From the Guidelines
To assess and manage a newly placed port, first verify the port's placement through chest X-ray confirmation and check for any immediate complications such as pneumothorax, hemothorax, or catheter malposition, as recommended by 1 and 1. The steps to assess port placement include:
- Verifying the port's placement through chest X-ray confirmation or alternative methods such as intracavitary ECG, as suggested by 1
- Checking for any immediate complications such as pneumothorax, hemothorax, or catheter malposition
- Inspecting the insertion site for signs of infection (redness, swelling, drainage, or tenderness) and ensuring proper healing
- Maintaining sterile technique when accessing the port, using chlorhexidine solutions with alcohol, as recommended by 1 and 1 The management of the port includes:
- Flushing the port with 10-20 mL of normal saline to confirm patency, followed by a saline lock, as recommended by 1
- Using a non-coring (Huber) needle of appropriate length after cleaning the site with 2% chlorhexidine in 70% alcohol
- Educating the patient about port care, including recognizing complications like infection, occlusion, or extravasation
- Regular maintenance includes replacing port needles at least once per week, as suggested by 1 and 1, and flushing the port with saline solution when not in active use It is essential to document all assessments, interventions, and patient education in the medical record to ensure proper port management and prevent complications, as ports provide reliable vascular access for medications, fluids, blood products, and blood sampling while reducing the need for repeated venipunctures.
From the Research
Steps to Assess Port Placement
- Review patient's medical history and current condition to determine the need for port placement
- Use ultrasound guidance to place the port via the right internal jugular vein, as described in 2
- Calculate the length of the catheter based on the patient's height to ensure correct placement
- Perform intraoperative fluoroscopy to confirm the correct position of the catheter, as recommended in 2
- Check for any complications, such as catheter malposition or pneumothorax, and address them promptly
Post-Placement Assessment
- Monitor the patient for any signs of complications, such as bleeding, infection, or catheter malfunction
- Use imaging studies, such as chest X-ray, to confirm the correct placement of the port, although this may not be necessary in all cases, as suggested in 2
- Review laboratory results, including complete blood counts, to ensure the patient's condition is stable, as discussed in 3, 4, and 5
- Consider the utility of routine complete blood counts, liver function tests, and chest X-rays in the evaluation of patients, as evaluated in 5 and 6
Management of the Port
- Ensure proper care and maintenance of the port to prevent complications, such as infection or catheter occlusion
- Use the port for administering medications, fluids, or nutrients, as needed
- Monitor the patient's condition and adjust the treatment plan accordingly, taking into account the results of laboratory tests and imaging studies, as discussed in 3, 4, 5, and 6