1 / 15

*Current affiliation is Maxim Healthcare, Dallas, TX

Importance of Ancillary Supplies for Subcutaneous Immunoglobulin Infusion: Management of the Local Infusion Site. Diane Ochoa, 1* Christine Curtis, 2 Carla Duff, 3 Patty Riley, 4 Elyse Murphy, 4 Annette Zampelli 4

eve-whitney
Download Presentation

*Current affiliation is Maxim Healthcare, Dallas, TX

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Importance of Ancillary Supplies for Subcutaneous Immunoglobulin Infusion: Management of the Local Infusion Site Diane Ochoa,1*Christine Curtis,2 Carla Duff,3 Patty Riley,4Elyse Murphy,4Annette Zampelli4 1Dallas Allergy and Immunology, Dallas, TX; 2Cook Children’s Medical Center−Infectious Disease Clinic, Fort Worth, TX; 3University of South Florida, Tampa, FL; 4CSL Behring, LLC, King of Prussia, PA The International Nursing Group for ImmunodeficienciesOctober 3-6, 2012, Florence, Italy *Current affiliation is Maxim Healthcare, Dallas, TX

  2. Disclosures and Acknowledgments • DO, CC, and CD are nurse consultants for CSL Behring. EM, PR, and AZ are employees of CSL Behring. • This presentation was supported by CSL Behring, LLC. • Medical writing and editorial support was provided by Daniel McCallus, PhD, of Complete Publication Solutions, LLC, and was funded by CSL Behring, LLC.

  3. Ancillary Supplies Use During SCIG Administration • Subcutaneous immunoglobulin (SCIG) • An effective treatment for patients with primary immunodeficiency disease (PIDD) • Ancillary supplies for SCIG therapy • May contribute to the development of issues at the local infusion site • Adjustment may reduce the incidence and severity of infusion related issues SCIG administration to the abdomen

  4. Ancillary Supplies Used During SCIG Administration Ancillary supplies for SCIG therapy • Disposable • Needle sets • Tubing • Antiseptic preparation • Post-infusion dressing • Tape • Non-disposable • Roller/cassette pump • Syringe driver pump

  5. Common Disposable Ancillary Supply Options for SCIG Administration

  6. Contributions of Needle Properties to Patient Tolerability Needle Length • Must adequately reach into the subcutaneous tissue • Improper length may cause: • Leaking at infusion site1 • Discomfort or pain from intradermal or intramuscular infusion 2,3 Needle Diameter • Smaller diameter needles are associated with less pain and leakage 4 Tissue Layers and Depth http://juvenation.org/juvenation_forums/general/f/130/t/10017.aspx 1. Juul KAP, et al. Skin Res Technol. 2012. [Epub ahead of print] 2. Murphy E, et al. Infusion. 2007;13(4 suppl):1-8. 3. Schwartz S, et al. Clin Ther. 2004;26(10):1663-1678. 4. McKay M, et al. Diabetes Technol Ther. 2009;11(3):195-201.

  7. Impact of Needle Properties on Patient Tolerability Needle Type • Type of skin puncture may affect the development of infusion related issues • Lancet needles result in more coring, bleeding, and tissue necrosis than tricuspid needles1 Puncture in Simulated Skin1 Tricuspid Lancet 1. Selafon A and Baker PM. Presented at National Home Infusion Association Annual Conference, Phoenix, AZ, April 23-26, 2012.

  8. Impact of Flawed Needles on Patient Tolerability Needles may be made inconsistently1 • Tip damage may occur during manufacturing or handling Flawed/damaged/blunted needles • May cause pain • Result in inefficient or improper delivery of product Needle tip damage (~ 10 microns) • Associated with patients’ perception of pain2 Patients or caregivers • Should thoroughly inspect needles • Use only if undamaged Needles “Out of the Box” Damaged During Manufacturing3 200X • Parker RK and White PF. AnesthAnalg. 1997;85(5):1101-1104. • Kinast P. Med Device Technol. 1992;3(6):46-49. • 3. Selafon A and Baker PM. Presented at National Home Infusion Association Annual Conference, Phoenix, AZ, April 23-26, 2012.

  9. Contributions of Other Ancillary Supplies to Patient Tolerability • Tubing • Size is a determinant of infusion rate, which may influence tolerability • Antiseptic preparation and post-infusion dressing • May affect skin sensitivity • Tape • May lead to local irritation at the site of application

  10. Case Studies Demonstrating the Effects of Ancillary Supplies on Local TolerabilityCase Study 1

  11. Case Studies Demonstrating the Effects of Ancillary Supplies on Local TolerabilityCase Study 2

  12. Case Studies Demonstrating the Effects of Ancillary Supplies on Local TolerabilityCase Study 3

  13. Case Studies Demonstrating the Effects of Ancillary Supplies on Local TolerabilityCase Study 4

  14. Treatment Algorithm for Patients With Technical or Clinical Complaints During or Following Initial SCIG Regimen • Should be followed for patients who experience tolerability problems beyond the mild, transient effects that may occur after SCIG

  15. Conclusions • • Careful attention to technical or clinical complaints at the local infusion site warrants reassessment of infusion regimen including supplies. • • Case studies demonstrate that adjustment of, or changes to, ancillary supplies may decrease the occurrence and/or severity of infusion related issues. • • Ancillary supplies should be adjusted before changing the SCIG product. • • Alterations in the choice of ancillary supplies can: • Improve the patient experience with SCIG administration • Positively impact patient quality of life and medication adherence

More Related