© 2018 by Helms Home Care

 

1697 N. Highway 16

Denver, NC 28037

704-802-9625 (P)

888-502-5390 (F)
service@helmshomecare.com

Cardiac (Milrinone & Dobutamine)

Dobutamine & Milrinone are cardiac meds infused through a continuous drip. 
 
Important Consideration: Do not flush the infusion line! This will cause a bolus of the drug.
 
Bag Changes:
  • Generally required every 48 hours (verify on the order). 
  • Needs to be changed before or just as the bag is emptying to avoid any disruption in the drip. 
  • Instruct the patient to never allow the bag to "run dry."
Lab Draws:
  • If the patient has a double lumen PICC line, use the lumen in which the med is not infusing.
  • If it is a single lumen PICC, you will need to draw labs peripherally. 
 

Chemotherapy

BASIC STEPS FOR CHEMO TAKEDOWN:

  1. Wash/Sanitize hands. Introduce yourself & HHC.

  2. Dress with gown (may be used), hair cap (if one is sent), gloves and mask.

    • All items are located in a “precautions kit” (similar to dressing change kit, looks like MRSA or VRE precaution kits you see in the hospital). 

    • Do not discard gown unless it is compromised during the visit.  If it is, please let us know as the Pharmacy does not send out new gowns unless we request.

  3. Flush port or PICC line with saline and heparin.  

  4. Take out/DC Huber needle (if patient has port). 

    • Place needle in sharpes container. 

  5. Ask the patient to Save/Keep gown for subsequent visits if it is not compromised (not dirty or contaminated from chemo). 

  6. Place gloves, mask and cap into bio hazard bag. Patient will take bio-bag to clinic for disposal.

  7. Cover port site with Band-Aid, or if bleeding, with gauze and tape (all provided by Pharmacy).  Most ports won’t bleed and a Band-Aid is sufficient.

  8. Check vitals and complete basic assessment. If this is a new patient to HHC, document on the 4 page Initial Assessment form.

    • Use a 1 page standard visit note for all subsequent/follow-up visits.

TYPICAL CHEMO TAKEDOWN ORDERS:

  • RN to disconnect chemo using chemo precautions, then flush port with 10mL NS, followed by 5mL Heparin.

  • RN to remove port access per protocol, as ordered.

  • RN to complete basic assessment including vital signs and systems review.

CHEMO TAKEDOWN HOW TO VIDEO: