Subcutaneous infusion, often referred to as hypodermoclysis, is a valuable technique in nursing for administering fluids and medications. It is especially beneficial for patients who require hydration or palliative care but have difficult venous access. This approach can be an appealing alternative to intravenous administration, offering ease of use and increased patient comfort.
What is Subcutaneous Infusion?
Subcutaneous infusion involves the administration of fluids, electrolytes, or medications into the subcutaneous tissue, the layer of tissue directly below the skin. This method is often utilized for patients in
palliative care settings, where maintaining comfort and minimizing invasive procedures is of utmost importance.
Why Choose Subcutaneous Infusion?
There are several reasons why healthcare professionals might opt for subcutaneous infusion over other methods: Ease of Access: Subcutaneous sites are easier to access than veins, reducing the stress and discomfort associated with finding a suitable vein.
Comfort: The procedure is generally less painful for patients and can be performed with minimal disruption to daily life.
Reduced Risk of Infection: The risk of infection is typically lower compared to intravenous infusions, making it a safer option for long-term therapy.
Cost-Effectiveness: It is often more cost-effective, requiring fewer resources and less specialized equipment.
How is Subcutaneous Infusion Performed?
The process involves inserting a small-gauge needle or catheter into the subcutaneous tissue. The site commonly used includes the upper arms, thighs, abdomen, or back. Once the
needle insertion is completed, fluids are administered slowly, usually at a rate of 20-75 ml/hour, although this can be adjusted based on patient needs and tolerance.
What Are the Common Indications?
Subcutaneous infusion is indicated in various scenarios, including: Hydration: For patients unable to take oral fluids adequately, especially in palliative settings.
Pain Management: Administering medications such as opioids for pain relief.
Nausea Control: Delivery of antiemetics to manage nausea and vomiting.
Chronic Illness: Patients with chronic illnesses requiring continuous medication administration.
Local Reactions: Redness, swelling, or discomfort at the infusion site.
Infection: Although less common than with intravenous methods, infections can occur if the site is not properly maintained.
Fluid Overload: Careful monitoring is required to avoid overloading the patient with fluids, which can lead to pulmonary or peripheral edema.
Tissue Damage: Prolonged infusion at one site can cause tissue damage or necrosis.
Site Rotation: Regularly rotating infusion sites to prevent irritation and tissue damage.
Monitoring: Frequent monitoring of the infusion site for signs of complications.
Education: Educating patients and caregivers about the procedure, potential side effects, and how to respond if issues arise.
Who Can Perform Subcutaneous Infusion?
Subcutaneous infusion can be performed by
nurses and other healthcare professionals who have received appropriate training. It is vital that the personnel involved are skilled in assessing patient needs, selecting appropriate infusion sites, and managing any complications that may arise.
Conclusion
Subcutaneous infusion is a practical and effective method for fluid and medication administration, particularly in palliative care settings. It offers several advantages, including ease of use, patient comfort, and a lower risk of complications compared to intravenous methods. However, it requires careful monitoring and skilled clinical judgment to maximize its benefits and minimize potential risks. As such, it remains a critical component of nursing care for patients with challenging healthcare needs.
