My friend, Jenny asked me the other day about giving Max IV medicine at home. Jenny is no stranger to the medical world. So when she asked me what all was involved with it, I thought, surely there are many more readers on Max's blog that are wondering the same thing.
So, tonight while we were getting his IV antibiotic going, I had Steve take pictures. The medicine and all the supplies are delivered from the home infusion company to our house. A nurse came out to meet Max, and make sure we were comfortable giving it to him. Since we did this back in December, it was still pretty fresh.
First thing, we set the antibiotic out about an hour ahead so it can warm to room temperature, since it has to be kept in the refrigerator.
This little Baxter pump holds the medicine. As the medicine goes in, that bubble filled with the antibiotic goes down. It takes about 45 minutes to completely go in, and then we know the infusion is complete.
I set up all of the supplies, then wash my hands.
Washing of hands is easily the most important skill as Max's caregiver. My hands are raw, but our boy stays pretty healthy because of not spreading germs.
This is Max's PICC line site. We have it covered with the top of a sock. We cut the bottom of the sock off and use the top to cover the tubing and PICC line so he can't get at it, and it doesn't catch on anything. They use a special stretchy tape in the hospital, but that gets gross and tightens on his arm too much.
This is how it looks "undressed".
Now onto the many little steps before giving him the medicine. First rule, everything needs to be clean. So, lots of making sure nothing touches my skin, or Max's skin, or fabric. The pieces that go into his PICC line are going directly into his blood stream, directly over his heart.
I start with clean hands, and cleaning the cap of the PICC. On the top and around the sides, for 30 seconds.
Then put I put the saline on the threaded lock canula, or the blue connector. This piece goes between the whatever fluid is going into the cap. It gets changed every time he gets medicine. Again, not touching any of the pieces with my clean hands.
Twist it on, and flush through with the saline, to make sure the line is moving, without any clots or obstructions. Then clamp again before giving the medicine.
I put the tubing from the baxter capsule pump into the blue connector, and release both clamps to release the pressure for the medicine to go into him.
Then we wait for 30-45 minutes.
When the infusion is complete, I take everything off and lock the line with heparin. This helps prevent clotting. But first, I remove the medicine tubing, attach another saline flush to move the medicine all the way through.
I have to get the air out of the all of the syringes before pushing them into his line. They come with a bubble in them and that has to be removed as it's not a good idea to push bubbles through PICC lines!
Then it's a quick 1, 2, 3, push and clamp it closed.
After that, I remove te syringe and tuck the tubing back into his sock band around his arm. I make sure I know what his PICC site looks like, so next time I give him medicine I know it hasn't changed. We have to watch for infection around the site to make sure it's still safe to use.
That's giving IV medicine at home, in a nutshell. This time is actually a lot easier, as it's only every 12 hours. And this time we're only having to do one medicine via IV.
Just another day in the life of the Monster though!
**And a disclaimer for work, I do not give Max IV medicines or any other medicines as his CNA. These are not CNA approved skills, so I have to do them off the clock. Since they're cracking down so much on that lately, I thought I should put it out there so no one thinks otherwise. **