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QJM 2004 97(11):765-768; doi:10.1093/qjmed/hch119
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QJM vol. 97 no. 11 © Association of Physicians 2004; all rights reserved.

Commentary

Using subcutaneous fluids to rehydrate older people: current practices and future challenges

A. Barton1, R. Fuller2 and N. Dudley3

From the 1Medical Directorate, Furness General Hospital, Barrow-in-Furness, 2 Medical Department for the Elderly, The General Infirmary at Leeds, and 3 Elderly Services, St. James's University Hospital, Leeds, UK

The first 150 words of the full text of this article appear below.


   Introduction
 
The management of unwell older people who have poor venous access, or who are unable to tolerate intravenous cannulation, presents a common and difficult challenge for clinicians in many specialities. Whilst the use of subcutaneous infusions (hypodermoclysis) is commonplace in a palliative care environment and elderly medical wards in UK hospitals, its use, particularly outside of hospice and acute hospital (medical centre) settings, remains rather variable. Medical and nursing staff working in the aforementioned places are relatively familiar with the practicalities of the technique. Therefore in this commentary, we will discuss and review the evidence for its use in the hospital setting, but also explore future developments including the potential use of hypodermoclysis for antibiotic administration and as a method of fluid delivery for older people resident in long-term care settings.


   Current practice: mechanisms of administration and absorption
 
Hypodermoclysis has been an alternative option to the traditional intravenous route for over 50 years.1 This method involves the . . . [Full Text of this Article]


   Identifying the role of hypodermoclysis: benefits and disadvantages
 

   Future challenges
 
A novel route for antibiotic administration?
Is there a role for hypodermoclysis in UK care homes?

   Conclusions
 

Address correspondence to Dr Barton, Medical Directorate, Furness General Hospital, Barrow-in-Furness, LA14 4LF. e-mail: alan.l.barton@fgh.mbht.nhs.uk


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