An implanted port, usually referred to simply as a port is often placed in patients requiring long-term IV treatment cancer patients receiving chemotherapy come to mind as they receive multiple rounds of chemo over an extended time period. A nurse certified in port access can access the port with a Huber needle for other types of IV medications and fluids. Cancer patients may be hospitalised for conditions unrelated to their cancer diagnosis; the port allows IV access with only one needle stick. A port may also be used to draw blood for lab work. Patients with ports typically have very poor veins and accessing them is almost impossible.
- Skill level:
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Things you need
- Huber needle
- 10cc syringes pre-filled with normal saline
- extra normal saline
- central line dressing kit
- small transparent dressing
- sterile gloves
Before beginning, wash your hands. Since the port is in a major blood vessel, aseptic technique minimises the risk of infection. Placing the Huber needle is a sterile procedure. Wear a mask while performing this procedure. Don sterile gloves and open central line kit, using the inside as a sterile field.
Open Huber needle packaging and place needle in sterile field, being careful not to touch any non-sterile surface with any part of needle. Attach a 10cc syringe of normal saline to end of tubing attached to needle. Flush until tubing is primed with saline.
Palpate the implanted port for the centre of the port. The insertion site feels spongy. After identifying insertion site, don sterile gloves. Clean the insertion site with chlorahexidine swab or as per your facility's protocol. Begin at the centre, working outward. Allow the site to dry thoroughly.
Remove needle guard from Huber needle. Place two fingers on either side of port site with non-dominant hand to stabilise skin around port. Holding the needle with the other hand, grasp the flexible "wings" using the thumb and middle finger. Firmly insert the needle at a 90 degree angle until you feel the end of the needle hit the back of the port.
Carefully release the needle, warning the patient to lie still as needle is not secure. Attach a 10cc syringe of normal saline to end of tubing. Pull back and aspirate to confirm blood return. Flush tubing using all of normal saline syringe. Secure the needle per your facility's policy. Some facilities may not allow tape to be used. Cover site with transparent dressing, ensuring that entire site is covered.
Mark dressing with date, time, and your initials in designated area on dressing. Clamp tubing if no infusion or medications are to be given; otherwise, attach IV tubing and begin infusion. Clear away trash, disposing of syringes and any sharps in approved sharps container. Wash your hands and document the port access in the patient's chart. Monitor the site and flush per your facility's guidelines.
Tips and warnings
- Beginners may find it easier to have someone help them the first few times they access a port. This person should be experienced in port accessing and troubleshooting, and should be able to take over the procedure if needed.
- Only nurses certified in accessing implanted ports should attempt to access a port. Do not allow any part of the needle or tubing to become contaminated, strict aseptic technique must be used to prevent potentially fatal infections. Document placement of access and check regularly for patency. Follow your facility's guidelines on flushing port and dressing changes.
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