Self-Infusion

Your child can learn to self infuse. Yes, it can be something you do yourself. Training can be arranged by contacting the haemophilia team at Children’s Health Ireland at Crumlin.

Self-Infusion is an important part of a person with haemophilia’s life. Self-infusion is when a person with haemophilia gives treatment to themselves. Before starting self-infusion, a child with haemophilia is entirely dependent on someone else to get their factor.

Self-infusing for the first time can bring fear which is quickly overwhelmed by pride and happiness. Starting self-infusion can be daunting for parents and children, especially when things are going well as they are. In case you think your child is too young the average age when children start to self-infuse is 7-9 years old, but there have been cases of younger children than this self-infusing.

The best advice in relation to self-infusing is to do it as soon possible, when the child is ready. If your child is not ready to self-infuse, try getting them to help you with the process. This will help them feel more comfortable when the time comes for them to self-infuse. Self-infusion is the next step in children becoming independent in giving their own factor. The earlier we start it and the more we get kids on board the easier it is to actually train them to do it themselves.

Self-Infusing is much easier and quicker. It makes the child much more independent. It eliminates the complications that goes along with a port – no risk of infection, no risk of blockages and no risk of breakage. It is much more portable, less equipment needed for peripheral access than port access. Once your port stops working you are already trained and you are good to go.

Items needed for self-infusion:

A tourniquet
Alcohol wipes
Butterfly needle
Tape
Syringe
Factor concentrate
Sharps container

Preparation:

Make sure your child’s hands have been washed and the area is clean.
The relevant limb should be adequately supported on a stable surface below heart level to allow gravity to enhance venous dilation. This causes blood to pool and veins to distend. Lightly tapping or gently stroking the vein along its length in a downward direction will also cause venous distension. Another simple, effective way to dilate veins consists of alternately clenching and relaxing your fist.
Feel the veins to see how big they are, and in which direction they go, choosing ones that are straight. Start by placing one or two fingers over the vein and press lightly. Your thumbs should not be used as they are less sensitive.
Apply a tourniquet two inches above the potential site for one minute only. Allow a few minutes for the vein to become more prominent.
Select the vein, clean the skin with an alcohol swab in a downward stroke, and allow skin to dry.
With the tourniquet applied, the vein identified, and the factor ready, hold the butterfly wings and insert the needle into the vein with the bevel facing upwards.
When there is blood flashback (visible in the butterfly tubing), remove the tourniquet and inject the factor concentrate slowly.
Once this is complete you can withdraw the needle, making sure to put pressure over the vein with a piece of cotton wool for two or three minutes. Then place a plaster on the site.

For more information please contact the haemophilia team at Children’s Health Ireland at Crumlin.