Injections and drips

Injection or a drip into your vein

Cancer drugs you have by injection or drip into your bloodstream usually work very quickly.

An injection into a vein is called an intravenous injection (IV) or bolus injection. You usually have the IV through a thin short tube that goes into a large vein in one of your arms. But sometimes you might have it in your hand. This is known as a cannula. This can stay in for a few days if needed.

Your nurse attaches a syringe to the cannula to inject the drug. The cannula has a rubber bung on it that they inject the drug through.

The following picture shows a cannula in an arm.

Some cancer drugs come diluted in a bag of fluid that you have as a drip. Your bag of fluid attaches to a long rubber tube called a giving set, the nurse attaches this set to your cannula. The drug flows through the tube into your vein over a number of minutes or hours.

An injection into your muscle

Some drugs come as an injection you have into a muscle. You usually have these in your buttocks, upper thigh or upper arm. These are called intramuscular injections.

You might have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much.

An injection under your skin

Some medicines come as an injection you have just under the skin. You usually have these types of injections into the stomach, thigh or top of your arm. These are called subcutaneous injections.

You might have stinging or a dull ache for a short time after this type of injection, but they don't usually hurt much. The skin in the area may go red and itchy for a while.

The video below shows you how to inject just under your skin (subcutaneously), it lasts just over 3 minutes.

Central lines (skin tunnelled catheters)

Central lines usually go into your body in the centre of your chest. Then they run under your skin to a large vein by your collarbone. They are also called skin tunnelled catheters.

The only bit you can see is the length of line that hangs out of the small entry hole in the skin on your chest. This is a diagram of a central line in place.

This is a picture of a skin tunnelled central line in place.

You usually have a central line inserted with a local anaesthetic. Some people may also have a sedative. You might have a general anaesthetic for a central line insertion, but this is less common. When it's in, the doctor stitches it in place or puts a dressing over it, so it doesn't come out.

Your doctor and nurse can take blood from the line for tests. They can also use the line to give you fluids or other treatments such as antibiotics, if you need them.

This video shows how a tunnelled central line is put in. It is 1 minute and 47 seconds long.

PICC lines

PICC stands for Peripherally Inserted Central Catheter. It is a long plastic tube that goes into a vein in your arm and ends in a large vein in your chest close to your heart.

This is a diagram showing a PICC line.

The following is a photograph of a PICC line on an arm.

It can be put in during an outpatient appointment under local anaesthetic.

A doctor or nurse can insert your PICC line. They use an ultrasound machine to help find the best vein to use. You might have an x-ray or ECG afterwards to make sure the end of the tube is in the best place.

PICC lines can be left in for several months and are used similarly to central lines.

Portacaths (implanted ports)

A Portacath is a particular type of central line. It has a small chamber or reservoir that sits under your skin. It’s attached to a long plastic tube that goes into a large vein close to your heart.

A following diagram shows you the placement of a Portacath.

You can feel the chamber but cannot usually see it. You don't have a tube coming out of your chest, as you do with other types of central line. It is also called:

• an implanted port

• a totally implantable venous access device (TIVAD)

• a port

When you need treatment, your nurse puts a needle into the chamber and gives you injections or attaches a drip. The needle stays in place during each treatment. The nurse removes the needle at the end of each treatment.

The following is a diagram showing a needle in the chamber of a Portacath.

The main advantage of a Portacath is that you can't see it on the outside of your body. But some people prefer a central line because they don't like having a needle put through the skin each time they need treatment.

If you prefer, you can have the area over the Portacath numbed with a local anaesthetic cream before the nurse puts the needle in.

Infusion pumps

A pump is a way to give a controlled amount of drugs or fluids into your bloodstream. There are several types of pumps. These include a:

• hospital pump

• continuous pressure pump

• computerised ambulatory delivery device (CADD pump)

Your nurse will show you or a family member how to look after a pump you take home. Contact your advice line number at any time of day if you have any problems or questions when you get home.

Hospital pump

You might have cancer drugs, fluids, and other medicines through a pump attached to a drip stand. The drip stand is on wheels and the pump works on a battery so you can walk about with it.

The following is a photograph showing a nurse using a hospital pump.

Continuous pressure pump

A continuous pressure pump also has some other names, this includes an elastomeric pump or an infusor pump.

It gives a low dose of the drug 24 hours a day. It contains a small balloon, which contains the drug. This connects to your central line by a plastic tube. The drug flows from the balloon and into your vein. The balloon will slowly deflate as you have the drug.

The pump is about the size of a small water bottle and is fitted at the hospital. You can usually go home with it, and it doesn't need a battery. You can carry it in a bag or belt holster, which they'll give you at the hospital.

You go back to the hospital after a few days or a week to have the pump changed or removed. Or a district nurse may be able to change or disconnect it in your home. You commonly have the chemotherapy drug fluorouracil this way.

A photograph below is of a continuous pressure pump.

CADD pump

A CADD pump stands for Computerised Ambulatory Delivery Device. It is a battery operated pump. It attaches to a cassette or infusion bag that contains the fluid or cancers drugs. This fits inside a bag that you wear like a rucksack or bag around your waist.

Your nurse programmes the pump and it delivers the correct dose of medicine or fluids at the right time, as prescribed by the doctor.

The CADD pump allows you to have the treatment at home. Or you might stay in a hotel or other residence nearby, which the hospital pays for.

Syringe drivers

A syringe driver can also be called a syringe pump. It can be:

• battery operated

• plugged into a normal electric wall socket

You have a syringe pump or driver if you need a constant dose of a particular drug.

Some of the reasons why you might have it include:

• you are finding it difficult to swallow

• your very ill and drowsy

• you’re in the last few weeks of life

• you are struggling with a particular symptom such as feeling sick

Your healthcare usually uses this route for pain and sickness control, but you can have it for some other medicines. It is a very efficient way of having continuous medicines.

You might have one or more drugs in the syringe. The syringe is connected to a soft plastic tube to a needle that goes under your skin or directly into your vein. Your nurse fixes the needle in place with a transparent plastic dressing stuck over the top.

Your nurse sets the pump so that you get exactly the dose you need each hour. Your nurse might change the syringe every day or so. Some drugs can't be used in syringe drivers because they irritate the skin or don't completely dissolve in water.

Find out about other ways to have cancer drugs