reply Lynette Re: Mallory( About IVs}

[Guest guest]

The sterile field I mentioned is for when I access the port. We do

the port accesses ourselves for several reasons. First, we have much

more investment in mainaining sterility than any nurses...as we are

obviously more invested in her keeping her port and being infection

free. I always breath a sigh of relief when a port flush or access

for ivs goes well...but that is because , our 6 yo has had two

ports fail and so I don't breath easy til we see a nice blood return.

Both of his ports failed due to line failure.....holes in the line

under his skin, so nothing we or anyone else did, just bad luck with

the lines. (though I am still mildly suspicious of the vest, since he

has no fat and you can feel the tubing under his skin running up his

chest -their ports are on bottom of rib cage--so I wonder if all the

stimulation from the vest might have contributed to the holes inthe

line?) The other reason we do it ourselves, honestly, is that the

kids prefer it. The only other person they really trust to access

their port is their favorite nurse at CF clinic. They never cry or

get stressed when we do the accesses. Finally, I must admit it is

also a matter of convenience. I cannot imagine having to run to cF

clinic or entertain home health nurses monthly for flushes, and if we

did home health route, they would be trying to do the flushes with the

other 5 k ids running around (a disadvantage to having 7 kids, eh?) so

we wait til the other kdis are alseep, and port flushnight becomes

special treat, late night movie (and even some candy...) fun time for

and Mallory...I am not sure the home health nurses would be

thrilled to come over so late to do flushes.

Our home health nurses don't do the meds, but they would do the

accesses if we wanted them to. One thing to consider is a situation

like you just encountered....if something happens and the line has not

been heplocked, then the needle needs to be replaced right away to

avoid the port clotting up, so that is another reason we went ahead

and learned to do the accesses. Sometimes when the nurses come out

for levels, they will go ahead and hook up the dose for the peak after

they draw the levels for the trough, though, but that is because they

are there anyway, and they ask first if we want them to do it for us.

So anyway, we don't use a sterile field for drawing up the saline and

heparin, either...only for laying out all of the supplies for

accessing their ports for ivs or monthly flushes. But we are still

very sterile when starting the ivs, etc as well...the usual stuff,

alcohol wipes before and after etc. Also, we change the safesite

valve every couple of days and use betadine on the end of the tubing

when we do that. We change the needle every 7 days when they are on

ivs unless they want to swim or are in desparate need of a bath (where

their ports are, and their age, makes a bath difficult when accessed)

That is another advantage of the parents doing the port accesses, I

suppose....at least the kids think so whenthey want to swim in between

doses in the summer.

Your example of the nurses error is part of why we avoid the hospital

if at all possible....don't even get me started on allthe errors that

have been made (or we caught in time and prevented) when our kids were

in the hospital. Lets just say we are very very cautious when someone

else is caring for our children.

So don't worry about the sterile thing for what you are doing. BTW,

our home health company says that now they can get pre-drawn syringes

of saline and heparin. What do you think of that? we are still doing

it the old way....I worry how sterile the preparation might be, but

the nurses seem to think it is pretty good. I figure if we went to

using those, it would save us more than an hour a day of drawing up

heparin and saline, and more when they are both on ivs at the same

time.

OH yes, and you mention right in bedroom....heck, we do them wherever

we happen to be....it doesn't matter where you are, for running ivs,

just so you maintain sterile technique with the alcohol, etc....the

only disadvantage is that you cannot sit stuff down if you happen to

be in the van, or at school, etc. so you need to be an octopus, lol

Take care,

Jen

> Traci is on IVs Primaxin(6hr) and Amakacin{8hr). Her home health

nurse goes

> to her school and gives her 8:00am meds. I do all the rest. I read

the

> message about sterile fields and got worried. I don't ever have a

sterile

> field to do IV meds. I just make sure the counter is clean etc. I

use alcohol

> and betadine to clean syringes and vials. I give her 10pm, 2am and

6am right

> in her bedroom. Should I be MORE clean? Now here a story of my day.

> Today was not a good day. Traci's nurse gave her the wrong meds at

8am!

> Amakacin instead of Primaxin. I pack a whole days worth of meds in

her cooler

> because the nurse gives 8am and I do the 2pm. I work at her school.

When I

> went to pick up her meds after the nurse left I noticed that I

didn't have

> her 2pm meds. I called her nurse and told her what I found. SHe said

I'll

> call her doctor. I called her doctor first and he told me to make

her drink

> LOTS of water, and had the nurse sign an incident report. THEN when

I went to

> give her the 2pm meds her line was split and there was BLOOD

everywhere. I

> quickly clamped it off. I had to call the nurse, that gave the wrong

meds, to

> change her med port needle. Her med schedule is a mess now!

> I'm tired and I'm going to bed!

>

> Lynette

> Mom to Traci 7w/cf and Jennif