# Implanted port access, flushing and care in adults having cancer treatment

Source: https://onco.cc/protocols/implanted-port-access-and-care/  
OnCo record `implanted-port-access-and-care` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A port is a small disc under the skin of the chest or arm that lets nurses give treatment and take blood through a special needle. Each time it is used the nurse should clean their hands and your skin, check that blood comes back before giving treatment and flush it with salt water, and between courses it is usually flushed about every four weeks.

## Summary

Port care rests on general central line infection prevention rather than port-specific trials. Hand hygiene before and after accessing (CDC/HICPAC Category IB) and aseptic technique (CDC IB; NICE CG139 names ANTT as one framework) come first. Skin and hub antisepsis is chlorhexidine in alcohol: CDC IA (>0.5% with alcohol, during dressing changes), epic3 IVAD23 Class A (2% chlorhexidine in 70% isopropyl alcohol, allowed to air dry), ESMO [I, A]. Hubs and connectors are scrubbed before each access (CDC IA, SHEA moderate quality, epic3 IVAD30 Class D/GPP for at least 15 seconds). Drying times beyond 'allow to dry' come from manufacturers and local policy.

Access is with a non-coring needle under aseptic technique, and blood return is confirmed before treatment; no guideline read grades either step, and the INS standards, which do address port access, could not be read. The site of an accessed port is covered with a sterile transparent dressing changed every 7 days or sooner if lifted or damp (NICE 1.4.3.4; CDC Category II for implanted sites). Needle change intervals are not stated in the national guidelines read; UK local policy changes the needle weekly.

Flush with 0.9% saline after every infusion or sample (ESMO [II, B]; epic3 IVAD34 Class A for frequently accessed lumens). On the lock, the evidence favours saline: the Cochrane review (2022, 12 RCTs, 2422 adults) found low-certainty evidence of fewer occlusions with heparin (RR 0.70, 95% CI 0.51 to 0.95) and was uncertain of any benefit; in ports specifically, a randomised trial of 802 patients found saline non-inferior to heparin 300 U/3 ml. NICE keeps heparin where the port maker recommends it (1.4.4.7, 2003). For ports not in use ESMO recommends a four-weekly flush [III, C]; a 2025 meta-analysis of 11 mostly observational studies tended to support three months, with caution.

No national or international guideline read recommends a mask for the clinician or the patient, or the patient turning their head away, at port access or dressing change; masks in these guidelines are for line insertion or splash risk. Some local policies require both (variants).

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: port access; accessing a portacath; port-a-cath care; Huber needle access; port flush; port de-access; TIVAD care; totally implantable venous access device care; chemo port care

## Connected records

- technologies: [Implanted ports for chemotherapy (port-a-cath, power-injectable, apheresis and intraperitoneal ports)](https://onco.cc/technologies/implanted-ports/), [Infusion pumps, ports, and ambulatory chemotherapy devices](https://onco.cc/technologies/infusion-devices-vascular-access/), [Non-coring (Huber) needles for port access](https://onco.cc/technologies/huber-needles-port-access/)
- terms: [Central venous access (port, PICC line)](https://onco.cc/terms/central-venous-access/), [Febrile neutropenia](https://onco.cc/terms/febrile-neutropenia/), [Infusion reactions, hypersensitivity and extravasation](https://onco.cc/terms/extravasation-infusion-reaction/), [Venous thromboembolism (VTE)](https://onco.cc/terms/vte/)
- ideas: [Masks on patient and nurse, and the head turned away, while a port is accessed: a comparison of infection rates](https://onco.cc/ideas/idea-upgrade-masks-and-head-turn-at-port-access-infection-study/)
- protocols: [Blocked central line or port: assessment and clearing with a thrombolytic](https://onco.cc/protocols/central-line-occlusion-management/), [Blood sampling from a central line or port](https://onco.cc/protocols/blood-sampling-from-a-central-line/), [Catheter-related thrombosis in people with cancer: diagnosis, anticoagulation and whether the line can stay](https://onco.cc/protocols/catheter-related-thrombosis-in-cancer/), [Central line and port care in the community and at home](https://onco.cc/protocols/community-care-of-vascular-access-devices/), [Central line insertion bundle: preventing bloodstream infection at the time of placement](https://onco.cc/protocols/central-line-insertion-bundle/), [Central line maintenance bundle: preventing bloodstream infection after insertion](https://onco.cc/protocols/central-line-maintenance-bundle/), [Central venous catheter insertion for anticancer treatment: PICC, tunnelled line and implanted port](https://onco.cc/protocols/central-venous-catheter-insertion-for-anticancer-therapy/), [Choosing a venous access device for anticancer treatment: port, PICC, tunnelled line or cannula](https://onco.cc/protocols/venous-access-device-selection-for-anticancer-therapy/), [PICC and tunnelled central line care: dressing, hub cleaning, flushing and living with the line](https://onco.cc/protocols/picc-and-tunnelled-line-care/), [Procedural pain and sedation for children with cancer: needles, lumbar punctures and marrow tests](https://onco.cc/protocols/paediatric-procedural-pain-and-sedation/), [Suspected central line infection in a person with cancer: paired blood cultures, first antibiotics and line removal or salvage](https://onco.cc/protocols/suspected-central-line-infection/)

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