Maintaining the subcutaneous cannula site

Although the subcutaneous cannula site may remain patent for up to 14 days, how frequently the site is changed will be determined by the local healthcare service policy and whether injection-site reactions occur (manifest by discomfort or pain, inflammation). Many policies recommend changing the cannula site every 72 hours. If frequent changing (every 24 to 48 hours) is necessary because of injection-site reactions, consider:

• ensuring the diluent is sodium chloride 0.9%, unless it is not compatible with the drug (eg cyclizine)
• using a more dilute solution by either using a larger syringe or changing to a shorter duration (eg 12-hour) infusion
• changing to a less irritant drug
• changing to a drug with a longer duration of effect that can be given as an intermittent subcutaneous injection rather than an infusion.

If injection-site reactions persist after the constituents of the CSCI have been optimised (ie diluent, concentration of solution, drug), seek specialist advice.