subcutaneous IV fluids?

I had never heard of it until a few months ago. We had a pt that wanted intermittent hydration but had no IV access. I don't know who recommended that we do sq, but this guy would do it himself in his leg. I never saw the process but his nurse explained that it was just how an animal looks when they've been given sq fluids. There is a huge hump that goes down as the fluid is absorbed into the blood stream.

I remember from nursing school that a drug called hyaluronidase (no doubt my spelling is wrong after all these years) is added to fluids when given SQ to accelerate absorption. Many years ago while working in Pediatrics we had one older Pediatrician who occasionally gave fluids to babies that way. It was dripped in slowly. The area swelled up of course, and after the drip was stopped the fluids were slowly absorbed. Obviously you can’t give much fluid that way… nor very quickly. It is an archaic way of administering fluid, especially in a hospice setting where peripheral circulation may well be compromised anyway.

i learned this as hypodermoclysis.

it's very effective and a perfectly appropriate alternative when venous access is no longer viable.

this route can also accommodate up to 3 liters of fluid/day, 2 separate sites.

the needle is anchored under the skin, which mostly comprises adipose tissue, rich in blood vessels, enabling asorption.

it works if circulatory shutdown is not an issue.

leslie

I wish they'd tried this with my aunt last week. She is on an experimental chemo at Mayo clinic and she got so sick that she was dehydrated and almost comatose. After admission to the hospital, it took ELEVEN hours to get a 24 gauge IV into her. Had I been there, I'd have asked about the possibility of sub Q fluids. She could have died, her electrolytes were so off. She was unconscious as it was.

HDC is quite common in LTC, sub-acute, and Palliative Care in my region. Most of the order I've seen for it have been to allow it to run overnight (20hr to 08) seems to be less disturbing to the patient that way.

LTC's around here don't accept patients that require IV treatments, so its a good way to get around it.

Main thing is to monitor the site for overload and change it as necessary. Just the Eze-set or "butterfly" into subq tissue and away you go.

thank you Leslie

Great explanation