Note: This guideline is currently under review.

This guide was created as part of the Clinical Guideline (Nursing): Subcutaneous Catheter devices; Management of Insuflon ™ and BD Saf-T-Intima™ devices

 Equipment

• Appropriate size syringe for drawing up medication
• 19G (drawing up) needles
• 10ml vial of Water for Injection or 0.9% Normal Saline – used to flush medication
• 1 or 3ml syringe for flush
• Alcohol swab
• Red caps
• Sharps container

NB: Ensure all medications given are recommended for subcutaneous use. Medication to be administered as ordered on the patient’s Medicine Chart (MR690/A)
Medications should be administered as per the Royal Children’s Hospital Medication Management Procedure http://ww2.rch.org.au/policy_rch/index.cfm?doc_id=6570

Procedure

1. Perform hand hygiene and assemble equipment
2.  Utilise an aseptic technique and non sterile gloves (if indicated) for medication preparation and administration
3. Draw up medication as ordered in accordance with the Royal Children’s Hospital Medication Management Procedure http://ww2.rch.org.au/policy_rch/index.cfm?doc_id=6570 and refer to the Palliative Care Team’s symptom management plan if appropriate
4. Prepare and explain the procedure to the child (if appropriate) and parents/caregivers
5. Clean injection port with an alcohol wipe and allow to dry. Remove red cap from injection port
6. Administer medication as ordered
7. Administer at least 0.3mls of either Water for Injection or 0.9% Normal Saline (check medication capabilities) flush to ensure the medication is delivered to the patient (dead space of the BD Saf-T-Intima is approximately 0.25 mls)
8. Observe the insertion site whilst administrating medication and flush ( look for signs of blanching or redness as examples, which may indicate that site is no longer appropriate for subcutaneous medications)
9. Remove the syringe
10. Replace red cap. Do not use smart sites
11. Dispose of any waste in the appropriate containers
12. Complete appropriate documentation; all medications administered should be documented on the patient’s Medicine Chart (MR690/A)

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