Paeds Fluids

Question 1

Maintenance fluids requirements?

Answer 1

100ml/kg for the first 10kg

+ 50ml/kg for each 1kg between 10kg-20kg

+ 20ml/kg for each 1kg over 20kg

Question 2

First line fluid choice for children?

Answer 2

0.9% NaCl plus 5% glucose

Question 3

Formula for % dehydration?

Answer 3

(Well weight - ill weight)/well weight x 100

Question 4

Fluid deficit?

Answer 4

% dehydration x well weight x 10

Question 5

For a dehydrated baby what would you have to calculate?

Answer 5

Fluid deficit + maintenance fluids

Question 6

What does oral rehydration solution work on?

Answer 6

Sodium-Glucose co-transporter in the small intestine

Question 7

How should you replace fluids in a child with hypernatraemia?

Answer 7

Over 48 hours

Question 8

Fluids management of septic shock?

Answer 8

1. 10mls/kg IV fluid bolus over 10 mins
2. Re-assess
3. Repeat upto 40mls/kg if no signs of overload

Question 9

DKA markers?

Answer 9

Blood glucose > 11
pH < 7.3
Blood ketones > 3 or ++ on urine ketones

Question 10

Mild DKA?

Answer 10

pH 7.2 – 7.29, OR

Bicarbonate < 15 -> 5% dehydration

Question 11

Moderate DKA?

Answer 11

pH 7.1 – 7.19, OR

Bicarbonate < 10 -> 5% dehydration

Question 12

Severe DKA?

Answer 12

pH < 7.1, OR

Bicarbonate < 5 -> 10% dehydration

Question 13

Hypoglycaemia fluids?

Answer 13

10% dextrose IV

2ml/kg bolus

Question 14

Blood abnormalities of DKA?

Answer 14

• hyperglycaemia
• acidosis
• ketonaemia
• raised creatinine

Question 15

How should you replace fluids in a child with hypernatremia?

Answer 15

Over 48 hours

Question 16

Fluid choice in DKA?

Answer 16

0.9% NaCl plus KCl 40mmol/L