SN NOR AWANI S HARNANI

o1 1
CARE O CHEMOPORT
THE OBJECTVE
ODeIIne cIemoporL
OTypes oI cIemoporL
OExpIuIn LIe specIIIc
responsIbIIILIes on munugIng
cIemoporL
HAT S CHEMPORT
O Is u Implunted sobcoteneoos centrul Venoos
Access port
O Or vuscolur uccess port { VAP )
O Inserted onder sobcotuneoos pocket onder
the skin
O Lnder sorgicully locul unuesthesiu [ GA
CENTRA VENOUS ACCESS DEVCES
O In Centrul Venoos Access evices {CVAs)
O The tip oI the cutheter resides in u centrul vessel in
the chest
O Connects with the right utriom.
O This is osoully the Soperior Venu Cuvu {SVC)
PCTURE
SINGLI PORT SINGLI PORT LOL PORT LOL PORT
TYPE O PORT
TYPIS OI IMPLANTI PORT
Chemoport
PorL cusIng - encIose
LIe porL reservoIr
Silicone, PL,
Open und
close ended
{Groshong-vulve
type)
cutheter
Septom
or InLruvenous
udmInIsLruLIon
connector
PICTLRI
AporL
BcuLIeLer |LubIng|
C subcIuvIun veIn
superIor Venu
cuvu
I puImonury veIn
I uorLu
GIeurL
PORT PACEMENT
2-3
ntercostal
space
MPATATON O STE
!erformed under LA/ GA
Common sites :-
A_ Vascular
1. nternal / External
Jagular veins
2. 8ubclavian vein
3. Brachial / Cephalic vein
B_ Non Vascular
1. !eritoneal
2. ntraspinal / Epidural
TYPE O CHEMOPORT CATHETER
1. Closed ended
cutheter
Groshong
- puLenLed
vuIve,LIIn wuII
- cIosed ended
sIIIcon cuLIeLer
CONT.
O. Open Inded
Cutheter
- SIIIcon cuLIeLer
CHOCES O NEEDES
CHOCES O NEEDE
Function Size NeedIes
1. Low Viscosity -
NacI 0.9% , PIasma
G 22
2. Average Viscosity- Lipid ,
Amino Acids
G 20
3. BIood Products- Packed
ceIIs and chemotherapy
G 19 - 20
Speciul needles ure recommended - non coring , Huber
needle.
CHOCES O NEEDES
njecLIon sILe
IexIbIe wIngs
NDCATONS
O Intruvenoos chemotherupy
1. Intruvenoos untibiotic therupy [ untivirul therupy
. Long termpurenterul notrition
. Blood prodocts trunsIosion [ blood sumpling
q. Long termpuin treutment { spinul [ epidorul )
ADVANTAGES
Putient who needs long term treutment
{chemotherupy [TPN[Blood TrunsIosion)
Able muintuin reudy uccess Ior the osed
withoot venoos ponctore.
Redoces risk oI extruvusutions or thrombophebitis.
Redoces risk oI peripherul vein sclerosis.
CONTRANDCATONS
Putients with locul {op site) inIection.
{ bucteriu [ virul [ Iongul )
Pt who ullergic to tituniomor silicones.
Pt with severe blood clotting disorder.
Prepurution putient Ior impluntution uccess port
1. Ixpluin procedore. {Pt huve to boy their own port)
. Tuke consent by doctor .
. ConIirm uppointment - OT
- rudiology depurtment.
q. Blood Ix : - IBC
- PT[ APTT [ INR
- RP
g. Skin prep iI reqoire ut sites oI impluntution.
6. InIorm pt NBM uIter 1mn.
POST MPANTATON PORT
1. Observution
i. vitul sign
ii. op site - redness , swollen , bleeding.
iii. pt compluin - puin, itching .
. ressing - port
- op site
- STO on duys ,- 1o
when cun be osed?
Oor pructice - uIter q-g duys post op , iI not osed needs to
Ilosh with sterile hepurin suline.
EY PRNCPES O CARE
1. ConIirmution oI plucement
O AIwuys conIIrm pIucemenL beIore commencIng
LreuLmenL
O Ensure LIere Is u wrILLen x-ruy reporL conIIrmIng
LIe pIucemenL oI LIe devIce
. Access
O AIwuys ensure u bIood reLurn beIore InIusIng uny
IIuIds or drug
EY PRNCPES O CARE
. Syringe size
O OnIy use syrInges 1o mIs or Iurger
O SmuIIer syrInges Increuse LIe pressure In
LIe cuLIeLer wuII
O ncreuse LIe rIsk oI rupLure oI LIe cuLIeLer
EY PRNCPES O CARE
q. Polsutile Iloshing
O AIwuys use u puIsuLIIe (sLopJsLurL) IIusIIng
LecInIque
O To creuLe LurbuIence In LIe Iumen oI LIe
cuLIeLer remove debrIs
O AvoId bIockuge oI LIe cuLIeLer
EY PRNCPES O CARE
g. Aseptic techniqoe
O SLerIIe Lruy und sLerIIe gIoves Ior uccessIng un open
sysLem (wIen cup Is removed)
6. Cleun techniqoe
O usI Iunds, cIeun gIoves und cIeun cup wILI uIcoIoI
swubs.
O AIIow cup Lo uIr dry beIore proceedIng Lo uccess u cIosed
sysLem (wIen cup Is In sILu)
EY PRNCPES O CARE
,. Hepurin Lock {Hepurinizution)
O weuk versus sLrong
SLrong HepurIn ock (1ooouJs In qmI NormuI
SuIIne - gIve 1o mI )
euk HepurIn ock (ouJs In mI)
COMPCATON
1. InIection
. Occlosions
N - doe to blood clot & incomputible drogs prodoce
crystullized
. Leukuge
M Pinch-oII syndrome
- doe to cutheter trupped between 1
st
rib & cluvicle
{sobcluviun plucement).
q. Cutheter migrution
M - doe to improper impluntution cuose cutheter
move uroond.
CONCUSON
O Cuncer puLIenLs usuuIIy requIred repeuLed venous
puncLures
O VAP - subsLunLIuIIy IucIIILuLed LIe probIem oI
vuscuIur uccess.
O To duLe suIe und eusy Lo IundIe porL sysLem
O Become un InLegruI purL oI duIIy nursIng rouLIne In
oncoIogy
REERA
O JABATAN ERJA SOSA HOSPTA TENGU
AMPUAN RAHMAH
- MEMO AND QUOTATON
O MANA
O PATENT
O JABATAN PERHDMATAN AAM (JPA)
- BORANG AATAN PERUBATAN
TIunk you