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Subcutaneous infusions (hypodermoclysis)
In medical practice, the term subcutaneous infusion or hypodermoclysis is used to designate an injection of a large amount of fluid into the subcutaneous tissues, by means of a needle for the purpose of supplying the body with fluids.
In this method, the fluid is absorbed principally by the lymphatics. It is given in a part where the tissue is loose. The purpose of subcutaneous infusions are same as that of intravenous infusions. This route is seldom used now-a-days due to increased facilities available for the intravenous infusions.
However, this route may be useful under emergency conditions. The Sites used for subcutaneous infusions are:
1. Anterior and outer aspect of the thigh, midway between the knee and the hip.
2. Under and outer margins of the breast.
3. Abdominal wall halfway between the umbilicus and the flank.
4. Back, just below the scapula.
5. The equipment used for the subcutaneous infusion is same which is used for intravenous infusions.
6. The subcutaneous infusions may be given in two places, using a T- connection to help in the maximum absorption of the fluid.
7. To start the subcutaneous infusions, pick up a fold of subcutaneous tissue with the left hand and with the right hand insert the needle at an angle into the subcutaneous tissue in the direction of venous blood flow.
8. The rate of flow is determined by the individual's rate of absorption.
9. In all cases, the rate at which the fluid is given, should be such that the tissue around the needle stay nearly normal in tension and appearance.
10. Hyaluronidase injected into the tissues at the site of infusion or added to the infusion fluid, will increase absorption.
11. When swelling occurs, the infusion should be stopped completely.
12. The solutions used for the subcutaneous infusion should be isotonic.
13. Sugar solutions that are electrolyte free are contraindicated, as it may produce oedema at the injection site.
14. Hypertonic solutions are not absorbed. On the contrary, they may attract body fluids into the injection site.
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