[CIS PIDD] [cis-pidd] SubQ first dose

[Kobrynski, Lisa]

We typically give an IV dose (in the clinic if it is the first time receiving IG, otherwise at home), then one week later start SC. We give the first 2 doses in the clinic.  Mostly to evaluate the patient's technique of administration and to counsel them regarding problems with the pump, tubing and local reactions.  While the home care companies are all too willing to "train" the patients in the home, I have had very poor experiences with this training.  Most of the nurses have little or no experience with SC infusion, and despite being told of the training video available from the IDF website few of them have watched it.  It is an ongoing problem as they are also unable to correctly counsel a patient who is having difficulties with their infusions.  In general they are unaware of proper needle placement, differences in needle sets and the correct flow rate tubing for administration of 20% IG.

If others have had better success in getting the home care companies to be responsive to training their staff, let me know!
Lisa


Lisa Kobrynski, MD, MPH
Associate Professor of Pediatrics
Marcus Professor of Immunology
Emory University, Section, Allergy/Immunology


________________________________________
From: Fabrício Prado Monteiro [fabriciopmonteiro at gmail.com]
Sent: Friday, May 24, 2013 8:10 AM
To: CIS-PIDD
Cc: CIS-PIDD
Subject: Re: [cis-pidd] SubQ first dose

Same Marc!

                                   F!
www.imunoped.com.br







Il giorno 23/mag/2013, alle ore 16:50, "Riedl, Marc" <MRiedl at mednet.ucla.edu> ha scritto:


> IV: first dose always supervised in the infusion center.  SQ: comfortable

> with patients starting at home with nursing education/supervision.

>

> Marc Riedl, M.D., M.S.

> Associate Professor of Medicine

> Section Head, Clinical Immunology and Allergy

> UCLA - David Geffen School of Medicine

> 10833 Le Conte Ave, 37-131 CHS

> Los Angeles, CA  90095-1680

> Tel 310.206.4345  Fax 310.267.0090

>

>

>

>

>

> On 5/23/13 12:14 PM, "Sullivan, Kathleen" <sullivak at mail.med.upenn.edu>

> wrote:

>

>> Question to allŠ

>>

>> It has been our tradition to always give a first dose of any new

>> immunoglobulin product under medical supervision (i.e. not at home).   I

>> wonder how many people do that for subcutaneous products though.  I think

>> the risk of a reaction that needs medical attention is very low.

>>

>> What do all of you do?

>>

>> Kate

>> Kate Sullivan, MD PhD

>> Professor of Pediatrics

>> ARC 1216 Immunology CHOP

>> 3615 Civic Center Blvd.

>> Philadelphia, PA 19104

>> (p) 215-590-1697

>> (f) 267-426-0363

>>

>>

>>

>> ---

>> The CIS-PIDD listserv is supported by the Clinical Immunology Society

>> The science & practice of human immunology

>>

>> P: +1.414.224.8095

>> E: info at clinimmsoc.org

>>

>> Not a member of CIS? Please visit www.clinimmsoc.org to join!

>>

>> You are currently subscribed to cis-pidd as: mriedl at mednet.ucla.edu.

>> To unsubscribe click here:

>> http://lm.clinimmsoc.org/u?id=183824731.9896b573560aeeae864c3bfac00aa474&n

>> =T&l=cis-pidd&o=43387357

>> or send a blank email to

>> leave-43387357-183824731.9896b573560aeeae864c3bfac00aa474 at lists.clinimmsoc

>> .org

>

>

>

> IMPORTANT WARNING:  This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential.  You, the recipient, are obligated to maintain it in a safe, secure and confidential manner.  Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.

>

> ---

> The CIS-PIDD listserv is supported by the Clinical Immunology Society

> The science & practice of human immunology

>

> P: +1.414.224.8095

> E: info at clinimmsoc.org

>

> Not a member of CIS? Please visit www.clinimmsoc.org to join!

>

> You are currently subscribed to cis-pidd as: fabriciopmonteiro at gmail.com.

> To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824680.2ac404399b1fed9cf3ecfd2dfdce4844&n=T&l=cis-pidd&o=43390983

> or send a blank email to leave-43390983-183824680.2ac404399b1fed9cf3ecfd2dfdce4844 at lists.clinimmsoc.org


---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: lkobryn at emory.edu.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824542.3201f5eed0ab3c3c73bfa5803d66dafd&n=T&l=cis-pidd&o=43395748
or send a blank email to leave-43395748-183824542.3201f5eed0ab3c3c73bfa5803d66dafd at lists.clinimmsoc.org

________________________________

This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).

---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183939985.3ea13d40a15475ac00ebbd9cd8a37d6d&n=T&l=cis-pidd&o=43396150
or send a blank email to leave-43396150-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org