Vascular Access Port Usage and Maintenance
A vascular access port consists of an implantable catheter linked to a reservoir. The device is placed subcutaneously and can be used over a long time period for many types of infusions.
Vascular access ports have considerably facilitated the development and security of general ambulatory treatment, especially in home care. They have also largely improved patient comfort.
Usage
It is of primary importance that the nursing staff takes care for hygiene precautions and follows the port usage process according to local protocols. It is a complex process and consists of 9 individual steps to follow:
- Preparation of the medical staff (hygiene measures)
- Preparation of the access site (inspection, disinfection and preparing needles and dressing component)
- Preparation of the port needle (rinsing and heparinization)
- Puncturing the port (careful needle insertion)
- Confirm the patency (aspiration of blood followed by injection of saline)
- Needle fixation (fixation with transparent / non-transparent dressing)
- Start the infusion (careful observation is required)
- End of treatment (rinsing of port with saline)
- Removal of the needle (end of process)
Hygiene Precautions
Rigorous aseptic rules must be followed, according to the given protocol of the hospital based on national and/or international guidelines to prevent infection of the access port.
To avoid any contamination of the injection site, it is important to ensure that the patient’s head remains turned away from the site during the procedure and refection of the dressing.
Maintenance
Rinsing and heparinisation
Always verify that the access port and catheter are functional by aspirating blood into the syringe and injecting 10 mL (or 5 mL for children) of saline solution (NaCl) 0,9 % into the access port/catheter before starting the infusion.
As part of port maintenance, rinsing is required before starting a treatment, after each treatment, before changing the infusion solution and every four weeks when the system is not in use. This applies regardless of whether it is a venous catheter, an arterial catheter, an epidural/intrathecal catheter or a pleural catheter.
Flushing with heparinised saline solution (NaCI) 0.9 % can follow if required by local protocol. When heparinised saline solution (NaCI) 0.9 % is used, the system should be rinsed with 10 mL of saline solution (NaCI) 0.9 % alone before rinsing with heparinised saline (NaCl) 0.9 %. Some drugs react with heparin and may result in blockage of the access port/catheter due to formation of precipitates.
Removal of the needle
To avoid blood inside in the catheter, the port is flushed with normal saline solution (NaCI) 0.9 %. There is no specific recommendation regarding the removal technique of the needle.
The use of positive pressure or not, upon withdrawal of the needle, does not prevent blood diffusion into the lumen of the catheter over time. More important is to rinse the port and catheter as recommended in the Celsite® IFU’s, before, in between and after each infusion.
More information about the port maintenance can be found in our brochure below.
