SubQ butterflys: How long can they be used for?

[saulgoodman]

hi there,

i work in a geriatric facility and was wondering how long could a subQ butterfly used for before they are changed? especially for palliative care patients who are on morphine.

thanks!

[Daytonite, BSN, RN]

You are referring to clysis. Essentially, this is an infection control issue. The needles are in the subcutaneous tissue and the infused solutions are infiltrating into the subcutaneous tissues where the body then absorbs them. The first thing that is going to happen is that the inflammation response by the person's body is going to be initiated. So, signs and symptoms of inflammation need to be assessed for continuously: redness, heat (fever), swelling (which is going to occur because of the infusion) and pain. INS (Intravenous Nurses Society) recommends that needles in the veins be changed after 72 hours. However, they do not address needles used for clysis. When we did clysis for fluid replacement, the needles were placed in the patients anterior thighs and we changed them every 3 days, rotating legs. Usually, after one or two changes, the patient would be going for a PEG tube or a central line catheter if IV fluids were needed.

[blondy2061h, MSN, RN]

Our policy is a week (eek!), but I personally feel that is WAY too long. 72 hrs sounds much better. We use them mostly in peds, but occasionally in adults since lovenox + insulin + growth factor shots aren't uncommon to have all for one patient and it can add up.

I use subq sites for my insulin pump and have always been told q72hrs for those as well, and often find myself changing it even at 48 hrs.