Port-a-Catheters

Why do I need a Port-A-Catheter?

Your doctor and CF care team may decide you would benefit from the use of a port-a-catheter because you require repeated injections of medicine into your blood.  Be sure to speak with your doctor or nurse if you have questions about your port-a-catheter, its use, and caring for it.

What is a port-a-catheter?

A port-a-catheter is a small implanted chamber placed in the subcutaneous tissue (under the skin) usually on the chest wall. It is about the size of a quarter. It is made up of two parts, the port or reservoir and the catheter (tube). The term port-a-catheter is actually a portmanteau (blending) of the words Portal and Catheter. It can appear as a bump in thinner patients, or not at all in those with thicker subcutaneous tissue.

There are several types of port-a-catheters:

-          Single

-          Double

-          Powerport (SL and DL)

How does a port-a-catheter allow medications to be administered to my bloodstream?

Your port-a-catheter device has one or two small reservoirs that are sealed with a soft silicone top, called a septum. The reservoir connects to a tube (a catheter) which is placed inside one of the large central veins that take blood to your heart. Once in place, your port device gives your care team "access" and medicine and fluids can be given through the needle.

Here is a diagram of what an implanted port-a-cath looks like. As you can see, it is supplying medicine directly into your bloodstream. 

Port A Catheter Image

Caring for your port

After your port is placed, your doctor will cover the site with a small bandage. For several days, avoid heavy exertion and follow instructions from your doctor and CF care team. Once the wound is healed, you can resume normal activities.

Identifying that you have a port-a-catheter

Most manufacturers of port-a-catheters provide patients with identification cards and/or bracelets. It is recommended that you wear these bracelets and keep the ID cards on your person. This helps healthcare workers become aware of the fact that you have a port-a-catheter inserted, and know which specific device you are using. It will be noted on your medical chart that you have a port-a-catheter inserted, so that the rest of the CF team is aware.

Accessing your port-a-catheter

Your CF nurse will use the port when they need to give you medications or fluids or if it becomes necessary  to withdraw blood samples.

They will be using a special needle called a Huber needle - needle which will not cause damage to the silicone septum, and inserting this into the port. You may feel a mild prickling when this occurs. Speak to your doctor or nurse about what to expect.

What should I know about having a port-a-catheter inserted?

There are benefits and risks associated with any medical device. Below are some risks and benefits of port-a-catheters: Be sure to discuss with your doctor and CF team any concerns you may have regarding your care.

Benefits

-          Long term access - can be years
-          Aesthetics/patient body image: port-a-catheters are entirely internal, meaning swimming and bathing are less of a problem for patients
-          Central line for giving medications and blood drawing should it be necessary
-          Can administer continuous IV medications or intermittent medications and other therapies such as lipid infusions.

Risks/Complications

-          Infiltration due to improper insertion or dislodgement of needle (needle essentially  slipping out of the correct position if tubing attached to needle is inadvertently tugged  on.
-          Occlusion (blocking) issues if not properly flushed or too frequently used for blood sampling
-         Skin breakdown - this is rare
-          Infection
-          Thrombus formation
-          Catheter fracture or migration

A note about heparin:

Sometimes blood in your catheter can clot and cause a blockage. This can prevent medicines from flowing through it. A medication called heparin (known as a blood thinner) can prevent your blood from clotting. Heparin is mixed with saline and is instilled into ports with open-ended catheters. This process is called a heparin lock. If your port will not be used for a long period of time, your nurse will  change the heparin lock solution every four weeks.

If you are allergic to heparin or have heparin induced thrombocytopenia (HIT), be sure to talk to your doctor about this.

Special Concerns regarding port-a-catheters

-          It is possible that security alarms may detect a small amount of metal in your device. If this does occur, show your device patient identification card.
-          You may need to avoid certain types of clothing depending on where your port site is. Speak to your CF care team for more information.
-          The length of time for your port to be in place varies considerably from person to person. Your doctor will let you know when they think you no longer need the device. At that time, it can be removed in a similar fashion to how it was inserted.
-          You can get a CT (computerized tomography, a medical imaging test) and an MRI under certain conditions (magnetic resonance imaging, a medical imaging test) while you have a port-a-catheter inserted. Your doctor and CF team will know more about this.

If you experience unusual changes including swelling, redness, soreness, pain, fever, chills, shortness of breath, or dizziness, contact your CF doctor right away.

Reference: Resource adapted from Bard PowerPort Patient Guide (2009).