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Giving IV medicines at home

 

Most patients at St. Jude receive some medicines by IV (by vein). You might need to give some of these medicines at home. The information below tells you how to give IV medicines safely.

Know about the medicine you are giving

Before giving your child any new medicine, read about that medicine. You can also ask your child’s doctor, nurse, or pharmacist the questions below.

  • What are the possible side effects of this medicine? How can I reduce them?
  • What should I do if my child has a bad reaction?
  • Where should I keep the medicine?

You should store most IV medicines in the refrigerator. But ask your child’s doctor, nurse, or pharmacist to be sure. If you need to store your child’s medicine in the refrigerator, the temperature should be 36 degrees F to 46 degrees F (2 degrees C to 8 degrees C).

Preparing to give the medicine

Clean your work area with an alcohol prep pad or other disinfectant.

Clean your hands with soap and water and dry well, or use an alcohol-based liquid or foam hand cleaner. For guidelines, see “Do you know… Clean hands.”

Then, gather your supplies and place them on your clean work area.

Supplies needed

  • Your child’s IV medicine
  • 2 syringes of sterile sodium chloride (saline for IV use). Check label for:
    • The name “0.9% Sodium Chloride Injection” on the syringe,
    • 5 mls of liquid in the syringe, and         
    • An expiration date on the syringe that is still in the future.
  • One (1) syringe of heparin 10 units/ml (for IV use). Check label for:
    • The name “Heparin Lock Flush 10 USP units/ml” on the syringe,
    • 3 mls of liquid in the syringe, and
    • An expiration date on the syringe that is still in the future.
  • 5 Site Scrubs® (If you do not have Site Scrubs, you may use 5 alcohol prep pads)
  • Medical tape, if needed to secure the line
  • 1 disinfectant cap
  • X-span® mesh (use as a onesie if your child is a baby or T-shirt if your child is an infant or toddler)

All supplies and medicine must be used only one (1) time and should be thrown away in the regular trash after use.

Check the medicine

Before each dose, check the medicine:

  • For your child’s name and for the correct medical record number, if available;
  • For the name of medicine ordered by the doctor;
  • For the dose, the rate to give the medicine, or both;
  • For the expiration date;
  • For storage guidelines; and
  • To make sure the medicine is clear—not cloudy, discolored, or specked.

If the liquid is cloudy, discolored, or speckled, do not give it to your child. Throw the medicine away, and call your home infusion nurse or the Medicine Room (901-595-2441) right away.

Starting the infusion

  • Put your child in a safe place where you can easily reach the central line and your supplies.
  • Clean your hands for 15–20 seconds with the soap and water or alcohol-based hand sanitizer. Use paper towels to dry your hands. Then, use the paper towels to turn off the faucets.
  • Take off the old X-span mesh, and untape the central line as needed.

1.   Prepare the saline syringes and the heparin syringe

  • Remove the cap from the saline syringe as you were taught without touching the inside of the cap or the tip of the syringe. Set the cap down so the inside is facing up.
  • Holding the syringe upright, pull back on the plunger of the syringe. Look for any large air pockets, and thump out the bubbles. Slowly, push the air out of the syringe and stop when the top of the plunger is at the 5ml mark. Place the cap back on the syringe. Be careful not to touch the inside of the cap or the tip of the syringe. The saline flush can now be laid down on the table. It is ready to use.
  • Repeat the same steps for the other saline syringe and the heparin syringe.

2.   Clean the Clave®

  • Open 2 Site Scrubs and place them on the clean work area.
  • On your child’s central line, remove the disinfectant cap from the Clave.
  • Using a Site Scrub, scrub with a back and forth motion for 10 seconds and let dry for 5 seconds. If using an alcohol pad, wipe the end of the Clave 8 seconds on the top and 8 seconds around the rim in the grooves and let dry for 15 seconds.
  • Do not blow on or fan the Clave.
  • After the Clave is clean, do not lay it down.

3.   Flush the line with saline

  • With your free hand, pick up the saline syringe and remove the cap as you were taught without laying down the Clave.
  • Attach the saline syringe to the Clave. Unclamp the central line, and flush with saline, using a pulsing motion as you were taught.
  • Clamp the line. Then, remove the syringe.

4.   Clean the Clave again

  • Using a Site Scrub, scrub with a back and forth motion for 10 seconds and let dry for 5 seconds. If using an alcohol pad, wipe the end of the Clave 8 seconds on the top and 8 seconds around the rim in the grooves and let dry for 15 seconds.
  • Do not blow on or fan the Clave.
  • After the Clave is clean, do not lay it down.

5.   Give the medicine

  • Remove the cap from the end of the IV medicine and connect to the cleaned Clave.
  • Unclamp your child’s central line.
  • Slowly push the medicine into the central line.

After the medicine is given

  • Clamp the central line.
  • Open 3 Site Scrubs and place them on the clean work area.
  • Remove the medicine syringe from the line.

1.   Clean the Clave

  • Using a Site Scrub, scrub with a back and forth motion for 10 seconds and let dry for 5 seconds. If using an alcohol pad, wipe the end of the Clave 8 seconds on the top and 8 seconds around the rim in the grooves and let dry for 15 seconds.
  • Do not blow on or fan the Clave.
  • After the Clave is clean, do not lay it down.

2.   Flush the line with saline

  • With your free hand, pick up the saline syringe and remove the cap as you were taught without laying down the Clave.
  • Attach the saline syringe to the Clave. Unclamp the central line, and flush with saline with a pulsing motion as you were taught.
  • Clamp the line. Remove the saline syringe.

3.   Clean the Clave again

  • Using a Site Scrub, scrub using a back and forth motion for 10 seconds and let dry for 5 seconds. If using an alcohol pad, wipe the end of the Clave 8 seconds on the top and 8 seconds around the rim in the grooves and let dry for 15 seconds.
  • Do not blow on or fan the Clave.
  • After the Clave is clean, do not lay it down.

4.   Flush the line with heparin

  • With your free hand, pick up the heparin syringe and remove the cap as you were taught without laying down the Clave.
  • Attach the syringe to the Clave. Unclamp the central line, and flush the line with most of the heparin. When the plunger reaches the 1ml mark on the syringe, do a steady push to finish the flush. While holding pressure on the plunger, clamp the central line.
  • Remove the heparin syringe.

5.   Clean the Clave again

  • Using a Site Scrub, scrub using a back and forth motion for 10 seconds and let dry for 5 seconds. If using an alcohol pad, wipe the end of the Clave 8 seconds on the top and 8 seconds around the rim in the grooves and let dry for 15 seconds.
  • Do not blow on or fan the Clave.
  • After the Clave is clean, do not lay it down.

6.   Cap the line

  • Remove the cover from the disinfectant cap and attach the cap to the Clave. Alcohol will spill from the cap, and your hand may get wet when you attach the cap to the Clave. This is OK. You may now lay down the line.
  • Loop the line, and put on X-span mesh if your child is an infant or toddler.
  • Throw the empty syringes into the regular trash.
  • Clean your hands again.

Problems and troubleshooting

Stop giving the medicine and call your home infusion nurse or the Medicine Room (901-595-2441) right away if:

  • You have problems with your supplies or how to use the syringe,
  • The IV site becomes red or swollen, or
  • You see leaking or drainage from the IV site.

Questions?

If you have questions about giving IV medicines at home, talk to the nurse in your child’s primary clinic, the line nurse, or the clinical pharmacist. The local St. Jude number is 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833).


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).