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SC Injections in DVT-Affected Limb — SCE Palliative Medicine MCQ

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ModeratePain ManagementSC Injections in DVT-Affected LimbSCE Palliative Medicine

A 55‑year‑old woman with advanced ovarian cancer develops a DVT in her arm from a PICC line. She has severe cancer pain managed with SC morphine via continuous subcutaneous infusion in the other arm. The DVT arm is the only other SC site available if needed. Can SC injections be given into a limb with DVT?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — SC injections should be avoided in a limb with DVT where possible — oedema impairs absorption and needle insertion risks thrombus propagation or infection; alternative sites should be sought

Explanation lettering: C = shown as B · B = shown as C · E = shown as D · D = shown as E

Option C is correct. UK palliative care guidance advises avoiding subcutaneous sites in oedematous areas — such as those with DVT — because tissue oedema impairs drug absorption and increases the risk of infection and worsening oedema; furthermore, needle insertion may mechanically dislodge thrombus or introduce infection. Options A and B are incorrect because they overlook impaired absorption and mechanical risks. Option D is false — SC injections do not treat DVT, anticoagulation does. Option E is also incorrect — absorption via SC route depends on tissue perfusion, which can be impaired by DVT as well.

Reference: Palliative Care Clinical Practice Summary (CSCI site selection guidance), 2022; Palliative Care Pain & Symptom Control Guidelines for Adults (site selection, oedema risks), 2020.