Get the free Intravenous Immunoglobulin - Subcutaneous ... - Security Health Plan

877. 727. 2232 715. 221. 9898 Intravenous Immunoglobulin/Subcutaneous Immunoglobulin Infusion Prior Authorization Request Date Member information Member name print SMID Date of birth month/day/year Telephone number Fax number Provider information Provider name print Medication requested l Bivigam l Carimune l Gammaplex l Gamunex Subcutaneous immunoglobulin SQIG l Gammagard l Gammaked l Flebogamma l Octagam l Privigen l Hizentra Indicate the diagnosis l Primary immunodeficiency syndrome...

How to fill out intravenous immunoglobulin - subcutaneous

How to fill out intravenous immunoglobulin - subcutaneous

1. Wash your hands thoroughly with soap and water before starting the procedure.
2. Gather all the necessary supplies, including the vial of intravenous immunoglobulin (IVIG), subcutaneous infusion sets, alcohol swabs, and a sharps container.
3. Check the expiration date and appearance of the IVIG vial. Do not use if expired, discolored, or contains particles.
4. Clean the rubber stopper of the IVIG vial with an alcohol swab.
5. Remove the protective cover from the subcutaneous infusion set and attach it to the IVIG vial.
6. Prime the infusion set by filling the tubing with IVIG according to the manufacturer's instructions.
7. Choose a suitable injection site for subcutaneous infusion, typically on the abdomen or thighs. Clean the site with an alcohol swab.
8. Pinch the skin at the selected site and insert the cannula of the infusion set into the subcutaneous tissue at a slight angle.
9. Secure the cannula in place with an adhesive dressing or tape.
10. Open the flow regulator on the infusion set to start the subcutaneous infusion.
11. Monitor the infusion site for any signs of infection, swelling, or discomfort during the infusion.
12. Once the infusion is complete, properly dispose of the used infusion set and vial in the sharps container.
13. Wash your hands again after completing the procedure.

Who needs intravenous immunoglobulin - subcutaneous?

1. Individuals with primary immunodeficiency disorders who are unable to produce sufficient antibodies.
2. Patients with autoimmune diseases such as immune thrombocytopenic purpura (ITP) or Kawasaki disease.
3. People undergoing bone marrow transplantation or solid organ transplantation.
4. Patients with certain types of cancers like chronic lymphocytic leukemia (CLL) or multiple myeloma.
5. Individuals with recurrent bacterial infections despite antibiotic treatment.
6. Patients with HIV/AIDS who have low levels of immunoglobulins.
7. People with specific genetic disorders affecting the immune system.

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What is intravenous immunoglobulin - subcutaneous?

Intravenous immunoglobulin - subcutaneous is a method of administering immunoglobulin therapy by injecting it under the skin rather than directly into a vein.

Who is required to file intravenous immunoglobulin - subcutaneous?

Patients who have been prescribed intravenous immunoglobulin - subcutaneous by their healthcare provider are required to administer and file the treatment.

How to fill out intravenous immunoglobulin - subcutaneous?

Intravenous immunoglobulin - subcutaneous is filled out by following the specific instructions provided by the healthcare provider for administering the treatment properly.

What is the purpose of intravenous immunoglobulin - subcutaneous?

The purpose of intravenous immunoglobulin - subcutaneous is to boost the immune system and provide antibodies to help fight off infections and diseases.

What information must be reported on intravenous immunoglobulin - subcutaneous?

The information reported on intravenous immunoglobulin - subcutaneous includes the date, time, dosage, and any side effects experienced during and after the treatment.