What is the proper maintenance and care for an Infusa (intrauterine infusion) port?

Proper Maintenance and Care for Infusa Ports

The proper maintenance of an implantable venous access port (Infusa port) requires strict adherence to aseptic technique, regular flushing with normal saline every four weeks when not in active use, and cleaning injection ports with 70% alcohol or an iodophor before accessing the system. 1, 2

Access and Cleaning Protocols

• Always clean the injection port with 70% alcohol or an iodophor before accessing the system to minimize contamination risk 1
• Access the port only with sterile devices using strict aseptic technique to prevent infection 1
• Insertion and maintenance should be performed by designated trained personnel to reduce complication risks 1
• Chlorhexidine solutions with alcohol should be used for skin preparation before accessing the port 1

Flushing Protocols

• For subcutaneous ports not in active use, perform a flush every four weeks with normal saline to maintain patency 1, 2
• Use a 10mL or larger syringe with a turbulent push-pause method for flushing to prevent catheter damage 3, 2
• Avoid using syringes smaller than 5mL as they generate higher pressure that could damage the catheter 2
• After completion of any infusion or blood sampling, flush with normal saline to maintain patency 1

Administration Set Maintenance

• Replace administration sets, including secondary sets and add-on devices, no more frequently than every 72 hours, unless catheter-related infection is suspected 1
• Replace tubing used to administer blood products or lipid emulsions within 24 hours of initiating the infusion 1
• Change needleless components at least as frequently as the administration set 1
• Change caps no more frequently than every 72 hours or according to manufacturer's recommendations 1

Infusion Completion Guidelines

• Complete infusions of lipid-containing solutions within 24 hours of hanging the solution 1
• Complete infusions of blood or other blood products within 4 hours of hanging the blood 1
• Ensure all components of the system are compatible to minimize leaks and breaks 1

Troubleshooting Blockages

• If resistance is encountered during access, check for external causes such as kinks in the catheter 2
• When blockage occurs, attempt to aspirate blood and any locking solution from the lumen 2
• If resistance persists, try a gentle back-and-forth motion to promote catheter patency, followed by flushing with 10mL of normal saline using a turbulent flushing technique 2
• Apply gentle pressure during flushing but avoid excessive force that could rupture the catheter 2

Complication Prevention

• Monitor for signs of infection including fever, erythema, or tenderness at the insertion site 4, 5
• Be vigilant for signs of catheter occlusion, which may require intervention with thrombolytic agents 6, 7
• Verify proper catheter tip position through radiographic assessment if complications are suspected 3
• Do not administer antimicrobial prophylaxis routinely before insertion or during use of the port 1

Common Pitfalls to Avoid

• Avoid using the femoral vein for port placement due to increased risk of infection and thrombosis 1
• Never use excessive force when flushing a blocked port as this could rupture the catheter 2
• Do not combine leftover content of single-use vials for later use 1
• Avoid manipulation of the port system unless necessary to reduce infection risk 8