Fluids

Question 1

Emergency resuscitation

Answer 1

NaCl 0.9% 500ml 15mins

Question 2

Emergency Hypoglycaemia

Answer 2

Glucose 20% 100ml 15m

Question 3

Emergency Hypokalaemia

Answer 3

NaCl/KCl 0.3% 1000ml 4h

Question 4

Emergency hypercalaemia

Answer 4

Nacl 0.9% 1000ml 4h

Question 5

Maintenance Fluids without deficits or losses

Answer 5

25-30ml/kg/24hWater
1mmol/kg/24h Na and K
50-100g/24h Glucose

(Aim 1000ml 8-12h)

Question 6

Maintenance fluids with deficits or losses
eg Na or K low, Vomiting, diarrhoea

Answer 6

Minimum 30ml/kg/24h water
ensure electrolytes replaced

(aim 1000ml 4-6h)

Question 7

Daily Requirements water

Answer 7

25-30ml/kg/24h water

Question 8

Daily Requirements Na and K (andCl)

Answer 8

1mmol/kg/24h

Question 9

Daily Requirements Glucose

Answer 9

50-100g/24h

Question 10

Max K replacement rate

Answer 10

10mmol/h

Question 11

Na contents in Nacl 0.9% 1000ml

Answer 11

150mmol Na

Question 12

K contents in Potassium Chloride (KCL) 0.3% 1000ml

Answer 12

40mmol K

Question 13

K contents in Potassium Chloride (KCL) 0.15% 1000ml

Answer 13

20mmol K

Question 14

Glucose contents Glucose 5% 1000ml

Answer 14

50g Glucose

Question 15

Childrens Emergency resuscitation

Answer 15

Nacl 0.9% 10ml/kg 15mins

Question 16

Childrens maintenance no deficits/losses

Answer 16

<10Kg = 100ml/kg/24h
10-20kg = 50ml/kg/24h
>20kg = 20ml/kg/24h

usually Nacl 0.9%/Glucose 5%

Question 17

When should IV fluid therapy be reviewed

Answer 17

• After each bolus in shocked pts
• every 12 hrs if req > 3litres a day
• daily in Stable pts

Question 18

When to use 250ml bolus in 15 mins for resuscitation

Answer 18

Heart Failure
frail
low body weight <50kg

Question 19

Fluid need in L and bags

Answer 19

approx 3L (3x 8 hourly bags)

Unless elderly or v underweight
2L - 12 hourly bags

Question 20

Hyperkalaemia on blood results cause DREAD

Answer 20

Drugs
Renal Failure (Cr)
Endocrine (if hypotension addisions disease)
artefact
DKA (look at blood sugar)