• A continuous subcutaneous infusion of medication aims to maintain symptom control. If the patient has uncontrolled symptoms before the infusion is started or during the infusion period, give breakthrough doses of medication as required.
• Prescribe the medication(s) for subcutaneous infusion and the diluent, calculating appropriate dose when converting from oral to subcutaneous route. The infusion is given over 24 hours.
• Prescribe the correct breakthrough dose, as required, for each medication in the infusion, a maximum volume of 2ml can be used for subcutaneous bolus but consider your patient and avoid a volume over 1ml for cachexic patients with little subcutaneous tissue. These should be administered via a separate site.
• Cannula does not need to be flushed prior to administering medicines, but should be flushed after with sterile water for injection and between any incompatible medications (refer to local guidelines for more information on subcutaneous administration of as required medication).
• Prepare a new syringe every 24 hours.
• Protect the syringe from direct light and heat.
• Check the syringe after set up and within acute setting every 4 hours for precipitation, cloudiness, particles, colour change. Make sure the pump is running to time. Check the line, connection and cannula regularly.