INTRAVENOUS ANTIBIOTIC THERAPY AT HOME CADD-Legacy PLUS pump method The antibiotics are in a bag connected to a pump. The pump will automatically inject the antibiotics into your blood at specific administration times. Outside those times, a very small amount of antibiotics will be administered to prevent your catheter from blocking. You must therefore wear the pump 24 hours a day. REQUIRED MATERIALS Clean the work surface with soap and water as explained in the video on preparing for administering the antibiotics and then gather the required materials listed below. You will need: - one bag of antibiotics; - a CADD-Legacy PLUS pump; - two alcohol swabs; - adhesive tape; - a pump pouch. Take the bag of antibiotics out of the fridge at least 1 hour before the scheduled time to replace the bag, to ensure that it is at room temperature. REPLACING THE ANTIBIOTICS BAG Do not change the bag during the time prescribed by your doctor for administering the antibiotics. The nurse will inform you of the best time for replacing the bag. Before replacing the bag Make sure that your name and the name of the medication are correctly identified on the medication label, and check the expiry date. Carefully inspect the bag of antibiotics. It must not contain any air bubbles or particles. If it does, contact your local pharmacy. IMPORTANT Contact your local pharmacy if there are problems with the materials. Procedure for replacing the bag (See the illustration of the pump on page 3.) Wash your hands as described in the brochure provided or in the video on the CHUS Web site. Sit comfortably near a clean work surface. 1. Put the pump in stop mode by holding down the ARRÊT/MARCHE (stop/start) button. Three bars will appear on the display panel. 2. Open an alcohol swab. 3. Hold the end of the bag with the blue protector cap between your thumb and index finger. 4. Remove the blue protector cap. 5. Set the bag aside, ensuring that its nozzle is pointing up. 6. Place the alcohol swab on the bag under the nozzle to ensure the nozzle doesn’t become contaminated by touching the bag. If the nozzle touches the bag or the work surface, decontaminate the nozzle with the alcohol swab and let dry for 30 seconds (do not blow on the material to dry it faster). 7. With your good hand (right hand for those who are right-handed or left hand for those who are left-handed) pick up the tube leading to the empty antibiotics bag. With the other hand, hold the empty bag firmly. 8. Remove the tubing from the empty bag by pulling upwards without touching the tube connection point. 9. Tell the CSSS nurse if there is more than 10% of the fluid remaining in the antibiotics therapy bag. 10. Take the new bag of antibiotics and insert the tubing into the nozzle to pierce the membrane. Push the piercing pin in to the line indicated while keeping the bag and connection point straight to avoid damaging the bag. 11. Place the bag of antibiotics in the pump pouch and adjust it to your waist. PROGRAMMING THE PUMP AFTER REPLACEMENT 12. Press the SUIVANT (next) button. The text VOLUME RÉSIDUEL will appear on the screen above. 13. Press the ENTRER/RAZ (enter/clear) button to set the residual volume at its initial value. 14. Start the pump by holding down the ARRÊT/MARCHE button. The three bars will disappear. 15. Place the pump into the pump pouch. REPLACING THE BATTERIES To ensure the pump works properly, you must change the batteries each week or when a battery warning message appears on the pump’s screen. Here is how you replace the batteries. 1. Hold down the ARRÊT/MARCHE button. Three bars will appear on the screen. This means the pump has stopped. 2. Slide open the battery compartment door at the back of the pump. 3. Replace the used batteries with new ones (type AA alkaline). The pump will beep when the batteries are correctly installed. 4. Close the battery compartment door, ensuring it is securely in place. 5. Hold down the ARRÊT/MARCHE button. The three bars will disappear. This means the pump is working again. PRACTICAL TIPS Washing the pump: once a week, wash the pump with a cloth dampened in a mixture of two tablespoons of household bleach in one cup of water. Getting dressed: put your arm with the catheter-tube-pump connection in the appropriate sleeve first. To undress, remove the other sleeve first then the one with the catheter and tubing. Display Enter/clear button Next button Stop/start button ALARMS The pump has several alarms to warn you of a situation that needs correcting. Always press the ARRÊT/MARCHE button before correcting an alarm. The pump and alarm will then stop for two minutes. The following table describes the different alarms and their meanings. MESSAGE & ALARM DESCRIPTION HOW TO CORRECT IT Vol rés Bas (low residual volume) The amount of fluid left in the bag is low. Prepare to replace the bag. Vol résiduel vide (no volume) The bag is empty. Replace the bag immediately. Piles faibles (low batteries) The batteries are low, but the pump can still function. Replace the batteries as soon as possible. Piles déchargées (dead batteries) The batteries are dead, and the pump can no longer work. Put new batteries in immediately. Haute pression (high pressure) High pressure is caused by a blockage, either in the tubing or catheter, or may be due to twisted tubing. Check if the tube is twisted or bent. If so, correct the problem and restart the pump. If the problem persists, contact the CSSS nurse. Occlusion en amont (upstream blockage) Remove the obstruction. Check for bends or air bubbles in the The fluid is not circulating between tube between the bag and the pump. Restart the pump. the bag and the pump. If the problem persists, contact the CSSS nurse. Arrêt (3 beeps every 5 minutes indicates a stoppage) The pump has stopped. Authors Day medicine team Editing and layout Direction des communications et des affaires publiques © Centre hospitalier universitaire de Sherbrooke (CHUS) chus.qc.ca May 2015 – 1-6-14727 Restart the pump.
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