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How To Care For Your Implanted Venous Access Port
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 total parenteral nutrition (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.
- Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
- Home IV medicines: Ask caregivers for information about the medicines and treatments that you need. Medicines may be brought to your home. Read the labels, and ask your caregiver if the medicine needs to be kept in the refrigerator. Some medicines may need to be stored in a dark area, out of direct sunlight. Ask your caregiver if you need to warm your refrigerated medicine before using it. Follow your caregiver's directions to give yourself medicine.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
Caring for your implanted venous access port site:
The area where your port was placed must be checked daily for signs of infection and other problems. Ask caregivers for written directions about caring for the port site. This includes cleaning your skin and changing the bandage while your port site heals. Always wash your hands with soap and water before touching the port site or the area around it. Washing your hands helps prevent infection. Once your port site heals, you will not need a bandage to cover the site. Ask caregivers for information about hand hygiene
Returning to activities:
When your port is not being used, and the area has healed, you may return to your normal activities. You will also be able to bathe, shower, swim, and do other water activities.
Accessing your implanted venous access port:
Your caregiver may show you or a family member how to access (enter) your port with a non-coring needle. Never try to use your port without proper training from a caregiver. To access your port, you may need to do the following:
- Prepare a clean work area: Clean the area you will use as a work space for your supplies. Wash your hands well with soap and water. Put on clean or sterile (germ-free) gloves as directed by your caregiver. Gather all the supplies you will need, such as a non-coring needle, medicine, tubing, a bandage, and tape. If you have a cough, wear a mask while preparing and accessing your port.
- Prepare the non-coring needle: The non-coring needle may have a small amount of tubing attached to it. You may also need to attach the tubing, called an extension set, to the needle. The extension set tubing should have a clamp on it that should stay clamped when not in use. You will attach a syringe with saline in it to the tubing. Open the clamp, slowly push saline through the tubing and needle, then close the clamp. This will help remove air from the tubing before accessing your port. Leave the syringe on the tubing.
- Clean your port site: The skin over and around your port must be cleaned before every use. Ask caregivers what kind of skin cleaner to use. Clean the skin for 30 to 90 seconds as directed by caregivers. Allow the cleaner to air-dry on your skin completely before accessing the site. Do not blow on the site to dry the area.
- Apply topical anesthetic: It may hurt the first few times your port is accessed with the non-coring needle. The more your port is used, the less it will hurt. Caregivers may give you an anesthetic (numbing) medicine to put on your skin before using your port. Ask your caregiver if and when you should put the medicine on your port site.
- Insert the non-coring needle: With one hand, feel for the edges of your port. Use this hand to stretch the skin across your port, to help hold the port in place. With your other hand, put the non-coring needle in through your skin and into the center of the port. Push the needle in until you hit the back wall of the port. Once the needle is in place, open the tubing clamp, and slowly pull back on the syringe. If blood flows back into the tubing and syringe, the needle is in the proper place. Close the clamp on the tubing. Ask your caregiver if you should dispose (throw away) of the blood-filled syringe, and where to dispose of it.
- Secure and cover the non-coring needle: Ask your caregiver if you need to cover your port site while the non-coring needle is in place. You may need to cover the site with a see-through or gauze dressing (bandage). The site should be completely covered by a dressing that does not allow air, dirt, and germs under it. Ask your caregiver how often you should change the dressing if you are leaving the non-coring needle in place.
Flushing your implanted venous access port:
Flushing your port is when a syringe is used to push a small amount of liquid into the port and catheter. This liquid may be saline (sterile salt water), heparin (blood thinning medicine), or both. Flushing helps prevent your catheter from getting blocked. Flushing also helps prevent medicines from mixing with each other in the tubing. Flushing with saline is normally done before, after, and between medicines and treatments. Flushing with heparin is normally done between each port use. Your port needs to be flushed with heparin every four weeks when it is not being used regularly. Ask caregivers what to use to flush your catheter, and how to flush it correctly.
Giving medicines through your implanted venous access port:
Your caregiver may show you or a family member how to give medicines or liquids through your port. A caregiver may visit you in your home to give you medicines or treatments. You may also go to an IV center to get your medicines or treatments. Medicines and treatments enter your port through tubing attached to the needle. The tubing cap, and the tubing used to give medicine or liquids, must be changed. Ask your caregiver to show you how to give yourself medicines and treatments through your port. Ask your caregiver how often to change the tubing and the tubing cap. Ask caregivers for written directions about giving yourself medicines and treatments through your port at home.
Using a medicine pump:
You may use a pump to get medicines and treatments. Caregivers will teach you how to use your pump. You may be taught to prepare and attach your medicines to the pump. Be sure the medicine tubing is not clamped or kinked. Let the liquid go in at the speed shown by your caregiver. Ask caregivers what to do when the alarm sounds, and how to care for the pump.
Remove the non-coring needle from your implanted venous access port:
You may have to take the non-coring needle out of the port after getting medicines or treatments. Wash your hands and put on gloves before removing the non-coring needle. Follow your caregiver's instructions about flushing your port before removing the non-coring needle. Caregivers may give you a needle container to dispose of your used needles. Ask your caregiver where to dispose of your non-coring needles if you do not have a needle container. Ask your caregiver if you need to cover your port site after the non-coring needle has been removed.
Implanted venous access port identification:
Your caregiver will give you a paper or card with information about your port type on it. Keep this information in a safe and easy-to-find place in case you need it.
Removing or replacing your implanted venous access port:
Your port may be removed if you no longer need IV medicines or treatments. Your port may also be removed if it is blocked, damaged, or you get an infection. Ask your caregiver for more information about removing or replacing your port.
CONTACT A CAREGIVER IF:
- The skin over or around your port breaks open.
- When accessing your port with a non-coring needle, the needle will not enter smoothly.
- You cannot pull blood from your port, flush your port, or give your medicine through your port.
- You feel pain or burning at your port site, with or without use.
- You have a fever.
- You have changes in skin color around your port, or fluid is leaking from your port.
- You have chest pain or trouble breathing that is getting worse over time.
- You have shoulder pain on the side where your port was placed.
- Your port site is red, warm, or swollen.
- You have questions or concerns about caring for your port.
SEEK CARE IMMEDIATELY IF:
- You feel like your heart is jumping or fluttering in your chest.
- You have a headache, blurred vision, and feel confused.
- You have pain or swelling in your neck, or an earache on the side where your port was placed.
- You have pus draining from your port site.
- You hear a bubbling noise when your port is flushed.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
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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.