This information describes your Dosi-Fuser® continuous infuser.
About Your Infuser
Your Dosi-Fuser® is a small, lightweight device that will deliver chemotherapy into your bloodstream at a steady rate. It has a balloon inside that holds the chemotherapy. As the chemotherapy goes through the tubing and into your bloodstream, the balloon slowly deflates. A capillary element is attached to the tubing. It controls the delivery rate and must touch your skin at all times.
The parts of the Dosi-Fuser are shown in Figure 1, and their functions are described below.
- The balloon holds the chemotherapy.
- The plastic container protects the balloon and chemotherapy.
- The indicator scale tells how much chemotherapy is in the infuser.
- The level indicator is used to read the indicator scale.
- The Luer-Lock inlet with cap is the port where the chemotherapy is 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 connection is where the Dosi-Fuser tubing will connect to your IV tubing.
- The infusion-line cap covers the Luer-Lock connection when it’s not connected to your IV tubing. It is removed and the Dosi-Fuser is connected to your IV tubing.
Your nurse will start the infusion. He or she will tell you how long it will take for all of the chemotherapy to go into your bloodstream. You must check the Dosi-Fuser once a day to make sure it is flowing properly. See the section “How to Monitor the Flow of the Infusion” below for more information.Back to top
- Carry your infuser in the fanny pack your nurse gives to you. Some people prefer to use the clip to attach the infuser to their waistband or belt loop.
- Your infuser 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 your infuser is in place.
- Your infuser is water-resistant but not waterproof. Do not take a full shower while your infuser is in place. It is too easy to get both your bandage and infuser wet. You can shower with a hand-held showerhead or take a bath. When bathing, place your infuser in a plastic Zip-Loc® bag outside of the tub. Do not wet or immerse the bandaged site or the air and particle filter in water.
- Avoid activities that can raise or lower your body temperature. This can cause your chemotherapy to flow too fast or too slowly. Do not:
- Place heating pads, electric blankets, or hot water bottles directly on your infuser.
- Take hot showers or baths.
- Swim, go in a sauna, or use a hot tub.
- Expose yourself or your infuser to direct sunlight or very cold weather.
- Do anything else that would raise or lower your body temperature, such as running, jogging, or strenuous exercise or activity that causes you to sweat.
- At bedtime, place your infuser next to your pillow. You can keep it uncovered or in its fanny pack. Do not hang it on a bedpost or place it on the floor.
- Review the information your nurse will give you about your chemotherapy. It lists the side effects you may have.
- Call your nurse if:
- You have any of the side effects listed on the information your nurse gave you.
- Your infuser empties before the date you were told it should.
- It does not appear to empty as expected.
How to Monitor the Flow of the Infusion
You must check the infuser every day to make sure your chemotherapy is flowing correctly. Your nurse will teach you how to do this. Remember that the chemotherapy flows very slowly. Wait at least 24 hours before you check the indicator scale for any change. If your infuser flows faster than expected, call your nurse.
- Read the volume indicator scale on the side of the bottle (see Figure 2). As the chemotherapy 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.
Figure 2. Volume indicator
Figure 3. Volume indicator at zero
If the chemotherapy is still not flowing, call your nurse or doctor.Back to top
Checking Your Dosi-Fuser Infuser and Needle Site
- Check your 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 your implanted port (e.g., Medi-port®, BardPort®).
- Check to see that there are no leaks, such as fluid on your skin or 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 Infuser from Your Implanted Port
Disconnect your infuser on (date)_________ at (time)_________.Back to top
- 1 (10 mL) syringe prefilled with normal saline
- 1 (5 mL) syringe prefilled with 500 units (5 mL) of heparin
- 1 pair of nonsterile gloves
- Alcohol pads
- Gauze pad
- A bandage (Band-Aid®)
- A heavy plastic container with a screw-on top, such as a laundry detergent bottle. It should be strong enough that needles can’t poke through the sides. Do not use plastic or paper bags. Make sure to label it ”Chemotherapy.”
- Prepare a clean workspace. Do not disconnect your Dosi-Fuser in the bathroom.
- Gather your supplies.
- Wash your hands thoroughly with soap and water or use an alcohol hand sanitizer.
- Put on the nonsterile gloves.
- Open the gauze pad and set it down on your clean workspace.
- Prepare your normal saline and heparin prefilled syringes. To do this, pick up the normal saline syringe. Hold it facing up. Loosen but do not remove the cap. Push the plunger gently to remove any air from the syringe. Retighten the cap. Place the syringe on your clean workspace. Repeat with the heparin syringe.
- Starting at the Dosi-Fuser, follow the tubing until you reach the capillary element that is attached to your skin. Gently remove the tape and the capillary element from your skin.
- You will see two yellow clamps. Close the clamp closest to the Dosi-Fuser. This is the clamp located below the clave (the clear injection port between the clamps) with the orange alcohol disinfectant cap (the SwabCap®). The yellow clamp is properly closed when the clear tubing is pinched by the yellow clamp. The second clamp, which is the one closest to the body, should be left alone. The injection port with the clear clave and the orange disinfectant cap between the 2 yellow clamps is the site you’ll use to flush your port.
- Remove the orange disinfectant cap that is connected to the clave by unscrewing it counterclockwise. If the orange disinfectant cap fell off or is missing, clean the clave with an alcohol swab for 15 seconds. Let it dry for 15 seconds.
- Take the cap off the normal saline syringe. Insert the saline syringe into the clave and turn the syringe clockwise to screw it in. Use the push / pause method to flush the tubing with 10 mL of saline:
- Quickly inject 1/3 of the syringe
- Inject the last 1/3 of the syringe. Twist the syringe counterclockwise to remove it from the clave.
- Clean the clave with an alcohol swab for 15 seconds and let dry for 15 seconds.
- Take the cap off the heparin syringe. Insert the heparin syringe into the clave. Flush it with 500 units (5 mL) of heparin. Use the same push / pause method as you did with the saline.
- Turn the empty syringe counterclockwise to remove.
- Close the second yellow clamp. This is the one closest to your body.
- Remove the dressing over the port. Peel the tape off of your skin.
- To remove the needle, grasp the safety hinged base with the 2 fingers of your non-dominant hand (the hand that you do not write with). Gently push down the base of the safety hinge against the port and use your dominant hand to 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).
- Apply pressure with a gauze pad over the site for 3 minutes. Place a bandage (Band-Aid®) over the area where the needle was. You are now disconnected from your Dosi-Fuser.
- Place needle with the bottle still attached in the container with a tight lid.
- Collect all soiled equipment in the container with lid. Bring it to your chemo nurse for disposal at your next visit.
Some chemotherapy may cause burning if they touch the skin or eyes. To avoid this, you must follow these guidelines when you disconnect your infuser.
- Chemotherapy that spills on your skin may cause irritation. Thoroughly wash the area with soap and water. Call your doctor or nurse if you develop any skin redness, pain or burning.
- If chemotherapy splashes in your eyes, immediately rinse them with running water. Keep the water flowing over your open eyes for 10 to 15 minutes. Call your doctor or nurse to ask for more instructions. Your eyes may need to be examined.
- Clamp your IV tubing right away.
- Put on disposable gloves.
- Soak up the spill with paper towels.
- Clean the area of the spill with a disinfectant wipe that contains bleach.
- Clean the area again with soap and water and paper towels.
- Place all supplies used to clean the spill in a plastic bag and seal it before you put it in the trash. When you throw them out, make sure people and pets will not come into contact with them. Put the equipment in a heavy plastic container that can be well-sealed. Be sure to separate the container from those to be recycled.
- Call your doctor or nurse.
- Put on disposable gloves.
- Make sure that the items with the chemotherapy do not touch any part of your body.
- Place the items with the chemotherapy on them in the washing machine and wash as usual. Do not wash any other laundry with chemotherapy-soiled items. If you do not have a washing machine, place the items in a plastic bag until they can be washed