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Surgically implanted infusion ports are placed below the clavicle (infraclavicular fossa), with the catheter threaded into the heart (right atrium) through a large vein. Once implanted, the port is accessed via noncoring "Huber" needles inserted through the skin. The health care provider may need to use topical anesthetic before accessing the port.
Midline access is a type of peripheral venous access inserted into peripheral veins and that extends further than standard peripheral catheters but does not yet reach the large central veins of the thorax. They are used when intermediate-term access (one month) is needed or when administering medications that are highly irritating to smaller veins.
The clinician and patient may elect to apply a topical anesthetic before accessing the port. Ports can be used for medications, chemotherapy, and blood sampling. 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. [1]
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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.
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A Hickman line two-lumen catheter inserted on the patient's left side. Scars at the base of the neck indicate the venotomy site and insertion point into the left jugular vein. A Hickman line is a central venous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis.