pain with SubQ butterfly use???

[missmiamoore]

Hello: I have a question about subcutaneous butterfly use. I am a new grad and have only put in two subq butterfly sites so far. They have both been in the upper arm area. They were both used for narcotics, one Dilaudid and the other morphine. My concern is that with the first push of medication after the insertion of the subq butterfly resulted in a burning sensation to the patient. I am wondering did I do something wrong? I primed the butterfly first with the appropriate concentration of narcotic and the actual insertion of the device did not hurt the patient, only the push of the medication. Any ideas or advice regarding this? It is bothering me and I want to know so that I can avoid causing my patients with subq butterfly's discomfort in the future.

[iluvivt, BSN, RN]

I personally like to use the thighs for clysis,b/c there is more fat down there,but you may use any area where there are fat pads. Also wanted to ask you if you are using a special SQ set designed for cylsis. The only one I can think of now is called Soft-Set. You can also use a small IV catheter. Make sure you are not inserting the needle flush to the skin you need to get a 15-40 degree angle on it. The depth you go will depend strictly upon how much fat the pt has,just make sure you are well into the fat. It is OK if there is a little burning when you start the clysis b/c essentially you are infiltrating (ON purpose) the medication. As the SQ tissue gets congested with the med it will deaden the sensation of burning , Also remeber to rotate sites per your policy.

[bagladyrn, RN]

This is not something I'm familiar with (subcutaneous butterfly use). Can you tell me why that route is used? (As opposed to regular IM injection or IV administration). Just curious what the advantages/purposes are.

Thanks!

[AuntieRN]

I too am unfamiliar with this procedure....

[Iam46yearsold]

Very common back in the old days

hypodermoclysis

Might well be coming back as a lot of people have used their veins up.

[RazorbackRN, BSN, RN]

I'm not familiar with your exact practice, however, I will say that we frequently use an Insuflon cath for Lovenox injections (basically the same concept, sm. butterfly like used sub q). Our pt's still complain of the burning sensation...

[leslie :-D]

i like to use the thighs and belly.

any discomfort is initially from a small area of edema, that can be massaged away.

insert at 30-45 deg angle.

change sites q few days.

it's really non-invasive.

leslie