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Flashcards in Paediatric fluids Deck (11):

Learning objectives

Assessment of hydriaito
Fluid requirements/
Common electrolyte imbalances


How do you assess fluid status?

Hx: urine output, thirst, vomit? diarrhoea?
O/E: Skin turgor/mucous membranes, tachycardia/tachypnoea
Ix: blood glucose, electrolytes


how do you calculate resus volume

Usually weight, but sometimes surface area (when)


Signs of increasing severity of dehydration

[fill in from NICE]


Calculating maintenance fluids in adults (NICE guidelines)

Daily maintenance fluid requirements (as per NICE guidelines):

25-30 ml/kg/day of water and
approximately 1 mmol/kg/day of potassium, sodium and chloride and
approximately 50-100 g/day of glucose to limit starvation ketosis (however note this will not address the patient’s nutritional needs)
Weight-based potassium prescriptions should be rounded to the nearest common fluids available. Potassium should NOT be manually added to fluids as this is dangerous.


Calculating fluids in children - what is used in shock

20mL/Kg bolus (maybe given 2nd time), term neonates 10mL/kg over 10m
Cautions: DKA, cardiac


Maintenance fluid: holliday-segar formula

How much would this be for a 23kg child?

100ml/kg/day for first 10kg
50ml/kg/day for next 10kg
20ml/kg/day for > 20kg
23kg child: 1560ml/24h


In a neonate

Capillary/venous gas


Normal neonatal glucose level?



What is kernicterus?

When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby's blood. It can cause athetoid cerebral palsy and hearing loss.


What could rarely cause hyponatraemia in a person (or child) with pneumonia

SIADH can sometimes happen for unknown reasons