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

2. Venous ports
Chest port
Arm port (passport)

3. Single or dual lumen

4. 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.

5. 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 days

6. Parts of a port

7. 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

8. Safety port access needle Example of a safety needle

9. 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!

10. 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.

11. 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!

12. 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

13. 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!

14. 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