Name of the Procedure:

Common Name: Continuous Intravenous Infusion

Medical Term: Intravenous Infusion for Therapy/Diagnosis; Initiation of Prolonged Infusion (more than 8 hours), Requiring Use of Portable or Implantable Pump (HCPCS Code: C8957)

Summary

This procedure involves the administration of medication or fluids directly into a vein through a portable or implantable pump for a prolonged period, typically more than 8 hours. The pump allows for continuous delivery of the treatment, which can be done at home or in a medical facility.

Purpose

Conditions Addressed:

• Chronic pain
• Cancer
• Infections requiring long-duration antibiotics
• Other conditions requiring continuous medication delivery

Goals:

• To provide a consistent and controlled flow of medication or fluids over a prolonged period.
• To enhance the effectiveness of the treatment through continuous administration.

Indications

Symptoms/Conditions:

• Severe infections
• Chronic pain conditions
• Palliative care for cancer patients
• Conditions requiring continuous drug delivery

Patient Criteria:

• Patients needing extended medication administration
• Patients who can benefit from at-home treatment
• Individuals who require a precise and controlled drug dosage over an extended period

Preparation

Pre-procedure instructions:

• Follow specific fasting instructions if required by the healthcare provider.
• Adjust any current medications as advised by the medical team.
• Complete necessary blood tests, kidney function tests, or imaging studies.

Procedure Description

Steps:

1. A healthcare professional accesses a vein, usually via a central line.
2. The portable or implantable pump is prepared and filled with the prescribed medication.
3. The pump is attached to the intravenous line, ensuring it is functioning correctly.
4. The medication is continuously infused over more than 8 hours.

Tools/Equipment:

• Central venous catheters or peripheral IV lines
• Portable or implantable infusion pumps
• Sterile syringes and needles

Anesthesia/Sedation:

• Usually not required, but local anesthesia might be used for line insertion.

Duration

The infusion takes more than 8 hours; the exact duration depends on the medical need and prescribed treatment plan.

Setting

This procedure can be performed in a hospital, outpatient clinic, or at the patient's home under the supervision of healthcare professionals.

Personnel

• Nurses
• Medical technicians
• Pharmacists
• Healthcare providers overseeing the treatment plan

Risks and Complications

Common Risks:

• Infection at the insertion site
• Phlebitis (vein inflammation)
• Allergic reaction to the medication

Rare Risks:

• Blood clots
• Mechanical failure of the pump
• Severe infection requiring hospitalization

Benefits

• Effective management of chronic conditions
• Improved quality of life by allowing treatment at home
• Continuous and consistent drug delivery
• Reduced need for frequent hospital visits

Recovery

Post-procedure care:

• Monitor the infusion site for signs of infection or complications.
• Follow specific care instructions for the infusion pump.
• Schedule follow-up appointments for pump maintenance and medication adjustments.

Recovery time:

• There is no traditional recovery time as the procedure is ongoing; patients can usually resume most normal activities.

Alternatives

Other Treatment Options:

• Oral medications
• Intermittent IV infusions
• Subcutaneous injections

Comparative Pros and Cons:

• Portable pumps offer more consistent drug levels compared to intermittent infusions but require more careful monitoring.
• Oral medications are less invasive but may not provide the needed therapeutic levels.

Patient Experience

During the Procedure:

• Minimal discomfort during IV line insertion.
• Ongoing sensation of the line in place.

After the Procedure:

• Adherence to daily pump management routines.
• Mild discomfort or inconvenience from wearing/maintaining the pump.
• Instructions on managing pain and ensuring comfort.