Infusion Ports, also called Implanted Chest Ports is a Vascular Access Device that is placed under the skin of the chest wall (planted), and the catheter tip is fed to the lower third of the SVC. Ports are a great device for the patient that has long term IV needs. Most often we see ports in our oncology departments for chemotherapy administration. There are other indications for this line as well. Some ports are CT compatible and some are not. You need to know if the device can withstand the psi of 300 or greater before being used for CT studies. When accessing the port, place the patient in a semi reclined position. Access the port with a hueber needle at a 45 degree angle. Before you access, be sure to assess the port and site. Make sure you can feel the septum. Ports are manufactured in different shapes and sizes. Accessing the port is a sterile procedure. Make sure you have all the supplies you need before you begin. If you are drawing labs off the port, make sure you draw a waste first, then draw the sample. Be sure to assess if accessing the port is painful for your patients. Use the appropriate numbing agent for their age. Topical creams work well, but you need to plan ahead for the time it takes the numbing agent to take affect. I use distraction, by having the patient take a deep breath while I insert the needle. The needle will only go in so far, so when you assess the patient make sure you have the right length to reach the septum, and you have the right gauge for the therapy ordered (blood products, 20g or larger in adults). I stabilize both hands on the patients chest wall: non dominate hand anchors the port, and my dominate hand accesses the port. Secure the needle and tubing per hospital policy. If you can not get a blood return you need to troubleshoot why this is happening. Ports can clott off and may need to be cleared. Have your patient take a deep breath, try the valsalva maneuver, or have them lift their port side arm above their head. Trouble shoot the line before instilling any catheter clearance products. Make sure you have reviewed your institutions policy and procedures for before you begin.
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