This document provides information on the care and use of a chemoport or port-a-cath. A port-a-cath is a surgically implanted device that provides long-term intravenous access. It consists of a portal and catheter under the skin. The portal can be punctured repeatedly by a Huber needle to administer medications, blood draws, or IV fluids. The document outlines the proper procedures for accessing the port with a needle, locking it with heparin, taking blood samples, starting IV therapy, and removing the needle. It also lists equipment needed and potential complications to watch for like infection, occlusion, or skin breakdown.

1. CARE OF CHEMOPORT / PORT-A-CATH

2. Types of IVaccess
Central
 Non tunneled centralcatheters
 Tunneled centralcatheters
Peripherally insertedcentral
catheters (PICC)
 Implantable ports
peripheral
 Cannula
 Butterfly

4. Definition ofport-a-Cath
• Aport-a-Cath, is animplanted device which allows easyaccessto apatient’s
veins. A port-a-Cath is surgically-inserted completely under the skin and
consists of two parts –the portal and the catheter.

5. • It is made from asilicone bubble and appears asasmall bump under the skin.
• Theportal, made of special self-sealing silicone, can be punctured by a
needle repeatedly before the strength of the material is compromised.
• Its design contributes to avery low risk of infection.

6. Types of port- a-Cath
• Single lumen
• Doublelumen

7. HUBER NEEDLE

8. Indication of port-a-Cath
 Difficult cannulation
 Long term access – can be used for many years
 Central line for blood drawing and medication administration
 May administer continuous infusion IV vesicants
 Ports placed for patients receiving chemotherapy , generally restricted
to chemotherapy infusions only
 Lowest incidence of catheter- related bloodborne infections
 Low maintenance care at home

9. Contraindication ofport-a-cath
• Occludedvein.
• Respiratoryproblems
• Infected site.
• Site with trauma for exampleclavicle fracture.

10. • PPE (personal protective equipment )
• Dressing tray/Trolley
• Huber needle with luer lock extension tubing
• Chlorhexidine 2%Gluconate with 70%IsopropylAlcohol solution
• 5ml, 10mLsyringe
• Normal saline
• Sterile dressing set (Gauze, Pad, Kidney tray)
• Transparent occlusivedressing
• Tape/ Tegaderm (8526 )
• Inj Heparin(1:10 ml ns / Inj hep lock (no dilution )
Articles / Equipment needed for procedure

11. PROCEDURE
• Position patient in low fowlers position.
• Expose IVAD site and palpate port.
• Assemble equipment and create sterile fields with the opened packages.
• Wash Hand, Mask and gloves.
• Cleanse port site with disinfectant in a circular motion from center of
port outward to cover an area approximately 4" in diameter.
• Repeat three times and allow to air dry 1 minute, and then wipe any
excess with sterile gauze.

12. • Attach saline filled syringe and prime the tubing and needle.
• Leave syringe attached to set and close the clamp.
• Be careful to maintain the sterility of the Huber needle

13. • Palpate the port system with the non-dominant hand and stabilize
the port edge with 2 or 3 fingers.
• With the dominant hand, using firm, consistent pressure, insert the
non-coring needle at a 90 degree angle) to the port septum until
the back of the port chamber is located.
• Rotate site with each access if last access site known.
• Open the clamp on the extension tubing and verify patency by
aspirating for blood return and instilling saline.
• Slowly flush the system with 10mL of saline, disconnect syringe and
close clamp.

14. • secure the needle and tubing to the Patient,
• using the 4-inch occlusive dressing.

15. • HEPARIN LOCKING
After saline flush, ports areflushed heparin to lock the system for intermittent access,
when discontinuing access,and every 4 weeks to maintain patency.
EQUIPMENT
• 10mLsyringecontaining5mLHeparinLock FlushSolution (100units/mL)
• 10mLsyringecontaining10mLsterile normal saline
• Chlorhexidine2%Gluconatewith 70%IsopropylAlcohol swab
 PROCEDURE
1.Cleansetop of adaptor with Chlorhexidine2%Gluconatewith 70%IsopropylAlcohol
swab.Allow to dry completely.
2.Attach syringeto adaptor.
3.Openclampon extensiontubing.
4.Verify patency and inject saline,disconnectsyringe.
5. Inject heparinsolution.
6. Disconnectsyringeand clampextensiontubing.

16. IVTHERAPY
• EQUIPMENT
• 10mLsyringewith 10mLsterile normal saline
• tape
• intravenous solution asordered with primed tubing
• Surgiprep
• PROCEDURE
• 1.Cleanseadaptor withsurgiprep allow toair dry.
• 2.Attach salinefilled syringeandassessfor patency.
• 3.Connectprimed IVto 3 way extension
• 4.Cleanseconnectionsite with alcoholswab,allow to dry.
• 5.Secureconnectionwith waterproof tape.
• 6.Infuse asper physician’s order.
• Note: Whendiscontinuing anIVinfusion,flush the port with 10mLnormal saline then 1mL
• heparin solution(1000units)

17. • BLOOD SAMPLING
EQUIPMENT
 PEE
 Chlorhexidine 2%Gluconate with 70%IsopropylAlcohol swab
 10ml syringes
 Needle
 Vacutainer
 5 ml syringe -2
 Sterile normalsaline
 Heparin solution 1000units =1 ml
 Requisition(s), label(s)

18. PROCEDURE
• Apply sterilegloves.
• Prepare 10mlsnormal salinein 10-ml.syringe.
• Prepare 1mls heparin solution in 10mlsyringe. ( with dilution 10 ml NS)
• Cleanthe adaptor with asurgiprep
• Attach a10mLsyringe.
• Withdraw the required amount of blood by attaching a10ml syringe
• Flushthe IVADwith 10mLnormal saline
• NSflush/heparinflush
• resumeIVtherapy.

19. EQUIPMENT
 PEE
 5mLsof heparin lock flush solution in 10mLsyringe
 10mLs sterile normal saline without preservative in 10mLsyringe
 2" x 2"gauze
 Bandaid

20.  REMOVING AN IVAD NEEDLE (GRIPPER)
PROCEDURE
• If IVinfusing, stop IV.
• Applygloves.
• Cleanse injection port or adaptor with Chlorhexidine 2%Gluconatewith
70%IsopropylAlcohol solution and allow to air dry.
• Attach 10mLsyringe with 10ccnormal saline, aspirate for blood return
then instill saline
• Disconnect salinesyringe.
• Attach syringe with 1 mLsHeparin Lock FlushSolution and inject.
• Loosen dressing fromneedle site.
• Apply pressureto edges of port with 2 or 3fingers while withdrawing the
needle straight
Apply pressureto the port site with a2" x2" gauze until bleeding stops
and micropore / tegaderm

21. Complication
duringaccessing
• Extravasation
• Infection
• Mal-position ofneedle

22. Complication.
after accessing
 Occlusion issues if not accessed or flushed properly
 Skin breakdown
 Infection
 Thrombus formation
 Catheter fracture or migration

23. Patienteducation 1-afterportinsertion (post operative)
• Limit activity for 24 hour
• Sterile dressing for 24 hr. if no drainage present (changedressing daily or
if needed)
• Transparent dressing till wound healing
• Notify physician if any complication (pain, fever, swelling, other)

24. Patienteducation 2- during in patient using port
• Do not sleep on site of port
• Observethat line is not kinked
• Low activity when connected with pump
• Mal-position ofneedle
• Extravasation
• Notify physician if any complication (pain, fever, swallowing, other)