Scene 1

© All Rights Reserved. This material is confidential and property of IHH Healthcare Berhad. No part of this material should be reproduced or published 
in any form by any means, nor should the material be disclosed to third parties without the consent of IHH.

WONG SUI CHU
ONCOLOGY POST BASIC SENIOR STAFF NURSE 
PHAK

Scene 2

Learning Outcomes
At the end of the session, you will be able to:

3.
List the advantages and disadvantages of chemoport.

4.
Explain the immediate and delayed complications of chemoport
insertion.

5.
Describe the measures to prevent infection and complications of 
chemoport.

6.
Demonstrate the technique of using chemoport.

Scene 3

CHEMOPORT
• Is a type of central venous
access device inserted either
surgically or by an interventional
radiologist using local anesthesia.
• Port can feel like a 'bump' under
the skin.
• For long term use from month to
years.

access device inserted either 
surgically or by an interventional 
radiologist using local anesthesia.

▪ Port can feel like a ‘bump’ under

Scene 4

CHEMOPORT
Also known as ' Port-a-Cath', 'Vascular access device' or
'Vascular access port'.
A noncoring needle is required to access the device.
PORT A CATH
Blood
,vesselN•-•-.-.
E xtension
tubing
nder skin
Septum
Self-sealing
septum
Skin
Suture
Noncoring
needle
Clamp
Indvvelling
Silastic
catheter
4

▪ Also known as ‘ Port-a-Cath’, ‘Vascular access device’ or

▪ A noncoring needle is required to access the device.

under skin
PORT A CATH
Septum
Skin
Needle
Blood
Catheter

E xtension
tubing
Self-sealing
septurn
Suture
Noncoring
needle
Clamp
Indwelling
S i last ic
catheter

Scene 5

CHEMOPORT
' Using special needle (noncoring needle / Huber-point
needle) to prevent damage to the silicon septum.
Standard
Needle
Huber-point
Needle
Huber
Needle
Connector
needle
Catheter
Line
Clip
5

• Using special needle (noncoring needle / Huber-point

needle) to prevent damage to the silicon septum.

Huber-point
Needle
Connector
Catheter
Line
Clip

Scene 6

TYPES OF NONCORING NEEDLE
' Noncoring right angle
Ilh
' Noncoring straight

Scene 7

CHEMOPORT
Can be single or double injection port with self-
sealing silicone septum cover by metal (titanium) or
Ilh
plastic chamber.
One access point
Two access point

▪ Can be single or double injection port with self-

sealing silicone septum cover by metal (titanium) or 
plastic chamber.

Scene 8

CHEMOPORT
' The catheter connects the port with reservoir to the
central vein typically to the superior vena cava
(Port)
Port-a-cath
under Skin
Superior
vena cava
Heart
Inserti ng needle
into
Blood is drawrn
from
8

• The catheter connects the port with reservoir to the

central vein, typically to the superior vena cava.

Port-a-cath
under Skin
(Port)
Superior
vena cava
Heart
Inserting needle
into
Blood is
frorn Port-a—cath

Scene 9

Ilh
The indications for chemoport
1. Chemotherapy.
2. Patient requires long-term IV therapy.
3. Intermittent infusions of medication.
4. Parenteral nutrition.
5. Blood transfusions.
6. Obtain blood samples.
7. Patient who requires repeated CT Scan with contrast.

2. Patient requires long-term IV therapy.

7. Patient who requires repeated CT Scan with contrast.

Scene 10

Advantages of Chemoport
' Benefit for patient in long term
treatment.
' No dresssing required when device
not in use.
Heparin flushing once a month.
No restriction in patient's normal
activities.
Ilh
10

• Heparin flushing once a  month.
• No restriction in patient’s normal

Scene 11

Advantages of Chemoport...con't
' No exit site for potential
infection (when not in use).
' Less maintenance cost.
' Better body image compare to
others access device.
' Implanted port can be left
inside body permanently with
minimal complication.
Ilh
11

• Less maintenance cost.
• Better body image compare to

inside body permanently with 
minimal complication.

Scene 12

Disadvantages of Chemoport
' Insertion procedure more costly
than others vascular access
device.
' Still required needle puncture for
accessing.
Risk of extravasation due to
needle malposition or migration
by unskilled staff.
Ilh
12

needle malposition or migration
by unskilled staff.

Scene 13

Disadvantages of Chemoport...con't
' Risk of catheter occlusion due to
inadequate flushing.
' Risk of infection at the port site.
' Risk of dislodgement catheter.
0 Lack of trained staff who know how to
handle port correctly and safely.
Ilh
13

Disadvantages of Chemoport…con’t
• Risk of catheter occlusion due to

• Risk of infection at the port site.
• Risk of dislodgement catheter.
• Lack of trained staff who know how to

Scene 14

COMPLICATIONS
Immediate Insertion Related
Complications
Bleeding
Pneumothorax
Air embolism
Arrhythmia
Puncture arterial
Thoracic injury
Catheter disconnected
Ilh
Delayed Insertion Related
Complications
Infection
' Occlusion
Thrombosis
Pinch-off syndrome
' Catheter rupture
Extravasation
' Catheter migration
14

▪
Immediate Insertion Related 
Complications

• Infection
• Occlusion
• Thrombosis
• Pinch-off syndrome
• Catheter rupture
• Extravasation
• Catheter migration

Scene 15

CARE AND MANAGEMENT
PORT INFECTION
Factors determining rate of port infection:
Surgical insertion technique of device
Dressing technique
Access technique
Contaminated infusate
Catheter material
Open ended / closed ended catheter
Ilh '
Fibrin sheath
Tu n ne'e
Port ket
reg ion
o p gn —ended - eattwt•r
15

Factors determining rate of port infection:
• Surgical insertion technique of device
• Dressing technique
• Access technique
• Contaminated infusate
• Catheter material
• Open ended / closed ended catheter
• Fibrin sheath

Scene 16

PORT INFECTION, PREVENTION IS THE KEY
Hand Hygiene
$CRuB
Maximum barrier precautions during insertion
Skin-prep solution
Regular assess of device
Sterile dressing technique
' Scrub the hub
Replace needle and transparent
semipermeable dressing every 5-7 days
but gauze dressings every 48 hours or wet.
Ilh
grs IN YOUR
PREVENT SEPSIS
IN HEALTH CARE
SAVE LIVES
CLEAN YOUR HANDS
*HandHygiene *Sepsis
16

• Hand Hygiene
• Maximum barrier precautions during insertion
• Skin-prep solution
• Regular assess of device
• Sterile dressing technique
• Scrub the hub
• Replace needle and transparent

semipermeable dressing every 5-7 days 
but gauze dressings every 48 hours or wet.

IT's IN YOUR
PREVENT SEPSIS
IN HEALTH CARE
SAVE LIVES
CLEAN YOUR HANDS
iHqndHygiene *Sepsis

Scene 17

HOW TO TREAT PORT INFECTION?
Act early to treat.
Antibiotics consideration.
Removal of device.
17

Scene 18

hill
upeaqs uwcl!d
91W!dse pue esrlJLl! 01 elqeun : uo!snpoo le101
91W!dse elqeun Inq esrlJLl! ueo : uo!snpoo len.aed
(eleud!091d) onoqwo,lL11 LION 10 onoqwo,lL11
sedK1
N01srnooo U313HIVO IUOd

• Thrombotic or Non thrombotic (precipitate)

• Partial occlusion : can infuse but unable aspirate

• Total occlusion : unable to infuse and aspirate

Scene 19

PORT OCCLUSION, PREVENTION IS THE KEY
' Non traumatic insertion, correct catheter size, catheter tip
location and optimal vessel used.
' Observe early sign of occlusion:
Poor / no blood return.
Inability or sluggish flow to infuse.
Increase resistance in flushing.
19

• Non traumatic insertion, correct catheter size, catheter tip

Scene 20

PORT OCCLUSION, PREVENTION IS THE KEY..
Flushing after each blood drawing
and infusions.
Flush with Normal saline between
each medication.
Avoid use incompatible drug
together.
Heparin locking.
.cont
20

PORT OCCLUSION, PREVENTION IS THE KEY…cont

Scene 21

HOW TO TREAT CATHETER OCCLUSION
Act early to treat.
Do not force or push.
Consider thrombolytic therapy.
12
9
3
ACT
Urokinase
Injection
U-FRAG95,øn
6

Urokinase For
Injection
U-FRAG 5.m.„tu
Fu I.V. use
Fot

Scene 22

CATHETER RUPTURE
Risk factors:
High pressure injection/ infusion.
Catheter thrombosis.
Location of catheter tip.
Daily activities cause frequent bending /
folding at catheter.
Ilh
22

• Daily activities cause frequent bending /

Scene 23

CATHETER RUPTURE, PREVENTION IS THE KEY
Use syringe 10mI or greater in administration to create pressure
less than 40 psi.
Use 'push pause' and positive pressure flushing technique to
minimize blood reflux to catheter.
Do not force if resistance in flushing.
Educate patient avoid activities cause bending of catheter.
Follow manufacture's instruction of implanted port.
23

• Use syringe 10ml or greater in administration to create pressure

• Use ‘push pause’ and positive pressure flushing technique to

• Do not force if resistance in flushing.
• Educate patient avoid activities cause bending of catheter.
• Follow manufacture’s instruction of implanted port.

Scene 24

HOW TO TREAT CATHETER RUPTURE
Removal of device.
24

Scene 25

References:
Ignatavicius, D. D., & Workman, M. L. (2016). Medical-Surgica/ Nursing-patient-centered
collaborative care. Canada: Elsevier.
Lippincott Procedures(2020). Implanted port accessing. Retrieved May 2021 from
https
Lippincott Procedures(2020). Implanted port accessing, pediatric . Retrieved May 2021 from
https:https://procedures.lww.com/lnp/view.do?pld=1606847&disciplineld=950
Lippincott Procedures(2020). Implanted port blood sampling. Retrieved May 2021 from
https
Lippincott Procedures(2020). Implanted port flushing and locking. Retrieved May 2021 from
https://procedures.lww.com/lnp/view.do?pld=3320414&disciplineld=950
Lippincott Procedures(2020). Implanted port dressing change. Retrieved May 2021 from
https ://procedures.lww.com/lnp/view.do?pld=6251516&disciplineld=950
Lippincott Procedures(2020). Implanted port noncoring needle removal. Retrieved May 2021 from
https
25

•
Ignatavicius, D. D., & Workman, M. L. (2016). Medical-Surgical Nursing-patient-centered 
collaborative care. Canada: Elsevier.

•
Lippincott Procedures(2020). Implanted port accessing. Retrieved May 2021 from
https://procedures.lww.com/lnp/view.do?pId=1606848&disciplineId=950

•
Lippincott Procedures(2020). Implanted port accessing, pediatric . Retrieved May 2021 from
https:https://procedures.lww.com/lnp/view.do?pId=1606847&disciplineId=950

•
Lippincott Procedures(2020). Implanted port blood sampling. Retrieved May 2021 from
https://procedures.lww.com/lnp/view.do?pId=1606849&disciplineId=950

•
Lippincott Procedures(2020). Implanted port flushing and locking. Retrieved May 2021 from 
https://procedures.lww.com/lnp/view.do?pId=3320414&disciplineId=950

•
Lippincott Procedures(2020). Implanted port dressing change. Retrieved May 2021 from 
https://procedures.lww.com/lnp/view.do?pId=6251516&disciplineId=950

•
Lippincott Procedures(2020). Implanted port noncoring needle removal. Retrieved May 2021 from
https://procedures.lww.com/lnp/view.do?pId=1607130&disciplineId=950

Scene 26

References:
Pantai Hospital Ayer Keroh. Work Instruction.(2021). Insertion of Venous Chemoport Coreless
Needle. PHAK-NUR-SW2-Wl-1.4(4). Version No: 5.0.
Pantai Hospital Ayer Keroh. Work Instruction.(2021). Removal of Venous Chemoport Coreless
Needle. PHAK-NUR-SW2-Wl-1.4(5). Version No: 5.0.
26

•
Pantai Hospital Ayer Keroh. Work Instruction.(2021). Insertion of Venous Chemoport Coreless 
Needle. PHAK-NUR-SW2-WI-1.4(4). Version No: 5.0.

•
Pantai Hospital Ayer Keroh. Work Instruction.(2021). Removal of Venous Chemoport Coreless 
Needle. PHAK-NUR-SW2-WI-1.4(5). Version No: 5.0.

PowerPoint Presentation

Page 1 (0s)

Page 2 (31s)

Page 3 (1m 11s)

Page 4 (1m 37s)

Page 5 (1m 58s)

Page 6 (2m 14s)

Page 7 (2m 25s)

Page 8 (2m 44s)

Page 9 (3m 1s)

Page 10 (3m 39s)

Page 11 (4m 0s)

Page 12 (4m 24s)

Page 13 (4m 44s)

Page 14 (5m 7s)

Page 15 (5m 39s)

Page 16 (6m 0s)

Page 17 (6m 28s)

Page 18 (6m 44s)

Page 19 (7m 3s)

Page 20 (7m 30s)

Page 21 (7m 53s)

Page 22 (8m 13s)

Page 23 (8m 33s)

Page 24 (9m 5s)

Page 25 (9m 16s)

Page 26 (10m 30s)

Page 27 (11m 15s)