Port-a-cath for chemotherapy

Port-a-cath or implantable port is a device that is placed under the skin, usually on the right side of the chest.

Port-a-cath or implantable port is a device that is placed under the skin, usually on the right side of the chest. A 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 catheter, a small flexible tube. There are different types of ports. This port is used to draw blood or fluids and give treatments, including drugs, intravenous fluids, blood transfusions, or chemotherapy drugs. This device may be kept in place for weeks or months.

What is the need of port-a-cath?

The implanted port may be used as a long-term IV access for:

  • Medicines, such as chemotherapy drugs
  • Fluids
  • Liquid nutrition, such as total parenteral nutrition (TPN)
  • Blood samples

A port avoids the need to use the veins in your arms for these procedures.

What are the risks?

Implanted port insertion is generally a safe procedure. However, some problems may occur during the procedure:

  • Damage to the blood vessel, bruising or bleeding at the puncture site
  • 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.
  • Allergic reactions to medicines or dyes
  • Damage to other structures or organs
  • Blood clot formation
  • Infection

What happens before the procedure?

When planning the procedure, inform your health care provider about:

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

Preparations for the procedure:

1. Staying hydrated:

Your healthcare provider will give you some guidelines to stay hydrated for the procedure, which may include:

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

2. Eating and drinking restrictions:

Follow the instructions given by your healthcare provider about eating and drinking:

  • 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

3. Medicines

Ask your health care provider about:

  • Changing or stopping your regular medicines, especially diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen, as these can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Taking any antibiotic medicine to help prevent infection.

General instructions:

  • You may undergo blood tests to evaluate your kidney and liver function.
  • You may be asked to shower with a germ-killing soap.
  • Ensure you 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.

What happens during the procedure?

Before heading to the procedure, to lower the risk of infection, your healthcare team will:

  • Wash or sanitize their hands
  • Wash your skin with soap
  • Remove hair from the surgical area
  • Insert an IV tube 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 anaesthetic)

Once the anaesthesia sets in, the procedure may be performed in the following steps:

  • 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, where the port will lie.
  • Continuous X-ray (fluoroscopy) or other imaging tools may be used to guide the catheter.
  • The port and catheter will be placed. There may be a small, raised area where the port is placed.
  • 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 healthcare 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.

A chest X-ray will be done to:

  • Check the placement of the port.
  • Make sure there is no injury to your lung.

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 healthcare provider, usually every few weeks.

 



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Copyright © 2019, Dr. Raghu. All rights reserved.
Designed & Developed by Deepak Kambhampati.