I've got quite bad asthma (15 admissions in the last year, 60mg of pred a day for 9 months, on everything else going, on a salicylate free diet, etc etc even doing some research studies to see if they will help) but I have been offered a trial of sub-cut bricanyl. Which I am thrilled about as I have seen lots of people on here who have responded really well to it. But I am having issues.
My GP surgery say they cannot provide the pumps/needles etc and the district nurses need to do it, however the district nurses say they have never given this sort of treatment before, and they hospital should be sorting it out. The hospital say that the community have all of the syringe drivers so they cant help. I am soo frustrated!
So I was wondering who supports you with your sub cut stuff? I know it will be different in each health care trust but it would be useful to know so I can 'nag' the right people! I am sick of icky hospital food!
My local hospital supplys all my syringes, needles sof sets etc. The pump is borrowed from the paliative care ward and my resp nurse sorts all that out. A few other patients have also been on it. The only thing my local surgery do is prescribe my Bricanyl.
I have had a very good respone from it, even hoping to return to work soon after 6 years off!
Any more questions, just ask
Clare
when I was on it the hospital supplied the syringe driver and the district nurses dealt with all the needles and syringes etc and the drs prescribed the bricanyl for infusion.
Hi
I got the pump training and a starter pack from the hospital (training was given by a MacMillan Nurse they had the most experience of the Syringe Driver at the time nearly 2 years now!), all the supplies now come via my GP/District Nurse. It can be a bit strained sometimes as the District Nurse can be a bit slow ordering my supplies but I have just learned to be much more forceful and if I have to make a wee mention of my Consultant and then low and behold it comes quickly
I have found it to be a big sucess so push for it if you can and good luck and if you need any help or advice or just someone to talk to about it give me a shout, good luck!
Hi just started it last month. My resp team at a Glasgow hospital provided pump and all supplies. They are keen for gp to take over supplies. Unfortunnately no one in communitty seems capable of deciding who is responsible for ordeing it. Gp is willing to cover the cost. Till they sort it out hospital will continue to supply....
My supplies come from (at the moment anyway...) from a county medical and surgical supplies centre. (Essex Medical Equipment Service) who supply anything needed in the community. (eg OT appliances such as perching stools, bath boards etc, needles, syringes , dressings etc etc etc )
I have come into this service as originally years ago when I first started s/c in 1995, it was handed to my GP surgery, then to the district nurses to sort, order and deliver stuff.
It was then centralised but the original orders come from the district nurses and it is them who I speak to to get anything changed ( I asked for Sillouette needles back in 2006 as they were more compact for a trip to the Falklands with a 14kg weight limit!!)
I just phone the equipment service when supplies start to get low and they usually deliver within 2-3 days. Sometimes the sillouette needles need to be ordered in)
I get syringes, Sillouette sof sets, drawing up needles, sterets and sharps bins from them.
My Pump comes from the hospital med equip library.......... Graseby MS26, though not sure it will be a graseby for long...
Regarding the district nurses giving the treatment, if you are competent at sorting it at home, all they need to do is supply the syringes etc and check that you are able to manage etc,
I have never had any real support from the dist nurses, was shown in hosp how to use it, fortunately another patient was in and so there was some support.
We wrote down a list of instructions on the back of a hospital menu card ( best thing for them !!!)
The ward was a great help and support.
Now it is up to me to sort it all myself at home. I am able to stop and start it, alter the dose (speaking to my Cons etc) and can generally get on with life.
Please speak to your consultant and get them to get the wheels rolling in the right direction. Perhaps a list of requirements both support, equipment and supplies may help.
Hope this helps
Kate
Thank you all for your advice! I'm spending most of this morning ringing round and hasseling people after yet another ED attendance yesterday hopefully I will get it all sorted! x
I get all my supplies from my resp nurse, all my GP needs to do is prescribe the terbutaline and exchange my sharps bins.
All I have needed is green needles, 10ml Luer lock syringes and soft sets. The pump is a McKinley T34 (formerly Graseby) the hospital provide the batteries and also sterets.
Recently however I haven't been able to get any Terbutaline at all, a national shortage apparently, and I have had to use sub cut Salbutamol instead which I don't rate at all.
The sub cut infusion does seem to have helped and I have managed to get back to work (I'm a nurse myself so the pump is a doddle!) so it's worth a try in my opinion.
Its a good idea to have your Potassium monitored regularly as Bricanyl can drive it out of your cells and cause all sorts of nasty side effects fom frequent painfull muscle cramps to heart arythmias, but with the right community support the risks are worth the benefits. Took me a while to get used to having the pump though and fitting it into my life, just silly things like being free to change it after each 24 hours, where to lay it when your in bed and what to wear to store it, i'm a bloke and don't have a hand bag and dont like the idea of a bum bag so I mainly wear combat pants.
Out of interest, what doses are people on? and any tips or advice for daily life with the pump, i'm still very self conscious of it and mine bbeeps every 5 minutes for an hour prior to needing changed.
I have a graseby MS26 still, no real noise apart from when it runs out! Squeeks loudly. The small squeeks when it pumps I don't notice at all now.
I use and prefer Ventolin, less volume and less cramps too! Ventolin is 1mg in1ml whereas Bricanyl is 0.5mg in 1ml.
when I was on Bric, I used between 7.5mg and 10mg (20mls) and occasionally higher.
Ventolin I am on 7.5mg/ml at the mo and can go up to 10mg/ml if needed.
Less volume leads to less site problems. I had a lot of tissuing issues with 20mls going in, even with some of the newer needle sets. I use Sillouettes now ( flat sof sets)
The only thing I have to buy is the batteries............ IKEA ones are fine but I have recently discovered 99p shops where I can get 2-3 in a pack. I was a bit nervous about using cheap batteries but they last just as long, over a month.
I think McKinleys eat batteries? Will check with a friend as he is the Rep for our area. (Nice friend to have for when my health trust finally catches up and goes over to McKinleys. )
In bed, I sometimes forget at 3am and wonder off to loo without picking it up. It sits just below my pillow.
Day - i have a selection of hand made pouches with belt loops - originated from a very old passport pouch I had which has more or less worn out... Lots of co-ordinating colours etc... It either loops onto trouser belt or I have an elastic belt with a snap clip for under clothes etc.
At home it goes in pockets ......... I have even sneeked it in my St John Amb combat pockets in a pouch ...... my colleages are aware of it so no probs. I try to keep it under the trousers when in uniform....
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hopefully I will get it all sorted! x
Sub cut pump
Sub cut terbutaline
