FAQ Portsystems and accessories
FAQ Portsystems and accessories
1. What is a port/catheter System?
The port/catheter system consists of a titanium port chamber and a catheter. The titanium chamber is sealed by a silicone membrane. Administration of medications, parenteral nutrition, and blood sampling are possible after inserting a special needle through the skin and the silicone membrane into the port chamber.
2. What are the advantages of a port/catheter system?
The risk of infection is minimized by the protective skin barrier.
The system is most often used in cancer patients requiring extensive chemotherapy.
Quality of life is optimized because the system does not interfere with patient mobility and puncture of the port membrane is easier and is associated with fewer risks.
Normal activities such as sports, bicycling, etc. are possible.
The implanted port chamber lies slightly elevated just below the skin and is barely noticeable. The port can be palpated easily.
3. Where is the port/catheter system positioned?
4. How is a port/catheter system implanted?
There may be slight swelling and pain at the site of implantation during the first few postoperative days but this is normal. If this should persist and progress to skin redness, fever, or bleeding a doctor should be consulted immediately to prevent complications.
The surgical incisions are either sutured or closed by adhesive strips. These can be removed painlessly on the 8th postoperative day. If a dressing is no longer necessary the patient may shower and eventually bathe after complete wound healing. Patients should refrain from physical exertion for the first 14 days. The port may be used for therapy immediately.
5. Which medications can be injected?
6. How can medications be administered?
The port/catheter system can be used subsequent to puncture of the membrane with the special needle. Drugs are administered either:
- as a bolus: using a syringe after puncture of the membrane.
- as a brief infusion: Using typical infusion tubes connected to the port needle, a small volume of infusate (approx. 100ml) is administered over a period of 20-30 minutes. The infusion bottle is placed on the infusion stand in the typical hanging position.
- as an extended infusion: the infusion continues over an extended period of time (e.g. 24h) with the aid of an infusion pump
The physician will decide which and when drugs are to be administered. It is important to flush the port/catheter system after usage otherwise clogging can occur.
Instructions and care guidelines must be followed. Patients should also carry their ID cards in which all relevant details are documented.
IMPORTANT: The port chamber is not a reservoir for either blood or drugs ! It should only contain saline/heparin solution after flushing
7. What special types of needles are required?
8. How should the port membrane be punctured?
Sample procedure:
- Skin Disinfection
Puncture area is prepped with an antiseptic solution (either transparent or colored) - Puncture
The special needle is advanced through the skin and silicone membrane into the port puncture site can be anesthetized 30 minutes prior to puncture with an anaesthetic chamber. The patient will feel slight pain at the puncture site. If necessary the ointment or spray. - Testing function
The doctor draws blood with a syringe to confirm access to the circulation and then flushes the system with 0.9% saline. - Fixation
For the duration of treatment the needle is secured with adhesive strips. Afterwards the system may be used again.
9. How to take care of the port/catheter system?
Flushing once every 3 months. This is usually done by the general practitioner when obtaining routine blood samples.
Connected port needles are checked daily by medical and nursing staff. Regular flushing of the systems is required after administration of infusions. This is particularly important after blood transfusions and infusion of differing medications which may possibly interact.
When applying a bolus, syringes of at least 10ml or larger are recommended. The same procedures are to be followed when extracting the needle. This ensures long term protection of the system.
10. What complications may occur?
Problem | Possible cause | What can be done? |
High resistance during injection, no aspiration of blood. | The tip of the catheter is resting on the vessel wall. |
|
Port and catheter cannot be flushed under normal pressure. Blood cannot be drawn. | Occlusion (clogging) of the catheter. | In these cases a physician should be consulted immediately. The physician will then discuss what needs to be done. |
Malaise, pain, and swelling of shoulder, neck and arm regions. | Venous thrombosis | |
Pain or redness at the implantation site, fever with unusual discharge at the puncture site. | Infection of the port recess. | |
Burning pain after infusion possibly accompanied by blister formation on the skin surface and swelling of the port recess. | Indicates system leakage. Medications are diffusing into surrounding tissues. |
The following complications are very rare but cannot be excluded:
Problem | Possible cause | What can be done? |
Rejection of the port by the body | Material incompatibility | In these cases a physician should be consulted immediately. The physician will then discuss what needs to be done. |
Spontaneous dislocation of the port. | Improper fixation of the port during implantation. | |
Dislocation of the port secondary to body movements. | Improper fixation of the port during implantation. | |
Pinching of the catheter between collar bone and first rib. | Individual anatomical position, operative technique. |
11. How can long-term use be achieved?
Port systems can remain in situ for several years. When no longer needed they can be surgically removed.
It is generally recommended that patients carry a special port needle to be used in the event of an emergency.
12. Are normal activities restricted?
After healing of surgical wounds normal physical activity may resume. If a port needle is not connected patients are permitted to bathe, swim, and exercise as they have done prior to port implantation.
13. Is the port visible?
14. Are port systems influenced by X-Rays, MRI studies, TENS, or other diagnostic procedures?
15. How long can a port remain implanted? Can they be removed later when not needed?
16. How important is the patient ID-card?
Patients should always request ID-cards from their surgeons or nurses and present them as required.
17. Medical terminology
- Aspiration: drawing blood from the port with a syringe.
- Implantation: surgical placement of the system
- Intravenous therapy: application of a drug through a vein
- NaCl 0,9: physiologic saline for flushing of the system
- Parenteral nutrition: application of nutrients, electrolytes, vitamins, and trace elements into veins thus by-passing the gastrointestinal tract.
- Peripheral veins: veins of the arms and legs
- Bolus application: given as a single injection
18. What does mean „ power port injection“?
This portcathetersystem in combination with special portneedles is also indicated for power injection ( high pressure) of radiopaque material into the vascular blood system.
The system is appropriate to a maximum flow of 5ml/sec at maximum pressure of 300 PSI/21bar. Stability is tested and the suitable systems or needles are indicated separately e.g.