Appendix I Instructions for inserting and caring for a butterfly needle for a subcutaneous infusion
| 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:
- Pain or hardness
- Bruising
- Leaking
- Swelling
- Redness
- Blood in the tubing
- Shifting of the needle.
How to insert the butterfly needle:
- Wash and sterilise hands.
- Put on gloves.
- Prefill butterfly needle and tubing with normal saline.
- Clean the site with Chlorhexidine 2%/alcohol swab (left to right, then up and down) for 15 seconds. Allow the skin to dry.
- Remove protective sheet from needle.
- Pinch a roll of tissue (approx. 2.5 cm) around the insertion site.
- 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.
- If blood appears in the tubing; discard the needle and start again with a new needle.
- Stick down the wings and the tubing securely. Loop the tubing to prevent it from dislodging.
- Attach to syringe driver tubing, place the syringe in the syringe driver and start infusion
