[Dysphagia] Hypodermoclysis

[Lucy.Balch at hdmc.dmhmrsas.virginia.gov (Balch, Lucy)]

Wish I knew why hypodermoclysis has such a bad rap in the U.S. I've been
asking around and always get similar responses, that PICC lines and IVs are
more efficient, and that the risk of infection is greater with
hypodermoclysis. I had one person even explain to me that it was because the
needle is closer to the skin and thus closer to the bacteria that reigns in
hospitals, the world, etc.
Are there any research articles out there that can disprove this infection
theory?
Lucy Balch
Speech Pathologist
Hiram Davis Medical Center
Petersburg, VA

-----Original Message-----
From: Furstoss, Jeanne ACMC [mailto:jfurstoss@acmedctr.org] 
Sent: Wednesday, February 08, 2006 2:31 PM
To: 'dysphagia@b9.com'
Subject: RE: [Dysphagia] Hypodermoclysis

In Swallowing Eval Recommendations, I may write: "Consider hypodermoclysis."

I am not aware of situations in my Acute Medical Center where physicians
have followed through writing such an order, though some have asked me about
it and I have offered articles. I see this as important advocacy for
alternatives and an attempt to contribute to the knowledge base of Physician
consideration.

Jeanne Furstoss MS OTR/L SWC



-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of lobsterpam@aol.com
Sent: Sunday, February 05, 2006 10:08 AM
To: Drirenect@aol.com; dysphagia@b9.com
Subject: Re: [Dysphagia] Hypodermoclysis


Good point - but I don't recommend PEG tubes per se. This is probably 
going to sound like quibbling with semantics, but here goes.  I might 
recommend that an alternative route of nutrition be considered.  What 
type, if any, is utilized, is a medical decision - and has to be, 
because there may be other issues with that patient that might preclude 
some medical procedure that I might think would be appropriate. 
Similarly, I can comment that a patient's swallowing status places him 
at risk of dehydration, but I won't say "Recommend D5 normal saline via 
IV."  I would recommend "consider neurological workup," not "CT scan 
without contrast."  Or I would recommend that pharmacy "evaluate 
medication regime," not suggest changing a certain medication.  I know 
an SLP who made recommendations for vent settings... didn't go over 
well at all, which is no surprise.

I think at times it IS a blurry line, and there might be settings where 
an SLP has the knowledge and experience where he/she is making more 
medically specific recommendations than are others.  I know there were 
certain physicians who wanted more specifics from SLP recommendations 
than did others.

ps


-----Original Message-----
From: Drirenect@aol.com
To: LOBSTERPAM@aol.com; dysphagia@b9.com
Sent: Sun, 5 Feb 2006 10:59:10 EST
Subject: Re: [Dysphagia] Hypodermoclysis

    Actually, Pam, I think SLPs are making medical recommendations all 
the time
- What about NPO? PEG? These are purely medical.
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