Name of the Procedure:

• Common Name: Non-coring needle or stylet with or without catheter
• Medical Term: HCPCS A4212 Procedure

Summary

This procedure involves using a non-coring needle or stylet, with or without a catheter, typically for accessing a venous port or other device. This is done to deliver medications or fluids, withdraw blood, or for other medical purposes, ensuring that the withdrawal point remains sealed and prevents damage to implanted devices.

Purpose

The primary purpose of using a non-coring needle or stylet is to safely and effectively access a port or reservoir implanted under the skin. This procedure is designed to:

• Administer medications or nutrition.
• Perform blood draws.
• Deliver therapies like chemotherapy.
• Minimize the risk of coring or tunneling the port membrane, which can lead to complications.

Indications

Indications for the procedure include:

• Patients requiring frequent venous access for medication or fluid administration.
• Individuals undergoing long-term therapies such as chemotherapy.

• Patients with difficult venous access.

  Preparation

  Pre-procedure instructions for patients may include:

• Fasting might not be necessary unless specified by the doctor.
• Follow instructions regarding the adjustment of current medications.
• A physical examination and review of medical history may be conducted to assess suitability.

Procedure Description

1. Patient is positioned comfortably and the site of the port is cleansed and sterilized.
2. A local anesthetic may be applied to numb the area.
3. The non-coring needle or stylet is carefully inserted into the port site.
4. If necessary, a catheter may be attached to the needle.
5. Medications or fluids are administered, or blood is drawn as required.
6. The needle or stylet is then removed, ensuring the port remains undamaged and sealed.
7. The site is cleaned and covered with a sterile dressing.

Tools and Equipment:

• Non-coring needle or stylet.
• Optional catheter.
• Sterilization supplies.
• Local anesthetic (if used).

Duration

The procedure typically takes about 10 to 20 minutes.

Setting

The procedure can be performed in various healthcare settings, including:

• Outpatient clinic.
• Hospital.
• Surgical center.

Personnel

The procedure involves:

• Nurses or specialized healthcare personnel.
• Possible supervision by doctors or nurse practitioners.

Risks and Complications

Common and rare risks associated with the procedure include:

• Pain or discomfort at the site of insertion.
• Infection at the port site.
• Minor bleeding or bruising.
• Very rarely, damage to the port membrane.

Benefits

Expected benefits include:

• Reliable and frequent access for necessary medical treatments.
• Reduced risk of long-term damage to venous access points.
• Improved patient comfort and convenience for repeated procedures.

Recovery

Post-procedure care and instructions may include:

• Keeping the insertion site clean and dry for 24 hours.
• Monitoring for signs of infection (redness, swelling, increased pain).
• Light activity can generally be resumed immediately.
• Follow-up appointments as necessary to monitor the port site.

Alternatives

Other treatment options include:

• Traditional needles, which can increase the risk of port damage.

• Peripheral IV lines, which may not be suitable for long-term or frequent use.

  Pros and Cons:

• Non-coring needles reduce port damage risk compared to traditional needles.
• Peripheral IV lines are less invasive but not ideal for repeated or long-term use.

Patient Experience

During the procedure, the patient may feel:

• Mild discomfort or pressure at the insertion site.
• Minimal pain if a local anesthetic is used.

After the procedure:

• Slight soreness or bruising at the site, usually resolves within a few days.
• Pain can be managed with over-the-counter analgesics if necessary.

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