Implantable port (portacath or port)
Information for patients and carers from the Haemophilia Centre
What is a portacath? A portacath is a small titanium or plastic chamber connected to a thin plastic tube (catheter). This is placed under your skin and the catheter is threaded under the skin in to the vein in your neck until it reaches the right side of your heart (see diagram below).
The portacath gives access to your bloodstream and a special needle is inserted through your skin in to the port chamber when treatment is given, or blood tests are needed. Once inserted, the port can stay in place for several years.
The portacath insertion is done in hospital under a general anaesthetic (meaning your child will be asleep for the procedure), by a consultant anaesthetist. The Haemophilia Centre staff will discuss with you when the time is right for a portacath to be put in, it is usually when we start prophylaxis (see separate information sheet Prophylaxis for more information).
The Haemophilia Centre staff will be able to spend plenty of time with you before the portacath is inserted, so that you feel fully prepared before it is fitted.
1 of 3 Implantable port (portacath or port) (September 2019) What are the benefits of having a portacath? When prophylaxis (or preventative treatment) starts, treatment will usually be given every two to three days. Sometimes, treatment is needed more frequently if there are any bleeding problems, but this will always be discussed with you at clinic appointments when treatment is reviewed.
Having a portacath provides easy and reliable access for the regular factor replacement treatment and blood tests that your child will need. Having the port removes any difficulty there may be in finding veins and it is less painful, particularly when your child is young and veins are often difficult to locate. It also means that, in the event of bleeding, treatment can be given quickly to stop the bleeding.
The portacath is under the skin so there is a lower risk of any infection. Consequently, your child can have a bath and go swimming, and the port can not be seen when covered with clothing which makes it less obvious to others.
What are the risks of having a portacath?
• The port needs to be put in under a general anaesthetic. Although every anaesthetic carries a risk, this risk is extremely small.
• There is a small risk of bleeding, but we will give clotting factor before and after the insertion to minimise this risk.
• Infection is the biggest complication with ports. The port gives direct access to your blood stream and, as such, there is the risk of bacteria getting in to your blood. You will be taught how to access the port using a sterile procedure, and be given plenty of supervision and guidance until you feel happy using the port yourself. The best way to minimise the risk of infection is by making sure that you follow exactly the procedure taught to you by the nurse.
How will I know if there is an infection? Infections can happen when bacteria enters the body. Infections can be local (meaning at the entry site of the port itself), regional (in the area around the port), or they can be systematic (the infection is throughout the body).
Bacteria normally found on the skin are often the cause of most infections relating to ports. This is why good hand washing and using a sterile technique is essential when you are accessing your port.
It is therefore very important to regularly check the general port area for any signs of infection. This could be indicated by redness, swelling, or pain at the site. The redness can sometimes follow where the tube lies under the skin towards the vein. It is also important to check for any high temperatures, chills, or whether your child is unwell, in case it is to do with their port.
If you are concerned about any of the above contact the Haemophilia Centre immediately.
2 of 3 Implantable port (portacath or port) (September 2019) Are there any other things that can go wrong with the port? There are other possible problems that can happen with the port, including blockages due to a blood clotting in the catheter (tube). You would know that this is the case if it is more difficult to push in the syringe when flushing the tube or giving treatment. Making sure the port is flushed properly and used regularly will help to prevent any blockages.
Another problem can be a blood clot (thrombosis). This is unusual because of the haemophilia; however, with the frequent infusions of factor treatment it is a possible risk. The likely side effects of a thrombosis include pain or swelling in your arm or at the base of your neck.
Mechanical problems can sometimes occur over time with the port, but these are quite uncommon. Remember that if anything changes with the port or you are worried that something may be wrong, always talk to the Haemophilia Centre staff so that they can assess the situation and reassure you.
What do I do if I think there is a problem? It is important to report any symptoms or concerns you may have about the port to the Haemophilia Centre, either in normal working hours or to the on call consultant who will be able to advise you.
This leaflet has been produced with and for patients
If you would like this information in another language, audio, Braille, Easy Read, or large print please ask a member of staff.
Any complaints, comments, concerns, or compliments please speak to your doctor or nurse, or contact the Patient Advice and Liaison Service (PALS) on 01227 783145 or 01227 864314, or email [email protected]
Further patient leaflets are available via the East Kent Hospitals web site www.ekhuft.nhs.uk/ patientinformation
Information produced by the Haemophilia Centre Date: September 2019 Review date: January 2022 Web 421
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