RE: New question for the group

[Chris Cavanaugh]

I have worked with LTC facilities to “resurrect” the use of Hypodermoclysis.  Why would you do this type of sq infusion?  That answer is easy in LTC –90 dehydrated patients with multiple medical issues usually do not have any veins left to stick.   24-72 hrs of hydration is a COMMON order in LTC, and hospice for our elderly.  I am not referring to those 65 and younger, but those 70 and older, who have CHF, diabetes, CAD, PVD, dementia, etc.  Clysis is easy, any nurse can do it (LPNS cannot place IVs in FL before taking a 30 course) if it gets pulled out, it does not bleed and can easily be restarted, it is painless to the patient, and MUCH cheaper than a PICC or MIDLINE which is what is asked for when the staff cannot get a PIV for 24-72 hrs of hydration.  I cannot speak for acute facilities, and the types of pts you see there, but if all a pt needs is Hydration, it is the cheapest, safest, pain free way to go.    Norfolk medical has great sets called Aqua-C for this purpose and they also have a training kit with a sample policy they can send you.  Chris Cavanaugh, CRNI From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of Scott Gilbert Sent: Saturday, April 15, 2006 4:17 AM To: Elizabeth Harmon; [EMAIL PROTECTED] Subject: Re: New question for the group   Elizabeth:   Good questions...but why are you doing this type of subq infusion when intravenous route is so easily performed and replacement of fluids and meds are so paramount to recovery. 1. No.     Scott ----- Original Message ----- From: Elizabeth Harmon To: [EMAIL PROTECTED] Sent: Friday, April 14, 2006 8:53 AM Subject: spam: New question for the group   Thanks in advance for all that are able to answer.    My new question is for all those out there that are doing hypodermoclysis.    1.  Are you doing hypodermoclysis in the acute care setting? 2.  If so, what type of guidelines are in place? 3.  What type of educational roll-out to the nursing staff and physicians was done? 4.  Does your pharmacy keep track of these patients so a medication that is not able to go this route is not inadvertantly ordered? 5.  Is this strictly a out patient setting treatment? 6.  Can anyone please share some guidelines, setup, educational roll-out, I'm trying not to have to re-invent the wheel.   We are a 150 bed IHS facility.  Our patient's are referred to us from throughtout the State of Alaska.  For those of you that don't know, the state of Alaska is quite large.  Take the State of Alaska and place it over the contiguous Lower 48.  Ketchikan is somewhere down by Miami, Barrow is up above the Minnesota/Canadian border, Anchorage would be somewhere around Tulsa OK and the Aleutian Chain would extend into the Pacific Ocean between San Diego and LA.    There are only 15 hospitals in the state so we get patients and tend to keep them until they completely well.  DRG's have not been a factor at this time.   Any help would be appreciated.   Betsy Harmon RN CRNI Vascular Access Team Critical Care Unit Alaska Native Medical Center [EMAIL PROTECTED]