Wow! A nurse willing to demo on herself! I am a patient! I so appreciate you bravery to do this... You are an amazing nurse! Well described and demonstrated - giving me the courage and strength!
Hello, in nursing school we had to practice everything on each other 3 times before we started on patients! We still practice things on each other sometimes to keep skills up.
I’m a patient too. I haven’t had this treatment before but as you can see by looking at my channel, I’ve had my fare share of needles. I’m COMPLETELY blind, autistic and have a chronic heart condition, this was in my recommended so I wanted to learn what this was. I have nurses in my family.
Your channel is GOLD! 🌟😃🏆 I just discovered it recently. Please continue to create Fundamental Nursing Skills topic. Our university is home to the highest number of nursing students in the entire state. We can definitely benefit from your channel. Thanks in adv.😘🏆⭐
My mother has dementia, and won't allow an IV, so I researched this, and found your video. The doctor refuses to try because she said it is very painful. She also says my mother will die of kidney failure because she refuses to drink much. This is getting so frustrating because I saw that this can help frail, older, dehydrated patients. Is it painful, or do you think this could work for her? Thanks.
Great question. There are a few different types. If it has dual lumen then you prime. If it is a single lumen you cannot prime it because of the wire in situ
@@NurseMinder : Thank you for answering my question . I watched your video on working with staff that make you uncomfortable . Brings back memories of the bullies in special care units . The infighting I witnessed and dealt with was unbelievable . Sometimes you can't talk to certain people , because the go off on you like a loaded gun . I worked both sides , administration and bedside . I worked with some very , very intelligent nurses , who were trained by physicians in early 1970s and early 1980s ; super skilled nurses . I seen nurse mangers get escorted out of the hospital by security , directors and CEOs fired , all because they would not listen and follow the rules . I used be so uncomfortable, when I was told I could leave early . Most times I would stay when my shift was over if there was only one person in the preoperative cardiac surgery area . I wanted to jump out my skin when patients had post operative ECG changes and a one to one RN would be placed by the bedside only to find her reading a novel . I am sure you have tons horrific situations you could talk about too . High risk medicine is only stressful , when the staff you work with are slacking off or making trouble .
Hi I am in nursing school and I would like to thank you for your videos. I also have a question. What it is considered a dedicated line? A line for one type of medication only? Or it means that no pump will be used instead intermittent flushes of meds will be administered.
Thanks for the question. Yes a dedicated line refers to a single medication and would have that information on the dressing label. For example Morphine 2.5 mg/ml. That tells the nurse that this line is already primed with this medication and at that concentration. If another medication or dose is required, a new site should be administered. It is not uncommon for a patient to have more than one HDC. If the preference is to have just one HDC than each medication must be flushed after admin .
great video! it’s the most informative video I found regarding hypodermoclysis. I just have a couple of questions: is it considered a safe procedure for patients with cachexia? and what are the contraindications for hypodermoclysis? Thank you!
for patients with cachexia you would need to consider the risks over the gains and if other options exist. Contraindications: Unless they have an allergy to the pastic; I can't think of any as it is a route for med admin and fluid admin. If you know of any, please share
Dl Aires it depends on what you are using the line for. If you are infusing normal saline at 50 ml/hr you can simply connect the line and start the infusion. If you are using it for medication delivery of one med only, you need to calculate the priming volume with the first infusion only. If you use it for multiple meds, you need to flush afterwards. Video on this is coming :)
Thanks so much for posting this. Probably a naive question, but when giving subcutaneous fluids to our dogs, we just use an 18-gauge hypodermic needle without the plastic insert tube and leave the needle in the dog throughout the infusion. Why do you think there a difference between how we administer fluids to animals versus humans? I assume we just place higher priority on patient safety/comfort in humans. Again, I know it’s a somewhat random question outside of the purview of your videos, so thanks for any perspective you have.
No - we used to have the same type before the plastic inserts came along! These are placed in tissue that is less mobile, i,e not a joint where it can be wiggled out
HI!! YOU'RE AMAZING AS USUAL! I am a new nurse and work in a dementia wing and I have a patient that's severely dehydrated, and no one can get an IV started on him. No one even suggested this, and I randomly thought about seeing if you did a video on it! I'm so glad you did! The patient is extremely combative, but also severely dehydrated. I know hypodermoclysis is meant for mild to moderate dehydration, but we have no other options. So I'm coming to you... I was thinking of recommending this to my supervisor... I also don't believe we have pumps at our facility, so we we may have to do it manually. I just did some research and found literature stating we can bolus 500mL in 1 hour. That being said, and assuming my tubing is 10gtt/mL, would this be correct: 500mL/hr X 10gtt/mL X 1hr/60 min = 83.33gtt/min... so 83gtt/min --> then I'd divide by 4 so 20.75 drops or basically 20 drops PER 15 seconds (just so I can calibrate my line quickly)... Any and all advice would be very appreciated! PS: The last time I commented on one of your videos I am pretty sure I mentioned how I wanted to quit nursing school because of a bully clinical instructor! But found your vids and you really rekindled my faith in nursing and being taught by other nurses :-) Thank you thank you!
OH - and he pulls at everything. Literature states best place to put is arms, abd and thigh (like you said). Can we also put in upper back? (I'm really just trying to think where we can put this on him...
yes you can use the upper back, soft tissue only so not over any bony areas. Check out this link (local hospital) and page 6 extcontent.covenanthealth.ca/Policy/VII-B-315.pdf
NurseMinder how crazy! I found that document right after I posted here. Yes, thank you for taking the time to help confirm! As always, you’re awesome! Thank you!
An HDC is subcutaneous and not embedded into a vessel. This means the direction is of little consequence as the fluids / meds will need to be absorbed. You can insert them point up, sideways, or down
when inserting the needle in the thigh does it matter the direction of insertion? in your demo the needle was inserted facing towards lower part of the legs
jkasidemir great question. It does not matter the direction when inserting peripherally. In the abdomen the main considerations are for patient comfort (horizontal for waist line to prevent occlusions with bending)
Actually it does matter. It depends on the organization you work at. In some workplaces, the direction should be towrds the venous return direction. So in the thigh, it should face towards the hip (up)
Yes. Great question. Many times I see the clamp removed. The better question to ask is “why does it come with a clamp?” Clamps are utilized to maintain pressure in the system to prevent backflow which can result in clotting
Well ..however it doesn’t go to vein but to subcutaneous you are supposed to insert needle facing upward to the heart level not like you inserted downward on your thigh .😊
It does not have to point in any direction - it is not in a vein or artery where blood flow impacts infusion. Gravity will pull the fluid down, no matter the direction you point the needle :)
Wow! A nurse willing to demo on herself! I am a patient! I so appreciate you bravery to do this... You are an amazing nurse! Well described and demonstrated - giving me the courage and strength!
Haha. I would demo on my husband but he always says no! Trying to figure out a way to demo IV insertion ... 😜
Hello, in nursing school we had to practice everything on each other 3 times before we started on patients! We still practice things on each other sometimes to keep skills up.
I’m a patient too.
I haven’t had this treatment before but as you can see by looking at my channel, I’ve had my fare share of needles.
I’m COMPLETELY blind, autistic and have a chronic heart condition, this was in my recommended so I wanted to learn what this was.
I have nurses in my family.
Reviewed this today as it's been a while since I've done one in nursing school. Very helpful
Awesome! I had never worked with it until I came to Alberta
SAME! Had a patients with this today and used this video to brush up!
Great video! The fact you did a self demo made me subscribe!! 👌
Haha. I believe in working with the product
Your channel is GOLD! 🌟😃🏆 I just discovered it recently. Please continue to create Fundamental Nursing Skills topic. Our university is home to the highest number of nursing students in the entire state. We can definitely benefit from your channel. Thanks in adv.😘🏆⭐
Thank you for sharing :)
This was best simple , informative and at point video I have seen so far.....
Thank you!
My mother has dementia, and won't allow an IV, so I researched this, and found your video. The doctor refuses to try because she said it is very painful. She also says my mother will die of kidney failure because she refuses to drink much. This is getting so frustrating because I saw that this can help frail, older, dehydrated patients. Is it painful, or do you think this could work for her? Thanks.
I am sorry to hear about your experience. An HDC is not painful and could be helpful for hydration
@@NurseMinder Thank you very much. You do wonderful videos even for someone not training to be a nurse, or currently a nurse.
I am happy I found this channel
I am happy you are here!
Great video.
Compact but wholesome and very great explanation.
Thank you.
Dr Samuel.
Thank you 🙏
Where did you order the needle from?
I don’t know where it was ordered from
Thank you so much ! As always, precise and informative.
Do you have to prime the line first or is that not necessary?
Only if you have two ports, then you can prime one line.
Should HDC line been primed or did it already NS 0.9 % preloaded ?
Great question. There are a few different types. If it has dual lumen then you prime. If it is a single lumen you cannot prime it because of the wire in situ
@@NurseMinder : Thank you for answering my question . I watched your video on working with staff that make you uncomfortable . Brings back memories of the bullies in special care units . The infighting I witnessed and dealt with was unbelievable . Sometimes you can't talk to certain people , because the go off on you like a loaded gun . I worked both sides , administration and bedside . I worked with some very , very intelligent nurses , who were trained by physicians in early 1970s and early 1980s ; super skilled nurses . I seen nurse mangers get escorted out of the hospital by security , directors and CEOs fired , all because they would not listen and follow the rules . I used be so uncomfortable, when I was told I could leave early . Most times I would stay when my shift was over if there was only one person in the preoperative cardiac surgery area . I wanted to jump out my skin when patients had post operative ECG changes and a one to one RN would be placed by the bedside only to find her reading a novel . I am sure you have tons horrific situations you could talk about too . High risk medicine is only stressful , when the staff you work with are slacking off or making trouble .
I came here to ask the same question
Great Tammy, Nice to see your face again! Terilee
Hey Terilee! Nice to hear from you Let’s connect on FB or LI for a catch up
You are awesome, good job with the teaching. Dr Bonilla.
☺️
do you need to prime before inserting it?
Only if it has a second port - prime the second port
This reminds me of the Silhouette and Varisoft subcutaneous infusion sets that are for insulin pumps that I have used for years.
Awesome
Hi I am in nursing school and I would like to thank you for your videos. I also have a question. What it is considered a dedicated line? A line for one type of medication only? Or it means that no pump will be used instead intermittent flushes of meds will be administered.
Thanks for the question. Yes a dedicated line refers to a single medication and would have that information on the dressing label. For example Morphine 2.5 mg/ml. That tells the nurse that this line is already primed with this medication and at that concentration. If another medication or dose is required, a new site should be administered. It is not uncommon for a patient to have more than one HDC. If the preference is to have just one HDC than each medication must be flushed after admin .
How often do you change the needle?
You will want to check with your facility policy, and many stay in longer than policy as long as they are inspected daily and remain healthy
@@NurseMinder Do you have any scientific evidence to suggest to me regarding this practice?
Wow, great video!
Thanks!
do we need to flush before and after giving meds eg dilaudid?
It will depend on if your line is a single use (for one med only) or a multimed port (yes flush the line)
Does it matter if the cannula goes towards distally than proximal?
Not for an HDC
@@NurseMinder Thank you!
great video! it’s the most informative video I found regarding hypodermoclysis. I just have a couple of questions: is it considered a safe procedure for patients with cachexia? and what are the contraindications for hypodermoclysis? Thank you!
for patients with cachexia you would need to consider the risks over the gains and if other options exist. Contraindications: Unless they have an allergy to the pastic; I can't think of any as it is a route for med admin and fluid admin. If you know of any, please share
Excellent vid.. with an hdc line would one not prime the line with the drug or solution prior to starting the line
Dl Aires it depends on what you are using the line for. If you are infusing normal saline at 50 ml/hr you can simply connect the line and start the infusion. If you are using it for medication delivery of one med only, you need to calculate the priming volume with the first infusion only. If you use it for multiple meds, you need to flush afterwards. Video on this is coming :)
Video is up now :)
Thanks so much for posting this. Probably a naive question, but when giving subcutaneous fluids to our dogs, we just use an 18-gauge hypodermic needle without the plastic insert tube and leave the needle in the dog throughout the infusion. Why do you think there a difference between how we administer fluids to animals versus humans? I assume we just place higher priority on patient safety/comfort in humans. Again, I know it’s a somewhat random question outside of the purview of your videos, so thanks for any perspective you have.
No - we used to have the same type before the plastic inserts came along! These are placed in tissue that is less mobile, i,e not a joint where it can be wiggled out
@@NurseMinder awesome, that makes sense. Thanks so much for taking the time to respond.
Thank you. So many questions answered.
high five!
HI!! YOU'RE AMAZING AS USUAL! I am a new nurse and work in a dementia wing and I have a patient that's severely dehydrated, and no one can get an IV started on him. No one even suggested this, and I randomly thought about seeing if you did a video on it! I'm so glad you did!
The patient is extremely combative, but also severely dehydrated. I know hypodermoclysis is meant for mild to moderate dehydration, but we have no other options. So I'm coming to you... I was thinking of recommending this to my supervisor... I also don't believe we have pumps at our facility, so we we may have to do it manually. I just did some research and found literature stating we can bolus 500mL in 1 hour. That being said, and assuming my tubing is 10gtt/mL, would this be correct:
500mL/hr X 10gtt/mL X 1hr/60 min = 83.33gtt/min... so 83gtt/min --> then I'd divide by 4 so 20.75 drops or basically 20 drops PER 15 seconds (just so I can calibrate my line quickly)...
Any and all advice would be very appreciated!
PS: The last time I commented on one of your videos I am pretty sure I mentioned how I wanted to quit nursing school because of a bully clinical instructor! But found your vids and you really rekindled my faith in nursing and being taught by other nurses :-) Thank you thank you!
OH - and he pulls at everything. Literature states best place to put is arms, abd and thigh (like you said). Can we also put in upper back? (I'm really just trying to think where we can put this on him...
yes you can use the upper back, soft tissue only so not over any bony areas. Check out this link (local hospital) and page 6 extcontent.covenanthealth.ca/Policy/VII-B-315.pdf
Thanks Brian.
NurseMinder how crazy! I found that document right after I posted here. Yes, thank you for taking the time to help confirm! As always, you’re awesome! Thank you!
Thanks for making this
Your welcome
Hi, I can see that the insertion of needle is towards the feet, its like opposite the direction of IV cannula. Is this the ruling?
An HDC is subcutaneous and not embedded into a vessel. This means the direction is of little consequence as the fluids / meds will need to be absorbed. You can insert them point up, sideways, or down
@@NurseMinder sorry, so does this mean that it would not matter where the needle is pointing proximally or distally? It would still be acceptable?
@@NurseMinder oh thanks. I saw you edited your response. Your video is really good. I feel more confident now to insert. Thanks
Thank you very much for this video.
Thank you for taking the time to write :)
Your Rock Nurse Jacky
😂
when inserting the needle in the thigh does it matter the direction of insertion? in your demo the needle was inserted facing towards lower part of the legs
jkasidemir great question. It does not matter the direction when inserting peripherally. In the abdomen the main considerations are for patient comfort (horizontal for waist line to prevent occlusions with bending)
thank you very much! good video!
Actually it does matter. It depends on the organization you work at. In some workplaces, the direction should be towrds the venous return direction. So in the thigh, it should face towards the hip (up)
Why do you need to clamp, when the clamp can be removed?
Yes. Great question. Many times I see the clamp removed. The better question to ask is “why does it come with a clamp?” Clamps are utilized to maintain pressure in the system to prevent backflow which can result in clotting
@@NurseMinder i saw on a youtube clip on Bd safe intima they stated the clamp can be removed
If patient has left breast cancer and on radiation therapy,is it ok to administer at right chest wall
Great question, in the absence of other reasons to not use the right side, it sounds like a potential location.
❤ thank you
You are welcome!
angle of insertion?
It’s been a while, but as I remember, 15-20 degrees
Well ..however it doesn’t go to vein but to subcutaneous you are supposed to insert needle facing upward to the heart level not like you inserted downward on your thigh .😊
It does not have to point in any direction - it is not in a vein or artery where blood flow impacts infusion.
Gravity will pull the fluid down, no matter the direction you point the needle :)
👍👍
😊