I had five days of intravenous antibiotics to complete at home. My choices were to have a PICC line put into my arm before I left the hospital to allow a visiting nurse to come to my home daily to administer the antibiotic or for me to go to an outpatient infusion center and have the antibiotic administer by a typical IV line by the nurse there. According to the hospital caseworker who was doing my discharge planning, initially none of the infusion centers that she could find were open on the weekend and some of my antibiotics would need to be given on a Saturday and Sunday. Finally, she was able to locate an infusion center open on the weekends, but I would have to drive 40 minutes from my home to get there.
PICC stands for peripherally inserted central catheter. A PICC line is a long thin plastic tube that is inserted using sterile techniques through a vein in the arm and pushed up through the vein until it reaches a large central vein near the heart. PICC lines are necessary if medicines can irritate small veins. They are meant to be used only for a few weeks. Other alternatives are available if infusions need to be given over a longer time.
PICC lines, while generally safe, do have the potential for more complications than an IV line. These potential complications include bleeding, nerve injury, Irregular heartbeat, damage to veins in your arm, blood clots, infection. The PICC line can also be blocked or broken.
Since I only needed five days of IV antibiotics, I felt the risk of a PICC line was not justified since my antibiotic could be given through a regular IV. I have chronic illnesses and, planning to live a longtime, wished not to subject my internal veins to any possible injury at this time, as I certainly may need to use them in the future.
That said, I was discharged from the hospital on Tuesday, after an IV-line placed Tuesday morning was removed. (It seems to be hospital policy that I couldn’t be discharged with the IV line in place.) I drove to the IV infusion center on Wednesday, to get my first of the five remaining daily doses of antibiotics.
When I arrived at the facility, I was surprised to see a notice on the entrance that the building was only open Monday through Friday since I had been assured that if I drove to this facility, it was also open on weekends. It wasn’t.
Nevertheless, the staff was wonderful and worked out a plan whereby they would place an IV in my arm and teach me how to administer the antibiotics to myself. The nurse believed the IV she placed would last for the full five days of antibiotics, but I was skeptical. We arrived at a backup plan where I would return to the infusion center on Friday morning for a new IV line if needed. Any problems at home on Saturday or Sunday would be covered by the infusion center’s visiting nurse department.
The nurse placed a (tiny) 24-gauge catheter in a small vein in my forearm, secured it, and then walked me through the steps to give myself the antibiotic. The process is markedly simplified by an ingenious prefilled plastic pump that automatically meters the antibiotic flow at 100 milliliters per hour, or in my case the 50 milliliters I needed in ½ hour.
The following videos show how to administer home antibiotics. The first video shows how to start the IV infusion. The second shows what to do when the antibiotic infusion is complete to prepare the IV for use the next day.
It is important to do the procedures as cleanly as possible. Wash your hands well with soap and water before you begin.
Video one – administering home antibiotics through an IV line: https://share.icloud.com/photos/0dalR1I3rIqOxdj7a6Np9rYTg
Video two – Stopping the antibiotics and preparing the IV for use the next day: