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Continuous Infusion with Your Dosi-Fuser Infusor

This information describes your Dosi-Fuser® continuous infusor.

About Your Infusor

The Dosi-Fuser® is a compact, lightweight device that will deliver chemotherapy into your bloodstream at a steady rate.

Figure 1 Figure 1. Dosi-Fuser continuous infuser

The parts of the Dosi-Fuser® are shown in Figure 1, and their functions are described below.

  • The indicator scale is used to tell how much chemotherapy is in the infusor.
  • The plastic container protects the balloon and chemotherapy.
  • The level indicator is used to read the indicator scale.
  • The balloon holds the chemotherapy.
  • The inlet is the port where the chemotherapy was filled.
  • The inlet cap protects the inlet port.
  • The clamp can be used to stop the infusion.
  • The air and particle filter takes air and particles out of the fluid.
  • The capillary element controls how fast the chemotherapy is infused.
  • The Luer-lock is where the tubing will connect to your IV tubing.

The infusor is a plastic container. It has a balloon inside that holds the chemotherapy. A capillary element is attached to the tubing. It controls the delivery rate and must touch your skin at all times. As the drug goes through the tubing and into your bloodstream, the balloon slowly deflates. Your nurse will tell you how long it will take for the entire drug to go into your bloodstream. The nurse will start the infusion. You must check the Dosi-Fuser® once a day to make sure it is flowing properly.

General Guidelines

  • Carry the infusor in the fanny pack your nurse will give you. Some people prefer to use the clip to attach the infusor to their waistband or belt loop.
  • The infusor will not affect most of the things you normally do. You can do mild exercise, such as walking. You may also engage in sexual activity. You should avoid vigorous exercise, such as contact sports, while the infusor is in place.
  • The infusor is water-resistant but not waterproof. Do not take a full shower while the infusor is in place. It is too easy to get both your bandage and the infusor wet. You can shower with a hand-held shower or take a bath. When bathing, place the infusor in a plastic Zip-Loc® bag outside of the tub. Do not wet or immerse the bandaged site in water.
  • The infusor will respond if your body becomes very hot or cold. Do not use hot water in the shower or bath. Also, protect the infusor from:
    • Direct sunlight
    • Very cold weather
    • A heating pad
    • Anything else that would raise or lower the temperature of the infusor
  • Do not swim or use a hot tub while your infusor is in place
  • At bedtime, place the infusor next to your pillow. You can keep it uncovered or in its fanny pack.

How to Monitor the Flow of the Infusion

Figure 2 Figure 2. Volume indicator You must check the infusor every day to make sure your chemotherapy is flowing correctly. Remember that the chemotherapy flows very slowly. Wait at least 24 hours before you check the indicator scale for any change. If your infusor flows faster than expected, call your nurse.

  • Figure 3 Figure 3. Volume indicator at zero Read the volume indicator scale on the side of the bottle (see Figure 2). As the drug goes in, the volume indicator moves down. The indicator scale will go to “0” when the balloon is empty (see Figure 3). Check the indicator scale at the same time each day.
  • If the volume indicator has not changed, check that:
    • Your IV tubing is unclamped
    • There are no kinks in the tubing

If the chemotherapy is still not flowing, call your nurse or doctor.

  • Figure 4 Figure 4. Closed clamp Safety checks
    • Check the needle site once a day to make sure the needle is in place. Press down on the needle gently with your index finger. You should feel it touch the back of the port.
    • Check to see that there are no leaks, such as fluid on your skin and around your port site.
    • If your nurse told you to, make sure the tubing is outside of the clamp and the clamp is closed (see Figure 4). If you were given other instructions, follow those. Make sure the clamp does not get closed on the tubing.
    • Look for signs of infection, such as redness, pain, swelling, or drainage.

Disconnecting Your Dosi-Fuser® Infusor from a Port

Disconnect your infusor on (date)_________ at (time)_________.

When your treatment is finished, you must disconnect the empty infusor from your implanted port (e.g., Medi-port®, BardPort®). You will know the infusor is empty when the volume indicator has reached “0” on the indicator scale (see Figure 3). Before you remove the needle from the port, flush the port with saline and then heparin. Instructions on how to do this are below. This will keep it from clotting.

Equipment

  • Gauze pad
  • One 10 mL (cc) syringe prefilled with normal saline
  • One 5 mL (cc) syringe prefilled with 500 units (5 mL) of heparin
  • One bandage (Band-Aid®)
  • One pair of nonsterile gloves
  • Alcohol pads
  • A puncture-proof sharps container marked “Chemotherapy.” Use a heavy plastic detergent bottle or metal coffee can with a lid.

Steps

  1. Prepare a clean workplace. Do not use a bathroom.
  2. Gather your equipment.
  3. Wash your hands thoroughly with soap and water or an alcohol hand cleanser.
  4. There are 2 clamps located on the tubing. Starting with the clamp closest to the Dosi-Fuser®, make sure the clamp on the tubing is closed. If your nurse closed the clamp with the tubing to the side before starting the infusor, unclamp the clamp now. Move the tubing so that it is between the edges of the clamp. Reclamp the clamp. Check to make sure the tubing is pinched (see Figure 4). The second clamp, one closest to the body, should be left alone.
  5. Gently push any air out of the saline and heparin syringes.
  6. Put on the nonsterile gloves.
  7. Remove the capillary element that is attached to your skin.
  8. Remove the orange swab cap that is connected to the clear injection port between the clamps.
  9. Clean the Y-site (clear injection port between the clamps) with an alcohol swab. Let it dry for 1 minute.
  10. Insert the saline syringe into the injection port of your implanted port needle tubing. Turn the syringe clockwise. Use the push / pause method to flush the tubing with 10 mL of saline:
  • Quickly inject one-third of the syringe
  • Pause
  • Repeat

Start injecting the last one-third of the syringe. Twist the syringe counter clockwise to remove it from the injection port.

  1. Wipe the injection port once more with an alcohol swab. Attach the prefilled heparin syringe to the same port of your implanted port needle tubing. Flush it with 500 units (5 mL) of heparin. Use the same push / pause method as you did with the saline.
  2. Remove the syringe. Do not disconnect the infusor from the needle tubing.
  3. Figure 5 Figure 5. Removing the needle Remove the dressing over the port. Peel the tape off of your skin.
  4. To remove the needle, grasp the safety hinged base with the 2 fingers from your left hand if you are right-handed and your right hand if you are left-handed. Gently push down the base of the safety hinge against the port and firmly pull the textured handle up until you feel a firm stop and the needle locks into the safety position (see Figures 5 and 6).
  5. Figure 6 Figure 6. Implanted port needle in locked safety position Place needle with the bottle still attached in a container with a tight lid. Use thick plastic detergent bottles or aluminum coffee cans. Do not use plastic or paper bags.
  6. Apply pressure with a gauze pad over the site for 3 minutes.
  7. Place a Band-Aid® over the area where the needle was.
  8. Collect all soiled equipment in the container with lid. Bring to your chemo nurse for disposal at your next visit.

Special Instructions

  • Please review the information your nurse will give you about your chemotherapy. It lists the side effects you may have. If you have any of these, contact your doctor or nurse. Their numbers are on the bottom of this page.
  • Call your nurse if:
    • Your infusor empties before the date you were told it should
    • It does not appear to empty as expected
  • If the infusor leaks or the balloon bursts, immediately clamp your IV tubing. Call your nurse or doctor.
  • If chemotherapy comes in contact with your skin, immediately wash your skin with warm soapy water. Wash your clothing and bedding twice. Do not mix them with other laundry.