What is the absorption rate of dextrose 50% if injected subcutaneously?

ervin

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What is the absorption rate of dextrose 50% if injected subcutaneously?
 

Ridryder911

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Very little to none; it usually causes tissue extravasation at the site causing necrosis and severe tissue damage (rotting it out). That is why it is essential that IV are very patent.

Now, Glucagon can be administered I.M., Sub-q , IV, etc.. but sub-q is the slowest route >1 hr.

R/r 911
 

mikeylikesit

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I usually do Glucagon IM and it takes areound 5 minutes to start working.
 

Hastings

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Lol, never give Dextrose any other route than IV. As said, massive tissue damage and other nasty complications.
 

mikeylikesit

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Lol, never give Dextrose any other route than IV. As said, massive tissue damage and other nasty complications.
Nah...just let them take a few drinks off it and they will be fine.;)
 

mikie

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Maybe a foolish question......what is the point of a subcutaneous injection? The only time I've ever seen one was for my TB test
 

Hastings

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Maybe a foolish question......what is the point of a subcutaneous injection? The only time I've ever seen one was for my TB test

That's actually intradermal. SubQ is a little deeper.

For instance, epinephrine in a severe anaphylactic reaction.
 

Hastings

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Ah, my mistake, thanks!

So would an Epi-Pen be an example?

I could be wrong, but I believe most Epi-pens are meant to be used intra-muscularly; into the muscle. SubQ is just the preferred method of most paramedics in the situation.
 

Jon

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Ah, my mistake, thanks!

So would an Epi-Pen be an example?
Nope... that is IM... because that is what auto injectors can do.
 

Flight-LP

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That's actually intradermal. SubQ is a little deeper.

For instance, epinephrine in a severe anaphylactic reaction.


Don't you mean IV vs. subQ????

SubQ Epi in a true anaphylactic reaction is ineffective.

I agree with some, why even consider a subQ injection? Other than the opinion of Epi, what others do we really HAVE to give that way?

O.K. maybe Brethine..............
 

Hastings

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Don't you mean IV vs. subQ????

SubQ Epi in a true anaphylactic reaction is ineffective.

I agree with some, why even consider a subQ injection? Other than the opinion of Epi, what others do we really HAVE to give that way?

O.K. maybe Brethine..............

SubQ Epi is in almost everyone's Anaphylaxis protocol because it's an emergency that needs immediately intervention, and taking the time to get an IV probably isn't the wisest idea. While the onset for most SubQ injections is long, the Epi works very fast when administered this way.

What other drugs do you inject SubQ? Insulin, for instance.
 

Jon

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SubQ Epi is in almost everyone's Anaphylaxis protocol because it's an emergency that needs immediately intervention, and taking the time to get an IV probably isn't the wisest idea. While the onset for most SubQ injections is long, the Epi works very fast when administered this way.

What other drugs do you inject SubQ? Insulin, for instance.
But paramedics don't administer Insulin.
 

mikeylikesit

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But paramedics don't administer Insulin.
I can administer insulin...to myself. Actually in my area we have the option of administering R insulin for regular insulin. the only thing with R is that it is out of your system in about an hour so crashing your patient could take place. plus as a diabetic i know that there are tons of factors that change change the dosing of insulin to give i.e exercise, baseline insulin levels, dehydration, sleep deprivation and urination to name a few.
 

mikie

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So if someone doesn't mind...what is the pros/cons, risks/benefits of SubQ vs IM?

thanks!
 

Ridryder911

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Personally many fail to recognize Sub-Q is the slowest as well must have a good perfusion to circulate the medication.. reasons why I don't understand most wanting to give Epi sub-q.. Especially in a shocky state. When if one can start and IV and administer the Epi per IV (of course different strength and dosage) but immediately works...

Sure, if all if fails Epi Sub-Q..

Other med.'s I give Sub-Q routinely is Morphine Sulfate.. lasts longer, Terbutaline, Loveknox, Heparin and so forth....

Benefits: slow absorption rate (good or bad dependent on the need) so larger dosages (strength) can be administered, less nerve damage, more systemically distributed.. in other words can throughout the body.. not as concentrated

Risks: Some medications are too toxic to the skin and subcutaneous fat, very slow absorption rate (less blood supply), smaller dosages may need to be given in two dosages, where IM is higher blood supply, muscle (larger such gluteal) can absorb larger dosages.. etc..

R/r 911
 
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KEVD18

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brady paramedic care vol. 1, ch.10, p.399 "Subcutaneous Injection"

"Like intradermal injections, no more than 1.0ml of medication is administered subcutaneously"

so for a moment, lets disregard the extravasation and tissue necrosis for a moment and pretend a subQ injection of d50 would be perfectly healthy. how many subq's would you have to do at 1ml per to reach an effective dose? there arent even enough spots on the body to do it...
 

Ridryder911

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brady paramedic care vol. 1, ch.10, p.399 "Subcutaneous Injection"

"Like intradermal injections, no more than 1.0ml of medication is administered subcutaneously"

so for a moment, lets disregard the extravasation and tissue necrosis for a moment and pretend a subQ injection of d50 would be perfectly healthy. how many subq's would you have to do at 1ml per to reach an effective dose? there arent even enough spots on the body to do it...

Actually not true.. remember, anywhere there is fat... there is sub-q. Now, there is preferred sites.. as well, one would not want to have 50 (1 ml) injections... :D
 
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