General - Fluid resuscitation Flashcards
IV fluids should only be prescribed for patients whose needs cannot be met by oral or enteral routes - what can cause this?
- Vomiting or severe diarrhoea
- Patient is nil by mouth
- Patient is hypovolemic as a result of blood loss
What are the 2 major categories of fluids that can be given, and what are they?
- Crystalloids: solutions of small molecules in water
- Colloids: solutions of larger organic molecules
Give 1 reason why colloids are used less than crystalloids
- Risk of anaphylaxis
- Crystalloids are superior in initial fluid resuscitation
What are the 5 Rs of fluid resuscitation?
- Resuscitation
- Routine maintenance
- Replacement
- Redistribution
- Reassessment
1) Name a fluid that can be used for resuscitation
2) What is initially given for IV fluid resuscitation?
1) Sodium chloride 0.9% (normal saline) or Hartmann’s solution
2) 500ml bolus dose of normal saline or Hartmann’s over less than 15 mins
If a patient is hemodynamically stable but unable to meet their daily fluid requirements via oral or enteral routes you will need to prescribe maintenance fluids - name 2 options for this
- Sodium chloride 0.9% (normal saline)
- Hartmann’s solution
- Dextrose 5%
- Sodium chloride 0.18% / Glucose 4%
How is how much maintenance fluid that should be given to a child calculated?
- 100ml/Kg for 1st 10Kg
- 50ml/Kg for 2nd 10Kg
- 20ml/Kg for every subsequent Kg
1) For the maintenance fluid for adults, how much ml/kg/day of water is given?
2) Approximately how much potassium, sodium and chloride is given in mmol/Kg/day?
3) Approximately how many g/day of glucose is given?
1) 25-30 ml/Kg/day
2) 1 mmol/Kg/day
3) 50-100g/day
If 0.9% saline is used in high volumes, the risk of what is increased?
Hyperchloremic metabolic acidosis
Patients with what (and why) should not be given Hartmann’s?
Hyperkalaemia - Hartmann’s contains K+
What is the formula to calculate fluid resus in burns?
Total percentage of the body covered in burns x weight x 4
