Ports TIVAD/P (totally implanted venous access device/port) Using a port Accessing and de-accessing Nov 2018

Venous ports Chest port Arm port (passport)

Single or dual lumen

CT or Power port – used for CT scanning with contrast CT ports will need specific CT injectable needles to access for a CT contrast procedure.

Post procedure care Steri-strips or sutures at the vein insertion site – usually in the neck but can be in the subclavian vein Remove after 7 days Wound above the port pocket Closed with either dissolvable sutures or non-dissolvable sutures Dressing to remain for 7- 10 days

Parts of a port

Accessing a port through the skin with a needle ONLY use a NON-coring needle Various lengths an gauges Length of needle to be determined post port placement This is dependant on the depth of the port and the amount of subcutaneous tissue. If in doubt – use a longer needle

Safety port access needle Example of a safety needle

Procedure Pain relief can be used i.e ametop ANTT principles Cleanse with chloraprep 30 secs Prime the needle – take care with key parts Put on sterile gloves Feel the port prior to accessing BARD power port will have the three nodules – AIM for the centre MUST obtain a blood return to use for therapy Flush with saline Infusion line can stay in situ for 7 days MUST get blood return before EACH infusion!

Type of port: with raised areas to denote that it is a CT PICC and a guide for needle placement – aim for the centre of the three raised areas as you feel through the skin.

Ensure stability of the needle Ensure stability of the needle. No need for a dressing if ONLY taking blood samples. Day case – two cannula dressings and looped Overnight or longer – padded with gauze and looped!

Removing the needle or de-accessing the port. Flush with saline. Use 5 mls of heparin 100units/ml or 5 mls of Hepsal for daily or weekly access. Flush & clamp as you flush the last 0.5ml. Activating the safety device FULLY – PULL whilst holding the purple wings

Ports Drug reaction Complications If a patient experiences a drug reaction whilst its being infused through a port: Stop the infusion Aspirate blood from the needle/extension line & discard Use the port needle for emergency medication Infection – monitor site (above the port)and signs of sepsis Flipped port – will feel a flat surface through the skin No blood return – DO NOT USE A PORT WITHOUT A BLOOD RETURN!

Referral procedure Insertion Removal Patients will be referred to practitioners in their Local Health Board. Vascular Surgeons or Interventional Radiologist All referrals need to come through IV Access Specialist or Chemo ANP Routine removal will be performed by the practitioner/team who placed the device Referral through the IV Access specialist Nurse or Chemo ANP