Implanted Port Insertion

What is Implanted Port Insertion

Implanted port insertion is a procedure to put in a port and catheter. The port is a device with an injectable disk that can be accessed by your health care provider.

The port is connected to a vein in the chest or neck by a small flexible tube (catheter). There are different types of ports. The implanted port may be used as a long-term IV access for:

  • Medicines, such as chemotherapy.
  • Fluids.
  • Liquid nutrition, such as total parenteral nutrition (TPN).

Having a port means that your health care provider will not need to use the veins in your arms for these procedures.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, especially blood thinners, as well as any vitamins, herbs, eye drops, creams, over-the-counter medicines, and steroids.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have, including diabetes or kidney problems.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Allergic reactions to medicines or dyes.
  • Damage to other structures or organs.
  • Infection.
  • Damage to the blood vessel, bruising, or bleeding at the puncture site.
  • Blood clot.
  • Breakdown of the skin over the port.
  • A collection of air in the chest that can cause one of the lungs to collapse (pneumothorax). This is rare.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

  • Follow instructions from your health care provider about eating and drinking, which may include:
    • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
    • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
    • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
    • 2 hours before the procedure – stop drinking clear liquids.

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • You may be given antibiotic medicine to help prevent infection.

General instructions

  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.
  • You may have blood tests.
  • You may be asked to shower with a germ-killing soap.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV tube will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
  • Two small cuts (incisions) will be made to insert the port.
    • One incision will be made in your neck to get access to the vein where the catheter will lie.
    • The other incision will be made in the upper chest. This is where the port will lie.
  • The procedure may be done using continuous X-ray (fluoroscopy) or other imaging tools for guidance.
  • The port and catheter will be placed. There may be a small, raised area where the port is.
  • The port will be flushed with a salt solution (saline), and blood will be drawn to make sure that it is working correctly.
  • The incisions will be closed.
  • Bandages (dressings) may be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • Do not drive for 24 hours if you were given a sedative.
  • You will be given a manufacturer’s information card for the type of port that you have. Keep this with you.
  • Your port will need to be flushed and checked as told by your health care provider, usually every few weeks.
  • A chest X-ray will be done to:
    • Check the placement of the port.
    • Make sure there is no injury to your lung.

Summary

  • Implanted port insertion is a procedure to put in a port and catheter.
  • The implanted port is used as a long-term IV access.
  • The port will need to be flushed and checked as told by your health care provider, usually every few weeks.
  • Keep your manufacturer’s information card with you at all times.

Care After Implanted Port Insertion

Here is the information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

  • Discomfort at the port insertion site.
  • Bruising on the skin over the port. This should improve over 3–4 days.

Follow these instructions at home:

Port care

  • After your port is placed, you will get a manufacturer’s information card. The card has information about your port. Keep this card with you at all times.
  • Take care of the port as told by your health care provider. Ask your health care provider if you or a family member can get training for taking care of the port at home. A home health care nurse may also take care of the port.
  • Make sure to remember what type of port you have.

Incision care

  • Follow instructions from your health care provider about how to take care of your port insertion site. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
  • Check your port insertion site every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.

General instructions

  • Do not take baths, swim, or use a hot tub until your health care provider approves.
  • Do not lift anything that is heavier than 10 lb (4.5 kg) for a week, or as told by your health care provider.
  • Ask your health care provider when it is okay to:
    • Return to work or school.
    • Resume usual physical activities or sports.
  • Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Wear a medical alert bracelet in case of an emergency. This will tell any health care providers that you have a port.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You cannot flush your port with saline as directed, or you cannot draw blood from the port.
  • You have a fever or chills.
  • You have more redness, swelling, or pain around your port insertion site.
  • You have more fluid or blood coming from your port insertion site.
  • Your port insertion site feels warm to the touch.
  • You have pus or a bad smell coming from the port insertion site.

Get help right away if:

  • You have chest pain or shortness of breath.
  • You have bleeding from your port that you cannot control.

Summary

  • Take care of the port as told by your health care provider.
  • Change your dressing as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider.

Implanted Port Home Guide

An implanted port is a device that is placed under the skin. It is usually placed in the chest. The device can be used to give IV medicine, to take blood, or for dialysis. You may have an implanted port if:

  • You need IV medicine that would be irritating to the small veins in your hands or arms.
  • You need IV medicines, such as antibiotics, for a long period of time.
  • You need IV nutrition for a long period of time.
  • You need dialysis.

Having a port means that your health care provider will not need to use the veins in your arms for these procedures. You may have fewer limitations when using a port than you would if you used other types of long-term IVs, and you will likely be able to return to normal activities after your incision heals.

An implanted port has two main parts:

  • Reservoir. The reservoir is the part where a needle is inserted to give medicines or draw blood. The reservoir is round. After it is placed, it appears as a small, raised area under your skin.
  • Catheter. The catheter is a thin, flexible tube that connects the reservoir to a vein. Medicine that is inserted into the reservoir goes into the catheter and then into the vein.

How is my port accessed?

To access your port:

  • A numbing cream may be placed on the skin over the port site.
  • Your health care provider will put on a mask and sterile gloves.
  • The skin over your port will be cleaned carefully with a germ-killing soap and allowed to dry.
  • Your health care provider will gently pinch the port and insert a needle into it.
  • Your health care provider will check for a blood return to make sure the port is in the vein and is not clogged.
  • If your port needs to remain accessed to get medicine continuously (constant infusion), your health care provider will place a clear bandage (dressing) over the needle site. The dressing and needle will need to be changed every week, or as told by your health care provider.

What is flushing?

Flushing helps keep the port from getting clogged. Follow instructions from your health care provider about how and when to flush the port. Ports are usually flushed with saline solution or a medicine called heparin. The need for flushing will depend on how the port is used:

  • If the port is only used from time to time to give medicines or draw blood, the port may need to be flushed:
    • Before and after medicines have been given.
    • Before and after blood has been drawn.
    • As part of routine maintenance. Flushing may be recommended every 4–6 weeks.
  • If a constant infusion is running, the port may not need to be flushed.
  • Throw away any syringes in a disposal container that is meant for sharp items (sharps container). You can buy a sharps container from a pharmacy, or you can make one by using an empty hard plastic bottle with a cover.

How long will my port stay implanted?

The port can stay in for as long as your health care provider thinks it is needed. When it is time for the port to come out, a surgery will be done to remove it. The surgery will be similar to the procedure that was done to put the port in.

Follow these instructions at home:

  • Flush your port as told by your health care provider.
  • If you need an infusion over several days, follow instructions from your health care provider about how to take care of your port site. Make sure you:
    • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use alcohol-based hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Place any used dressings or infusion bags into a plastic bag. Throw that bag in the trash.
    • Keep the dressing that covers the needle clean and dry. Do not get it wet.
    • Do not use scissors or sharp objects near the tube.
    • Keep the tube clamped, unless it is being used.
  • Check your port site every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Pus or a bad smell.
  • Protect the skin around the port site.
    • Avoid wearing bra straps that rub or irritate the site.
    • Protect the skin around your port from seat belts. Place a soft pad over your chest if needed.
  • Bathe or shower as told by your health care provider. The site may get wet as long as you are not actively receiving an infusion.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Carry a medical alert card or wear a medical alert bracelet at all times. This will let health care providers know that you have an implanted port in case of an emergency.

Get help right away if:

  • You have redness, swelling, or pain at the port site.
  • You have fluid or blood coming from your port site.
  • You have pus or a bad smell coming from the port site.
  • You have a fever.

Summary

  • Implanted ports are usually placed in the chest for long-term IV access.
  • Follow instructions from your health care provider about flushing the port and changing bandages (dressings).
  • Take care of the area around your port by avoiding clothing that puts pressure on the area, and by watching for signs of infection.
  • Protect the skin around your port from seat belts. Place a soft pad over your chest if needed.
  • Get help right away if you have a fever or you have redness, swelling, pain, drainage, or a bad smell at the port site.
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