Big Sky I.V. Care is dedicated to compassionate care, and clinical and educational excellence. In order to promote these ideals, we maintain an active quality improvement program to continue our tradition of exceptional care and patient satisfaction.
Clinical Pharmacy – Big Sky I.V. has skilled and trained pharmacists trained to oversee the intravenous and injectable therapies.
Sterile Compounding of Medications – All of our sterile medications are prepared in a compliant (USP 797 compliant) clean room environment.
Dietary Consult and Nutritional Assessment – We offer a Registered Dietician on staff will assess patient lab values and make diet and therapy recommendations to providing physicians.
Skilled Nursing – Big Sky I.V. nurses have over 45 years in I.V. infusion therapy and over 65 years in nursing care.
Catheter Placement and Care – Nurses at Big Sky I.V. Care are trained in PICC (peripheral inserted central catheter) and PIV (peripheral intravenous catheter).
We provide care for all types of I.V. catheters and central lines.
Your doctor may prescribe anti-infective therapy to treat a serious infection that cannot be treated with oral medications or pills.
Our Anti-infectives Program provides comprehensive infusion services to combat serious infections in patients of all ages.
Intravenous Anti-infective therapy includes the provision of intravenous medications classified as antibiotics, antivirals and antifungals.
The Big Sky IV Care staff works closely with a patient’s physician to ensure the best quality of care. We remain in close communication with the patient and the physician throughout the course of treatment to ensure the best possible outcome.
Patients and their family members can easily learn to administer home IV anti-infective with training and support from skilled pharmacist and home infusion registered nurses.
Intravenous Catheter Types and Care
Central Venous Catheter
- You have a central venous catheter. This is a tube that goes into a vein in your chest. It helps carry nutrients and medicine into your body. It is also used to draw blood when you need to have blood tests.
- These catheters are used when people need medical treatment over a long period.
- You may need antibiotics or other medicines for weeks to months.
- You may need extra nutrition because your bowels are not working correctly.
Central Venous Catheter – Port
What is the purpose of a central venous catheter and port? Catheters are used when you need medical treatment over a long period of time. For example, you may need:
- Antibiotics or other medicines for weeks to months
- Extra nutrition because your bowels are not working correctly
Peripherally Inserted Central Catheter-PICC
Peripherally inserted central catheter – flushing. You have a peripherally inserted central catheter (PICC). This is a tube that goes into a vein in your arm. It helps carry nutrients or medicine into your body. It is also used to take blood when you need to have blood tests.
These catheters are used when people need intravenous (IV) medical treatment or routine blood drawing over a long period.
You will need to make sure the skin where the catheter is placed stays healthy. This will help protect you from infection.
You will also need to rinse out your catheter after every use. This is called flushing. Sometimes you will need to flush it between uses.
After some practice, flushing your catheter will get easier. One of our nursing staff will educate you, a friend, family member, or caregiver on how to flush your PICC line at home.
Hemophilia (factor therapy)
Hemophilia is a rare disorder in which your blood doesn’t clot normally because it lacks sufficient blood-clotting proteins (clotting factors). If you have hemophilia, you may bleed for a longer time after an injury than you would if your blood clotted normally.
Small cuts usually aren’t much of a problem. The greater health concern is deep bleeding inside your body, especially in your knees, ankles and elbows. That internal bleeding can damage your organs and tissues, and may be life-threatening.
Hemophilia is an inherited (genetic) disorder. There’s no cure yet. But with proper treatment and self-care, most people with hemophilia can maintain an active, productive lifestyle.
Treatment: Factor Replacement Therapy
What is factor replacement therapy?
The basic treatment to stop or prevent bleeding in people with hemophilia A and B is factor replacement therapy. This is the infusion (injection into the bloodstream) of factor VIII and IX concentrates to prevent or control bleeding. These concentrates come from two sources:
- human plasma (a component of blood) or
- a genetically engineered cell line made by DNA technology, called recombinant.
In both cases, the factor VIII or IX protein is nearly identical to the protein which is lacking in the blood of hemophiliacs. After an infusion of the concentrate, all the proteins needed for clotting are in place.
A hemophiliac’s blood becomes ‘normal’, at least for a few hours. This allows the time for a clot to form at the site of the damaged blood vessel.
Unfortunately, the replacement of the missing clotting factors is not permanent. Half of the clotting factor activity which was infused is removed by the body every 12 to 24 hours. This means that within 2 or 3 days almost none is left. The hemophiliac’s blood is again unable to clot normally.
For more information, visit the web site for the National Hemophilia Foundation: http://www.hemophilia.org/
Parenteral (intravenous) Nutrition (PN), often called Total Parenteral Nutrition (TPN), is the medical term for infusing a specialized form of nutrition through your vein to treat and prevent malnutrition. It is typically used for people whose digestive systems either can’t absorb or can’t adequately tolerate food eaten by mouth. When used outside the hospital, intravenous feeding is called home PN. Using home PN may be necessary for weeks, months or lifelong, but most people who use it do so for less than one year.
Parenteral nutrition provides liquid nutrients, including carbohydrates, proteins, fats, vitamins, minerals and electrolytes, through a needle inserted into a vein.
You may need PN or Enteral feedings for one of the following reasons:
- Cancer. Cancer of the digestive tract may cause an obstruction of the bowels, preventing adequate food intake. Cancer treatment, such as chemotherapy, may cause your body to poorly absorb nutrients.
- Crohn’s disease. Crohn’s disease may cause pain, inflammation, bowel narrowing and other symptoms that affect your ability to eat, digest and absorb food.
- Short bowel syndrome. In this condition, which can be present at birth or occur as the result of surgery, you don’t have enough bowel to absorb enough of the nutrients you eat.
- Ischemic bowel disease. This may cause difficulties resulting from reduced blood flow to the bowel.
- Abnormal bowel function. This causes food you eat to have trouble moving through your intestines, resulting in a variety of symptoms that keep you from eating. Abnormal bowel function can occur due to surgical adhesions or abnormalities in bowel motility. These may be caused by radiation enteritis, neurological disorders and many other conditions.
- Vomiting and nausea. If unmanageable, uncontrolled vomiting and nausea may require that you take in no food by mouth and be prescribed nutritional supplementation.
Enteral feedings, also known as tube feeding, are used to supplement or provide complete nutrition by routing special formulas through a tube placed into the stomach or small bowel (e.g. PEG Tube or J Tube). Your doctor might recommend tube feeding if you can’t eat enough to get the nutrients you need.
When tube feeding occurs outside the hospital, doctors refer to it as home enteral nutrition. Big Sky I.V. will teach you or your caregiver how to feed through a tube and provide support when you encounter problems.
Home enteral nutrition might be recommended if you have difficulty eating, but your digestive system works normally. Examples include:
- Cancer, such as head and neck cancers or cancer treatment that makes it difficult or painful to swallow
- Neurological problems, such as stroke and amyotrophic lateral sclerosis (ALS)
- Gastrointestinal problems, such as gastroparesis and bowel obstruction
- Trauma, such as an injury to your digestive tract
Types of feeding tubes
Feeding tubes deliver liquid nutrition directly to your stomach or small intestine. Options may include:
- Feeding tube passed through the nose. If you’ll need a feeding tube for a month or less, your health care provider may recommend inserting a tube through your nose and into your stomach (nasogastric tube) or your small intestine (nasojejunal tube).
- Feeding tube passed through the skin on your abdomen. If you’ll need longer term tube feeding, your doctor may recommend a procedure to place a tube through the skin on your abdomen and into your stomach (gastrostomy) or into your small intestine (jejunostomy).
Which tube is best for you will depend on your situation? Discuss your options with your health care provider.
Intravenous Immunoglobulin (IVIG)
What is IVIG therapy?
Intravenous immune globulin is abbreviated as IVIG and is often referred to as IG therapy. Immune globulin therapy is generally for people who have deficient or dysfunctional immune systems or who have autoimmune diseases.
Why is the home an appropriate place for IVIG treatment?
Treatments administered in the home provide a more comfortable and convenient setting for patients, and they allow the patient to fit the treatment into his or her own schedule.
Will my insurance cover IVIG therapy at home?
Yes, most IVIG therapy is covered by major medical benefits especially if the diagnosis is considered a Primary Immune Deficiency (PID). Depending on your insurance plan, patient out of pocket amounts can reach into the thousands of dollars. Our reimbursement specialists examine all your benefit options (including pharmacy and major medical benefits) to help you find the most cost-effective treatment.
For more information on intravenous immune globulin therapy, take a look at the Immune Deficiency Foundation web site: http://www.primaryimmune.org/
Big Sky I.V. can provide a limited range of continuous and injectable chemotherapy medications that compliment your physician’s plan of care. We also provide adjunctive therapies for cancer related treatments. Contact us for specific information (406) 752-0440.
Pain management is important for chronic pain control. Big Sky I.V. provides medications to safely allow patients to give their own pain medications via a enclosed delivery system with a push of a button to offer timely pain relief. We work with your physician to determine an effective plan of care and most effective medications.
I.V. Fluids and Hydration
IV rehydration is a treatment that involves injecting fluids into the veins. The fluid solutions are different depending on patient needs but are usually sterile solutions with salts, sugars or other additives. The solution can be administered with rate flow regulator or infusion pump through a catheter in a vein in the patient’s arm.
Purpose of Intravenous Rehydration
IV rehydration is a treatment that is used for cases of dehydration. When a person becomes dehydrated, fluid including water and dissolved salts, called electrolytes, is lost from the body. For mild cases of dehydration, that loss can be restored by drinking water or electrolyte solutions, such as sports drinks.
For moderate or severe cases of dehydration, the body may not respond to attempts to rehydrate orally. A doctor, or emergency medical professionals, can decide whether IV rehydration is needed.
Adults or children can develop chronic dehydration from being sick and having diarrhea, a fever, or vomiting. When a child is dehydrated, medical attention should be sought as soon as possible. Children are more quickly and more severely affected by dehydration than adults are. Children are more likely to need IV dehydration to restore fluid balance than adults.
Specialty Drugs for Immune Compromising Diseases:
Big Sky I.V. Care has two infusions suites on site in which patients can receive specialty drug infusions to treat a variety of immune compromising diseases. These drugs may include IVIG, Remicade, Simponi Aria, Benlysta, Fabrazyme, Lumizyme, Orencia, Actemra and others. Some of the disease states we treat are as follows:
- Crohn’s Disease and Ulcerative Colitis
- Rheumatoid Arthritis
- Primary Immune Deficiencies
- Enzyme Deficiencies
- Ankylosing spondylitis
Patient Education Big Sky I.V. Care
Educating patients and caregivers in proper infusion care is our primary concern. To this end, each patient and caregiver receive personal education and an instruction manual tailored to their treatment needs. This personalized care plan provides an easy-to-understand resource, supporting the patient’s ability to regain independence as quickly and comfortably as possible.
Our Reimbursement experts will take care of all reimbursement issues, from obtaining up-front authorizations to informing the patient of coverage and co-pay amounts prior to start of care.