Care of your portacath

Information for patients

This leaflet answers common questions about caring for your portacath. If you would like any further information or have any particular worries, please do not hesitate to contact your specialist nurse or doctor.

What is a portacath?

A portacath is a type of central venous line (or catheter). A central venous line is a soft, hollow tube that is placed into a large vein that leads into the heart.

A Portacath is made up of two parts:

1. The catheter. One end of the catheter sits at the entrance to the heart and the other end is connected to the port.
2. The port: this is a small metal chamber that is implanted underneath the skin in the chest area. A special needle can be inserted through your skin and into the port so you can have your treatment.

At the end of the procedure, you will see two small scars. One of them is about 1 cm long and is at the base of the neck or just under the collar bone. The other scar is a bit lower down on your chest and is about 3-4 cm long. Just underneath this scar you may notice a small bump under your skin; this is the port.

Both of the scars have dissolvable stiches under the skin – these do not need to be removed. At the end of the procedure a special glue (clinical grade super glue) is applied to both scars.

Benefits

The portacath can be used to give you fluids, blood products and medicines, and to take blood samples. It is designed to stay in your body for many months or years.

Will I need to stay in hospital after my central venous line has been inserted?

Most people have their line inserted as a day case under local anaesthetic and intravenous sedation. There is no need to fast beforehand but you should only have a light breakfast. Some patients will be admitted to hospital to start treatment as soon as the line is inserted, in this case we may leave a needle in your portacath ready for it to be used.

How can I look after my portacath?

Caring for your Portacath

A portacath requires very minimal care and maintenance.

At the end of the procedure a special glue (clinical grade super glue) is applied to both of the scars. The glue is water resistant but not fully water proof so try not to get it too wet for the first 7-10 days – showering is fine. There is no need to peel off the glue as it sloughs off on its own in seven to ten days. Once the scars have healed, there are no restrictions to taking baths, showering and swimming.

When a needle is in place in your portacath, it will be covered with a water-resistant dressing. This dressing is not fully water proof so you should try to keep it as dry as possible.

To keep the port functioning, it needs flushing after any treatment with 20 ml of 0.9% sodium chloride (normal saline) using a syringe no smaller than 10 ml. If the port is not going to be used for more than a few days, then it will also be ‘locked’ with Hepsal (a fluid that reduced blood clots).

Regular flushing of your line is necessary to prevent it from becoming blocked, this should be done once a month. You may get this done at the hospital or in the community by the district nurses - this is arranged by your treating team.

What do I need to know about the use of my portacath?

The portacath can be used as soon as it is inserted. Prior to use, the skin will be cleaned and a special needle (a special needle called a Huber needle or Gripper needle) is pushed through the skin into the port. The needle will be covered with a temporary dressing and your treatments can then be given down the needle. At the end of your treatment the portacath is flushed and the needle can be removed.

The image shows a port accessed with a non-coring needle. A film dressing is placed, securing and covering the needle as well as the access site.

Will it be painful afterwards?

Once the local anaesthetic wears off you may find the procedure site tender and uncomfortable – this is normal and should only last a few days. It is fine to take simple painkillers such as paracetamol if required. Some people get some pins and needles in their arm, this should not last more than 24 hours.

Can I have a bath/shower?

You can shower immediately – the glue is water resistant but not fully water proof so try not to get it too wet for the first 7-10 days. Once the scars have healed then you can submerge the area.

Can I live a normal social life?

Having a portacath should not interfere with your social life. Please talk to your specialist team before planning a trip abroad.

Can I play sports and swim?

As portacaths are completely under the skin, it is fine to play sports and exercise but try to avoid very vigorous exercise.

Having a portacath should not prevent you from being able to swim.

What are the risks with my portacaths?

Infection

Redness around the skin where the port sits, a temperature above 37.5 degrees, fever, chills or feel generally unwell, are all signs of possible line infection. Please contact your team immediately if this happens.

Signs of a blood clot

Pain, swelling or discomfort in your neck or arm on the side of the line insertion could be signs of a blood clot in the vein around the line. This is not a medical emergency, but you would need to seek advice from your team.

Blocked line

If the port becomes blocked, then it may be difficult to take blood or to inject through the line. In most cases, the line should not be used until the problem has been dealt with. Special clot-busting drugs can usually help – please contact your specialist teams.

Rare complications

Rarely, the line can irritate the heart and cause abnormal heart rhythms or cause fluid to build up in the sac around the heart. If you feel any palpitations, light-headedness, dizziness or shortness of breath it is important to seek immediate medical advice.

You should not feel pain when the line is being used – if you do, then please report this.

CONTACT YOUR SPECIALIST TEAMS IMMEDIATELY IF YOU HAVE ANY OF THE ABOVE SYMPTOMS.

How is the portacath removed when it is no longer needed?

The portacath is removed in hospital by making a small cut just above the port. Local anesthetic is given to numb the area around the port. Dissolvable stitches are used to close the wound and it will be sealed with glue - this sloughs off on its own approximately one week after the application. It is important to note that blood samples may be taken and blood thinning medication will be stopped before the removal - this will be arranged by the specialist team.

Alternatives

Your team has requested the portacath for your treatment, but if you would like to have information for other types of lines that may be appropriate, the Vascular Access Unit team can discuss these with you.

My Chart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on the My Chart section on our website.

Contacts/ further i

Vascular Access Unit

Outpatients

Radiology, Level 4

Tel: 01223 596020

Vascular Access Unit is located on Level 4, at the Outpatient end of the hospital.

On Level 3, next to the Ultrasound Department, you will find the lift (number 4) and stairs which will bring you up to Vascular Access Unit.

Nearest bus stop - Outpatient Bus Stop or main Addenbrooke’s bus station

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.