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Updated: Jul 24, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
International Consensus Recommendation Guidelines for Subcutaneous Infusions of Hydration and Medication in Adults:
Daphne Broadhurst1, Marie Cooke, Deepa Sriram
1Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia (Mss Broadhurst, Cooke, and Sriram); Infusion Excellence Consulting, Ottawa, Ontario, Canada (Ms Broadhurst); School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Queensland, Australia (Ms Cooke); Needle Calm Pty, Melbourne, Victoria, Australia (Ms Barber); Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (Mr Caccialanza); Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark [ORCID https://orcid.org/0000-0001-7431-5257 ] (Mr Danielsen); Optum Complex Care Management, Horsham, Pennsylvania (Ms Ebersold); Ascension at Home, Indianapolis, Indiana (Ms Gorski); The Johns Hopkins Home Care Group, Baltimore, Maryland (Mr Hirsch); Centre for Nurse Education, Cork University Hospital, Cork, Ireland (Ms Lynch); FAMS Institution: Division of Supportive and Palliative Care, National Cancer Centre, Singapore (Ms Neo); Roubaud CHU de Bordeaux, Pôle de Gérontologie Clinique, Bordeaux, France (Ms Roubaud-Baudron); Clinical Pharmacy Partners, Tampa, Florida (Ms Gray).
Abstract:
Infusion of fluids and medications is traditionally performed intravenously. However, venous depletion in patients has led to the quest for vessel health preservation. A safe, effective, acceptable, and efficient alternative is the subcutaneous route. A lack of organizational policies may contribute to the slow uptake of this practice. This modified e-Delphi (electronic) study aimed to derive international consensus on practice recommendations for subcutaneous infusions of fluids and medications. A panel of 11 international clinicians, with expertise in subcutaneous infusion research and/or clinical practice, rated and edited subcutaneous infusion practice recommendations from evidence, clinical practice guidelines, and clinical expertise within an Assessment, Best Practice, and Competency (ABC) domain guideline model. The ABC Model for Subcutaneous Infusion Therapy provides a systematic guideline of 42 practice recommendations for the safe delivery of subcutaneous infusions of fluids and medications in the adult population in all care settings. These consensus recommendations provide a guideline for health care providers, organizations, and policy makers to optimize use of the subcutaneous access route.
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