II. Definition
- Subcutaneous fluid administration
III. Indications
- Mild to moderate Dehydration in adults
- Geriatric patients
- Palliative Care
- Intravenous Access difficult or impractical
- Patient unable to take fluids orally
IV. Contraindications
- Not indicated in pediatric patients
- Clotting disorder
- Pulmonary Edema
- Large volume fluids required
- Severe Dehydration or shock
- Severe Electrolyte disturbance
V. Technique
VI. Adverse Effects
- Mild subcutaneous edema (resolves with local massage)
- Local catheter site erythema, swelling or obstruction
- Infusion site discomfort (less common than with IV)
- Associated with deep needle insertion into Muscle
- Associated with too rapid infusion rate
- Cellulitis at infusion site rarely occurs
VII. Efficacy
- Similar to Intravenous Fluid in moderate Dehydration
VIII. Advantages over intravenous therapy
- Less discomfort (and Agitation in cognitively impaired)
- Fewer complications than with IV fluid
- Less likely to cause Pulmonary Edema
- No Thrombophlebitis risk
- No associated Sepsis risk
- No Clot Formation when clamped
- Family members can administer at home
- Lower cost
IX. Disadvantages compared with intravenous therapy
- Infusion rate is slow: 1 ml/minute on average
- May be increased with use of hyaluronidase
- Local edema at site (see adverse effects)
X. References
- Fainsinger (1994) J Pain Symptom Manage 9:298-302 [PubMed]
- Farrand (1996) Br J Hosp Med 55:690-2 [PubMed]
- Ferry (1999) J Am Geriatr Soc 47:93-5 [PubMed]
- Hussain (1996) J Am Geriatr Soc 44:969-73 [PubMed]
- Mansfield (1998) Nurs Stand 13:56-62 [PubMed]
- Sasson (2001) Am Fam Physician 64(9):1575-8 [PubMed]
- Slesak (2003) J Am Geriatr Soc 51:155-60 [PubMed]