Possibility of ports and blood draws

Chemotherapy is a group of drugs that destroy cancer cells. Many chemotherapy treatments are given intravenously. This is called intravenous (IV) administration.

Unfortunately, some chemotherapy drugs are too dangerous to be used in the small veins in the hands and arms that are usually used for IV lines. If this medication accidentally leaks out of a vein, it can cause tissue and skin damage to the surrounding area.

Chemotherapy can be safely administered with a special vascular access device (VAD) called a catheter port. The port can also be used for blood draws, other IV medications, and special imaging tests such as CT (computed tomography) scans or PET (positron emission tomography) scans.

This article explains what ports are, how they are used, and their potential benefits.

What is a port?

A port is a device that is surgically placed under the skin on both sides of the chest, just below the collarbone. Ports can also be placed in different areas of the body, depending on the type of cancer and the person’s health. The procedure is done in the hospital and most people go home the same day.

The port consists of two parts: the inlet and the conduit. The entrance is a small heart-shaped drum. The top of the drum is made of self-sealing silicone so a Huber needle can pierce it. The rest of the drum is plastic.

Some may have a port with two portals or drums. Although completely under the skin, the portal will appear as a small lump in the chest.

A conduit is a thin plastic tube that connects to the bottom of the inlet. It is a large vein several inches long that is surgically threaded into the chest. Commonly used veins are the jugular, subclavian, or superior vena cava.

This port allows safe and easy delivery of medication, as well as blood draw. When the port is not in use, there are no tubes or catheters outside the body. Swimming, bathing, and showering are allowed after the surgical site has healed.

Find out if chemotherapy ports are better than IV

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Who gets the port?

you and your oncologist Together (the cancer doctor) will decide if you need a port. Factors to consider are:

  • cancer type
  • type of chemotherapy
  • frequency of chemotherapy
  • cancer treatment time
  • condition of the veins in the arm

Not everyone undergoing cancer treatment needs a port. Some cancer drugs can be safely injected into a vein in the arm. Your oncology nurse will evaluate the veins in your arm to determine if you need a port.

benefit

The biggest benefit of a port is security. Ensuring that chemotherapy is administered in the safest way can give you and your oncology team peace of mind.

Ports are also easy to use. There is no difficulty in finding veins. If you have daily chemotherapy or need frequent blood draws, the Huber needle can be left in, reducing the number of venipunctures you may need. Place a clear dressing over the Huber needle to protect it while it remains in place.

In addition, the port device can remain in the body for many years, facilitating subsequent imaging and blood work. Clinical guidelines need to be followed for administration and use of infusion ports.

How are the ports used?

Before entering (puncturing) the port, the nurse will clean the skin over and around the port site. Cleaning the skin with an alcohol solution can help reduce infection.

During this process, nurses will wear masks and use sterile supplies that are free of microbes. You should not cough or breathe on your skin during this procedure. It is helpful to turn your head to the other side.

Once your skin is dry:

  • The nurse will use the Huber needle to pierce your skin and gently push it into the silicone port device.
  • The Huber needle has a tube attached to it that remains outside the body during infusion. A clear dressing is placed over the needle to keep it clean and secure to the chest wall.
  • Next, attach a syringe to the end of the tube to aspirate (remove) blood from the port. This shows that the port is working. Lab tubes can be attached to tubing for easy blood draw.
  • The nurse will then flush the tubing with a saline syringe to flush blood from the tubing and port device. You may experience a salty or metallic taste when flushing the port.
  • When the medicine is ready, the nurse will connect the chemotherapy tube to the port tube. Most chemotherapy is delivered via a pump programmed to deliver the right amount of drug at the right time.
  • After the chemotherapy drug is injected, the nurse will flush the port tube with more saline. Some ports also require a solution called heparin lock. This helps prevent blood clots from forming in the port device.
  • The nurse will then remove the Huber needle and place a bandage or small dressing over the puncture site. After the port needle is removed, you can shower and bathe at any time.
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Why doesn’t my clinic draw blood through the port?

Although it is convenient to use the port for the laboratory, sometimes you may need to have a venipuncture (drawing blood from your arm). Here are some reasons why your blood test may not be available through your port:

  • No qualified staff entered the port.
  • Some laboratories require venipuncture.
  • Using ports is more expensive.
  • The port appears to be damaged.
  • There is no return of blood to this port due to a thrombus or abnormal location.

A nurse or phlebotomist (health care professional who draws blood) must be trained in the proper method of cleaning or flushing a port before using it to obtain a blood sample.

generalize

A port is a device implanted under the skin to connect a large vein. They are used when a person needs frequent blood draws or intravenous medications. They are also used to manage chemotherapy drugs that are too dangerous to be given through a small vein. Their main benefit is safety and the ability to stay in place for long periods of time.

VigorTip words

Being diagnosed with cancer and needing chemotherapy can be scary and stressful. While the thought of getting a port can also be unsettling, it is vital to your safety and well-being during cancer treatment. Once the port site has healed, you can resume your normal daily activities without even knowing it was there. Plus, having a port relieves the annoyance of being poked countless times. After treatment, you and your oncologist can discuss the best time to remove the port.

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Frequently Asked Questions

  • How long can you leave a port?

    Depending on the type of cancer, you may need to keep your port for up to a year after treatment. However, many people enjoy the convenience of owning ports and keep them for years. As long as the port is functioning properly, there are no signs of infection, and it is flushed every 12 weeks, your port can stay in place long-term.

  • Who can draw blood from the port?

    All registered nurses, nurse practitioners and doctors can draw blood from the port. Other clinical staff, such as phlebotomists, may require special certification to draw blood from the port. Each state and organization has its own rules for who can access ports.

  • Why can’t they take blood from my port?

    Sometimes a small blood clot called a “fibrin sheath” forms at the tip of the port catheter. This clot prevents blood from being drawn from the port. Port device catheters can also be twisted or positioned incorrectly, preventing the backflow of blood.

  • Does it hurt to draw blood from the port?

    The pain of drawing blood from your port is about the same as drawing blood from your arm. Placing ice on your port site 10 minutes before the piercing can relieve some discomfort. If you find the port piercing too painful, a numbing cream is available by prescription.

  • Do the ports need cleaning?

    Before entering (piercing) your port with a Huber needle, a nurse will clean your skin with an alcohol solution to prevent infection. Once in the port, it will be flushed with saline to clean or flush the inside of the device.