THE
UTILIZATION AND CARE OF PORT-A-CATHETER FOR ONCOLOGY CHILDREN
*Gu, G-X; *Shen, N-P,
*Yu, Y-H; **Hsu, L.
*Shanghai Children’s Medical
Center, Shanghai, China
**Project HOPE, Shanghai,
China
Objective: Children with cancer face an unpleasant experience form frequent venous punctures. In addition, some
chemotherapy agents can cause local tissue irritation if extravagated. Central line device such as
Port-A-Catheter or Boviac Catheter are very useful devices
for oncology children during therapy. Therefore, the purpose of this paper is to present
a process of implementing
and utilization of
Port-A-Catheter for oncology children.
Methods: Central
venous devices
selection criteria were based on the family self-care ability, medical supply affordability, and
availability for
continuality of medial or nursing service in their
hometown. Port-A-Catheter, which requires very minimal care at home, is chosen for oncology children. Nursing
policies and a
detail home care handout which include
Port-A-Catheter needle insertion, local area observation, site dressing
change, method of flushing,
ways of solving catheter
occlusion, and use of appropriate syringe to avoid catheter rupture were all developed to ensure quality of care.
Results: Since
June 1999, a total of 39 oncology cases received Port-A-Catheter surgical
placement. A
total of 261 Port-A-Catheter needle insertions had been
carried out for children.
The range of time to have Port-A-Catheter
in place is between 19 months to 20 days.
Currently, only one case removed his Port-A-Catheter due to
recurrent fever and positive blood culture for hemolytic Streptococcus
infection. Other two
cases had catheter occlusion
and were resolved with Urokinase.
One case had catheter occluded because
the catheter was kinked and it
was replaced by surgical correction procedure.
Conclusions: Port-A-Catheter
is placed under the
skin, the infection rate is lower than other
kind of central venous catheters. The Port-A-Catheter also can enhance
the quality of life for oncology children and their family. To ensure the safety of using Port-A-Catheter, it
is important to develop a systematic approach to address the steps of
implementation so that the care quality can be assured.