Equipment 8-702 - Port Access Kit

CMH EMS & MIH Protocols

Scope of Practice:

Registered Nurse
Paramedic

Indications:

Express request by the patient to utilize established access instead of starting an IV.
Any patient who needs IV access, two attempts at IV access have failed, IO contraindicated or conscious patient, and at least one of the following:

ALOC or GCS less than 8,
Hemodynamic instability,
Extreme respiratory compromise, OR
Full Arrest.

Contraindications:

Inability to obtain/maintain sterile field.

Precautions:

Sterile technique must be utilized.

Procedure:

Gather equipment and don mask.
Palpate subcutaneous tissue to determine borders of the access device. Palpate the implanted infusion port borders and locate the septum and center of the septum. Determine if the patient has a single or double lumen implanted infusion port. Choose the smallest gauge non-coring needle that accommodates the therapy. Select a length that allows the length of the needle to sit flush to the skin and securely within the port.
Assess the site for symptoms of infection.
Open the implanted infusion port access kit using the sterile inner surface to create sterile field.
Using sterile technique, remove wrapper from 10 ml syringe and place on sterile field. Remove packaging and place the needle with extension tubing, needleless injection cap, adhesive skin closures, and dressing on sterile field.
Using sterile technique, prime tubing with NS syringe. Attach needleless injection cap to extension to needle.
Cleanse insertion site with antiseptic for 30 seconds and allow to air dry.
Stabilize borders of implanted port and insert needle firmly into center of port septum using 90 degree angle perpendicular to the skin. Advance needle until reaching base of portal reservoir.
Aspirate blood and then flush with NS/LR. Use at least a 10 ml syringe using a push-pause method.
Stabilize needle with dressing, occlusive dressing, and/or tape. Document date, time, and your initials on external dressing.

Citations:

Protocol 9-010 - References
Citizens Memorial Hospital, 2013.

Change Log:

Date	Link to previous version	Description of change
04/05/18	pdf	Per CMH Vascular Access Team, added comment to use at least a 10 ml syringe and use a push-pull method.
11/27/19	pdf	Added comment that port could be accessed prior to IV attempts at the request of the patient.
07/04/20		Renumbered the section to allow for future additions.
08/08/20	pdf	Added content (without substantive modification) from old Section 8-320 - Port Access Kit.
06/15/21	pdf	Moved to emsprotocols.online
03/17/23		Changed link to NS.
03/19/23		Changed link for LR.

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