Integrated & Community Services - Children's Home Intravenous and Intramuscular Antibiotics

This leaflet has been given to you because your child has started a course of intravenous (IV) or Intramuscular (IM) antibiotics in hospital.

The term intravenous (IV) is used when medication is given directly into a vein.

The term intramuscular (IM) injection is used when an injection is given into the outer muscle of a thigh or the upper outer muscle of the buttock.

Introduction

If your child does not need to be in hospital for any other reason, it may be possible for your child to have their IV or IM antibiotics at home. Antibiotics are used to treat many different types of infection.

The Children’s Community Nurses (CCN) are a team of nurses who provide nursing care and support in the community to parents and carers of children and young people 0 to 19 years of age.

The advantages and disadvantages of both hospital and home IV or IM antibiotics are:

In hospital

Advantages:

• It allows your child to be regularly assessed
• The effects of your child’s treatment can be easily monitored by the doctors and nurses

Disadvantages:

• Your child will have to stay in hospital for the time they need treatment
• Your child may experience separation from family and friends
• There may be travelling expenses for visitors or parents
• The hospital environment may cause stress for your child

At home

A member of the CCN team can visit your home within their service hours to give your child’s IV/IM antibiotics.

The nurse will contact you to discuss the times of their visit.

Advantages:

• Your child will not have to stay in hospital
• A CCN will review your child’s condition at the time of treatment
• There is a 24 hour telephone help line, available if you have any concerns

Disadvantages:

• If your child has a cannula, you will need to learn about it and how to look after it
• You will have to learn about the antibiotic and its possible side effects. This will be detailed later in the leaflet
• The CCN visiting your home will not be able to give you a fixed time so a degree of flexibility is required
• Compared to being in hospital your child won’t have medical staff around, though the CCN will maintain contact with the doctors in hospital concerning your child’s condition
• If the cannula comes out, you may need to return to the hospital for it to be replaced

What happens now

You will have time to read this leaflet and ask the doctor and hospital nurses questions about this service before you decide whether you would like your child to have their IV/IM antibiotics at home.

The doctor or hospital nurses will discuss your child’s health needs, home circumstances and the support available with you, and will agree if home antibiotics are suitable for your child.

Once you go home with your child, a CCN will telephone you at home to arrange a visit to give your child their next dose of their IV or IM antibiotics.

If a CCN has booked a visit to see your child at home, please inform them if you are returning to the hospital so that your visit can be cancelled.

Frequently asked questions

Does my child have to have their IV or IM antibiotics at home?

No. It is up to you to decide if you would like to have your child’s treatment at home.

If at any time you change your mind or your child becomes unwell, you can always return to a hospital to continue treatment.

Before you leave hospital, the doctors and nurses will discuss the signs and symptoms you will need to watch for in case your child becomes unwell again.

Are there any risks of having IV antibiotics at home?

To have IV antibiotic treatment at home your child will need to have a cannula placed into a vein. There are risks associated with your child having a cannula - see page 9 for further information.

An allergy (reaction to a medicine) can sometimes happen when medicines are given. Written advice on the types of reactions and what to do if a reaction occurs is given in this leaflet.

When can I take my child home?

Your child will have to be assessed by the hospital team and their condition needs to be stable before you take your child home.

You may also have to wait to collect a prescription from the hospital pharmacy.

How will I get my child’s medication?

If your child lives within Salford the CCN will bring the antibiotics with them on the visit.

If your child lives outside of Salford, you will need to take a prescription and a supply of the antibiotics home with you when your child is discharged.

Do I have to tell my child’s GP (General Practitioner)?

No. Your child’s GP will be informed that your child is having antibiotic treatment at home.

How will my child’s antibiotics get into their vein?

A cannula is a very narrow plastic tube approximately 2 to 3 centimetres long which sits in a vein. The hospital team will have inserted a cannula into a vein within either your child’s arm or leg.
 
Although a needle is used to insert the cannula, the needle will have been removed from the vein/cannula when it was inserted at the hospital.

The antibiotics are then given to your child through this cannula. The cannula is kept in place with a sterile adhesive dressing which is then covered with a bandage.

By covering the cannula in this way, it helps prevent infection getting into the vein where the cannula has been placed as well as preventing the cannula being pulled out.

Can I help care for my child’s cannula?

Yes. To help prevent infection you should keep the cannula and dressing clean and dry. Strict hygiene is important.

You and your child should not touch the cannula or dressing unnecessarily. Do not allow anyone else to touch the cannula or dressing apart from the CCN visiting your home.

If you notice any redness, pus rash, swelling, heat or blood in or around the dressing which covers your child’s cannula, then you should contact the helpline number (on page 11) and arrangements will be made for your child’s cannula to be reviewed.

If your child’s cannula comes out completely

Apply pressure on the site where your child’s cannula was placed for 5 minutes using a clean paper towel or clean swab.

• Elevate your child’s arm
• When the bleeding has stopped, apply a plaster or similar dressing
• Contact the helpline as soon as possible

How long will my child’s cannula last?

A cannula lasts between one and seven days. Sometimes the cannula can become blocked or move and this may require your child to have a new one inserted in the hospital.

If you have a concern that the cannula may have moved, you should ring the hospital or CCN team for advice using the help line telephone numbers.

If there is an issue with your child’s cannula the doctors and nurses in the hospital may discuss the option of your child having their antibiotics as an intramuscular injection (IM) as an alternative route.

Not all children will be suitable to have an IM injection. It will be dependent on the age of your child and it may also involve more than one injection into the muscle in their legs.

The hospital team will discuss this further if it is an option.

If the cannula is in my child’s arm/hand, will my child be able to move their arm?

Your child will be aware that the cannula is in their arm, but it should not stop them carrying out basic activities.

Excessive use of their arm should be avoided as there is a risk their cannula may become dislodged.

Can my child have a bath or shower?

Yes. Your child can still bathe or shower, as long as the bandage and dressing around the cannula is kept dry. Do not allow your child to get the bandage/dressing wet.

If the bandage/dressing gets wet, you should contact the helplines as the bandage and dressing will need to be changed promptly.

Can my child play sports?

No. This is due to a high risk of the cannula falling out. You should also be aware that using hand-held devices such as game consoles could also cause your child’s cannula to fall out, therefore care should be taken.

Can my child go swimming?

No. You should not allow your child to go swimming as there is a high risk of infection and excessive movement may cause the cannula to fall out.

How is the cannula removed when it is no longer needed?

A CCN can visit your home to remove your child’s cannula. Removing the cannula should not hurt your child.

Things to remember

Please be aware that in order for the CCN to safely administer your child’s IV or IM antibiotic they will need access to warm water, liquid soap and kitchen roll so that they can thoroughly clean and dry their hands.

The CCN will need a table or work top that is clean. This will allow them to safely prepare the medication. To minimise the risk of infection to your child, we ask that all household pets are kept in a separate room for the duration of each CCN visit.

Parents must not smoke in the presence of the visiting nurse.

Sharps boxes are for the disposal of used sharp equipment including needles, glass etc. They should be kept out of reach of children and animals. The nurse will discuss how the sharps box will be disposed of with you on the visit.

Apart from sharps boxes, all other waste generated can go in the normal waste.
 
Adrenaline should not be left in the home. The nurse will discuss storage of this with you on the first visit.

How will I know if something is wrong?

There are many symptoms that can indicate there is something wrong. Some common problems include:

• Pain, inflammation, redness or heat around the site of your child’s cannula. Chills, sweats, raised temperature or your child feeling generally unwell: These can all be signs of infection. Contact the helplines using the telephone numbers in this leaflet
• If your child’s cannula looks as if it has moved or become disconnected: This could mean your child needs a new cannula inserted. Contact the helplines using the telephone numbers in this leaflet
• If your child’s cannula has fallen out completely: Apply pressure on the site where your child’s cannula was placed for 5 minutes using a clean paper towel or clean swab. Elevate your child’s arm. When the bleeding has stopped, apply a plaster or similar dressing. Contact the helpline as soon as possible

Reaction to medication

Reactions to medication are rare and usually relate to the first few doses. Reactions can be classed into three main groups.

Mild reactions

These may include:

Headaches, chills, fevers, nausea, vomiting, joint or back pain or dizziness. Contact the helplines.

Moderate reactions

These may include:

Wheezing, itching or a rash. Other symptoms (as above) rapidly getting worse or recurring.

Contact the helpline or consider returning to the local Accident and Emergency Unit.

Severe reactions

These may include:

Tightness of the throat, severe headaches or shaking, severe dizziness or fainting, severe breathlessness or wheezing, collapse, any kind of chest pain. Other symptoms (as above) persisting or rapidly getting worse.

Call 999 and wait until an ambulance arrives.

If your child becomes unconscious, lay the child down on their side in the recovery position and check their airway and breathing. If in any doubt do not hesitate to contact the help lines.

If a problem occurs, we will aim for your child to remain at home, but if it cannot be resolved, your child may have to return to hospital.

Helplines

If you have a non-urgent issue specifically linked to your child’s condition or cannula, please contact the number below relating to the area in which you live:

Children’s Community Team HMR

Telephone: 0161 206 0606 - 8am to 8pm, if problems out of hours please ring referring hospital.

Children’s Community Team Oldham

Telephone: 0161 357 5115 - 8am to 10pm. If problems out of hours please ring referring hospital.

Children’s Community Team Bury

Telephone: 0161 724 2137 8am to 8pm, If problems out of hours please ring referring hospital.

Children's Community Team Salford

Telephone: 0161 206 2370 - 8am to 8pm, If problems out of hours please ring referring hospital.