if the port gets infected, it is not so easy to take out, whereas a picc can be pulled and REPLACED very easily.
The picc line looks more freakish than a port since once de-accessed, the port cannot be seen.
On port access, usually lidocane given so ther is a small bit of pain with the lido. needle. The Picc access is painless
BLood can be drawn from a Picc easier than from a port, as the port diaphram can collapse inwards if you try to pull blood from it, there is also a problem with trying to flush the blood from the port once the draw is done. A picc does not have these problems in that it is basically a hollow tube.
If is was me, I would say go with the PICC. I have had one for a long time and had multiple installed. They are really not a big deal.
Hope that helps.
Posts: 1184 | From north america | Registered: Feb 2003
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arg82
Frequent Contributor (1K+ posts)
Member # 161
posted
Just wanted to respond to a few things David mentioned.
It is true that ports have a limited number of times it can be accessed but the low end of this estimate is 1000 punctures which would amount to almost 3 years of daily accessing and most ports now have somewhere around 2000 accesses in a lifetime.
When you access a port, you don't use lidocaine - I think maybe you meant for the placement. For accessing you can use EMLA cream to numb the skin and you don't feel the needle at all or you can just access without anything and even that isn't very painful.
And I have to say that, in my experience PICC line placement isn't painless. I'm sure it depends on who is placing it and what kind of numbing stuff they use (if any) but my placement (and especially attempts that didn't result in a placement) weren't pleasant. For the placement that DID work, I had local anesthesia and it was more discomfort than pain and then I had complications (not typical).
As far as blood draws go, there's risk with drawing blood from any IV line but, from what I've read and heard from others, ports are better for drawing blood from than PICCs because there is less chance of getting a clot in the line (partially since the line is shorter). I did weekly blood draws from my port for six months and had no problems. Once while getting blood drawn from my port at my doctor's office, we had trouble getting all the blood and had to use extra flushes when it was done but there was no problem with it that couldn't happen with any line.
Just speaking from my experience of 2+ years with a port (and 6 months with a PICC previously) and from what I've read and heard from others I know with ports.
I'm wondering if there's a way to consolidate the three separate identical posts going about ports and piccs? I've been responding to all of them and it's getting a bit confusing.
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