Consumer Information

Implanted Venous Access Ports

WHAT YOU SHOULD KNOW:

An implanted port is made up of two parts: a catheter (kath-uh-ter) and a port. A catheter is a small plastic flexible tube. A port is a pocket for fluids that you get through the catheter. It is made of metal or plastic and holds a small amount of liquid. One end of the catheter is connected to the port, and the other end goes through a vein near your heart.
Most ports are the size of a quarter. They have plastic or metal on the sides and rubber over the top. The port is placed right under your skin and you can usually feel it through your skin. A special needle goes through your skin and the rubber on top of the port when the port is used. By having an access port, you can have blood taken for tests, and get IV fluids quickly and easily. Having the port may keep your arm from being stuck many times with a needle.
A vein is a tube inside you that carries blood from the body to the heart and lungs. Your doctor will put the catheter into a vein near your neck. The port is placed on your chest near your collarbone, or in your upper arm. If the port will be used often, there may be a catheter tube (tail) attached to the needle. It will hang down onto your chest.

INSTRUCTIONS:

Medicines:

Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Activity: Ask your caregiver if you should change the way you do everyday activities. You may shower, bathe and swim when there is no needle in your port. This is because your skin covers the port. When you are using the port, keep the bandage over your port dry.

Appointments:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Catheter Care:

Air: Air should not get into your port. Make sure that tubing, syringes, and caps are tightly connected.
Bandages: When you are allowed to bathe or shower, carefully wash the stitches with soap and water. Afterwards put on a clean, new bandage. Change your bandage any time it gets wet or dirty. If you cannot reach the bandage, ask someone else to help you change it. You will have stitches on your chest for about a week after the surgery. Then your caregiver will remove the stitches. Usually you do not need to keep a bandage over your port after the stitches are out.
Blocked Port: If your port is blocked, it may be hard to push in the plunger (the inside part of the syringe). If this happens, do not force the plunger. This could damage the port or break off a blood clot into your body. Call your caregiver right away. Follow instructions from your caregiver closely for flushing your port to keep it from getting blocked.
Double Ports: Caregivers will give you special instructions if you have a double port. A double port has 2 different pockets under your skin that are placed very close to each other. Double ports are used if you need more than one medicine. They are also used if you need both medicines and blood draws.
Flushing: Ask your caregiver what medicine to use to flush the port. Ask him when and how often to flush the port. Flushing means screwing or pushing a syringe into the plastic cap on the tubing connected to the needle in your port. Then use the plunger to push the fluid out of the syringe into the port. Usually you will follow the "SASH" rule for flushing. This is S aline solution, followed by the A ntibiotic (or other medicine). Then when the medicine has finished, flush with S aline solution, then finish by flushing with H eparin.
Medicine: Special medicine called heparin must be put in your port when it is not in use. This medicine keeps the port from becoming blocked with a blood clot. You need to use this medicine after using your port each time, and even if you are not using your port. Your caregiver will tell you how often to use this medicine if you are not using your port.
Medicine Pump: You may also get your medicine all the time through a pump. If so, you do not need to flush the port. You may be taught how to connect new containers of medicine to the pump.
Needleless System: A "needleless" system is used to give fluid and medicine and to take blood out of your IV line. This means there are no needles used, and there is no chance of poking yourself. Plastic ends of your medicine containers or syringes are pushed or screwed into the caps on your catheter tails.
Other Ports: Sometimes ports are used for other things besides giving an IV. Never use a port that caregivers have not given you instructions. Putting medicine into a port that is going into your belly, brain or artery may make you very sick. You could even die.

Pain: Pain and swelling should go away in a few days to a week after you have your port put in. Your shoulder may feel stiff and sore. It might also hurt the first time when you put the needle into the port. The more you use the port, the less it will hurt. Caregivers may give you a special numbing medicine to use on your skin before you use your port.

Ice: Ice causes blood vessels to constrict (get small) which helps lessen inflammation (swelling, pain, and redness). Ice is best started after surgery and for the next 24 to 48 hours afterwards. Put crushed ice in a plastic bag and cover it with a towel. Place this on the surgery area for 15 to 20 minutes every hour as long as you need it. Do not sleep on the ice pack because you can get frostbite.

Heat: After the first 24 to 48 hours, use heat 15 to 20 minutes every hour as long as you need it to lessen pain or swelling. Heat brings blood to the surgery area and helps it heal faster. Use warm compresses, a heating pad, a hot water bottle, or sit in a warm water bath.

A warm moist compress is a small towel dampened with hot water and placed in a plastic bag. Wrap a towel around the plastic bag to prevent burns.
Be careful if you use a heating pad by keeping it turned on low.

Infusion Centers: An Infusion (in-fyu-zshun) Center is a place where you may go to get IV medicines or treatments. Some catheters can be put in and removed there. If you are having problems with your IV, you may go to an Infusion Center to get help. Your caregiver will tell you where Infusion Centers are located.

Port Identification: There are many different types of ports. Your caregiver will give you a paper that tells you the brand name and lot number of your port. Keep it in a safe place in case you need it in an emergency.

Accessing your Implanted Venous Access Port:

Accessing the Port: At first, the needle will be put into your port by your caregiver. Putting the needle into the port is called "accessing" the port. Accessing your port is a sterile procedure. This means extra care is taken to prevent infection (in-fek-shun). Your caregiver will clean the skin over the port with special soap.
Non-coring Needle:
- A special needle called a "non-coring" needle will be put through your skin and into the rubber part of the port. "Non-coring" means the needle will not leave a hole or tear the port when you put it in or out. This needle is shaped like an "L" and has a short IV tubing attached.
- Your caregiver will insert the needle straight down into your port until it hits the metal bottom of your port. Since the needle is shaped like an "L" the part of the needle that is outside of your skin will lay flat against your skin. If your port will be used often, there will be a catheter tube (tail) attached to the needle. It will hang down onto your chest.
- A sterile bandage will be put over the needle to hold it in place and to prevent infection. If you are getting IV fluid or medicine, this needle may stay in your port for up to one week. The needle and bandage should be changed once weekly for as long as you are using your port. If you are not using the port, the needle will be removed and a bandage will not be used.

Using your Port at Home: You may be taught how to care for your port and give yourself medicines at home. You may also go to a clinic or Infusion Center to get medicines and fluids through your port. Following are steps for using your implanted venous access port:

Wash your hands well with soap and water. Put on clean plastic gloves if you have them. Gather all the supplies you will need.
Prepare the medicine you will be using. Some medicines must be kept in the refrigerator. You may need to take the medicine out before you use it so that it warms up.
Clean the cap on the port tail with alcohol as shown by your caregiver. Do not touch the cap or syringe tip or let them touch anything after they are cleaned.
Hold the syringe with flush liquid in one hand. Use the other hand to hold the cap on the catheter tail. Screw or push the ends together firmly. If there is a clamp on the tail, unclamp it. Flush the port as shown by your caregiver and remove the syringe.
Clean the cap of the catheter tail with alcohol.
Screw or push the end attached to the bag of IV medicine or liquid into the cap on the catheter tail.
Start the pump that gives the medicine or liquid, or adjust the flow of the medicine as shown by your caregiver. Be sure the medicine tubing is not clamped or kinked. Let the liquid go in at the speed shown by your caregiver.
If your medicine comes in a syringe, screw or push the syringe on to the cap on the tail of the port. Be sure it is tight. Push your medicines into the port slowly over the length of time shown by your caregiver.
When the right amount of liquid has gone in, unscrew or pull apart the two ends. Flush the port as shown by your caregiver. You may have to flush it twice with different liquids. If there is a clamp on the port tail, close it.
You may have to take the needle out of the port after receiving your medicine. If you do, caregivers may give you a special container to put the used needle in. If you do not have a special container, put the needle in a place where others will not get stuck with it.

CONTACT A CAREGIVER IF:

You have a fever (increased body temperature).
Your stitches are swollen, red, or have pus coming out of them. This may mean they are infected.
There is a red streak from the port up your chest.
Your face or neck gets swollen.
The area around the port is red, swollen and warm. These are signs of infection.
There is swelling around the port, and the skin around the port is painful and cool.
The pain in your shoulder, arms, and neck does not go away or gets worse.
It is hard to get medicines to go into the port, or the medicine has started going in much slower.
You have questions or concerns about your port.

SEEK CARE IMMEDIATELY IF:

You feel chest pain. This might be a sign of a blood clot or a heart attack.
You have trouble breathing or your skin turns blue or pale. Air may have gotten into your catheter:
- Clamp the catheter.
- Lie down on your left side with your head down and your feet raised.
- Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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