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November 2011, Volume 41 Number 11 , p 16 - 17


  • Pegge Humphrey MSM, BSN, RN, CEN


EMMA, AN OTHERWISE healthy 3-year-old with autism, had flulike symptoms for less than 2 days but because of refusing all oral intake, she'd become dehydrated. Her parents brought her to the local ED, where the healthcare provider prescribed I.V. fluid therapy to be administered by peripheral venous access. Four unsuccessful venipuncture attempts were made before venous access was established. Even though the nurse secured the peripheral I.V. catheter, Emma removed it before she received the I.V. fluids, and no other venous access was available.Does Emma need a central venous access device? Will she need to be sedated? Or is there an alternative to I.V. therapy? This article explores one such option, hypodermoclysis, for treating or preventing dehydration in patients like Emma.Dehydration is especially dangerous in the very young, the very old, and those with chronic illnesses. And as the world's population grows, demands for cost-effective and better management techniques are certain to grow as well.1A less-invasive alternative to I.V. therapy for dehydration is hypodermoclysis, also known as "clysis." According to the Infusion Nurses Society (INS), this therapy is the subcutaneous administration of isotonic fluids to treat or prevent dehydration.2 Clysis was widely used until the 1950s, when it fell out of favor because of complications related to inappropriate patient selection, incorrect administration rates, and inappropriate fluids.3Although the focus of this article is on using clysis for dehydration, medications can also be given by continuous subcutaneous infusion.4 (See Consider the advantages of hypodermoclysis.)Clysis isn't an appropriate therapy for treating severe dehydration, shock, or any condition in which fluids must be administered rapidly or in large amounts, or when fluid titration is required.5 Clysis is contraindicated for patients in shock because circulation to the skin and subcutaneous tissues is decreased. Clysis is also contraindicated in

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