How to Access a Central Venous Port

A central venous port is often placed into patients who anticipate needing repeated doses of large amounts of medications. People who receive chemotherapy and other types of long term or frequent therapy are better served by a central venous port than by repeated attachment of tradition IV's. Training and practice are needed to do an adequate job of accessing these ports when it is needed. The process is not lengthy, but extreme care must be taken to maintain a sterile field to avoid any possible contamination of the port.

Determine the patient's ability to stand pain.

While accessing a central venous port is not extremely painful, it can produce a little pain. Until the port has been accessed several times, the pain may be a little more intense. If pain is a problem, use an anesthetic cream to reduce the sensitivity of the area around the port. This should be applied about one hour before the port is accessed and covered with a dressing. Before accessing the port, remove all of the cream and cleanse the area.

Use a non-coring Huber needle for port access.

This needle has a 90 degree turn and comes in various gauges and lengths. When no specific size is indicated, use a 22 gauge 1 'Æ'''½ inch needle. If when the port is accessed, there is more than 'Æ'''¼ inch between the turn in the needle and the skin, use a shorter needle on the next access of the port.

You and the patient should both wear masks.

Keeping the area sterile is paramount. Wear sterile gloves and establish a sterile field near the port to rest the supplies needed to access the port. Place disinfectant, dressing, a needleless valve, an empty 10 cc syringe, and the Huber needle on the sterile field. You will also need three 10 cc syringes filled with normal saline solution for priming the needle and flushing the port.

Attach a 10cc syringe filled with normal saline to Huber tubing and prime the needle.

Next, you will need to clamp Huber needle connecting tubing and remove syringe while maintaining the sterile field. Put on a new pair of sterile gloves. Attach the empty 10cc syringe to the Huber connecting tubing. Cleanse the area around the port with disinfectant to prepare it for the needle insertion.

Grasp the port to stabilize it while piercing it at a 90 degree angle to the skin with the Huber needle.

Push the needle in until it touches the bottom of the port reservoir. Aspirate to check for a blood return. Attach the needleless valve to the end of the Huber tubing. Flush the port with 20cc of normal saline solution. Once the port has been flushed, you can attach the IV to the Huber tubing.

Reference:

http://safercare.s3.amazonaws.com/support_media/docs/clabsi/VAD_APPX/Appendix_L-Accessing_Deaccessing_Implanted_Central_Venous_Access_Port.pdf