For the most part, hospital departments have familiar names – think surgery, emergency or maternity. But there’s another important medical service that many people have never heard of. It’s called pediatric infusion therapy, and it helps kids from toddlers to teenagers stay as healthy as possible with their chronic illness.
You might even know one of these kids. They have conditions such as juvenile arthritis, Crohn’s disease, metabolic disorders and bone diseases, cancer and others. According to Maria Gurreri, RN, many children and teens who get infusion therapies don’t appear sick.
“Their friends may not even know they have a problem, because the infusion therapy is keeping their symptoms under control,” says Gurreri, who is a pediatric infusion nurse coordinator at Community Medical Center.
Here’s how it works. When the patient comes to the infusion center, he or she gets a full medical assessment every time. Both a specially trained nurse and a pediatric hospitalist do physical exams and measure heart rate, respirations and other vital signs. Blood tests also are done to make sure the patient is well enough to get the infusion. All the while, the nurse and doctor are talking to the patient and his or her parents about how they have been doing since the last treatment.
If the lab work and other tests show that the patient can have the infusion, the nurse starts the process. First heart and respiration monitors are applied. Allergic reactions are always a possibility, and the patient may get a premedication such as a steroid to minimize that risk. As another precaution, the medication is started at a low dose and then tapered up so any reaction can be caught and treated as soon as possible.
Once the infusion is underway and the patient is doing well, everyone settles in for the duration. The nurse checks vitals every 15 to 30 minutes and watches closely for problems.
“Bad reactions in kids can be very subtle,” Gurreri says. It takes close attention and experience to catch them quickly. Nurses who are certified by the Association of Pediatric Hematology and Oncology are specially trained to identify problems and care for these kids.
A typical pediatric infusion session lasts about 2 ½ hours, though it actually takes more like 4 hours with the preparation time. Some conditions require longer sessions and kids may be at the center for 8 hours.
How kids and their families spend that time depends on the facility. In some centers, pediatric and adult infusions are done in the same area with beds or recliners shielded by curtains. In others, especially in dedicated pediatric infusion centers, the kids and their families stay in private rooms. This type of center treats only children and teens, who may pass the time with TV, movies, games and even homework.
Reactions can occur even after the infusion is finished. For that reason, patients remain at the center for another 30 minutes. They also get instructions on danger signs to watch for later and when to call 911.
Depending on their condition, patients may come to the pediatric infusion center once a week, once a month or on another schedule that fits their needs. These sessions can be a disruption for kids and their families. Many older children and teens are in school sports and other activities. Pediatric infusion centers can often schedule around practices and other events.
Many kids who get infusion therapy will need it for life. It allows them to be active, play sports and hang out with their friends without pain or other symptoms. Gurreri has seen infusions help children go from being carried to the center to riding a bike after just three sessions.
“These are serious drugs that can have side effects, but most kids do well,” she says.
“That’s why we do this work.”