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Giving Factor Through a Subcutaneous Port

You have been asked to start giving your child factor at home through a subcutaneous port. This will tell you how to place a needle in the port, infuse (give) the factor medicine, and remove the needle from the port when you are finished.

Know the medicine

Before giving any new medicine to your child, read the “Patient Medication” handout for the medicine. Or ask your child’s doctor, nurse, or pharmacist these questions:

  • What are the possible side effects of this medicine? And what do I do to lessen those?
  • What should I do if my child has a bad reaction?
  • How should I store this medicine? Keep all medicines out of children’s reach.

Getting ready

  • Pick a well-lit work area.
  • Clean and disinfect your workspace. Use an alcohol prep pad or antibacterial cleaner.
  • Wash your hands with soap and water. Dry them well.

Gather your supplies

These are the supplies you will need to place the needle in the port, give the factor, and remove the needle.

  • 1- 3ml Chloraprep (chlorhexidine gluconate 2% and isopropyl alcohol 70%) applicator
  • 1 pair of sterile gloves
  • 1 Huber port needle
  • Alcohol prep pads
  • 3 – saline flush syringes
  • Heparin flush syringe (use prescribed heparin)
  • Empty syringe (for the factor)
  • Factor (powder) and diluent (liquid)
  • Needle remover device
  • Sterile gauze
  • Self-stick bandage

Preparing for the procedure

  • Wash your hands for 15–20 seconds with soap and water. Dry your hands with paper towels. Then, use the same towels to turn off the water faucets.
  • Check the labels on the saline, heparin, and the factor. Check for the name of the medicine, the correct dose, and the expiration date.
  • Peel open the syringe packages and use the clear part of the package as a clean tray for the syringes.
  • Mix the factor with the diluent according to the package insert.
  • Fill the empty syringe with the correct amount of factor.
  • Check the syringes of saline, heparin, and factor for air bubbles.
    • With the needle pointing upward, gently tap the syringe with your hand to make the air bubbles float to the top.
    • Use the plunger to push the air out until you see a drop of fluid at the top of the needle.
  • Place each syringe back in the clear package so it remains clean.
Huber Needle to access subcutaneous port

Huber Needle to access subcutaneous port

Placing the Huber needle in the port

  • Open the package containing the Huber needle. Keep the package to use as a clean tray.
  • Pick up the end of the tubing that has the yellow end with the white cap. Remove the white cap. Do not touch the yellow end of the tubing.
  • Pick up 1 of the saline syringes that have 5ml of saline. Twist off the needle. Attach the syringe to the end of the tubing. Push a little saline into the tubing until you see it come out of the Huber needle. Lay the tubing back down in the package.
  • Feel the location of the port with two fingers, placing them on both sides of the port. Have your child lie down if needed to feel the port.
  • Clean the port site with the Chloraprep applicator:
    • Pinch the wings of the applicator to release the solution; you should hear it pop.
    • Press the sponge to the center of the port site. 
    • Using an up and down then back and forth motion, cover about 3 inches for about 30 seconds.
    • Allow the skin to air dry completely. Do not blow on the site.
  • Open the package of sterile gloves. Put on the gloves.
  • Pick up the Huber needle and remove the cover. Do not touch the needle. Fold back the plastic wings and hold the needle by the wings.
  • Place the fingers of your other hand on each side of the port, holding it firmly between your fingers. Insert the Huber needle straight down into the port, pushing firmly until you feel the needle touch the back of the port. Do not tilt or rock the needle in the port. When you feel the needle touch the back of the port, stop pushing on the needle.
  • Pull back on the plunger of the syringe until you see blood. Push 4ml of saline into the port, using a pulsing motion. While flushing with the last 1 ml of saline, close the clamp. The port should be easy to flush. Do not force it. If the line will not flush, check to make sure the clamp is open and that the tubing is not kinked. If you still cannot flush the port, please call your clinic.

Giving the factor

  • Remove the first saline flush from the line. Do not lay the end of the tubing down.
  • Clean the end of the line with alcohol for 7 seconds. Let it dry for 7 seconds. Do not blow on the tubing.
  • Pick up the syringe containing factor and twist off the needle.
  • Attach the syringe to the tubing. Open the clamp.
  • Slowly push the factor into the line. Close the clamp.
  • Remove the factor syringe from the line.
  • Clean the end of the tubing again with alcohol for 7 seconds. Let it dry for 7 seconds. Do not blow on the tubing.
  • Pick up the second saline syringe and twist off the needle.
  • Attach the saline flush to the line. Open the clamp.
  • Slowly flush the saline into the line, using a pulsing motion. While flushing in the last 1ml of saline, close the clamp.
  • Remove the saline syringe from the line.
  • Clean the end of the tubing again with alcohol for 7 seconds. Let it dry for 7 seconds. Do not blow on the tubing.
  • Pick up the heparin syringe and twist off the needle.
  • Attach the heparin syringe to the line. Slowly push the heparin into the line, using a pulsing motion. As you push the last 1ml of heparin into the line, close the clamp. This leaves a positive pressure in the line.
Pre-filled heparin syringe for flushing

Pre-filled heparin syringe for flushing

Removing the needle from the port

  • Place the needle remover on top of the port and apply gentle downward pressure. Remove the needle from the port with your other hand, grasping the wings and pulling straight up and out. Stick the needle into the handle of the needle-removing device for disposal.
  • Use a gauze pad and hold pressure over the port where the needle was. Hold pressure until bleeding stops. Cover the site with a self-stick bandage.
  • Place the needle in your sharps container. Throw away other used supplies in the regular trash.
  • Wash your hands.

Tips and troubleshooting

  • Before you place the Huber needle in your child’s subcutaneous port, make sure you have the proper supplies. If you run low on any supplies, please tell your clinic nurse. The supplies will be ordered for you.
  • Think through the process of placing the needle before you begin. Read through the steps of the process and prepare your supplies.
  • Only a Huber needle should be used in the port. Never allow anyone to insert a regular needle into the port. It could damage the port.
  • Remember to report signs and symptoms of infection (redness, swelling, drainage, or fever) to the doctor.
  • Always document the lot number, date, and time of every infusion in your factor log.

Questions?

If you have questions or concerns about giving factor at home through a port, please call the Hematology clinic at 901-595-5041. If you are calling after hours or on the weekend, dial 901-595-3300 and ask for the nursing coordinator or the doctor-on-call. If you are outside the Memphis area, dial toll-free 1-866-278-5833 and press 0 when the call connects.


Reviewed: July 2022