Port (implantable venous access device) factsheet
Introduction
An implantable venous access device, also called a port, is a type of central venous access device (CVAD). It is a soft, flexible tube inserted into a large vein near the heart.
Ports are used to reduce the number of needle pricks during treatment and can help:
- to give certain medications
- support treatment when veins are small or hard to access
- give long-term treatment.
A port can stay in place for up to two years or more, as long as it’s working and still needed for treatment.
About the device
A port has two parts:
- a small injection chamber with a soft top that seals after each use.
- a thin tube or catheter, connected to the chamber and placed in a large vein near the heart.
Inserting the port
Your child’s treatment team will give you information about the procedure and how to prepare.
In hospital, a surgeon places the port while your child is under general anaesthetic. This means your child will be asleep and not feel anything. A local anaesthetic may also be injected around the area to reduce pain.
The surgeon usually makes two small cuts:
- one on the neck to insert the catheter into the vein.
- one on the chest to place the port under the skin.
In older children, only one cut may be needed. The cuts are closed with stitches.
Pain relief may be needed for up to five days after insertion. The area may feel sore for about a week. If your child still has pain after a week, speak to your doctor or nurse.
Care of the device
Accessing the port
To access the port, a special “non-coring” needle is inserted through the skin and into the port to give medications or take blood.
Generally, the steps for accessing the port are:
- a local anaesthetic cream is applied to numb the skin
- the needle is inserted through the skin, into the top of the port
- a clear, waterproof dressing is placed over the top to stop the needle from being accidentally removed.
This needle can stay in for up to seven days.
Needle and port catheter positioning
The needle must be placed correctly so it touches the back of the port chamber. If it moves or becomes blocked, it will need to be replaced.
Sometimes the catheter tip can also move. If blood cannot be drawn or flushed, an X-ray may be needed to check he position.
Looking after the port
Your child should still bathe or shower to keep their skin clean and free of germs.
- in the bath, tape the end of the tube to your child’s chest
- in the shower, cover the dressing and tube with cling wrap and seal it with tape
- your child cannot swim while the port is accessed
- keep the port and catheter away from nappies and sharp objects like scissors.
When to seek help
Bleeding
Some bleeding or oozing can happen around the insertion site in the neck and the exit site on the chest. This usually settles within the first few days after insertion.
Speak to your child’s treatment team if bleeding or oozing continues.
Infection
Infections can happen if germs enter through a cut or opening.
The hospital will ensure everything is clean and sterile, or free of germs, when the port is inserted.
Go to the emergency department if you notice signs of infection, including:
- redness
- pain
- heat
- swelling
- fever over 38°C.
Infections are treated with antibiotics. Severe infection can also mean the port needs to be removed or replaced.
Blockage
Ports can become blocked if blood or medicine gets stuck. Regular flushing helps prevent this.
Some blockages can be treated with medication, but the port may need to be removed if it can’t be cleared.
Air bubbles
Leaks or breaks in the needle equipment or tubing may let air in. Check the port regularly.
If you notice this, clamp the line immediately and contact your care team.
Blood clots
Clots can form around the catheter in the vein. They usually don’t cause harm and can be treated with medication. If clots are large or spreading, the port may need to be removed.
Management
Removing the port
The port is removed when it’s no longer needed or if it stops working. Removal is done under general anaesthetic by a surgeon.
Flushing and locking
Flushing is when a normal salt water or saline solution is pushed into the port by a syringe. This helps to stop it from becoming blocked and is done after medication has been given or blood has been taken.
Locking is when an anti-blood clotting and antibacterial solution is left in the catheter if it’s not used for a few days. This helps prevent infection and blockages. It should be done monthly when the port is not in use.
Rare but serious complications
Serious but rare complications can include:
- severe infection
- damage to the walls of the blood vessels or heart
- cardiac tamponade - fluid or blood collecting around the heart
- a haemothorax - fluid or blood collecting in the chest
- pneumothorax – damage to the lung during insertion.
Your child may need emergency surgery to treat serious complications.
This could include:
- draining out any blood or fluid around the heart and in the chest
- placement of a second tube or drain into the chest cavity to drain out any air
- repairing any damage.
Ask your child’s doctor if you have any questions.
Your childs activities
Your child can return to daycare or school once the port is in, and the dressings have stayed dry for at least 7 days after insertion.
Your child can swim only when the port is not accessed. If a needle is in place, do not let them swim or get bath or shower water on the port.
Showers or sitting in a bath are okay as long as the port is covered with a taped plastic bag to stop it getting wet.
Speak to your child’s treatment team for advice on returning to activities like contact sports.
Resources and more information
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