A port-a-cath (often simply called a “port”) is a small device that delivers intravenous medications. It is usually placed under the skin in the upper chest above the heart. Ports are central venous access devices (CVADs), which make it easier for patients to receive the infusions needed to maintain their health.
The biggest advantage of ports is that they help take the guesswork out of locating hard-to-find veins. Ports mean fewer trips to the hospital and life made easier for patients and their families. They can be used for several years and require no dressings when not in use or external lines. However, the area around the port must always be kept clean to avoid infections.
Types of ports.
- Internal CVADs are surgically implanted under the skin, usually above the heart. They can be used for several years and require no dressings or external lines.
- Nontunneled (external) central venous catheters are inserted into a vein near the heart, usually through the chest, for short-term use. Factor product is injected into a cap at the end of the tube located on the arm or chest. Dressings over the cap are needed to avoid infection and must be changed often.
- Tunneled central venous catheters (brand names are Hickman® and Broviac® catheters) are surgically implanted under the skin and inserted into a vein in the neck or chest. Infusions are done through the part of the catheter that is outside the body. This type of catheter can stay implanted for a year or more.
- Peripherally inserted central catheters (PICCs) are inserted into a vein in the arm and connected to a large blood vessel in the chest. Infusions are done through the part of the catheter that is outside the body. The devices are cost-effective and easy to install, but can only be used for several weeks or months.
Sports with ports?
Does having a port installed mean you have to limit activities? Not necessarily. The only sports that are off limits with ports are the same contact sports that should be avoided by all hemophilia patients. Playing football or hockey increases your risk for bruising and bleeding. Talk to your primary health care provider about the best sports and activities for you. If you have a child with a port who plans to participate in sports, it is a good idea to notify your child’s teachers and school nurse.
If your port is bumped, a bruise may develop in the area. Do not access your port when a bruise is present, because it may lead to infection. It is not common to have mechanical problems from an injury, but it is possible. If there is no blood return when you access your port after an injury, call your health care provider immediately.
Caring for your port at home.
Ports work very well for most, but it’s important to remember that a port is a temporary solution and that it requires some care, maintenance, and monitoring.
Keep it covered.
Always keep the area where the needle enters the skin covered and taped securely to the skin. Change the dressing every seven days, or right away if you notice it is dirty, wet or loose. A loose bandage can be as bad as no bandage at all, and a dirty or wet bandage can increase your risk of infection.
Keep it clean.
Always wash your hands before and after contact with the port or supplies. Wear gloves as instructed. Keeping the area clean helps limit the risk of infection. Call your doctor right away if you have a fever higher than 100.5 or if the skin around the port becomes red or painful.
Keep it closed.
When the port is accessed, intravenous (IV) tubing is connected to the port with clamps. Always keep clamps closed when not in use to avoid potential blood clots. Caps allow you to access the port and give IV medications. Always scrub the cap with alcohol as instructed before each use. Caps should be changed every seven days or as instructed by your health care team.
Keep it sterile.
Sterile gloves should always be used when caring for your port. When you receive a dressing change kit, everything inside is sterile. Do not open any packages until you are ready to change the bandage. Make sure you have a clean work surface (wipe it down with soap and water or alcohol). Remember, sterile things can touch each other, but if something sterile touches something that is not sterile, it is no longer sterile and can’t be used. Your nurse or health care professional will show you how to keep your supplies sterile.