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Ambulatory Care for Children requiring Intravenous Drug Administration via a Peripheral Cannula

What is Ambulating?

Ambulating is when a child is well enough to leave hospital and continue their recovery at home, but require intravenous (IV) antibiotics whilst waiting blood culture results (it takes 48-72 hours to receive blood culture results) or to complete a course of intravenous antibiotic treatment, before the decision to stop intravenous antibiotics can be made. A decision to ambulate is made between the medical staff and the child/parents, this is often an appropriate choice for children who require IV medications once or twice daily. Ambulating means that your child will go home with their cannula (small hollow plastic tube) still in place.

There might be occasions where nursing staff request to move the time of your next dose of IV antibiotics, this is to make the time more child friendly or to try prevent long waiting times on the Ward during busy periods such as Ward round and doctor/nurse shift changes.

What to expect when ambulating

When you return to the Ward for your child’s next dose of IV antibiotics, please inform a member of the nursing team of your arrival and they will direct you to an appropriate waiting area.  A nurse will then take your child’s observations and administer the medication required. On occasion you may be required to wait for a nurse to be available to administer the IV antibiotics due to attending the Inpatient Ward. It may not always be necessary to be reviewed by a doctor when returning to the Ward, but if you have any concerns, please inform the nursing staff who will be happy to contact the doctor and arrange a review if necessary.

If a doctor review is required the nurses on the Ward will inform the medical team of your arrival, you can still expect to have a set of observations taken, but IV medication might not be given until the doctor has seen your child and made an updated plan of care.

When the decision to stop intravenous antibiotics is made by the Doctor, the cannula will be removed by a member of the nursing team. If longer term treatment is needed or more frequent IV antibiotics are required, we may be able to refer to the Children’s Community Nursing (CCN) team who would visit your house to administer IV antibiotics; this is not always possible or appropriate and will be reviewed on a case by case basis.

Caring for a cannula

Parents can be nervous about taking their child home with a cannula in place. Nursing staff will always secure the cannula with a splint and/or bandage before sending you home; in babies and younger children you can also cover the cannula in the hand with a mitten or sock.  If the bandage becomes soiled please inform nursing staff who will replace it on your next visit to the Ward.

Below are a few precautions you can take to keep the cannula safe and secure while at home:

  • Do not allow it to get wet.
  • Take care when removing your child’s clothing.
  • Ensure that your child is supervised when playing and is not allowed to play with sand or soil.

Occasionally cannulas fall out while at home, if this happens follow the steps below and contact the Ward to discuss replacing the cannula if required:

  • Apply pressure to the area with a tissue.
  • Maintain this pressure until the bleeding has completely stopped.
  • Once the bleeding has stopped apply a plaster.

If the Bleeding Does Not Stop:

  • Keep applying pressure to the area.
  • Lift the child’s arm above their head.
  • Go to your nearest Hospital Accident and Emergency Department.

Contacting the Ward:

If you have any questions or queries between your visit to the ward, please do not hesitate to contact us:

The Children’s Ward (Ward 3), Stoke Mandeville Hospital: 01296 315145 (open 24 hours every day)

The Children’s Day Unit (CDU), Wycombe  Hospital: 01494 425506 (open Monday-Friday 9am-5pm)