A protocol for hyperalimentation in a community hospital.

Hyperalimentation can be used safely on an infrequent basis by a physician who has once familiarized himself with the basic information, if he is willing to reread pertinent information with each use and is compulsive about following a good protocol and using flow sheets. Hyperalimentation can be used safely in a community hospital when there are interested nurses, willing to learn and apply the protocol. There should be some sort of warning system for a malfunctioning hyperalimentation line, be it a pump with a warning buzzer or an ever-present nurse. The hospital should have a pharmacy with one or two skilled people who can aseptically prepare the solution using closed techniques. A laboratory should be immediately available to run SMA-6, SMA-12, blood pH, and obtain in reasonable time a serum osolarity and serum magnesium reading.