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Infusion Sites

Whether you have been self-infusing for years or have just started, or changed a self-infusion regimen, this section can provide some important tips and pointers.

Knowing how to self-infuse confidently can help you manage your bleeding disorder with less impact on your day-to-day life. When you self-infuse, you avoid trips to the hospital or HTC for infusions. Additionally, you’re able to treat bleeds early, which will help minimize long-term impact on your health.

The Basics of Infusion

When you infuse, you are delivering factor directly into a vein. Your health care provider or HTC team will teach you the specific steps to follow to infuse factor.

Clean Versus Sterile

  • Clean means there’s no dirt and the amount of germs has been reduced
  • Sterile means that no germs exist

Here is some guidance on keeping your infusions clean and sterile:

  • The infusion needle must remain sterile
    • It is provided in sterile packaging
    • If it touches anything nonsterile (even a tabletop that has been cleaned), you must discard it and use a new sterile needle instead
    • Always use sterile alcohol pads
  • Never reuse or share needles
  • Your hands and work area must be clean
  • Clean your work area before you begin and wash your hands and arms up to the elbow with soap and warm water
  • Wear gloves during the infusion and when you throw away supplies after the infusion
  • Place used needles in your sharps container
  • If you spill factor or if there is blood on your work area, use chlorine bleach to clean it

Finding a Vein Can Be Tricky

Finding a vein for self-infusion is not always easy. This can be especially true if you’re infusing a child for the first time or have been self-infusing for many years.

Here are some tips for finding a vein:

  • Use a tourniquet placed several inches above the desired infusion site (release it after you have inserted the needle)
  • Gently slap the skin in the area of the desired infusion site
  • Apply a warm washcloth to the desired infusion site. (Remember to clean the area again prior to infusion)

Using a Central Venous Access Device (CVAD)

If you find self-infusion difficult, a central venous access device (CVAD) may help. Although they are used more commonly in children, adults may also find them helpful. A CVAD provides direct access to a vein—it remains implanted in your body for a period of time. The downside of a CVAD is the increased risk of infection and forming blood clots in the vein.

Several types of CVADs are available. Implantation of these devices are invasive procedures and require factor treatment during insertion. You, along with your health care provider and Hemophilia Treatment Center (HTC) team, can decide which type of CVAD is right for you. Proper care, such as the flushing of ports in order to avoid infection, is extremely important.

Here are some of the CVADs that are available:

  • Port (internal CVAD). A port is implanted surgically under the skin, often in the chest. To infuse, a person places a special needle into a reservoir connected to a catheter that has been inserted into a blood vessel. No dressings or external lines are needed and the port can be used for several years. The Port-A-Cath is a common version of this device
  • Nontunneled (external) central venous catheter. This type of catheter is inserted into a vein, often in the chest. To infuse, a person injects into a cap on the end of the catheter tube. Dressings are put over the cap to help prevent infections. This device may only be used for a short time
  • Tunneled central venous catheter. This type of catheter is surgically implanted under the skin and inserted into a vein in the neck or chest. To infuse, a person accesses the external end of the catheter. The device can be used for a year or more. Hickman catheters and Broviac catheters are common versions
  • Peripherally inserted central catheter (PICC). This type of catheter is inserted into a vein in the arm and connected to a large blood vessel in the chest. To infuse, a person accesses the external end of the catheter. These types of devices are easily inserted but can only be used for a short time