IV Medicines at Home

Most children treated for pediatric cancer receive some medicines by IV. This means that the medicine is given into a vein as an intravenous (IV) injection or infusion. For some patients, IV medicines can be given at home. Because these medicines are given into the bloodstream, steps must be followed to reduce risk of infection. Before giving IV medications at home, caregivers should be trained in proper handwashing and aseptic technique, using the infusion device, and recognizing signs of an allergic reaction or infection. Some medicines can be harmful to caregivers, and extra care may be needed when handling and disposing of the medicine.

Usually, children who receive IV medicines at home during cancer treatment have a central venous catheter, but some medicines may be given by peripheral IV. IV medicines may be given at home by different methods. These include:

• Push Method – Medicine is given from the syringe into the catheter over a short period of time. This may also be known as a “bolus” injection.
• Infusion – Medicine is given at a controlled rate over a longer period of time. Some medicines are given as short infusions over 15 minutes to an hour. Others are given as continuous infusions over several hours to days. An external pump or device regulates the rate of the infusion.

Below are general steps for giving IV medicines at home. Specific procedures depend on the type of medicine and device used. Always follow the instructions given by your care team.

NOTE: The process of preparing the medicine will vary depending on the medication. It could include adding a liquid solution such as sterile water to a powdered drug, withdrawing a dose from a vial, or adding medicine to an infusion bag.

Give medicine as instructed.

• Follow steps for medication administration as instructed. Steps will depend on the type of injection or infusion. This may include cleaning the end cap and attaching the syringe to give medicine, programming a pump device to deliver the medicine at the correct rate, and flushing the IV tubing with saline and/or heparin.
• Be sure to follow instructions carefully. Some medications can cause side effects or be less effective if given too quickly or too slowly.
• Document doses given as instructed by a provider.

Dispose of used supplies properly.

Appropriate disposal of home IV supplies is important to ensure that the patient, caregivers, and others stay safe from infection and injury.

• Medications. Many drugs can be disposed of in the garbage. Others have very specific requirements for disposal. Your pharmacist should provide drug-specific instruction on proper disposal.
• Sharp materials. Patients and families using home IVs should always be supplied with a sharps container to dispose of all sharp objects. This includes glass vials and needles. Do not fill the container more than 2/3 full. If the container becomes too full, the risk for accidental injury increases. Your provider will let you know how to return used sharps containers for safe disposal and get a new one.
• Other supplies. Other equipment, including syringes, plastic saline or sterile water bottles, cleaning supplies, gloves, and tubing sets can usually be thrown away in ordinary trash bins. However, this is not always true. Always check with your doctor or pharmacist when starting a new medicine.

Questions to ask your doctor or pharmacist:

• Do I need to wear gloves when I prepare and give this medicine?
• How fast should I give this medicine?
• Are there special disposal rules for this medicine?
• What should I do with my sharps container when it is full?
• How can I request more supplies?
• What should I do if I have problems with the infusion?
• What are the side effects of this medicine?
• Are there any severe side effects that I should call the doctor about right away?