RE: [vascular] SQ Morphine infusion

[rkg50]

YES--We use a SQ needle by Baxter 27 gauge 1.2 cm attached to a sticky disc that helps with securement--we reinforce with sterile tape and cover with transparent drsg--change Q96 hrs with cassette/tubing change

 

--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia

 

-------------- Original message --------------
From: "Bartholomew , Jerry A (SPO)" <[EMAIL PROTECTED]>

> Ooh, sorry. My bad. The article mentions a 25 gauge winged needle, but
> doesn't specify length. The flyer that I have for the Aqua-C hydration
> system for hypodermoclysis shows a device with two 27 gauge X 6mm long
> needles. Are the ones you use for pain management smaller than that?
>
>
> Jerry Bartholomew RN BSN CRNI
> Vascular Access Specialist
> Veterans Affairs Medical Center
> Spokane, Washington
>
> -----Original Message-----
> From: Ann Marie Parry [mailto:[EMAIL PROTECTED]
> Sent: Thursday, March 02, 2006 10:24 AM
> To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; Bartholomew ,
> Jerry A (SPO)
> Cc: [EMAIL PROTECTED]
> Subject: RE: [vascular] SQ Morphine infusion
>
> There is a difference in equipment and such between sub q infusions for
> pain management and hypodermoclysis for hydration. They are not the
> same and you can not compare them. Two different therapies with two
> different needles - one very small and short (for sub q infusions
> primarily pain management) the other a larger bore and longer (called
> Hypodermaoclysis - not sub q - for hydration).
>
> AnnMarie
>
>
> >>> "Bartholomew , Jerry A (SPO)" <[EMAIL PROTECTED]>3/2/2006
> >>> 10:44 AM >>>
> 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]
> To: [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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