(CVC) Management Guidance - the Royal Cornwall Hospitals Trust ...

Standard Operating Procedure for Flushing Implanted Ports (Portacaths) CVC SOP4
Procedure
Rationale
Equipment:
To prepare for task
Open and prepare;
Sterile dressing pack, Hand cleanser, Non sterile gloves,
x2 10ml luer lock syringe, 10-20mls 0.9%Sodium Chloride
flush, 2% Chlorhexidine 70% Applicator 3 ml, sharps bin,
non coring Huber needle with extension set, care plan,
cover dressing if required, prescription chart
1. Wash hands apply gloves and apron To reduce risk of cross contamination
2. Prepare sterile field and equipment Advanced preparation for task and reduce risk of contamination
3. Expose port area and observe for any redness or To allow easy access and note any signs of infection
swelling in area
4. Apply topical anaesthetic solution if patient requires 30- To reduce feeling of pain on insertion of needle
60 minutes prior to access
5. Locate port and septum and assess thickness of skin. To select correct length of Huber needle to insert
Refer to care plan
6. Wash hands and put on sterile gloves Reduce risk of contamination and maintain sterile filed
7. Flush port needle and extension set Check patency of needle and set
8. Clean port area of skin with applicator in a cross hatch To minimize risk of contamination and destroy skin flora
fashion
9. Ready the patient and explain you are about to insert Prepare patient and ensure needle is well inserted into portal
needle and push needle into port through the skin until it
touches back plate
10. Draw back on the syringe and check for blood return 2- To check needle is correctly placed
3mls . Dispose of Heparin mix blood solution.
11. Flush and observes any sign of swelling Check fro patency and correct positioning
12. If needle is not to remain in place monthly
To maintain patency over long periods of time (PHNT Guidelines for flushing and locking central
maintenance flushes should be done with 0.9% saline and lines)
locked with Heparinised saline 100iu/ml . When needle is
to remain in place flush with saline then lock with
(See guidelines for explanation of lock)
appropriate volume of 10iu/ml heparin.
13. Maintain pressure on plunger as syringe is
To prevent backflow of blood and possible clot formation
disconnected from injection cap
14. Remove needle and discard. Document needle size Reduce risk of contamination to others and maintain continuous records
and number of attempts on care plan
15. No dressing is required but a small plaster may be To prevent oozing from site
used
*The Royal Marsden Manual of Clinical Nursing Procedures 2010
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