Implanted Venous Access Ports

WHAT YOU SHOULD KNOW:

• An implanted venous access port is a device placed under your skin to give you medicines and treatments. An implanted venous access port is also called a port, or a totally implanted port (TIP). It may also be called a central venous access device (CVAD). The port is a small container that is normally placed in your upper chest. A port can also be placed in your arm or abdomen (stomach area). The port container is attached to a catheter (tube) that enters a large vein (blood vessel). You may need a port to receive long-term intravenous (IV) medicines or treatments. These include getting chemotherapy medicine to treat cancer, antibiotic (germ-killing) medicine, or liquid food. A port can also be used to take blood samples for testing.
  
  
• The port is made of plastic or metal with a self-sealing cover over the top. The device may have one or two ports, called a single lumen (tube) or a double lumen port. You may get a double lumen port if you need medicines or treatments that cannot be given together. To give medicines or treatments, a non-coring needle is put through your skin and into the port. Non-coring needles do not cause holes when entering or exiting a port. Medicines and treatments can be given through your port at different times, or constantly. Depending on the treatment you are getting, the non-coring needle can stay in place for up to seven days. Having a port may help you get the medicines and treatments that you need.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• During catheter placement, the catheter may enter the wrong area, causing abnormal heartbeats. Blood vessels may be damaged, causing you to bleed more than expected. Blood may collect around your heart, making it hard for your heart to beat. Your lung may collapse, and air or blood may fill the space around the collapsed lung. Air may enter your chest and cause heart or lung problems. Blood may collect in the area your port was placed and you may bruise around the port site. You may have pain or discomfort, and get a scar where the port was placed. You may get an infection around your port or catheter that may lead to a blood infection.
  
  
• The tip of your catheter may become blocked, break, kink, or move from its position. Medicine may leak from your port and cause swelling, pain, and tissue damage. You may be allergic to the heparin used to flush your port and heparin may increase your risk for bleeding. Heparin may also cause heparin-induced thrombocytopenia (HIT), which is a low number of platelets, increasing your risk for bleeding. You may get a blood clot in your arm that causes pain and swelling, and can stop blood flow. The blood clot may break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• If you do not have a port placed, you may not get the treatment you need. If blood samples are needed, they will have to be taken from a vein using a needle stick. You may need many needle sticks to get enough blood for testing. Your veins may get damaged if treatments that are harmful to smaller veins are given through a regular IV. You may need many needle sticks to place regular IVs to get needed treatments. Talk with your caregiver if you have questions or concerns about your procedure or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Local anesthesia: Anesthesia medicine makes you more comfortable during your procedure. Local anesthesia is a shot of numbing medicine put into the skin where your port will be placed. You may still feel pressure or pushing during the procedure after getting this medicine. With local anesthesia, you are awake during the procedure.

During your procedure:

• You will lie on your back, with your head slightly lower than your feet. A cushion may be placed under you, between your shoulder blades. An ultrasound or fluoroscopy (special x-ray) may be done to help guide the placement of the catheter and port. Your caregiver will wear a sterile (germ-free) gown, mask, gloves, and head cover to help prevent infection. The skin where your port and catheter will be placed is cleaned with germ-killing soap. Your caregiver inserts a needle through your skin until it reaches your vein. A guidewire and sheath (cover) is put through the needle and into your vein, and the needle is removed.
  
  
• A catheter is placed over the guidewire, through the sheath, and into your vein. You may be asked to hum while the catheter is placed to prevent air from entering the catheter. The guidewire and sheath are removed. A skin incision (cut), and a pocket under your skin, is made where the port will be placed. A tunnel is made under your skin to connect the catheter and port together. The port is secured with stitches to nearby tissue. The cut is closed with stitches or tissue glue, and may be covered with a bandage.

After your procedure:

• You will need to rest for awhile after your procedure. Do not get out of bed until your caregiver says it is okay. A chest x-ray will be done to check the placement of the catheter and port. You may have a non-coring needle in your port right after it is placed to start your treatments. Caregivers may also show you how to insert a non-coring needle into your port.
  
  
• Before going home, a caregiver will show you how to care for your port site. You may learn how to flush your port with saline before and after you get medicines and treatments. Saline is a germ-free mixture of salt and water, and helps keep your catheter clear of medicines or liquids. You may also learn how to flush your port with heparin. Heparin is a medicine that helps prevent blood clots from forming in your port while it is not being used.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

Learn more about Implanted Venous Access Ports (Inpatient Care)