Blinatumomab (BLINCYTO®) Bag Changes at Home

Instructions for disconnecting to change the bag:

1. Wash your hands with soap and water.

2. Wipe your prep area well with an antibacterial cleanser before laying down supplies.

3. Gather your supplies:

• Hand sanitizer 

• Timer 

• Alcohol pads or Site-Scrubs® 

• 4 AA batteries

• New blinatumomab bag with tubing- Check expiration date.

• Protective barrier such as ValGuard®

• Dressing reinforcement or central line securement devices may also be needed.

4. Perform a visual check of the line.

• Check that the dressing is intact.

• Check that the central line site looks unchanged.

• Look for any wetness or soiling of the dressing or tubing.

• Reinforce dressing if appropriate.

• Call your infusion company to discuss concerns about the needleless cap, the central line, or if a dressing change is needed.

5. Turn off the infusion pump and close all clamps.

• Press Stop/Start

• When “Stop Pump?” appears on the pump screen, select Yes.

• The pump stops running. The green “Running” message in the status bar changes to a red “Stopped” message, and “Pump is stopping…” appears briefly on the screen.

• Clamp tubing.

6. Clean your hands with soap and water or hand sanitizer again. 

7. Remove any protective barrier (like ValGuard®)

8. Disconnect the IV tubing from the needleless cap by twisting it to the left: Use one hand to secure the line and hold the needleless cap where it meets the central line. This helps to prevent accidentally unscrewing the needleless cap while removing the IV tubing. 

9. Remove cassette from CADD pump.

10. Be sure to unhook the tubing from your child’s clothing and set it aside to throw away.

11. Power off the pump. Press the power switch to turn the pump off. When you see “Power down?” on the screen, select “Yes”. The pump then powers down.

12. Change the batteries. The batteries must be changed with every bag change. The pump remembers all programmed settings when the batteries are removed, but the batteries must be in place during delivery. 

• Make sure the pump is stopped and powered off. Using your fingers, the pump key, or a coin, turn the knob on the battery door counterclockwise (from right to left) to open the battery door.

• Remove batteries.

• Hold the pump at an angle and place four new AA batteries in the pump, from the bottom up. Match the + and – markings on the new batteries with the markings on the pump.

Instructions for connecting a new bag to your child’s central line: 

1. Clean your hands.

2. Power up the pump. Press and hold the power switch to turn the pump on. The pump starts the power up sequence during which it performs various self-tests and tests for alarm conditions.

3. Install the cassette.

• Before attaching a new cassette, make sure the pump is powered on. 

• Make sure the cassette latch is unlocked then open the latch.

• Insert the cassette hooks into the hinge pins on the bottom of the pump, then swing the cassette to the latch position.

• Place the pump upright on a firm, flat surface, and then press down on the latch side of the pump so the cassette fits tightly against the pump.

• Lift the cassette latch handle into the closed position. If you experience resistance when lifting the cassette latch handle, do not force the latch. If the pump doesn’t latch easily, unlatch the cassette and repeat the process.

• Verify the cassette is attached correctly. Looking from left to right, the top of the cassette should line up evenly with the bottom of the pump and be securely attached. If an uneven gap exists, unlatch the cassette and repeat the process.

• Secure latch with white medical tape to ensure that it stays closed.

4. The pump will ask if you want to prime. 

• Blinatumomab tubing comes primed from CHOP Home Care pharmacy. Tubing from other home care companies may not be primed. If you need to prime the tubing, answer Yes to priming. Hold button down until you see a drop of medicine at the end of the tubing. 

5. Reset reservoir volume. Answer Yes when the pump asks if you want to reset reservoir volume.

6. Clean your hands with hand sanitizer. 

7. Scrub the needleless cap with an alcohol pad or Site-Scrub® for 15 seconds and let it dry for 15 seconds. Do not blow or fan the needless cap. If anything touches the cap, you must clean it again.

8. Remove the sterile cover on the end of the IV tubing. Twist the end of the IV tubing to the right to connect tubing to the needleless cap. Do not twist the central line.

9. Starting nearest to your child, unclamp any line or tubing clamps. Check that all connections are snug. Start pump. 

• Press Stop/Start

• When “Start Pump?” appears, select Yes.

• When the pump is running, “Running” appears on the status bar, the graphic on the home screen is green, and the green indicator light flashes. If the pump will not start, a message appears on the display.

10. You will need to apply a protective barrier (like ValGuard®, Parafilm ® or other product provided by your infusion company). Example of Valguard® to cover all tubing connections if your child: 

• Wears a diaper or has accidents overnight. 

• Occasionally vomits or spits up. 

• Has a feeding tube or ostomy.

Example of Velcro device securing IV tubing to clothing. Use a Velcro device to secure IV tubing to your child’s clothing. Secure so that tubing does not pull on your child’s central line or drag on the floor. Check to be sure that no metal clips are touching your child’s skin,  

Call your CHOP oncology team if:

• Your child has a fever of 101.3°F (38.5°C) once, or 100.4°F (38°C)- 101.2°F (38.4°C) three times in a 24-hour period, taken at least 2 hours apart.

• Your child complains of side effects.

• Your home care company cannot fix an infusion problem, and you need to come to the CHOP ED or Oncology Clinic.

• You have any questions or concerns.

If your child shows signs of a life-threatening reaction, call 911.

Oncology Contact Information

Reviewed October 2024 by Patty Burns-Lynch MSN,RN, CPHON