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. Dosi-Fuser continuous infuserFigure 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.

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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
  • 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
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How to Monitor the Flow of the Infusion

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.

  •  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
Figure 2. Volume indicatorFigure 2. Volume indicator

 

         
Figure 3. Volume indicator at zeroFigure 3. Volume indicator at zero

 

Figure 4. Closed clampFigure 4. Closed clamp

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

  • 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.
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Disconnecting Your Dosi-Fuser® Infusor from a Port

This video will teach you how to disconnect your Dosi-Fuser®chemotherapy bottle, flush your implanted port, and remove the needle.

 

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.

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Equipment

  • Gauze pad
  • 1 (10 mL) syringe prefilled with normal saline
  • 1 (5 mL) syringe prefilled with 500 units (5 mL) of heparin
  • A bandage (Band-Aid®)
  • 1 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.
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Steps

Figure 5. Removing the needleFigure 5. Removing the needle

  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. Put on nonsterile gloves.

  5. Open the gauze pad and set it down on your clean workspace.

  6. Prepare your normal saline and heparin prefilled syringes. To do this, pick up the normal saline syringe and twist the cap clockwise to partially remove the cap. Do not remove the cap from the syringe. Hold the syringe in your dominant hand (the hand you write with), facing up. Push the plunger gently to remove any air from the syringe. Place the syringe, with the cap still on, on your clean area. Repeat with the heparin syringe.

  7. Gently remove the tape and the capillary element that is attached to your skin.

  8. You will see two yellow clamps.  Close the clamp closest to the Dosi-Fuser®. This is the clamp located below the clear injection port between the clamps (the clave)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.

  9. Remove the orange SwabCap® that is connected to the clave. If the orange SwabCap® fell off or is missing, clean the clave with an alcohol swab for 15 seconds. Let it dry for 15 seconds.

  10. 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 one-third of the syringe
    • Pause
    • Repeat

    Inject the last one-third of the syringe. Twist the syringe counterclockwise to remove it from the clave.

    Figure 6. Implanted port needle in locked safety positionFigure 6. Implanted port needle in locked safety position
  11. Clean the clave with an alcohol swab for 15 seconds and let dry for 15 seconds.

  12. 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.

  13. Turn the empty syringe counterclockwise to remove.

  14. Close the second yellow clamp. This is the one closest to your body.

  15. Remove the dressing over the port. Peel the tape off of your skin.

  16. 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).

  17. Apply pressure with a gauze pad over the site for 3 minutes. Place a bandage (Band-Aid®) over the area where the needle was.

  18. 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.

  19. Collect all soiled equipment in the container with lid. Bring to your chemo nurse for disposal at your next visit.

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Handling Chemotherapy

If the infuser leaks or the balloon bursts

  • Clamp your IV tubing right away
  • Call your doctor or nurse

If your chemotherapy gets on your clothing or linens

  • 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
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If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.
Continuous Infusion with Your Dosi-Fuser Infusor
©2015 Memorial Sloan Kettering Cancer Center - Generated on September 4, 2015