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The port access site is fixed at 5 cm below the midline of the clavicle and 9 to 10 cm lateral to the midline of the chest. Then, a 5 to 6 cm incision is made to create a subcutaneous tissue pouch for the placement of port access site. A tunnel is made from the port access site until adjacent to the internal jugular neck wound.
Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required. Long-term venous catheters became available in 1968, and the design was improved by Dr. John W. Broviac (b. 1942), a nephrologist based in East Lansing, Michigan , in 1973.
Intraosseous access has roughly the same absorption rate as IV access, and allows for fluid resuscitation. For example, sodium bicarbonate can be administered IO during a cardiac arrest when IV access is unavailable. [1] High flow rates are attainable with an IO infusion, up to 125 milliliters per minute.
Port access requires specialized equipment and training. Ports are typically used on patients requiring periodic venous access over an extended course of therapy, then flushed regularly until surgically removed. If venous access is required on a frequent basis over a short period, a catheter having external access is more commonly used. [1]
Ports can be used for medications, chemotherapy, and blood. As ports are located completely under the skin, they are easier to maintain and have a lower risk of infection than CVC or PICC catheters. [4] Ports are typically used on patients requiring only occasional venous access over a long duration course of therapy.
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An IV line can be threaded through a peripheral vein to end near the heart, which is termed a "peripherally inserted central catheter" or PICC line. If a person is likely to need long-term intravenous therapy, a medical port may be implanted to enable easier repeated access to the vein without having to pierce the vein repeatedly.
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