Appendix I Instructions for inserting and caring for a butterfly needle for a subcutaneous infusion

Figure A

Good sites for insertion of needle and proper care Bad sites for insertion
Lots of fat under the skin
Not near a joint
You can get to it easily
Rotate sites; upper arm, abdomen, chest, upper thighs
Can last up to two weeks
Swollen areas
Infected and inflamed areas
Areas where there is open skin
Near joints or where the bone is near the skin
In skin folds
Areas that are scarred

What to look for when inspecting the site:

How to insert the butterfly needle:

  1. Wash and sterilise hands.
  2. Put on gloves.
  3. Prefill butterfly needle and tubing with normal saline.
  4. Clean the site with Chlorhexidine 2%/alcohol swab (left to right, then up and down) for 15 seconds. Allow the skin to dry.
  5. Remove protective sheet from needle.
  6. Pinch a roll of tissue (approx. 2.5 cm) around the insertion site.
  7. Grasp and hold the pebbled side wings of the butterfly needle with bevel down, insert at a 45 degree angle to skin, insert the entire length of the needle into the skin.
  8. If blood appears in the tubing; discard the needle and start again with a new needle.
  9. Stick down the wings and the tubing securely. Loop the tubing to prevent it from dislodging.
  10. Attach to syringe driver tubing, place the syringe in the syringe driver and start infusion

Figure B

Figure C

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