SO how do you do it? do you use EMLA/LMX to anesthetise the entry site? How big a needle is used for the subcut infusion? How much volume is placed at one time?
DOes anyone know if Meds can be given this way also?? DOn't know why not, since we give meds sc at times. WOuld keep from having to stick another time to give meds IM..I generally prefer to go to either NG fluids in cases of dehydration associated with diarrhea/vomiting..or IO if we can't get an IV. Everywhere I have worked the nurses just take it as a personal challenge to get the IV and will stick 6-8 even 10 times, in spite of policies to the contrary.. I don't get notified of failures until the parents either go balistic or they ( nurses) finally quit. maybe I need to be more vigilant..Or better still maybe we just need a policy to limit the number of sticks before moving to a differnet method. SO using Hylenex...I know my predecessors used clysis back in the " day". SO what is the advantage of using Hylenex? Why not just regular IV fluids? As an aside, when my cat was in renal failure the vets had us do clysis at home. just instilled NS sc between the animals shoulder blades. After it was done you could see these fluid collections along his leg and flanks, sure looked funny. It definitely helped. We stopped after a while because the cat was old and seemed to hate getting stuck..we eventually put him down..On the plus side, I got convinced clysis would work.
Martin Herman, M.D.
Pediatric Emergency Medicine
Sacred Heart Children's Hospital
FSU @ Sacred Heart, Division of Pediatrics
5153 N. 9th Ave, 6th Floor Nemours Bldg
Pensacola, FL 32504
Ph: 850 416 7658(office)
Ph: 901 219 9202 ( cell)
Fx: 850 416 7677
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> Date: Sun, 12 Feb 2012 13:57:59 -0500
> From: [log in to unmask]
> Subject: Re: Hylenex
> To: [log in to unmask]
> I have had excellent results with hylenex. More than a few cases where an IV could not be started and we were able to use the subcutaneous hydration alternative. I can't express how happy those parents were! They just wished we had started with it instead.
> I am by no means an expert as compared to many other institutions but from my point of view, it's a nice back up for those tough sticks.
> Christopher S. Amato,MD FACEP, FAAP
> Sent from my iPhone
> On Feb 12, 2012, at 12:39 PM, Dominic Lucia <[log in to unmask]> wrote:
> > Hello all,
> > I have been informed Hylenex is back on the market with FDA approval for use and my institution will be carrying it. Does anyone have experience using this with children in the ED for rehydration (and presumably difficult IV access) ?
> > It is something that I am not familiar with and wanted some front line feedback on your experiences with it in children. Thanks in advance.
> > Dominic Lucia M.D.
> > Medical Director Emergency Medicine
> > Children's Hospital at Scott and White
> > office: 254 724-1068
> > [log in to unmask]
> > For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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