WEBVTT 00:02.154 --> 00:08.287 This video will guide you through the five steps of administering CRYSVITA. 00:09.090 --> 00:14.079 Please read the Patient Information Leaflet and Instructions for Use carefully before you use the medicine. 00:15.000 --> 00:19.256 Only inject yourself or your child if you have been told by your doctor and trained by your healthcare provider. 00:20.000 --> 00:24.500 Your doctor will prescribe your correct dose and tell you how much medicine to give yourself or your child. 00:24.977 --> 00:29.566 You or your child may be given more than one vial to get the correct dose. 00:30.276 --> 00:37.009 If you need more than one injection, repeat steps 2–5 and use new supplies and a different injection site. 00:38.206 --> 00:42.727 Only use the syringe and needles provided or prescribed by your healthcare provider to give an injection. 00:43.450 --> 00:50.689 When giving the medicine to a young child, it may be helpful to have another person present to provide support. 00:54.460 --> 00:57.315 STEP 1: GATHER AND INSPECT SUPPLIES 00:57.947 --> 01:00.633 Remove the medicine vials you need from the refrigerator. 01:01.291 --> 01:05.963 Check the strength on the label of each vial. 01:05.963 --> 01:10.516 Make sure that you have the correct number of vials to match the dose in milligrams as advised by your healthcare provider. 01:11.814 --> 01:14.839 Let the vials warm to room temperature for 30 minutes. 01:15.351 --> 01:23.398 Do not warm the vials in any other way, such as with hot water or a microwave oven. Do not put the vials in direct sunlight. 01:24.269 --> 01:31.394 Next, check the expiry date on the label of the vial and inspect the liquid inside the vial, but be careful not to shake it. 01:32.208 --> 01:39.239 Do not use the vial if it is past the expiry date or if the liquid appears discoloured, cloudy, or contains any particles. 01:40.076 --> 01:45.171 The liquid should be clear to slightly opalescent, colourless to pale brown-yellow. 01:46.042 --> 01:49.280 Place the following items on a clean, flat surface: 01:49.812 --> 01:59.889 a vial(s) of the medicine, one syringe with plunger, one large syringe needle to withdraw the medicine, one small syringe needle to inject the medicine, 02:00.110 --> 02:07.967 alcohol wipes, a sharps container, a plaster (should you need it), and a gauze pad or cotton wool. 02:09.363 --> 02:14.049 Your healthcare provider will explain the use of the different needles. 02:14.777 --> 02:21.108 The large needle is used for withdrawing CRYSVITA from the vial and the small needle is used for injecting CRYSVITA. 02:21.889 --> 02:25.460 Do not remove the caps from the needles until you are ready to use them. 02:26.222 --> 02:32.388 Do not use any items that have missing pieces or are damaged in any way. 02:33.614 --> 02:37.372 Before moving on to step 2, wash your hands thoroughly with soap and water. 02:39.243 --> 02:43.485 STEP 2: WITHDRAW THE MEDICINE AND PREPARE THE INJECTION 02:43.849 --> 02:48.187 We will now demonstrate step 2, which needs to be repeated for each injection. 02:48.772 --> 02:51.531 Firstly, remove the sealing cap from the vial. 02:52.432 --> 02:56.240 Then, clean the rubber stopper of the vial with an alcohol wipe and let it dry. 02:56.448 --> 03:01.964 Don’t touch the rubber stopper after it has been cleaned. 03:03.194 --> 03:08.564 Select the large needle and remove the sterile packaging, but do not remove the cap covering the needle. 03:08.980 --> 03:16.898 To attach the needle to the syringe, hold the large needle by the protective cap in one hand and the syringe by the barrel in the other hand. 03:17.678 --> 03:19.829 Depending on the supplies that you have been given, 03:19.947 --> 03:28.824 you will need to push the needle down and turn clockwise onto the syringe until tight, or push the needle down until it is firmly attached. 03:29.359 --> 03:34.312 Do not touch the needle itself or the end of the syringe where the needle attaches. 03:34.647 --> 03:43.100 Next, hold the syringe by the barrel with the needle pointing up and remove the needle cap by pulling it straight off. Do not throw the needle cap away. 03:44.001 --> 03:48.952 Do not touch the needle or allow the needle to touch any surface once the cap has been removed. 03:48.952 --> 03:54.882 Do not use the syringe if you drop it after removing the cap or if the needle appears damaged. 03:55.714 --> 04:01.422 Your healthcare provider will tell you how much liquid to inject and which mark to use. 04:01.630 --> 04:03.630 Always use the mark equal to your dose. 04:04.480 --> 04:09.670 Pull back the syringe plunger until the end of the plunger lines up with the mark equal to your dose. 04:10.073 --> 04:12.073 This fills the syringe with air. 04:13.736 --> 04:19.860 Keep the vial on a flat surface. Slowly insert the large needle through the rubber stopper and into the vial. 04:20.328 --> 04:23.813 Do not let the tip of the needle touch the liquid inside the vial. 04:23.935 --> 04:31.160 If the tip of the needle touches the liquid, slowly pull the needle until it no longer touches the liquid. 04:32.060 --> 04:37.235 Slowly push the plunger into the syringe to push air from the syringe into the vial. 04:37.997 --> 04:41.412 Keep the needle in the vial and turn the vial upside down. 04:41.759 --> 04:49.228 Make sure that the tip of the needle is at the bottom of the liquid and then slowly pull back the plunger to fill the syringe 04:49.331 --> 04:53.090 until the end of the plunger lines up with the mark equal to your dose. 04:53.388 --> 04:58.420 Keep the tip of the needle in the liquid at all times. 04:58.957 --> 05:02.247 Afterwards, check the liquid in the syringe for air bubbles. 05:02.380 --> 05:07.614 If you see bubbles, keep the syringe upright with the needle still inside the vial 05:07.614 --> 05:13.208 and gently tap the barrel with your finger to move the air bubbles. 05:13.910 --> 05:20.944 When the air bubbles are at the top, slowly push the plunger to push out the air bubbles. 05:21.302 --> 05:24.769 Check your dose again against the markings on the syringe. 05:25.087 --> 05:30.000 If required, withdraw some more liquid to line up with the mark equal to your dose. 05:30.118 --> 05:34.689 Check again for bubbles and repeat this process if required. 05:35.434 --> 05:40.560 When there are no bubbles in the syringe, pull the syringe and needle straight down out of the vial. 05:41.132 --> 05:43.954 You will now need to remove the large needle from the syringe. 05:44.387 --> 05:48.360 To do this, take the large needle cap and place it on a flat surface. 05:48.941 --> 05:56.334 Using one hand, slide the large needle into the cap and scoop upward to cover the needle without using your other hand to avoid injury. 05:57.079 --> 06:00.853 Then use your other hand to secure the cap and snap it into place. 06:01.286 --> 06:08.146 Depending on your supplies, you will need to twist the capped large needle anti-clockwise to remove it from the syringe, 06:08.389 --> 06:14.087 or pull the capped large needle straight from the syringe and place it into the sharps container. 06:15.281 --> 06:21.037 Afterwards, select the small needle and remove the sterile packaging, but do not remove the cap covering the needle. 06:21.496 --> 06:29.132 To attach the needle to the syringe, hold the small needle by the protective cap in one hand and the syringe by the barrel in the other hand. 06:29.419 --> 06:36.994 Depending on the supplies that you have been given, you will need to push the needle down and turn clockwise onto the syringe until tight, 06:36.994 --> 06:39.486 or push the needle down until it is firmly attached. 06:39.757 --> 06:44.573 Do not touch the needle itself or the end of the syringe where the needle attaches. 06:47.155 --> 06:50.188 STEP 3: PREPARE THE INJECTION SITE 06:50.577 --> 06:58.592 We will now demonstrate step 3, which involves preparation of the injection site. You will need to repeat this step for each injection. 06:59.338 --> 07:02.967 The injection must be given into the fatty layer just below the skin. 07:03.249 --> 07:09.259 If you are giving the injection to yourself, you can choose the stomach area or upper thighs as injection sites. 07:09.779 --> 07:18.825 If you are giving the injection to someone else, the stomach area, upper thighs, outer area of the upper arms and buttocks are suitable injection sites. 07:19.361 --> 07:26.655 Do not inject an area that is sore, red or bruised, or that has broken skin, stretch marks or scars (including burns). 07:27.000 --> 07:31.496 Do not inject directly into a mole or an area around a mole. 07:31.888 --> 07:34.496 If you are giving more than one injection, use a different site for each injection. 07:34.739 --> 07:42.914 Clean each injection site with a new alcohol wipe and leave the skin to dry. The medicine should be injected into clean, dry skin. 07:44.078 --> 07:46.598 STEP 4: INJECT THE MEDICINE 07:47.175 --> 07:54.183 We will now demonstrate step 4, which involves the injection procedure. Remember to repeat this for each injection. 07:55.000 --> 07:58.803 Remove the small needle cap by pulling it straight off. 07:59.844 --> 08:06.020 Pinch the skin firmly between your thumb and fingers, creating an area about 5 cm wide. 08:06.679 --> 08:15.736 Hold the syringe between the thumb and index finger of your dominant hand and insert the needle into the skin at a 45° angle or 90° angle. 08:16.168 --> 08:19.440 Your healthcare provider will show you which angle you should use. 08:20.000 --> 08:24.337 Use a quick ‘dart-like’ motion to insert the needle into the pinched skin. 08:24.414 --> 08:30.545 Do not to push the plunger when inserting the needle. 08:31.082 --> 08:34.441 Once the needle is inserted, do not move it around. 08:34.700 --> 08:39.833 Keep pinching the skin and slowly push the plunger into the syringe, for up to 30 seconds, until the syringe is empty. 08:40.630 --> 08:47.669 After you have given the full dose, remove the injection needle by gently pulling the syringe straight out. 08:48.483 --> 08:54.925 You can now release the pinched skin and press the injection site with a cotton ball or gauze pad for a few seconds to stop bleeding. 08:55.245 --> 09:00.163 Apply a plaster if needed, but do not rub the injection site. To avoid injury, do not put the cap back on the small needle and place it in the sharps disposal container. 09:00.301 --> 09:02.880 STEP 5: AFTER EACH INJECTION 09:03.614 --> 09:09.645 Put your used needles and caps, syringes and vials in the sharps disposal container. 09:09.907 --> 09:17.964 Do not throw away needles, syringes or vials in your household waste and do not save vials with leftover medicine for future use or pass it to others. 09:18.726 --> 09:26.087 If you are giving more than one injection, please remember to repeat steps 2–5 and use new supplies for each injection. 09:27.161 --> 09:30.750 Thanks for watching this video – we hope you found it helpful. 09:30.883 --> 09:37.290 For further details, please refer to the CRYSVITA Patient Information Leaflet and Instructions for Use.