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Martin

Disagree re your concerns. 

Yes all of the risks you mentioned are plausible but exceedingly rare. 

Please look at the myriad of studies - especially from Australia attesting to safety and success.  



Sent from my iPhone

> On Jun 10, 2017, at 12:15 PM, Martin Herman <[log in to unmask]> wrote:
> 
> we used it in Pensacola at the Sacred Heart Children's Hospital ED.
> very helpful for moderate dehydration cases, when po and IV failed. by failed I mean the team couldn't establish IV access in 2 attempts
> 
> someone mentioned NG, which has a role, but also is more risky in an uncooperative child. choking, vagal syncope, tracheal intubations and esophageal injuries are attendant risks, not seen with clysis.
> 
> 
> 
> 
> 
> Marty, (Dad, Brother, etc.)
> Martin Herman , M.D.
> 1527 Columbine Dr
> Tupelo Ms 38801
> 901 219 9202
> Sent from my iPhone
> 
> 
> On Jun 10, 2017, at 6:58 AM, PED-EM-L automatic digest system <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> There are 4 messages totaling 10948 lines in this issue.
> 
> Topics in this special issue:
> 
> 1. Clysis (3)
> 2. Fwd: Clysis
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                http://listserv.brown.edu/ped-em-l.html
> 
> ----------------------------------------------------------------------
> 
> Date:    Sat, 10 Jun 2017 01:29:27 +0000
> From:    "Kilian, Karen" <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Re: Clysis
> 
> We are doing NG fluids in the ED on occasion, not Urgent Care (we don't have the pumps needed).  Clysis would seem to be a very good idea for the UC environment when starting IV's may not be performed as often, so skills aren't as great as in the ED.  I do like the "2 strikes and you're out" idea on a previous email---given, again; one doesn't need lab work and *simply* needs fluids.   Articles I read about clysis stated the clysis fluids would help with hydration leading to a subsequent IV start being much easier.
> 
> Karen
> 
> -----Original Message-----
> From: Joe Nemeth, Dr [mailto:[log in to unmask]]
> Sent: Friday, June 09, 2017 5:40 PM
> To: Kilian, Karen
> Cc: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Clysis
> 
> I have never seen it not heard of it being used in the ED ( have worked at 2 of the busiest PEDs in Canada).
> 
> 
> 
> Personally, the NG literature especially from the Aussies is quite convincing in this context and would think it be more ideal and physiologic than clysis if iv access was an issue.
> 
> 
> 
> 
> 
> Joe Nemeth MD
> 
> Toronto Hospital for Sick Children
> 
> Montréal Children's Hospital
> 
> 
> 
> Sent from my iPhone
> 
> 
> 
> On Jun 9, 2017, at 8:08 PM, Kilian, Karen <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> 
> 
> I tried to get this enacted at my facility in situations in which IV access was difficult and/or the pt *simply* needed IVF (no labs beyond glucose).   However, despite me thinking it would be GREAT to use in urgent care and/or the ED.....seemed other's weren't so keen on it.    Those who have enacted this procedure---what made folks buy into it?
> 
> 
> 
> Karen Kilian, ARNP
> 
> Seattle Children's
> 
> 
> 
> -----Original Message-----
> 
> From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Brian Sanders
> 
> Sent: Friday, June 09, 2017 4:20 PM
> 
> To: [log in to unmask]<mailto:[log in to unmask]>
> 
> Subject: Re: Clysis
> 
> 
> 
> We have similar volume in community hospital and similar protocol. Parents love it.
> 
> 
> 
> Brian Sanders, MD
> 
> Medical Director
> 
> Pediatric Emergency Medicine
> 
> Lowell General Hospital
> 
> 
> 
> On Jun 9, 2017, at 6:04 PM, Carla Laos <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> 
> 
> We just started using  hylenex , context is that we are a small community Peds ED, Level 4, 16.5k kids/year. Single physician coverage, APC coverage 8-10hrs.
> 
> 
> 
> We utilize hylenex for moderate dehydration, explain to parents we will attempt IV x2, and if unsuccessful will move to SQ. Parents receptive and love it.
> 
> 
> 
> It works because we are small and can't support a PICC team ($$), are housed in an adult hospital so Peds Anesthesia not in house 24-7, and during RSV/Flu season it's not ideal to have NICU nurses help us (but in off season they do help us with difficult access cases).
> 
> 
> 
> Let me know if you want me to send policy.
> 
> Carla
> 
> 
> 
> ...cml...
> 
> Sent from my iPhone
> 
> 
> 
> On Jun 9, 2017, at 16:18, Van der Jagt, Elise <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> 
> 
> Hi, Sergey,
> 
> 
> 
> You might want to contact Dr. Sharon Mace at the Cleveland Clinic. She is a friend of mine in pediatric emergency medicine and first introduced me again to the concept (I was familiar with it since it had been used in the 1950s and 60s, as well as in veterinary medicine).  I believe she was involved in the clinical trials of Hylenex (hyaluronidase) which is used under the skin before the IV catheter is inserted.  She was using it at the time, probably about 10 years ago and was very impressed with it. She used to be here in Rochester, then in Syracuse and then went out to the Cleveland Clinics.  She is wonderful to work with and please give her my regards. I am also glad to contact her and give you an introduction, if that would work better.
> 
> 
> 
> I personally have used clysis on one of our cats once when she couldn’t drink, and it worked well, was easy and kept the cat hydrated for at least 24-36 hours.
> 
> 
> 
> Elise
> 
> 
> 
> Elise W. van der Jagt, MD, MPH, FAAP, FCP, SFHM, Professor of
> 
> Pediatrics and Critical Care Chief, Pediatric Hospital Medicine
> 
> University of Rochester Medical Center
> 
> 601 Elmwood Ave., Box 667
> 
> Rochester, NY 14642
> 
> 
> 
> Tele:  585-275-8138/585-276-4113
> 
> Fax:   585-276-1128
> 
> Golisano Children's Hospital
> 
> 
> 
> 
> 
> -----Original Message-----
> 
> From: Pediatric Emergency Medicine Discussion List
> 
> [mailto:[log in to unmask]] On Behalf Of Sergey Kunkov
> 
> Sent: Friday, June 09, 2017 10:31 AM
> 
> To: [log in to unmask]<mailto:[log in to unmask]>
> 
> Subject: Clysis
> 
> 
> 
> Dear colleagues,
> 
> 
> 
> I wanted  to ask you about clysis: I know there was a discussion a few years back about its use , but does anyone is using it on a routine basis or , better yet, incorporated it in some kind of a protocol for difficult IV access?
> 
> 
> 
> Thank you very much
> 
> 
> 
> Sergey Kunkov
> 
> Stony Brook
> 
> 
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> 
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.ed
> 
> u_ped-2Dem-2Dl.html&d=DQIBaQ&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLU
> 
> QRxhA&r=U8mD137vcSlcKJYPnZ2lgpiN1pKg9W8j4g606YTHprDbGeReCmYTGhJOFWn9r
> 
> qv-&m=8rqhcQ3wiNOdA5YfBNTUIAb2htW_BoRTpOsYYDfO1QI&s=3B1pR9Z5pIdAu433u
> 
> -Tj_BCSMhiKDdTrAT_7pV8h2Rg&e=
> 
> 
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with
> 
> the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> 
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.ed
> 
> u_ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2
> 
> xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7D
> 
> Y2L&m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn
> 
> 9bHjcWELkI4IrQDy5zHnVKByqE&e=
> 
> 
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with
> 
> the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> 
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.edu
> 
> _ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xV
> 
> Ry0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L
> 
> &m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn9bHj
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> cWELkI4IrQDy5zHnVKByqE&e=
> 
> 
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
>               https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.edu_ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L&m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn9bHjcWELkI4IrQDy5zHnVKByqE&e=
> 
> CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
> 
> 
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L
> 
> The URL for the PED-EM-L Web Page is:
> 
>               https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.edu_ped-2Dem-2Dl.html&d=DwIGaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L&m=XO-24yq4iv7vbQZeV7gYoZYzg5PJNZ3rpFr8wJIjoRA&s=fxahdB_aZKmlN0XBOwNp0YFSa7zYP_tpqGvh698UKeY&e=
> 
> CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                http://listserv.brown.edu/ped-em-l.html
> 
> ------------------------------
> 
> Date:    Sat, 10 Jun 2017 00:40:17 +0000
> From:    "Joe Nemeth, Dr" <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Re: Clysis
> 
> I have never seen it not heard of it being used in the ED ( have worked at 2 of the busiest PEDs in Canada).
> 
> Personally, the NG literature especially from the Aussies is quite convincing in this context and would think it be more ideal and physiologic than clysis if iv access was an issue.
> 
> 
> Joe Nemeth MD
> Toronto Hospital for Sick Children
> Montréal Children's Hospital
> 
> Sent from my iPhone
> 
> On Jun 9, 2017, at 8:08 PM, Kilian, Karen <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> I tried to get this enacted at my facility in situations in which IV access was difficult and/or the pt *simply* needed IVF (no labs beyond glucose).   However, despite me thinking it would be GREAT to use in urgent care and/or the ED.....seemed other's weren't so keen on it.    Those who have enacted this procedure---what made folks buy into it?
> 
> Karen Kilian, ARNP
> Seattle Children's
> 
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Brian Sanders
> Sent: Friday, June 09, 2017 4:20 PM
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Clysis
> 
> We have similar volume in community hospital and similar protocol. Parents love it.
> 
> Brian Sanders, MD
> Medical Director
> Pediatric Emergency Medicine
> Lowell General Hospital
> 
> On Jun 9, 2017, at 6:04 PM, Carla Laos <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> We just started using  hylenex , context is that we are a small community Peds ED, Level 4, 16.5k kids/year. Single physician coverage, APC coverage 8-10hrs.
> 
> We utilize hylenex for moderate dehydration, explain to parents we will attempt IV x2, and if unsuccessful will move to SQ. Parents receptive and love it.
> 
> It works because we are small and can't support a PICC team ($$), are housed in an adult hospital so Peds Anesthesia not in house 24-7, and during RSV/Flu season it's not ideal to have NICU nurses help us (but in off season they do help us with difficult access cases).
> 
> Let me know if you want me to send policy.
> Carla
> 
> ...cml...
> Sent from my iPhone
> 
> On Jun 9, 2017, at 16:18, Van der Jagt, Elise <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> Hi, Sergey,
> 
> You might want to contact Dr. Sharon Mace at the Cleveland Clinic. She is a friend of mine in pediatric emergency medicine and first introduced me again to the concept (I was familiar with it since it had been used in the 1950s and 60s, as well as in veterinary medicine).  I believe she was involved in the clinical trials of Hylenex (hyaluronidase) which is used under the skin before the IV catheter is inserted.  She was using it at the time, probably about 10 years ago and was very impressed with it. She used to be here in Rochester, then in Syracuse and then went out to the Cleveland Clinics.  She is wonderful to work with and please give her my regards. I am also glad to contact her and give you an introduction, if that would work better.
> 
> I personally have used clysis on one of our cats once when she couldn’t drink, and it worked well, was easy and kept the cat hydrated for at least 24-36 hours.
> 
> Elise
> 
> Elise W. van der Jagt, MD, MPH, FAAP, FCP, SFHM, Professor of
> Pediatrics and Critical Care Chief, Pediatric Hospital Medicine
> University of Rochester Medical Center
> 601 Elmwood Ave., Box 667
> Rochester, NY 14642
> 
> Tele:  585-275-8138/585-276-4113
> Fax:   585-276-1128
> Golisano Children's Hospital
> 
> 
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List
> [mailto:[log in to unmask]] On Behalf Of Sergey Kunkov
> Sent: Friday, June 09, 2017 10:31 AM
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Clysis
> 
> Dear colleagues,
> 
> I wanted  to ask you about clysis: I know there was a discussion a few years back about its use , but does anyone is using it on a routine basis or , better yet, incorporated it in some kind of a protocol for difficult IV access?
> 
> Thank you very much
> 
> Sergey Kunkov
> Stony Brook
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.ed
> u_ped-2Dem-2Dl.html&d=DQIBaQ&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLU
> QRxhA&r=U8mD137vcSlcKJYPnZ2lgpiN1pKg9W8j4g606YTHprDbGeReCmYTGhJOFWn9r
> qv-&m=8rqhcQ3wiNOdA5YfBNTUIAb2htW_BoRTpOsYYDfO1QI&s=3B1pR9Z5pIdAu433u
> -Tj_BCSMhiKDdTrAT_7pV8h2Rg&e=
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with
> the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.ed
> u_ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2
> xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7D
> Y2L&m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn
> 9bHjcWELkI4IrQDy5zHnVKByqE&e=
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with
> the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.edu
> _ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xV
> Ry0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L
> &m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn9bHj
> cWELkI4IrQDy5zHnVKByqE&e=
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
>               https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.edu_ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L&m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn9bHjcWELkI4IrQDy5zHnVKByqE&e=
> CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information protected by law. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>               http://listserv.brown.edu/ped-em-l.html
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                http://listserv.brown.edu/ped-em-l.html
> 
> ------------------------------
> 
> Date:    Sat, 10 Jun 2017 06:32:24 -0400
> From:    Michael Falk <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Re: Clysis
> 
> While I am familiar with the idea of it, I have to agree with Joe…NG/OG rehydration is easy and safe.  I am really not sure why you would do this procedure over those options?  The reviews I have seen say that OG is quicker, faster and fewer side effects than IV.
> Mike Falk
> NY, NY.
> 
> On Jun 9, 2017, at 8:40 PM, Joe Nemeth, Dr <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> I have never seen it not heard of it being used in the ED ( have worked at 2 of the busiest PEDs in Canada).
> 
> Personally, the NG literature especially from the Aussies is quite convincing in this context and would think it be more ideal and physiologic than clysis if iv access was an issue.
> 
> 
> Joe Nemeth MD
> Toronto Hospital for Sick Children
> Montréal Children's Hospital
> 
> Sent from my iPhone
> 
> On Jun 9, 2017, at 8:08 PM, Kilian, Karen <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> I tried to get this enacted at my facility in situations in which IV access was difficult and/or the pt *simply* needed IVF (no labs beyond glucose).   However, despite me thinking it would be GREAT to use in urgent care and/or the ED.....seemed other's weren't so keen on it.    Those who have enacted this procedure---what made folks buy into it?
> 
> Karen Kilian, ARNP
> Seattle Children's
> 
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Brian Sanders
> Sent: Friday, June 09, 2017 4:20 PM
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Clysis
> 
> We have similar volume in community hospital and similar protocol. Parents love it.
> 
> Brian Sanders, MD
> Medical Director
> Pediatric Emergency Medicine
> Lowell General Hospital
> 
> On Jun 9, 2017, at 6:04 PM, Carla Laos <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> We just started using  hylenex , context is that we are a small community Peds ED, Level 4, 16.5k kids/year. Single physician coverage, APC coverage 8-10hrs.
> 
> We utilize hylenex for moderate dehydration, explain to parents we will attempt IV x2, and if unsuccessful will move to SQ. Parents receptive and love it.
> 
> It works because we are small and can't support a PICC team ($$), are housed in an adult hospital so Peds Anesthesia not in house 24-7, and during RSV/Flu season it's not ideal to have NICU nurses help us (but in off season they do help us with difficult access cases).
> 
> Let me know if you want me to send policy.
> Carla
> 
> ...cml...
> Sent from my iPhone
> 
> On Jun 9, 2017, at 16:18, Van der Jagt, Elise <[log in to unmask]<mailto:[log in to unmask]>> wrote:
> 
> Hi, Sergey,
> 
> You might want to contact Dr. Sharon Mace at the Cleveland Clinic. She is a friend of mine in pediatric emergency medicine and first introduced me again to the concept (I was familiar with it since it had been used in the 1950s and 60s, as well as in veterinary medicine).  I believe she was involved in the clinical trials of Hylenex (hyaluronidase) which is used under the skin before the IV catheter is inserted.  She was using it at the time, probably about 10 years ago and was very impressed with it. She used to be here in Rochester, then in Syracuse and then went out to the Cleveland Clinics.  She is wonderful to work with and please give her my regards. I am also glad to contact her and give you an introduction, if that would work better.
> 
> I personally have used clysis on one of our cats once when she couldn’t drink, and it worked well, was easy and kept the cat hydrated for at least 24-36 hours.
> 
> Elise
> 
> Elise W. van der Jagt, MD, MPH, FAAP, FCP, SFHM, Professor of
> Pediatrics and Critical Care Chief, Pediatric Hospital Medicine
> University of Rochester Medical Center
> 601 Elmwood Ave., Box 667
> Rochester, NY 14642
> 
> Tele:  585-275-8138/585-276-4113
> Fax:   585-276-1128
> Golisano Children's Hospital
> 
> 
> -----Original Message-----
> From: Pediatric Emergency Medicine Discussion List
> [mailto:[log in to unmask]] On Behalf Of Sergey Kunkov
> Sent: Friday, June 09, 2017 10:31 AM
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Clysis
> 
> Dear colleagues,
> 
> I wanted  to ask you about clysis: I know there was a discussion a few years back about its use , but does anyone is using it on a routine basis or , better yet, incorporated it in some kind of a protocol for difficult IV access?
> 
> Thank you very much
> 
> Sergey Kunkov
> Stony Brook
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
> 
> https://urldefense.proofpoint.com/v2/url?u=http-3A__listserv.brown.ed
> u_ped-2Dem-2Dl.html&d=DQIBaQ&c=4sF48jRmVAe_CH-k9mXYXEGfSnM3bY53YSKuLU
> QRxhA&r=U8mD137vcSlcKJYPnZ2lgpiN1pKg9W8j4g606YTHprDbGeReCmYTGhJOFWn9r
> qv-&m=8rqhcQ3wiNOdA5YfBNTUIAb2htW_BoRTpOsYYDfO1QI&s=3B1pR9Z5pIdAu433u
> -Tj_BCSMhiKDdTrAT_7pV8h2Rg&e=
> 
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> u_ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2
> xVRy0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7D
> Y2L&m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn
> 9bHjcWELkI4IrQDy5zHnVKByqE&e=
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> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with
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> _ped-2Dem-2Dl.html&d=DwIFaQ&c=aBkXpkKi7gN5fe5MqrMaN-VmRugaRb1IDRfSv2xV
> Ry0&r=YU2wsqX55LLe-gYylr2qk1WWF633oi3uF87JRDRfpv-QYyUjYWZhwzRw8Qv7DY2L
> &m=U0uj05bIupqNms6Av6gkdvS4eVGSddNqKvoN7vbF9fw&s=HtUtGCEtJGxihF_Qn9bHj
> cWELkI4IrQDy5zHnVKByqE&e=
> 
> For more information, send mail to [log in to unmask]<mailto:[log in to unmask]> with the message: info PED-EM-L The URL for the PED-EM-L Web Page is:
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> ------------------------------
> 
> Date:    Sat, 10 Jun 2017 04:55:07 -0700
> From:    David Nelson <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Fwd: Clysis
> 
> 
> 
> This study in Peds in 2009 showed promising results…
> 
> 
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> 
> ------------------------------
> 
> End of PED-EM-L Digest - 9 Jun 2017 to 10 Jun 2017 - Special issue (#2017-110)
> ******************************************************************************
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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