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Treatment Administration Devices

Central Venous Catheters

What is a Port?

• A port is a device which is used to deliver medications into the bloodstream. The word implanted refers to the fact that the device is placed completely beneath the skin. The port will be visible merely as a small “raised area” beneath your skin. Daily care is generally not required and it does not affect your normal activities.
• The port is made from special medical grade materials designed for safe long-term use in the human body.
• A port is a small disk about one and a half inches in diameter. The port has a raised center or septum which is made from a self-sealing rubber material. The septum is where the needle is inserted for delivery of medication, which is carried from the port into the bloodstream through a small flexible tube called a catheter.
• Implanted ports are available in a variety of shapes and sizes. A port will be chosen that is most appropriate for your body size and therapy.

How is the Port Placed?

• The port is placed during a brief surgical operation that usually is performed under local anesthesia.

Where is the Port Placed?

• Your doctor will place the port just beneath your skin, and insert the end of the catheter into the blood vessel that has been selected to receive the medication. Your doctor will locate the port in a position most suitable for your treatment. Frequently the port is placed on the upper chest in an area just below the collarbone.

How does the Port Work?

• Once the port is placed beneath the skin, it is ready to be used for easy delivery of medication into the bloodstream. The venous port also provides an easy method for collecting blood samples. When a medical treatment or blood sample is needed, a special needle is placed through the septum of the port which connects to the catheter. For most patients, only a mild pricking sensation is felt during the needle insertion. Frequently, the sensation of the needle insertion decreases over time.

Care of Your Port

• During the first few days after receiving the port, it will be important to avoid any heavy exertion and to follow any special instructions the doctor gives for care of the small incision. Once the incision is healed, normal activity can resume.

Hickman Catheter

The catheter (or line) is a long, thin plastic tube made of flexible silicone rubber which is used to secure a good intravenous (I.V.) access. Depending on your therapy needs, the catheter may have either a single, double, or triple lumen (opening) at the tip.

The Hickman Catheter is inserted into a large vein in the chest. The procedure is done under local anesthesia and sedation, normally done in a hospital or outpatient surgical center. The catheter is inserted through a small incision in the skin of the upper part of the chest, under the collarbone. From there, the catheter is introduced into the large vein under the collarbone and is further advanced to the superior vena cava, a very large vein that drains the blood into the heart.

Part of the catheter, where it enters the skin and before entering the vein, is kept under the skin in an area referred to as a "tunnel." The purpose of the tunnel is to prevent infection from finding its way into the blood vessel. The length of the tunnel is about one to two inches.

Catheter comes in many shapes and forms. The tube that enters the body may contain one or multiple lumens. Each lumen is connected to a separate tube (port) outside the body. Drugs and fluids may be given into each external port of catheter. This catheter is commonly used in patients who may require an I.V. access for a period of one to three months only.

Peripherally Inserted Central Catheter

The peripherally inserted central catheter, or PICC line, is made of soft, biocompatible silicone. Their small diameter makes them ideal for use in the very young and the elderly. They do not restrict arm movement or normal activity.

The catheter can remain in place for up to three months, sparing the patient the multiple needle sticks, interruptions in treatment, and vein wasting often associated with short-term peripheral angicaths. PICC lines are simple to insert, less expensive, and do not require surgery.

However, PICC lines are not a viable option for everyone. If the antecubital vessels are sclerosed, for example, the patient is not a candidate.

Groshong Peripherally Inserted Central Venous Catheter

A Groshong Peripherally Inserted Central Venous Catheter, or PICC, is designed for short- or long-term deliveries.

The Groshong PICC is inserted through a standard peripheral catheter. The process involves threading a catheter through a catheter—not through a needle, thus eliminating the risk of shear.

The Groshong catheter incorporates the patented, 3-position, pressure-sensitive Groshong valve. The valve is located near the rounded, closed, radiopaque catheter tip and allows fluid infusion and blood aspiration. When not in use, the valve restricts blood backflow and air embolism by remaining closed.