Flashcards in Paediatric fluids Deck (11):
Assessment of hydriaito
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
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.