Maintenance and Care
Maintenance
of a patient with a port includes:
·
Assessment of portal integrity:
o
Inspect the portal site
for swelling, redness or drainage
o
Inspect the portal site
for swelling or leakage at the portal site before, during and after flushing
o
Ask the patient about
any experiences of symptoms that might suggest a potential complication such as
pain or burning.
o
When flushing the line,
determine the quality of patency and blood return. Determine possible causes
for a one-way or two-way effect.
·
Flushing the port to maintain
patency:
o
Prep injection cap well
prior to proceeding
o
Use positive pressure
technique. Click here to review this skill.
o
Before and after any
infusion/medication.
o
Every 30 days if the
port has not been needle accessed.
o
Use a syringe with a
barrel-size no smaller than 10mL
o
Use flushing as a means
of assessing portal integrity.
·
Changing the non-coring needle:
o
Change and re-access
the port with a new needle every 7 days
·
Accessing the port:
o
Follow infection
control guidelines to prevent local and systemic infection while accessing the
port
o
Access the port every
30 days when not in use.
o
Use SASH procedure to
flush the port. NOTE: Instill heparin ONLY if the catheter will not be in use
·
Emptying the reservoir:
o
Empty the reservoir if
the port has not been needle accessed or used for 14 days or greater. CLICK HERE
for information on how to empty the reservoir.
·
Heparin:
o
Use 3mL of 100 units
Heparin solution (pre-filled syringes are available) to flush the port
o
Always instill heparin
before removing the non-coring needle
o
If the portal is
accessed, use heparin for prolonged periods of time when no solutions will be
infusing as per hospital policy.
·
Blood sampling:
o
Best time to take a
blood sample is when the port is initially accessed
o
Discard at least the
first 5mL of solution from the port
o
Vacutaners are
permissible
o
Always use 20mL (2
pre-filled 10mL saline syringes) of normal saline following blood sampling.
o
Avoid daily routine
blood-drawing unless necessary to avoid potential exposure to catheter-related
blood stream infection
·
Dual Ports:
o
Some have a ridge
between the two septums to assist the clinician in locating a site for needle
insertion
o
Scheduled accessing and
flushing is the same as with a single lumen port
o
If two needles are used
at the same time, place both needles parallel to one another in the same
direction to reduce a bulky dressing.
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