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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]> 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]> 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]
>> 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]> 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]> 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]
>>>> 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
>>>> 
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>>>> 
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