Fan of the Blood Bath
Most people probably do not enjoy the sight of blood. It can make you squeamish, faint, grossed out, scared, concerned, and panicked. In general, we don’t want to see blood; it’s something that is hidden away and safely flows through our veins to help keep us alive and healthy.
But there are circumstances in which we might want to see blood, particularly when it involves someone with a needle who is tasked to access a vein for a medical purpose. I know that at the laboratory I always appreciate it when I see blood quickly fill vials needed for testing.
I also REALLY enjoy seeing the little flash of blood that shows up when the infusion nurse successfully “sticks” my vein prior to starting in IV. I have historically been a “hard stick” meaning that nurses and technicians have had to try several times to get an IV started on me. My record in one sitting was 9 attempts to start an IV and this has happened twice.
Yesterday, I was in for an infusion of my RA medication, Rituxan. I love my local hospital outpatient infusion center and feel comfortable and safe among highly-skilled nurses. For several visits in a row over the past 3-4 years, I have been assigned to one particular nurse. She is the one with the magic touch that always gets an IV started on the first try. Leslie is my one-stick wonder-nurse.
Leslie has been an infusion nurse working in oncology for many, many years. She knows many of the special tips and tricks that help make the experience go more smoothly. There is one procedure which she does that really helps to make the infusion experience less painful. It is called a “blood bath.”
Rituxan is a medication that is associated with potential infusion reactions and I had several of those during the early years of using this drug. To reduce the risk of infusion reactions, patients are given certain pre-medications. The specific choice of pre-meds varies according to patient response and doctor preference. I typically receive acetaminophen (Tylenol), diphenhydramine (Benadryl), and methylprednisolone (SoluMedrol).
Benadryl is administered by IV prior to every infusion; some patients may be able to take oral Benadryl instead during subsequent infusions. One thing you may not know if you’ve never had IV Benadryl is that it STINGS and BURNS like all get out. It’s very irritating to the inner surfaces of veins and can cause severe discomfort and pain. OUCH!
Good news is that there are ways to mitigate the pain of diphenhydramine. One easy solution is to dilute the drug into a small bag of saline and to infuse it over a short period of time. But if your doctor did not specify this detail in the orders, the nurse must give the drug in a bolus or single push directly into the IV tubing. Doing this slowly helps to reduce the pain somewhat, but not entirely.
Another option is to use the “blood bath” technique which involves withdrawing some of your own blood back into the syringe which holds the medication and has been attached to the IV tubing. Mixing your own blood with the medication helps to dilute it somewhat and provides a buffer between the medication and the inner surface of your vein.
Yesterday I asked Leslie if we could pause so that I could take a quick picture of the colorful IV tubing and syringe while she was slowly pushing the Benadryl. That’s when she told me that not all nurses may be aware of the technique. She learned about it during her many years working in oncology. Like magic, the blood bath reduces the burn of Benadryl.
I’ve become a fan of the blood bath and am very thankful for this simple little step that makes the entire infusion experience easier and less painful.
What tips or tricks do you notice your own nurses using that help make receiving IV treatments easier?
Has having RA put a hold on your ambitions?