Chemotherapy at home by IV push

Article Translations: (Spanish)

Your child needs to take these medicines at home:

Chemotherapy (chemo) medicine:

Your child's chemo may also be labeled as:

Dose: ______ 

Give the chemotherapy medicine over ______ minutes.

Give the chemotherapy medicine on the following days:

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday

Ondansetron (Zofran®), to prevent nausea

• Dose: ______

Give Zofran by mouth:

• ___ 30 minutes before giving chemotherapy
• ___ every 4 to 6 hours for doses.

Normal saline solution (2 syringes)

• Amount to give: ______ ml

Heparin solution (1 syringe)

•  ______ units/ml
• Amount to give: ______ ml

Quick reference for giving medicines Give Zofran. Check for blood return and flush with saline. Give chemo medicine. Flush with saline. Flush with heparin.

Preventing infection

It is very important to prevent infection, which might require removal of the IV catheter. The nurse will show you how to keep your supplies sterile, so no germs will enter the catheter and cause an infection.

Cleanliness is a must! Each time you give the chemotherapy, follow these steps:

1. Prepare a clean work area by cleaning a solid surface with household cleanser (such as Lysol® or another brand) and lay a clean towel on it.
2. Clean your hands well, using one of the following methods:
   
   • Use an alcohol hand sanitizer (Purell® or another brand) according to directions.
   • If hands are dirty or sanitizer is not available, wash your hands with antibacterial soap for at least 15 seconds, rubbing all surfaces briskly, including under fingernails. Use a paper towel or clean hand towel to dry your hands, and then use the towel to turn off the faucet.
3. Before each time you flush or put any medicine into the IV tubing, scrub the injection cap for 30 seconds with a fresh chlorhexidine wipe, using friction. Let it dry. Do not fan or blow on it.

Note: Filled syringes have an air bubble in them. Before using, squirt the air bubble out.

Giving the medicines

1. Give Zofran 30 minutes before you plan to give the chemotherapy.
2. Prepare the work area.
3. Clean your hands well.
4. Gather supplies:
   
   • chlorhexidine wipes
   • chemotherapy medicine
   • gown and gloves
   • heparin syringe (1)
   • normal saline syringes (2)
5. Put supplies in order of use on the work surface.
6. Compare the chemotherapy syringe with your written instructions. Check the label to make sure it states your child's name, the right medicine, and the right dose. If the label on the syringe does not exactly match your written instructions, do not give it. Contact the oncology clinic or the home care nurse on call.
7. Check the labels of the normal saline and heparin syringes before giving them. Make sure they are the right medicines and the heparin is in the right strength.
   
   • If you don't have pre-filled syringes, draw up the correct amount into separate syringes. (See the education sheet, "IV medicines: Preparing at home.")
8. Put on the gown and gloves. Put on goggles if you have been instructed to do so.
9. Open the clamp on the catheter or port needle tubing.
10. Scrub the injection cap with a chlorhexidine wipe and let it dry.
11. Remove the cap from a normal saline syringe.
12. Twist the syringe tip into the injection cap.
13. Pull back on the syringe plunger to make sure you get a blood return before injecting any medicines or fluids.
    
    • If there is a blood return, flush with the normal saline using the "push-and-pause" method. When empty, remove the syringe.
    • If there is no blood return, follow the instructions for your indwelling IV.
14. Scrub the injection cap with a chlorhexidine wipe and let it dry.
15. Remove the cap from the chemotherapy syringe. Twist the chemotherapy syringe tip into the injection cap.
16. Give the chemotherapy by slow IV push. Remove the syringe.
17. Scrub the injection cap with a chlorhexidine wipe and let it dry.
18. Flush the catheter with normal saline using the "push-and-pause" method. Remove the syringe.
19. Scrub the injection cap with a chlorhexidine wipe and let it dry.
20. Flush the catheter with heparin solution using the "push-and-pause" method. Remove the syringe.
21. Clamp the tubing.
22. Put the empty chemotherapy syringe, gloves and other supplies in the trash.
23. The gown can be re-used if it has not been soiled. Put it in the regular trash when chemotherapy is completed.

Other instructions:

 

 

 

 

 

 

What precautions should I take?

All caregivers should wear gloves when handling urine, stool, and vomit while your child is receiving the chemotherapy infusion and for 48 hours after the chemotherapy is completed. Urine, stool, and vomit can be safely disposed of in septic tanks and the sewer system.

Any clothing or bed linens that are contaminated with urine, stool, or vomit should be washed separately from other laundry in hot water and detergent. Anyone handling the contaminated laundry should wear gloves.

Chemotherapy spills

If skin is contaminated by chemotherapy or body wastes, wash the affected area well with soap and water as soon as possible. If eyes are contaminated by chemotherapy or body wastes, flush the eyes with water for 5 minutes and get medical attention right away.

If you have a chemotherapy spill, follow the procedure below right away.

Clean-up procedure

Supplies for clean-up, provided by the infusion company, include:

• gloves
• gown
• plastic-backed absorbent sheets
• leak resistant bag

1. Double-glove and put on a gown.
2. Soak up the spill with the plastic-backed absorbent sheet.
3. Clean the spill area well with soap and water, or a household cleaner such as window cleaner, bleach, or liquid carpet cleaner, and then rinse with clean water. Repeat 3 times.
4. Place the absorbent sheet and all used supplies in the leak resistant bag provided.
5. Call the home care pharmacy.

Who and when should I call for help?

Call the oncology clinic if:

• nausea or vomiting not controlled by Zofran.
• chemo splashes on skin or in eyes (call after following the chemotherapy spill procedure).
• any questions about the chemo medicine or its side effects.

Call the home care nurse if:

• the chemo label does not match written instructions.
• you are unable to get a blood return.
• you are unable to flush the IV.
• you have any questions about the procedure.

What else do I need to know?

You and your child should know the names and doses of all the medicines he or she is taking. Share this information with anyone involved in your child's health care.

If you miss a dose or suspect that you have made an error in giving these or any medicines, please contact the oncology clinic right away.

Keep all medicines out of children's reach, locked up if possible.

Questions?

For more information, see the specific education sheets for your child's chemotherapy. If you have any questions or concerns, please call:

Home care nurse: ____________________________

Supply company: ____________________________

Clinic: ____________________________

 

Last reviewed 8/2018

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