Giving Medicines Through a Central Line at Home
Your child may need to get some medicines through a central line or central venous catheter, a small tube placed into a vein near the heart. This means the medicine is given by injection or infusion. For some patients, medicine can be given at home through the central line.
Because these medicines are given into the bloodstream, steps must be followed to reduce the risk of infection. Before you give medicines through a central line, you will be trained to:
- Wash your hands properly and use aseptic (clean) technique to reduce the risk of infection
- Use the infusion pump device
- Prepare supplies aseptically (clean and germ-free)
- Watch for signs of an allergic reaction, infection, or other problems
- Store, handle, and dispose of medicines safely
Below are general tips to help you safely give medicine through a central line. Always follow the instructions given by your care team.
Take steps to prevent infection
- Clean your hands using proper handwashing technique. Then, put on gloves if needed.
- Choose an area in your home to handle medicines and clean supplies.
- Disinfect the workspace using alcohol gel or spray.
- Prepare the medication using aseptic technique. Avoid touching the ends of needles or syringes.
- If you have any concerns about contamination, start over with new materials and throw out the old ones.
If your child has a central line, they are at risk for CLABSI, or central line associated bloodstream infection. CLABSI is a serious infection that happens when germs enter the blood through a central line.
Follow your care team’s instructions for how to prevent infection through correct line care and use.
Get supplies and check labels
- Clear your workspace and lay out all your supplies before you start.
- Keep a checklist of materials to be sure you have everything you need before you begin.
- Read product labels and instructions to make sure you have the correct medicines and liquids used to mix powdered medicine if needed.
- Check that products are not expired and that the packaging for all materials is intact.
Sample materials checklist
- Gloves
- Alcohol gel or spray
- Alcohol pads or disinfectant scrubs
- Sterile disinfectant caps
- Medication vials or syringes
- Diluting liquid for powdered medicine, such as saline or sterile water
- Flushes
- Syringes
- Needles
- Sharps container
Give medicine as instructed
- There are different ways to give IV medicines. These include:
- Push method (bolus): Medicine is pushed in with a syringe into the catheter over a short period of time. This is also 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.
- Steps will depend on the type of injection or infusion and 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
- Flushing the IV tubing with saline and heparin if needed
- Be sure to follow instructions carefully. Giving medicine too fast or too slow can cause side effects or be less effective.
- Write down the doses given as instructed by a provider.
NOTE: Instructions will depend on the specific medicine. You may need to add a liquid solution such as sterile water to a powdered drug, withdraw a dose from a vial, or add medicine to an infusion bag.
Troubleshooting your infusion pump
IV pumps vary by manufacturer, but these are common problems to check:
- Is the battery charged and in the correct position?
- Is the tubing kinked or blocked?
- Is the infusion rate set correctly? Is it set too fast or too slow?
If these steps don’t help, contact your care team.
Dispose of used supplies and medicines properly
Throwing away home IV medicines and supplies the right way helps keep everyone safe.
- Medications: Many medicines can be disposed of in the garbage. Other medicines have very specific instructions. Be sure you know proper disposal instructions for all medicines your child takes.
- Sharp materials: Use 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 of accidental injury increases. Your care team will let you know how to return used sharps containers for safe disposal and how to get a new one.
- Other supplies: Other equipment, including syringes without needles, plastic saline or sterile water bottles, cleaning supplies, gloves, and tubing sets can usually be thrown away in ordinary trash bins. Follow disposal instructions given by your care team.
Always check with your care team when starting a new medicine for how to handle, store, and dispose of the medicine.
Questions to ask your care team
- 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 do I get more supplies?
- What should I do if I have problems with giving the medication?
- What side effects should I watch for?
- When should I call the doctor?
Key points about IV medicines at home
- Some children can safely get IV medicines at home through a central line.
- Caregivers must be trained on proper handwashing, using clean (aseptic) techniques, giving the medicine, using the pump, and disposing of medicines and supplies.
- To prevent infection, it’s important to clean your hands well, disinfect the workspace, use sterile supplies, and avoid touching the ends of syringes or connectors.
- Know instructions for how to prepare, store, and dispose of each medicine your child takes.
- Contact your care team if you have any questions or concerns and always follow your care team’s instructions for giving medicines.
