10. Skin site selection and skin care 10.1 Skin For Subcutaneous Infusion The best sites to use for continuous infusion of drugs are: - (Cooper and Mitten 2000; Danne et al 2000; Dickman et al 2002; Johnson 1998; Macmillan et al 1994) 10.2 Sites Which Should Not Be Used For Cannula Placements Are: Lymphoedematous limbs. The rate of absorption from the site would be adversely affected and infection could also occur. Sites over a bony prominence: the amount of subcutaneous tissue would be diminished impairing the rate of drug absorption. Previously irradiated skin area. Radiotherapy can cause sclerosis of small blood vessels, thus reducing skin perfusion. Sites near a joint, excessive movement may cause cannula displacement and patient discomfort. Broken skin. Localised areas of disease e.g. chest wall with breast cancer. Affected limb following lymph node dissection. Patients may decide (in partnership with the nurse responsible for their care) for themselves, after consultation, a suitable site that will interfere as little as possible with their lifestyle (Cooper and Mitten 2000; Danne et al 2000; Dickman et al 2002; Johnson 1998 ) 10.3 Care Of the Skin Site and Checks Hospital, Hospice and Nursing Home Check 4 hourly. Check position of needle Condition of site Volume infused (mls) Check symptom control Record above details on syringe driver observation chart Community Patient/carer may be taught how to assess if appropriate. The District Nurse or Community Nurse will check the site at each visit.
10. Skin site selection and skin care 10.1 Skin For Subcutaneous Infusion The best sites to use for continuous infusion of drugs are: - (Cooper and Mitten 2000; Danne et al 2000; Dickman et al 2002; Johnson 1998; Macmillan et al 1994) 10.2 Sites Which Should Not Be Used For Cannula Placements Are: Lymphoedematous limbs. The rate of absorption from the site would be adversely affected and infection could also occur. Sites over a bony prominence: the amount of subcutaneous tissue would be diminished impairing the rate of drug absorption. Previously irradiated skin area. Radiotherapy can cause sclerosis of small blood vessels, thus reducing skin perfusion. Sites near a joint, excessive movement may cause cannula displacement and patient discomfort. Broken skin. Localised areas of disease e.g. chest wall with breast cancer. Affected limb following lymph node dissection. Patients may decide (in partnership with the nurse responsible for their care) for themselves, after consultation, a suitable site that will interfere as little as possible with their lifestyle (Cooper and Mitten 2000; Danne et al 2000; Dickman et al 2002; Johnson 1998 ) 10.3 Care Of the Skin Site and Checks Hospital, Hospice and Nursing Home Check 4 hourly. Check position of needle Condition of site Volume infused (mls) Check symptom control Record above details on syringe driver observation chart Community Patient/carer may be taught how to assess if appropriate. The District Nurse or Community Nurse will check the site at each visit.
procedure_for_the_use_of_the_syringe_pump_in_palliative_and_end_of_life_care1.docx