The Revision Guide for Student Nurses (Part I)

Routes For Fluid Therapy - Key Notes

ROUTE
ADVANTAGES
DISADVANTAGES
Intrasosseus (Intramedullary)

Excellent fluid uptake

Good alternative to venous access in very small patients

Suitable route for shocked patients with collapsed veins

Difficult technique

Infection risk

Only sterile, isotonic, non-irritant fluids may be used

Intraperitoneal

Large surface area for absorption

Relatively large volumes may be given

Vasoconstriction occurs later in the peritoneum in cases of circulatory shock than subcutaneous

Suitable for mildly dehydrated patients where the oral route is contraindicated

Risk of peritonitis

Risk of the puncture of an abdominal organ

Only sterile, isotonic, non-irritant fluids may be used

Intravenous

Fluid is released directly into the circulation making this the most rapid route for fluid uptake

Ideal route for the administration of large volumes of fluid in cases of circulatory shock

The only route suitable for colloidal and hypertonic solutions

Allows very precise dosage particularly if a constant rate infusion pump is used

Circulatory overload

Relatively time consuming and expensive

Risk of infection and thrombophlebitis

Patient interference

Oral

Simple, inexpensive and painless

Fluid composition is not critical due to selective absorption

Large volumes may be given

Suitable for the provision of maintenance fluid requirements in mildly dehydrated patients

Slow, restricted absorption

Contraindicated in cases of vomiting, intestinal obstruction and circulatory shock

Rectal

Inexpensive

Not recommended as this is not proven to provide effective fluid uptake

Subcutaneous

Simple and inexpensive

Suitable for very small patients where other routes are inaccessible

Painful

Risk of infection

Slow absorption Only relatively small volumes may be administered

Only sterile, isotonic, non-irritant solutions may be used