By Cindi Berry, RN BSN
Subcutaneous administration of immune globulin (SCIG) can be a great option for IG therapy. It can allow a person who needs treatment so much freedom! But, whether your SCIG is administered weekly, bi-weekly or daily, it is necessary to have the proper equipment to ensure successful administration and continuation of therapy.
The necessary equipment includes:
1. Clean work area: It is very important to have a designated “clean” area when preparing for your SCIG administration. Make sure you designate one space, and keep all equipment close by.
2. Emergency equipment: Prior to each infusion, always have your anaphylaxis kit/Epi Pen readily available. Make sure you also have access to a phone to call 911 if necessary.
3. Topical numbing cream: Although this is optional, many prescribers will include numbing cream as a part of SCIG administration. This can be applied 30 minutes to 60 minutes prior to needle insertion. It is important to remember that your numbing cream should be covered with an occlusive dressing (such as Tegaderm, or even a homemade dressing such as Saran Wrap). This helps allow the cream to remain on the skin and properly numb the area. The numbing cream contains lidocaine, so do not cover an area larger than 4 inches by 4 inches.
4. IG product: Have your IG product ready on your clean work area. Check the vial dose. Follow your physician orders regarding the dosage. Check vial for any particles. If you happen to see anything in the IG, alert your provider, and do not use this vial.
5. Syringe: This is necessary for the delivery of IG. Depending on the syringe pump or administration orders, you may use a 60 mL syringe or smaller.
6. Vial transfer device or an 18 gauge needle for drug transfer: You will need a needleless vial transfer device or an 18 gauge needle to withdraw IG from the vial into the syringe.
7. Syringe pump: SCIG is administered through a pump. Your provider will pick the best one for your administration.
8. Flow rate tubing: This tubing helps to control the time it takes for the IG to infuse. This is a very important piece of equipment for infusing.
9. Needle set with tape or clear dressings: It is important to have the correct needle set for administration. This includes the correct number of sites and needle length. If you are concerned your needle set needs to be changed, consult your provider. Make sure to secure the needles with tape or dressing to help prevent needle movement or displacement.
10. Alcohol swabs: Always disinfect skin and IG vials.
11. Sharps container: Once your IG infusion is complete, discard all supplies into the sharps container. This includes the syringe and needle set.
12. Gauze, tape and/or Band Aids: After removing the needle set, make sure you have something to protect the insertion site. Always cover with gauze, tape and/or Band Aids.
Prior to each infusion, check all supplies and make sure you are well-stocked. Contact your provider if you need to replace any items.
Keeping a checklist of all of your needed supplies will help ensure a smooth SCIG administration!