Vascular Access Ports
From Holoprosencephaly
Vascular Access Ports
These are port devices surgically implanted into a deep, large neck or chest vein. There is a small box or chamber underneath the skin, usually around the collar bone. The other end of the line extends into the upper chamber of the heart via the right ventricle.
Indications
VAP’s are usually placed when there is need for long-term delivery of IV medicine, food or blood products or if access is frequently needed for blood sampling.
Accessing the port
Sterile technique should be observed while accessing the port.
EMLA cream may be used 1 hour prior to puncturing the port to decrease pain.
A huber needle is used in the port to prevent damage to the silicon plug that covers the chamber. A bandage or dressing is placed over the needle and connecting tubing.These may be kept in place for up to seven days at a time.
While the port is being accessed during a hospital stay, it will be flushed at regular intervals with an anticoagulant.
If the port isn’t being used regularly, it should be flushed every 30 days per physician’s orders.
Nothing smaller than a 12 ml syringe should be used in withdrawing or injecting into the port because smaller needles create too much pressure that could damage the port.
Signs of Infection—this requires immediate medical attention
Fever Swelling, redness and/or tenderness around the port Drainage from the port site Chest pain and difficulty breathing
Suggestions
Follow physician’s home care instructions!
PICC lines for infants
A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic tube that is placed in a small blood vessel.
The primary reason for a PICC is to deliver fluids and medicine over a long period of time without having to frequently replace an IV. A regular IV usually last only 1-3 days before needing to be replaced. A PICC can often be kept in for 2-3 weeks, or longer. Infants most likely to benefit from a PICC include those who are very immature, who have bowel problems that prevent feeding, or who need to take IV medicines for a long time.
Potential Problems:
Sometimes, despite several attempts, a PICC cannot be properly positioned. There is a small risk of infection. The longer the PICC is in the greater the risk for infection. Though the catheters are very soft and flexible, at times they can wear away the blood vessel wall, causing the IV fluid or medication to leak into the nearby areas of the body.
In very rare cases, the wall of the heart can wear away (erode) and cause serious bleeding and poor heart function. Another very rare complication is breaking of the catheter in the blood vessel.
If you have any concerns, please don't hesitate to discuss your concerns with your child's doctor(s).
For information about dealing with other potential health problems, treatments and medications, please visit our Miscellaneous Health Information category.
Click here to read what specialists have to say about caring for children with Holoprosencephaly: Doctor Q&A
