Vascular Access and Blood Administration

Introduction to Vascular Access Devices

Vascular access devices, such as chemotherapy ports, are designed to provide reliable long-term venous access for various purposes, including administration of chemotherapy, delivery of parenteral nutrition, blood product transfusions, and blood sampling 1
Ports have the lowest infection rate (0.1 per 1,000 days) compared to other central venous devices, making them safer for blood administration, as recommended by the American Academy of Family Physicians 2, 1

Clean the injection port with 70% alcohol or an iodophor before accessing the system, as recommended by the Centers for Disease Control and Prevention (CDC) 3
Cap all stopcocks when not in use, as recommended by the CDC 3
Minimize contamination risk by scrubbing hub connectors with appropriate antiseptic, as suggested by the European Society for Clinical Nutrition and Metabolism 4
Replace port needles at least once per week during continuous use, as suggested by the European Society for Clinical Nutrition and Metabolism 4

Avoid routine drawing of blood samples from central venous access devices (CVAD) when possible due to an increased risk of complications, particularly catheter-related bloodstream infections, as recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines 1
When blood drawing from a port is necessary, protocols such as verifying proper port placement and function, checking for blood return, and using proper Aseptic Non-Touch Technique (ANTT) should be followed to minimize risks 5
Complete infusions of blood or blood products within 4 hours of hanging the blood, as recommended by the Centers for Disease Control and Prevention 3
Consider dedicating one lumen for blood transfusions when using a multi-lumen central catheter, as recommended by the European Society for Clinical Nutrition and Metabolism 6

Flush with saline solution (10-20 ml) after blood administration to prevent occlusion, as recommended by 5
Ensure that personnel administering transfusions through ports are properly trained, as recommended by the Centers for Disease Control and Prevention 3

For patients requiring frequent blood transfusions over extended periods, ports are preferable to non-tunneled catheters, according to the American College of Radiology 7
Double lumen ports are particularly recommended for patients requiring regular blood transfusions or bone marrow transplantation, as suggested by the American College of Radiology 7
Ports eliminate the need for repeated peripheral venipuncture, reducing access-related anxiety and pain, according to the American College of Radiology 7