Medical Abbers?

[ilovemarkb]

Which is the most popular way to hydrate your elderly patients on a ward.
IV Fluids
Oral fluids
SC rehydration therapy
Enteral fluid replacement

thanks docs and nurses

[anneasquith]

it depends how ill the patient is,as a first step obviously oral.

[ilovemarkb]

If she too frail and unwell what would be the next choice (please)

[anneasquith]

iv fluids.

[ilovemarkb]

thats what I was hoping you would say !! Now I need to find evidence. Quite a lot of research papers suggest sub cut rehydrations but Ive never seen this done on the wards. thank you !! x

[anneasquith]

id say sub cuts are very unusual. id think they would only be used if the patients veins were completely knackered.

[LazyGun]

If Oral hydration has not worked or is not feasible, and where parenteral fluid administration is required for mild to moderate dehydration, IV is often the first choice - but Sub-Cutaneous rehydration is finding a lot of favour- It seems at least as efficient as IV,and can be easier for patients who are confused/agitated, or have difficult to visualise veins, collapsed veins - that sort of thing.

Couple of academic papers, if you are interested;
http://www.ncbi.nlm.nih.gov/pubmed/21378529

http://www.ncbi.nlm.nih.gov/pubmed/12558710

[woofgang]

From my experience with my late DH, who had IV rehydration many times, the advantage with getting a line in and doing IV is that its much easier to add other drugs and so on through an IV line than getting a sub cut needle in for rehydration and then having to put an IV line in as well to administer other things. I can't imagine that there would be many times when all the patient who was that frail would need would be IV fluid without any other treatment and if they fail oral rehydration, there would likely be problems getting them to take drugs orally.
I couldn't find any research though.

[ilovemarkb]

thankyou so much!! What a fab educated bunch you's are !!! xxxx

[woofgang]

happy to help :-)

[Goodsoulette]

Sub cuts, in my experience. I do a lot of end of life care btw..... obviously oral fluids is first defense but I'm assuming they're already dehydrated.

[ilovemarkb]

ok thanks guys!!