WARNING: The information in this section is meant as a general guide to help parents and caregivers with common issues and is not intended to replace the care provided by your child’s healthcare team. 

Discuss your child’s unique needs with your healthcare team, including WHO and WHEN to contact when problems arise.

 

Fever with or without other symptoms: ≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit

General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy)

One or more of these symptoms: decreased urination - increased thirst - dry lips and mouth - faster heart rate than usual - weight loss

Redness, heat, swelling, tenderness or pain at the catheter entry site

Blood leaking at catheter insertion site

One or more of these symptoms: burning or pain at the entrance site of the catheter, cold skin around the entrance site of the catheter, swelling of the arm (PICC line), swelling around the catheter catheter site, leakage at catheter entry site, change in skin color (whiteness or redness) around the catheter entry site

Length of the external portion of the catheter has changed (length is shorter or longer than usual) or the catheter is completely removed from the vein

Extended redness or itching of the skin under dressing

Protective dressing is wet or damp due to leakage of blood, pus or other discharge

Dressing is falling off, loose, punctured or torn

Cord-like sensation of the vein where the catheter is inserted (may be hard, red or tender to touch)

One or more of these symptoms: swelling of the hand, arm or side where the catheter is located, underarm pain in the arm where the catheter is located, swelling of the neck and face

Resistance or inability to irrigate (flush) the catheter

Presence of blood in catheter tubing

Broken (leaking) catheter or malfunctioning equipment

Child with an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation

Pain in the ear, throat, neck, armpit (under the arm) or shoulder on the same side of the catheter

Particular odor or a strange taste reported by your child during irrigation

Unusual sound heard by your child on the catheter side during irrigation of the catheter or administration of medication with or without: pain in the ear, throat pain

Swelling in the neck, face or in the arm on the same side of the catheter; pain in the armpit (under the arm)

Presence of air bubbles or particles in the medication bag, cassette reservoir or elastomeric infusion pump

Medication administration time longer than usual

More solution left than expected in the medication bag/cassette reservoir at the end of administration

More solution left than expected in the balloon reservoir at the end of administration (the balloon should be empty, flattened and small ridges visible)

Inadvertent disconnection of the needleless connector or the pump tubing

Ambulatory infusion pump alarms

Leakage of the elastomeric infusion pump or bursting of the balloon

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.

When to consult your healthcare team

General state of health

When your child has any of the following symptoms:

  • Fever (≥ 38⁰C rectal or ≥ 37.5⁰C buccal or ≥ 37.5⁰C armpit).
  • General irritability, poor appetite, fatigue or wanting to sleep more than usual (lethargy).
  • Signs and/or symptoms of dehydration:
    • Decreased urination,
    • Increased thirst,
    • Dry lips and mouth,
    • Faster heart rate than usual,
    • Weight loss.

Intravenous catheter

  • The catheter entry site is red, swollen, hot or painful.
  • There is bleeding or other leakage at the entrance site of the catheter.
  • The color of the skin is pale or red around the entrance site of the catheter.
  • The skin around the entrance site of the catheter is cold or your child reports burning or pain at this location.
  • The length of the external portion of the catheter has changed (length is shorter or longer than usual) or the catheter is completely removed from the vein.
  • There is redness or itching of the skin under the dressing.
  • The dressing is damp or soiled with pus or other discharge.
  • The dressing is peeled off, punctured or torn.
  • There is redness, sensitivity or a cord-like feeling along the vein where the catheter is inserted.
  • Irrigation/flushing of the catheter is difficult or impossible.
  • The catheter is broken.
  • If your child has an implantable chamber catheter (eg, Port-a-Cath®): pain or swelling at the site of insertion of the reservoir during the administration of the solution or irrigation.
  • Your child:
    • complains of pain in the ear, throat, neck, armpit or shoulder on the same side of the catheter;
    • smells a particular odor or has a strange taste in their mouth during irrigation of the catheter;
    • hears an unusual sound during irrigation of the catheter or administration of medication;
    • has swelling in the neck, face or the arm on the same side as the catheter.

Equipment for administering the medication

  • The medication bag, cassette reservoir or balloon reservoir contains air bubbles or particles.
  • Medication takes longer than usual to administer, and you cannot solve the issue.
  • There is more solution left than expected in the medication bag/cassette reservoir at the end of administration.
  • There is more solution left than expected in the balloon reservoir at the end of administration (the balloon should be empty, flattened and small ridges visible).
  • The needleless connector or extension tubing is broken or inadvertently disconnected.
  • A piece of equipment is broken.
  • You are unable to operate the ambulatory infusion pump correctly or to correct problems related to the alarms.
  • The ambulatory infusion pump screen is broken or displayed incorrectly.

Your child’s healthcare team will take the opportunity during your child’s follow-up appointments to review your child’s care and equipment.  Adjustments will be made as required.

Do not hesitate to refer to your child’s healthcare team for any questions or for specific advice related to your child’s condition.