We are a nurse team giving intravenous (IV) treatment to patients outside of hospital.
IV therapy is the term used when medication is given directly into a vein.
The benefits of giving IV treatment in the community include:
you can be treated at home, rather than be admitted to hospital
you can be discharged from hospital sooner
you are less at risk of the problems that come with being in hospital, such as getting an infection.
We also offer telephone advice, education and support for the local community, and health and social care services.
Who we treat
The service is for all patients registered with a Richmond GP.
A letter will be sent to your GP when you start IV therapy. If you need to see a doctor during the treatment, we will arrange this.
All patients must have a IV catheter put into a vein.
IV catheters
The best way for you to receive your medicines is through an IV catheter. This is a thin flexible tube that can stay in place while you need treatment.
The catheter allows us to give you medicines directly into your bloodstream without needing to give you a separate injection each time. Some drugs cannot be given through a small vein in your arm or leg. It can also be used to take blood samples, saving you from repeated needle pricks.
Usually, the catheter is inserted into a vein in your upper arm. The end of the catheter reaches up, either:
to a vein close to your shoulder (in which case, it is a called a midline catheter)
or a vein just above your heart (so it is called a PICC, or 'peripherally inserted central catheter').
There are also other types of IV catheters that are inserted through your chest, such as a Hickman line or implanted port.
Risks of IV treatment
Possible complications
There is a small risk of the following complications.
Infection
An infection can develop inside the blood vessel or around where the CVAD goes in through the skin. Symptoms can include fever, chills, tiredness, low blood pressure, and redness, swelling or pus in the skin around the CVAD.
Inflammation of the vein
Inflammation can happen where the CVAD is inserted. Symptoms can include redness, pain or pus around the CVAD. This can also be called phlebitis.
Blocked line
Occasionally a CVAD can get blocked. The nurse will try to unblock the line at home. If this fails, the IV Service Team will help. If this is not possible, you may have to return to the hospital for it to be unblocked.
Call your community nurse as soon as possible:
if you begin to feel unwell with high fever, shivering or shaking, vomiting, dizziness
if your arm is red, feels hot, swollen or painful.
You may need to go back to hospital for further treatment.
Severe side effects, report immediately
Allergic reaction to medicine
An allergic reaction can happen within minutes of being given a medicine, but sometimes occurs after several hours or even days. Symptoms can include:
general flushing of the skin
nettle rash (hives) anywhere on the body
difficulty in swallowing or speaking
alterations in heart rate
severe asthma or shortness of breath
nausea and vomiting
sudden weakness or floppiness.
Air bubble blocking a vein or artery
A bubble of air can block a vein or artery. This is also called an air embolism. Symptoms can include:
low blood pressure
confusion
fast heart rate
chest pain
shortness of breath.
Call 999 if you get any of these symptoms of an allergic reaction or blockage.
Care of the CVAD
Do not touch the device or the dressing.
Report any redness, pain or swelling to the Community Nurse immediately.
Try to keep the CVAD clean and dry. Cover when washing/showering with a glove or cling film.
Avoid heavy lifting and excessive movement.
What will happen at the end of the treatment?
The hospital or IV nurse will arrange for your CVAD to be removed when your IV treatment is finished.
A dry sterile dressing will be applied. You can remove this after 48 hours.
A letter will be sent to your GP to say that your course of IV treatment has finished.
