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Chemotherapy Checklist

Chemotherapy (Injectable) Checklist

Pre-Treatment

  • Owner Authorization papers signed
  • Patient chart
  • Physical by DVM
  • Physical by Oncology technician
  • Patient weight in kilograms
  • Chemistry panel
  • CBC
  • Neutrophil count, postpone treatment if less than 3,000/ul
  • WBC, postpone if low, possibly start antibiotics

Patient

  • Housed in an appropriate sized cage or run, if caged a lower cage is suggested to avoid urine running to lower cage.
  • Cage/run is in a location where the patient can be observed at all times
  • Patient identification card
  • Cage marked with a very visible sign indicating “Chemotherapy Patient”
  • Fresh water

Supplies

  • Chemotherapy log sheet
  • M2 Conversion chart
  • Calculator
  • Calculate drug dosage, triple check
  • Chemotherapy agent
  • Hair clipper with 40 blade
  • Surgical scrub/alcohol
  • 1”white tape
  • Bandaging material
  • Scissors
  • Gauze pads
  • Butterfly catheter (depending on chemotherapy agent)
  • Over-the-needle 22g catheter (depending on chemotherapy agent)
    • Universal Vial Spike w/Clave (one per bottle)
    • Spiros Closed Male adaptor
    • Administration set – Clave Drip Chamber
    • 250 ml bag Nacl

Supplies (cont)

  • Luerlock syringe – appropriate size
  • Chemotherapy gloves – one pair per person
  • Chemotherapy gown – one per person
  • Protective eye wear – one per person
  • Chemotherapy mask – one per person
  • Chemotherapy medical waste bag
  • Chemotherapy sharps container

Treatment Procedure

  • Have the patient walked prior to treatment
  • Procedure should be performed in Chemotherapy room or a low traffic area
  • Have assistant and yourself dress in appropriate clothing
  • Place catheter alternating between right and left leg, This MUST be a clean stick, if not place higher on same leg or place in other leg
  • Secure catheter in place
  • Draw up chemotherapy agent in Luerlock syringe
  • Make sure patient and assistant are comfortable
  • Administer chemotherapy agent following hospital protocol
  • Monitor above catheter site for swelling during entire treatment, if swelling is noted STOP injecting immediately. Remove IV catheter and follow extravasation procedure.
  • Once treatment is finished remove catheter with injection site covered with several gauze pads; once catheter is removed hold steady pressure over IV site for 5 minutes
  • Place a firm bandage over IV site and leave in place for one hour
  • Wear gloves when removing bandage, send gloves home with owner if out patient treatment is being performed
  • Patient can be placed back into their cage/run, be sure “Chemotherapy Patient” sign is visible.
  • Place all waste material, syringes, catheter, IV line, etc. in appropriate waste containers
  • You can now safely remove chemotherapy clothing; gloves should go into medical waste bag.

Patient Clean Up

  • Medical staff must wear gloves when cleaning cage, bedding and excrement of all chemotherapy patients
  • All solid waste must be double bagged before being placed in the trash
  • If possible collect urine in a pan and flush it down the drain
  • If you do not catch the urine thoroughly rinse the area with copious amounts of water, avoiding splashing at all times
  • Blankets and bedding should be washed asap with regular disinfectant
  • Cage/run can be cleaned with regular disinfectant. DO NOT use a spray bottle or hose, avoid aerosolization

Discharge

  • Supply owner with written home care instruction. Go over the entire form at EVERY visit.
  • Have owner sign two copies of discharge papers, one for them and one for the patient record. See our version of “Home Care Instruction” in our specialty folder
  • Supply owner with gloves
  • Schedule follow-up blood work, CBC 10 day post treatment
  • Schedule next tentative chemotherapy treatment

24 hours post Chemotherapy

Follow up phone call to owner

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