I have an article from Nursing May 2000 entitled Hypodermoclysis
Another Way To Replace Fluids, by Mark K. Brown. The focus of the
article in hydration using the subcutaneous route. Here's an excerpt:
"Begin the infusion at 30ml/hour and monitor the patient's response. If
he tolerates this rate well for 1 hour, increase the rate as ordered, to
a maximum of 80ml/hour. In our facility, a typical infusion rate is
75ml/hour to a maximum of 2,000 ml/24hours."
They also add the enzyme hyaluronidase to the infusion. With
the availability of ultrasound here, we haven't had to resort to this
procedure to hydrate our patients, but based on this, I would say the
maximum rate of a subQ infusion is well beyond 2cc/hr.
Jerry Bartholomew RN BSN CRNI
Vascular Access Specialist
Veterans Affairs Medical Center
Spokane, Washington
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Dianne Sim
Sent: Wednesday, March 01, 2006 3:33 PM
To: 'KayBeth Weibel, CRNI'
Cc: [EMAIL PROTECTED]
Subject: RE: [vascular] SQ Morphine infusion
I thought that the maximum infusion rate for subQ infusion is 2cc/hr. Am
I incorrect?
Dianne Sim
IV Assist, Inc
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]
On Behalf Of KayBeth Weibel, CRNI
Sent: Wednesday, March 01, 2006 6:13 AM
To: [EMAIL PROTECTED]
Subject: RE: [vascular] SQ Morphine infusion
Hi Carole,
We occasionally use subcutaneous morphine for pain management. We use
27gx1/2 inch sets. We prepare site just as we would for a peripheral IV
and rotate q3days. INS Policies and Procedures, 2nd edition recommends
q3-5day rotation. We don't plan to administer more than 3ml/hr via this
route, and less if the patient's site cannot tolerate. We increase the
concentration of the morphine to accommodate.
KayBeth Weibel, CRNI
Infusion Network
Falmouth, MA
-----Original Message-----
From: ann marie parry [mailto:[EMAIL PROTECTED]
Sent: Saturday, February 25, 2006 8:15 PM
To: [EMAIL PROTECTED]
Subject: Re: [vascular] SQ Morphine infusion
We occasionally, successfully managed pain in palliative med and hospice
patients with pain management via the sub q route when there is not
vascular access and the patient is not expected to be around for a long
along with other reasons - our policy is to change q 5 days and prn-
using alcohol and chloraprep cover with tegaderm there are limits on the
amount you should infuse - need to check to absorption problems and may
need to rotate the site more frequently on patients with lower amounts
adipose tissue - email me with specific questions - I can fax you
something on monday or you can talk with you by phone
Ann Marie
VITALine Home Infusion Pharmacy
1-800-245-8767
----- Original Message -----
From: [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]>
Sent: Saturday, February 25, 2006 2:43 PM
Subject: [vascular] SQ Morphine infusion
Hi,
Has anyone heard of having a PCA (patient-controlled analgesia)
infusion with morphine by using the subcutaneous route? The patient had
a 25-gauge needle to her left upper chest connected to a pump upon
admission from the host hospital. Staff called me looking for our P & P
-- which we do not have -- limited info on the internet. Can anyone
share information about this, maybe even a protocol?
Thanks so much,
Carole
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