Intravenous Fluid Technique in Infancy
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Outside the children’s hospital, the administration of intravenous fluids in babies is fortunately an unusual necessity. Rightly, subcutaneous fluids given with hyalase are used extensively in the milder cases of dehydration and are usually sufficient to correct the imbalance. However, in infants severely dehydrated from, for example, gastroenteritis or pyloric stenosis, in those with peripheral vascular failure from overwhelming toxaemia, in cases of severe haemorrhage and in burns and other surgical problems, the need for an intravenous '‘drip” arises, often with great urgency. Generally a “cut-down” will be performed over the ankle, often after several time-consuming but unsuccessful attempts at “push-ins” in arm, wrist or scalp. As like as not, the “cut-down” drip, when completed, will be found to be delivering only a niggardly five drops per minute, despite the injection of a local anaesthetic to relax venous spasm and with the infant's condition steadily deteriorating. This communication will draw attention to some principles and techniques which have been found successful in dealing with problems of this sort.