Caring for my child’s portacath at home

What is a portacath?

A portacath (port) is an implanted venous access device for people who need frequent intravenous (IV) antibiotics or other drugs.

Having a port inserted requires an operation under general anaesthetic.

Your child may have some bruising or swelling over the area, and some discomfort after the operation. This generally goes away within the first week. The stitches are usually under the skin and will dissolve.

A Portacath has a reservoir (portal) and a tube (catheter). In the operation, the surgeon will place the portal under the skin, usually in the upper chest. The catheter attached to the portal runs under the skin, going over the collar bone, and then enters the large vein in the lower neck leading to the heart.

We will insert a special needle into the reservoir to give the IV medication through the port. When the needle is in place it is referred to as the port being ‘accessed’. To fit the needle some anaesthetic ‘numbing’ cream called ‘Elma’ or ‘Ametop’ may be used to help reduce the pain and discomfort your child may feel.

The needle can stay in place for up to 2 weeks. If it needs to stay in longer, we will remove it and replace with a new one. This needle will be taped in place with dressing to stop it from moving.

Ports can stay in for many years as long as they are still working. It is important that your child’s port is accessed and flushed at least every 6 weeks (even if it is not being used for treatment). This is to check it is still working and stop the catheter from getting blocked.

When your child has a port inserted, make sure you are given the contact details of the nursing team who will be responsible for the flushes. The nurse will usually visit at home or it will be arranged for your child to attend hospital.

Looking after the portacath at home

When accessing the port

When accessing the port, it must be kept secure with a clear dressing. The line needs to be taped up to secure. The port must be kept clean and dry. Avoid contact exercise or games where the port could easily get knocked.

Bathe your child in a shallow bath and cover the dressing to protect from splashes. If the dressing does become wet, pat it dry it with a clean towel. Please contact the OPAT team or local community nursing team as a new dressing will need to be applied. Do not take your child swimming until the needle has been removed by your child’s nurse.

It is best if the line can stay covered under clothes when your child is active, to help prevent the line getting caught or pulled. The port needle and line should only be touched by trained individuals.

If the line looks like it has come out or has moved, please let the OPAT team or community nurse know. You may need to come back into hospital even if your child is having home IV antibiotics. The nurses will check if the line can still be used or whether the needle needs re-fitting.

When the port does not need to be accessed

When the port is not accessed no special care is needed. Your child can carry on with all their normal activities including sports and swimming. However if the port is knocked under the skin which may be painful and could damage the port itself.

What happens if the needle comes out at home?

There is a very small chance of the needle coming out if the port is secured correctly. If the needle comes out at home, apply pressure to the site for up to a minute to stop any bleeding then apply a plaster.

The needle is sharp and needs disposing of correctly. Put the needle in a safe place away from children until it can be disposed of by a healthcare professional.

If the needle comes out at night, you can wait till the morning to inform the OPAT team. The OPAT team will arrange for another needle to be inserted or make a decision about whether your child can go onto oral antibiotics. This will be discussed with your child’s medical or surgical team.

Signs of infection

The nurse will look at your child’s portacath before each dose. In between this you should also look for possible signs of infection. These include:

• high temperature

• pain, heat or redness around the entry point of the line

The nurses will change the dressing over the needle when soiled or every 14 days when a new needle is used.

Can my child attend school or nursery?

If your child is feeling well enough, they should be able to go back to school or nursery.

Check with your school or nursery first, some may want to know about caring for the line. We are happy to talk to the school with your permission.

Your child can take part in most normal activities at school or nursery, but they should avoid vigorous exercise and contact sports.