Management of Subcutaneous Infusions in Palliative Care

Video Transcript: “Choosing a Suitable Site”
Excerpt from Chapter 2 – ‘Who Needs One?’ of Brisbane South Palliative Care Collaborative’s Guide for Clinicians – How to Use a Syringe Driver for Palliative Care Patients.

Narrator:
"This section discusses the suitable sites for a subcutaneous infusion and instruction on inserting the subcutaneous cannula.  

You will need to use an area of skin that has a reasonable depth of subcutaneous fat in order for the medication to be absorbed.  Where possible choose a site that can be easily viewed for inspection.  Suitable subcutaneous sites include upper arm, abdomen or thigh.  The upper chest wall is also appropriate, particularly in patients who are emaciated or bed bound.  With confused or agitated patients where there is a high risk of dislodgement the preferred choice of site is the scapula.  

It is important to ensure that you choose a suitable site for subcutaneous cannula.  Unsuitable sites include oedematous areas, areas where skin is broken, skin sites that have recently been irradiated, sites of infection, bony prominences, close proximity to a joint, sites of tumour, skin folds, inflamed skin areas, wherever ascites or pitting oedema are present, where scarring is present and areas where lymphatic drainage may be compromised."

End of Transcript.