Hypodermoclysis Procedure 2024 PDF

HYPODERMO- CLYSIS Skills ||| - Spring 2024 By Shana Bouley HYPODERMOCLYSIS What is it? Hypodermoclysis is a simple, safe and effective technique for subcutaneously administering fluids to a patient who requires hydration. It avoids the need for venous access in patie...

HYPODERMO- CLYSIS Skills ||| - Spring 2024 By Shana Bouley HYPODERMOCLYSIS What is it? Hypodermoclysis is a simple, safe and effective technique for subcutaneously administering fluids to a patient who requires hydration. It avoids the need for venous access in patients who, at the end of life, often have very poor veins. In the home/ hospice/residential care facility settings, it can be carried out without the need for fully IV credentialed nursing staff.  OVERVIEW Assessment & Care Changing Solution Bag Unexpected Findings Indications For Site & Drsg Assessment Documentation Perry & Potter  NICE TO KNOW HYPODERMOCLYSIS Also known as “clysis” Less invasive alternative to IV therapy for mild to moderate dehydration Subcutaneous administration of isotonic fluids to treat or prevent dehydration, nausea and vomiting or for medication administration  INSERTION Small gauge needle inserted into subcutaneous space 22-25 gauge ½ -3/4 inch or subcutaneous device(butterfly) Insert into subcutaneous tissue; if blood return remove 45-60 degree angle insertion Change site every 24-48 hours for fluid administration as needed and every 7 days for medications (subcutaneous therapy) Tubing changed every 96 hours HYPODERMOCLYSIS Location Choice Outer upper arms, upper back between scapula, abdomen(at least 2 inches away from umbilicus) and lateral aspects of thighs Avoid areas that are scarred, bruised, infected, inflamed, near bony prominences, waistline, and sites that are highly vascular, damaged or edematous  IV FLUIDS 0.9%NaCl or LR most common fluids to be used; can also use D5NS, D51/2NS, 2/3 & 1/3, 0.45% NaCl Can add KCl or Hyaluronidase(to enhance fluid absorption) Maximum volume 3000 mls/24 hours in 2 sites=1 ml/min Can massage site to enhance edema absorption When possible deliver with pump  CHANGE SOLUTION BAG Steps 1. Perform Hand Hygiene 2. Check order to verify solution, rate, and frequency 3. Gather supplies 4. Assess IV solution & remove it from outer bag 5. Remove the protective cover from the new solution bag Remove old IV solution bag upside down. Carefully remove old IV tubing 6. spike from bag and spike new bag with dominate hand.  ADVANTAGES Patient comfort & ease of insertion Does not cause thrombophlebitis, septicemia, systemic infection More suitable for home  DISADVANTAGES Slow rate of infusion / Limited fluids for administration Edema (massage helpful) / Cellulitis for complications Pain / Discomfort rare  CONTRAINDICATIONS Rapid Administration Required Shock / Bleeding Disorder Major Dehydration Severe electrolyte disturbance  PREPARATION Explain the procedure to the patient Gather Supplies Select the Infusion Site Wash Hands  THE PROCEDURE Assemble fluid and tubing; prime line Don gloves Cleanse the site with chlorhexidine Insert needle, bevel up, into subcutaneous tissue at a 45-60 degree angle; insert in same direction as venous return Secure needle and tubing with bio-occlusive dressing Adjust fluid drip rate as prescribed(no more than 1 ml/min)  POST-PROCEDURE Steps Date and initial dressing and tubing; label with medication name if being used for 1. specific medication 2. Document Check patient and infusion after one hour ; no signs of edema, leakage, 3. disconnection or fluid collection distal to the site, and the patient does not show signs of fluid overload 4. If necessary, the infusion site can be massaged to enhance edema absorption  POST-PROCEDURE Steps Assess site for redness, tenderness, edema, bruising, bleeding, 5. burning, leaking, blood in tubing and cannula displacement; if any of these remove catheter 6. Ensure rotation of sites to prevent tissue damage