Nursing Guide Portsystems

Transcription

1 Quality and Experience Portsystems This nursing-guide is intended to answer general questions concerning port catheter systems. All other questions should be addressed to your attending physician or nursing team.

2 The pfm medical ag port catheter systems are fully implantable and facilitate repeated, continuous venous access. View Cross-section of port catheter system (TitaJet light) 1 Silicone membrane 2 Port chamber 3 Catheter A port catheter system consists of a port chamber and a catheter. Care and maintenance of pfm medicals port catheter systems is essential to ensure the long life of the systems. 2

3 General The port chamber is implanted under the skin and the attached catheter extends into the venous bloodstream. The position of the port chamber and the catheter will be determined for you by your physician. 3 possible accesses The port catheter system allows direct access to the venous blood system. A specially designed needle the Huber needle (e.g. EZ Huber ) is used for this purpose. The point of the Huber needle penetrates the skin and silicone membrane, and enters the port chamber. Using a Huber needle (e.g. EZ Huber ), an infusion can be injected into the port chamber, for instance, and introduced into the venous bloodstream via the catheter. This avoids painful punctures, e.g. of the veins in the arms. When the port chamber is punctured with a Huber needle, normally no more than a tiny pinprick is felt. 3

4 Basic information Port catheter systems may be punctured using Huber needles (e.g. EZ Huber ) only. Only syringes with a capacity of at least 10 cc should be used. Never use excessive pressure when performing the infusion. Ensure work procedures are sterile. To avoid the risk of air embolism, always clamp the Huber needle extension, when not in use. If the port catheter system is not in use, flush the system with preservative-free 0.9% sodium chloride or other flush solutions according to organizational policies and procedures, every four weeks in order to prevent catheter occlusion*. * Infusion Nurses Society. Infusion Nursing Standards of Practice. Journal of Infusion Nursing, 2006; 29 ( 1S ) 4

5 Preparation 1 Examine the patient s skin for any redness, swelling etc. 2 Palpate the port chamber. 3 Prepare all the materials needed to administer the drug or the infusion. Only Huber needles (e.g. EZ Huber ) of the correct length for the patient and syringes with a capacity of at least 10 cc should be used for puncturing the port catheter system. EZ Huber 4 Wash and disinfect your hands. 5 Put on sterile gloves. 5

6 Preparation 1 Prepare the skin with antiseptic and according to your hospital policy*. Allow sufficient time for the disinfectant to dry. 2 The skin may also be covered with a sterile fenestrated drape. 3 Palpate the port chamber. 4 Flush the Huber needle (e.g. EZ Huber ) with preservative-free 0.9% sodium chloride in order to expel any air. * Guidelines for the Prevention of Intravascular Catheter-Related Infections

7 Drug administration 1 Puncture with the Huber needle (e.g. EZ Huber ). Triangulate port between thumb and first two fingers of non-dominant hand. Holding the EZ Huber needle by the wings, slowly insert it through the skin and the silicone membrane into the port chamber until it touches the base of the port chamber. Ask the patient in a seated or lying position to breathe in deeply. 2 Check correct position by gaining flashback of blood into syringe, use approx. 10 cc of preservative-free 0.9% sodium chloride to check that the port catheter system is unob-structed. It should be easy to perform this procedure (see: Possible complications at page 10). 7

8 3 Fix the Huber needle with a secure fixation device. 4 Administer the drugs or infusion. If more than one drug is being injected per therapy cycle, the port catheter system must be flushed with approx. 10 cc of preservative-free 0.9% sodium chloride, before the next drug is administered. If two drugs are administered directly one after the other without flushing, they may interact and/ or there may be a chemical precipitate which may occlude the port-system. 5 Flush the system with approx. 30 cc of preservative-free 0.9% sodium chloride. 6 Lock the port catheter system according to your hospital policy. 8

9 Patient aftercare 1 Remove the dressing. 2 Remove the Huber needle while maintaining a positive pressure and holding the port chamber in place with two fingers. To relax the patient, ask to breathe in deeply and slowly withdraw the needle. 3 Disinfect the skin and place a small plaster over the exit site. 4 Enter the details on the patient s record card. 9

10 Possible complications The preservative-free 0.9% sodium chloride cannot be injected easily. The Huber needle has not been correctly inserted into the port chamber and is still in the membrane. Push the point of the needle through the membrane until it touches the base of the port chamber. Swelling occurs next to the port chamber during injection of the preservative-free 0.9% sodium chloride. The point of the needle has been inserted next to the port chamber and the preservative-free 0.9% sodium chloride is being injected beneath the skin. Withdraw the Huber needle and perform the puncture correctly using a sterile Huber needle. There is an obstruction in the port catheter system. A physcian must be contacted to handle further handling of an occlusion in a port catherter system. 10

11 Portfolio For the puncture of the port catheter system a noncoring Huber needle (e. g. EZ Huber ) must be used. pfm medical ag provides a broad assortment of EZ Huber safety infusion set in 19G, 20G and 22G with lengths from 15 mm to 38 mm. Medical references Infusion Nurses Society. Infusion Nursing Standards of Practice. Journal of Infusion Nursing, 2006; 29 (1S) Guidelines for the Prevention of Intravascular Catheter- Related Infections

12 Contact Should you have any questions our Customer Service & Sales Support team is happy to advise you. T +49 (0) F +49 (0) Your information source for the products of pfm medical ag pfm medical ag Wankelstraße Köln, Germany Certified by DIN EN ISO PB2005EN/