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Comparing subcutaneous fluid infusion with intravenous fluid infusion in children
1Mercy Children’s Hospital, St. Louis, MO 63129, USA. laura@kuensting.net
Insights
Subcutaneous (SC) infusions offer a faster way to start parenteral rehydration in children with mild to moderate illness, significantly reducing the number of needlesticks compared to intravenous (IV) methods.
Area of Science:
- Pediatrics
- Emergency Medicine
- Fluid Management
Background:
- Subcutaneous (SC) infusion is explored as a parenteral alternative for pediatric patients with mild to moderate illness.
- Intravenous (IV) fluid administration is the standard, but can present challenges in pediatric care.
Purpose of the Study:
- Compare infusion start times between initial SC and IV fluid orders.
- Evaluate the number of needlesticks required for each method.
- Determine if SC fluids improve subsequent IV cannulation success.
Main Methods:
- Retrospective descriptive study of 36 children's medical records (November 2008 - May 2010).
- Included children receiving SC fluids only or SC fluids after multiple failed IV attempts.
Main Results:
- The SC group had a significantly shorter time to infusion (20.95 minutes) compared to the IV/SC group (97.33 minutes).
- The SC group required fewer needlesticks (mean = 1) than the IV/SC group (mean = 4.87).
Conclusions:
- SC infusions appear to facilitate parenteral rehydration initiation in non-critically ill children.
- SC infusions significantly minimize patient discomfort by reducing needlesticks.
- Further research is needed to confirm if SC fluids enhance subsequent IV cannulation success.
Introduction:
This study examined subcutaneous (SC) infusion as a parenteral alternative for children with mild to moderate illness. The purpose was to compare the difference in infusion start time of parenteral fluid between an initial SC order and an initial intravenous (IV) order. In addition, the number of needlesticks a child received for each method was evaluated. This study also sought to address the following question: If SC fluids were given and an IV attempt was made later, did the administration of SC fluids enhance the success of venous cannulation?
Methods:
A retrospective descriptive design was used for review of medical records for 36 children from November 2008 to May 2010 who had received SC fluids only or received SC fluids after 2 or more failed IV attempts.
Results:
The IV/SC group had significantly longer time to infusion (M = 97.33 minutes) than did the SC group (M = 20.95 minutes; U = .000; P < .001). The IV/SC group included the number of needlesticks for the intravenous attempts plus the needle stick needed for the subcutaneous infusion. A significant difference was found between the 2 groups (mean IV = 4.87; mean SC = 1; Z = .000; P < .001).
Discussion:
In a child who is not seriously ill, SC infusions appear to facilitate the initiation of parenteral rehydration. SC infusions minimized the number of needlesticks a child endured. More study is needed to determine if SC fluids enhance success of subsequent venous cannulation.
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