Dear HoG: Using Butterfly Needles in a Port

Horizons in Hemophilia, Fall 2008

Dear HoG:
Can I use a regular butterfly needle that is used for infusions in the hand or arm in a port?
    --Wondering Mom

Dear Mom:
The short answer is no. Under no circumstances should you ever use a regular butterfly needle for a port-acath (port) infusion. Butterfly needles have wings that look like a butterfly to help hold the needle for insertion, hence the name. The butterfly needles that are used for small veins in the hands or arms have a slanted opening, called the bevel of the needle, also known as a coring needle, that makes a small round hole on introduction into a vein to allow drawing blood samples or infusing factor or other medications directly into a vein. The port winged infusion needles used for a port also have wings, but the needle is at a right angle to the skin and has a long thin slanted tip instead of the straight butterfly needle used for peripheral infusions.

There are special port needles—either a Gripper® needle or port-a-cath winged infusion set—that create a slit instead of a round hole to prevent leaking over a port, which could create bleeding from the port membrane. Blood pooling over the port may cause an infection. A regular butterfly coring needle could also cut the round hole and introduce the core from the needle into the bloodstream which could cause it to lodge in a valve or cause clotting problems. This could drastically reduce the lifespan of a workable port as well as creating other complications. A port is made with a self healing membrane which can close the small slits from port needles when the needle is removed (de-accessed).

During an infusion into a port if you notice any leakage, swelling around the port, difficulty with flushing the line, chills or fever, call your nurse or doctor right away. In Georgia either your Hemophilia Treatment Center (HTC) nurse, or your HoG outreach nurse can help answer any questions you might have about port care. Any time your child is discharged from the hospital, be sure to ask the discharge nurse about any follow-up care and how you can get port needles and supplies. If you live a long distance from the hospital and have already learned port care, ask if they might give you a spare port needle until you can order supplies from the company where you order factor and infusion supplies. Call your supplier as soon as possible to have port needles, supplies and factor sent to your home.

We appreciate your letter and hope we have cleared up the confusion. If you have any questions, please call your HoG outreach nurse or HTC nurse.