Vascular access by physician assistants: evaluation of an implantable peripheral port system in cancer patients.
OBJECTIVE
To determine the ability of a physician assistant (PA) to insert, in an ambulatory setting, a peripheral subcutaneous implanted vascular-access device (VAD) and to evaluate the ability to transfer this training to a second PA. We also evaluated the performance and complications associated with this new device.


METHODS
The Peripheral Access System (PAS) Port catheter system (Sims-Deltec Inc, St Paul, MN) was inserted in patients who required long-term (> 3 months) vascular access for infusion therapy.


RESULTS
The first PA (PA-1) successfully inserted 57 of 62 devices (92%) after gaining experience with the technique in 10 patients (success rate, five of 10 [50%]; P = .003). The second PA (PA-2) was successful in eight of 10 initial attempts (80%) and 25 of 30 overall (83%). Complications were few and limited to phlebitis, thrombosis, and a low infection rate (0.2 per 1,000 catheter days).


CONCLUSIONS
PAs can be taught to insert a peripheral subcutaneous implanted VAD. This technique is transferable from one PA to another, and the device studied is appropriate for outpatient VAD programs.
Rubenstein
E B
EB
Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Fender
A
A
Rolston
K V
KV
Elting
L S
LS
Prasco
P
P
Palmer
J
J
Road
I
I
Pollock
R E
RE
Frisbee-Hume
S
S
Laurence
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D010823:Physician Assistants