Important Safety Information

What You Should Know About Vascular Access Devices
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What is a vascular access device?

A vascular access device (VAD) provides access to your veins for the delivery of I.V. medications and chemotherapy. A peripheral I.V. (PIV) is common type of VAD appropriate for short–term use. A PIV is typically placed in the lower part of the arm or hand where smaller veins are located. PIV use may often require multiple needle sticks for treatment and blood draws4 and has the potential to cause collapsed veins, bruising, and painful restarts.5 In fact, one study has shown that more than 50% of patients receiving chemotherapy have problems with I.V. needle starts and the drawing of peripheral blood work.2

Other types of VADs require minor surgery and can stay in the body for an extended period of time, which help to reduce the need for frequent searches for veins.5 They can be used to administer I.V. medications or chemotherapy, obtain blood samples, or deliver supplemental therapy to the blood stream.5

They include:

  • Peripherally Inserted Central Catheters (PICCs) - A PICC is an external device that is usually placed in the upper arm.
    This is a photo of a Peripherally Inserted Central Catheter.
  • Tunneled Central Venous Catheters (Chronic CVCs) - A chronic CVC is an external device that is usually placed in the chest.
    This is a photo of a Tunneled Central Venous Catheter
  • Implanted Ports - An implanted device that is placed underneath the skin usually in the chest.
    This is a photo of an Implanted Port.
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What is a port?
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An implanted port (or port) is a small vascular access device - about the size of a quarter in diameter - with a hollow space inside that is sealed by a soft top. It is used to carry medications into the bloodstream and is placed in patients who need intermittent to long-term I.V. therapy. The implanted port is connected to a small flexible tube called a catheter. A special needle is put in the soft top of the port so that medications and fluids can be given and blood samples withdrawn. In a minor surgical procedure, the port is implanted, which means it is placed completely beneath the skin, and the catheter is inserted inside a blood vessel.

An implanted port allows the doctor or nurse to deliver medications and fluids or withdraw blood samples without having to stick your arm veins directly with a needle. The implanted port allows the medications to be delivered directly into your heart to dilute and deliver the medication more quickly than if the medication was given in the veins in your arms or hands. An infusion or oncology nurse will use a special needle to deliver medication or take blood, and they may use an anesthetic cream to numb the skin to eliminate discomfort. The port may help to make these procedures more comfortable for you, especially if your treatment requires frequent access to the bloodstream for medication delivery or blood withdrawal. Some ports can also be used for CECT or CT scans. 6

Why would I consider a port?
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If you are receiving a treatment such as chemotherapy, it may involve frequent injections or infusions of medication and other fluids directly into the bloodstream. The treatment may also require that blood samples be withdrawn. An implanted port may help to decrease the discomfort of these procedures.

Frequent needle sticks and certain medication can damage the peripheral veins in your arm or hand, making access more difficult over time. 4 An implanted port gives you a choice and can help to protect against these risks.

Why would I not consider a port?
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You should not consider a port if you:

  • Have or are suspected of having an infection
  • Have a history of forming blood clots
  • Have a body size that will not allow for proper port placement or port access
  • Have had the port insertion site exposed to radiation
  • Are not emotionally prepared to have an implanted medical device

A port is not for everyone. Talk to your physician or nurse about these and other risks, and whether a port or other treatments are right for you. For important safety information, please click here.

What are the advantages to having a port?
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Implanted ports have certain advantages over other devices to deliver chemotherapy3:

  • Lifestyle. Implanted ports, compared to other centrally-placed vascular access devices, are more likely to permit you to go about your normal day-to-day activities, like showering, swimming, jogging, and playing with your children. Ask your doctor or nurse about specific activities and the appropriate time to resume them.
  • Comfort. Once placed, a port can remain for as long your doctor determines you need it. While the port itself will still need to be accessed with a special needle, there will be a decreased need for the sometimes painful poking and prodding to find a peripheral vein in the arms or hands with an I.V. every time you receive chemotherapy or have your blood drawn.
  • Increased Privacy and Appearance. Implanted ports are small and can be hidden from view. With an implanted port, there is no exposed device and, because ports are typically placed in the chest, there's no potential for bruised arms. No one needs to know about your treatment unless you want them to.
  • Long-term Health. Since ports are typically placed in the chest, port usage can reduce the likelihood of damage to the peripheral veins in your arm or hand. This may benefit a patient who needs blood work or I.V.s down the road.
What are some of the risks associated with a port?
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A port is not for everyone - especially patients with a history of forming blood clots, who have had previous vascular access surgery, or who are not emotionally prepared to have an implanted medical device. Like any vascular access procedure, there is always a risk of complications, including venous blood clots, skin erosion, infection, a collapsed lung, or clotting of the port catheter. Talk to your physician or nurse about these and other risks, and whether a port or other treatments are right for you. For important safety information, please click here.

Types of Ports
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There are many different types of ports. Your doctor or nurse will choose one that best meets your needs based on the types of treatments and tests you will undergo.

  • Single lumen ports have one entrance for medications. Single lumen ports come in different sizes and profiles to help fit different patient sizes.
  • This is one example of a single lumen port body.
  • Double lumen ports have two entrances for medication, and are used if you need to have more than one type of infusion at the same time. This is one example of a double lumen port.
  • This is one example of a double lumen port.
  • Power injectable ports offer the ability to provide access for power–injected Contrast Enhanced Computer Tomography (CECT) or CT scans. CT scans produce quick, accurate images of your body to help the medical team better manage your care.7 Not all ports are used or indicated for power injection of contrast media. Power injectable ports are available in both a single lumen port configuration, and a double lumen port configuration.
  • This is one example of a power injectable port.
Who decides if I should have a port? When?
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You can along with your doctor or nurse! Talk to your doctor or nurse to see if a port may be appropriate for you. Once your course of treatment has been decided, your doctor or nurse will review with you the advantages and disadvantages of using a port as opposed to I.V. needles or central venous catheter.

VFL Implanted Ports - a guide to the course of treatment wall chart pdf - patient tool available for download - showing the different steps to determine if a port is right for you or if you should receive a port: first learning about the advantages and disadvantages; the prescribing of a port; the application for insurance reimbursement; insertion; and ongoing maintenance.

You can impact the way you fight cancer
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A randomly selected, blinded survey of U.S. oncology nurses conducted by Bard Access Systems, Inc., has shown that:

  • An estimated 27% of patients receive chemotherapy via peripheral I.V. in the arm or hand.1
  • 59% of patients who receive chemotherapy through a peripheral I.V. are unable to complete their therapy via peripheral I.V. 1
  • More than half of all patients who begin chemotherapy via peripheral I.V. eventually need a vascular access device in order to complete their chemotherapy. 1

Talk to your doctor or nurse to determine if a port is right for you—the decision to use a port or other vascular access device is between you and your healthcare provider.

A port is not for everyone - especially patients with a history of forming blood clots, who have had previous vascular access surgery, or who are not emotionally prepared to have an implanted medical device. Like any vascular access procedure, there is always a risk of complications, including venous blood clots, skin erosion, infection, a collapsed lung, or clotting of the port catheter. Talk to your physician or nurse about these and other risks, and whether a port or other treatments are right for you. For important safety information, please click here.

How is the port inserted and where is it placed?
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Typically, your port is placed during a minor surgical procedure that does not usually require general anesthesia or hospitalization.6 Your port is placed just beneath your skin, with the end of the catheter placed into a large vein with the catheter tip placed near the heart.6

Frequently the port is placed on the upper chest in an area just below the collarbone.6 Talk to your doctor or nurse about placing your port in a spot that's best for you. It's important that the physician inserting your port is aware of your daily activities and clothing preferences so that your port can be placed out of view.

How does the port work in my body?
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Your port is designed to deliver medications and chemotherapy through a large vein directly into your heart. This allows the medication to be diluted more quickly than if your medication was given in the peripheral veins in your arms or hands. Also, by delivering chemotherapy directly into your heart, the chemotherapy does not break down or deteriorate the peripheral veins in your arms or hands. This may benefit a patient who needs blood work or I.V.s at a later time.

Once your port is placed under your skin, it's ready to deliver medication into the bloodstream. A special needle is placed through the septum (flexible cover) of your port, which connects to a catheter. The catheter is placed into a large vein, with the catheter tip placed near the heart. Most patients feel a mild pricking sensation during needle insertion.6 An anesthetic cream can be used to numb your skin to reduce discomfort. Your port can deliver medication in two ways. The first way, called bolus injection, delivers the medication all at once with the needle left in place only for a short period of time. The second way is a slow delivery of medication called a continuous infusion. For this type of medication, a dressing will usually be placed over the needle to hold it in the port for a longer period of time and a small tube will connect it to the I.V. bag.6

Your port also provides a method for collecting blood samples and, if it is indicated for this use, it may also deliver contrast media to perform CT scans. The needle is inserted in the same way through the cover of your port. Ports can minimize the number of peripheral I.V. needle sticks in your arms and hands that may cause damage to your veins.

How do I take care of my port?
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During the first few days after receiving your port, avoid any heavy exertion and follow all special instructions that your doctor or nurse gives for care of the small incision. Once the incision has healed, you should be able to resume your normal daily activities.8 Follow the instructions of your healthcare provider for care and maintenance of your port once it is implanted.

After each treatment, and occasionally between treatments if your port is not used often, the port and catheter are flushed with a special solution. If your doctor has asked you to help with these procedures, you will receive special training and information to help you accomplish this.8

Speaking with your healthcare provider
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It's perfectly normal to be nervous about undergoing a new course of treatment, particularly if you've never had treatment before or haven't spent much time in hospitals or clinics. Talk about your discomforts with people who know what's going to happen—your doctor, your nurse, or perhaps a counselor or patient support group your doctor recommends.

Remember, reporting or describing your discomforts is not complaining. After your port is inserted, you will have a small incision and some tenderness in the area of the incision, which normally subsides in the first 24 to 48 hours.4 If you notice any unusual changes in the skin area over the port such as increased swelling, redness, or soreness, don't hesitate to let your doctor or nurse know. If you experience pain, fever, chills, shortness of breath or dizziness, contact your doctor right away.4 These symptoms may be signs of an infection.

Because visits with your doctor are normally filled with a lot of information, which can be hard for one person to remember, it may be a good idea to bring a family member or friend along who can act as another set of ears and perhaps even take notes.

Daily Living Tips
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For the first few days after receiving your port, it is recommended that you take care of your small incision area and try to avoid strenuous activities. Once your incision heals, you should be able to return to your normal daily activities, such as showering, swimming, jogging, and playing with your children.4

Ask your doctor or nurse about specific activities and the appropriate time to resume them. Diet is normally not affected by the use of a port. However, the nature of your illness and required treatment may call for dietary restrictions. If any special restrictions are necessary, your doctor or nurse will inform you.


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