Fluid Administration Flashcards
When can we administer fluid in the medical guideline
To achieve?
Haemorrhagic hypovolaemia and obstructive shock states
To a RADIAL PULSE AND STABLE GCS
- When should clinical support be sought for fluid under the medical guideline
- If clinical support is not available
1. DPPCANTS Dehydration with hypotension Paeds Pregnant trauma Crushed >4HRS Asthma - Life Threatening Neurogenic Shock Traumatic Cardiac Arrest Sepsis
- Consult EOC for 0.9% saline - In some cases, Commence Transport
When can we administer fluid under the TRAUMA guideline
To achieve?
Traumatic Hypovolaemia or Obstructive shock
0.9% saline to achieve RADIAL PULSE AND STABLE GCS
When do we consider clinical support in Traumatic Fluid administration (3)
PAEDS
NEUROGENIC SHOCK- secondary to spinal injury causing hypotension or bradycardia -then commence 0.9% to MAX 1000ml
SEVERELY CRUSHED patients - then commence 0.9% via LARGE BORE proportional to crush and anticipated hypovolaemia, and potential hypotension.
Suspected Significant Haemorrhage in THIRD TRIMESTER - physiologically compromised - IMMEDIATE clinical support - 0.9% in 250ml aliquots to 1000ml - Heart rate decrease and BP above normotension -
When do we consult EOC in Traumatic Fluid Guideline
Paeds
Neurogenic shock for further management
Prolonged crush injury
3rd trimester if no decrease in HR or BP change
Fluid for Neurogenic Shock
What GL
Until PERMISSIVE HYPOTENSION is achieved - max 1000ml.
Reassess every 250ml
Trauma
Fluid for Sepsis
What GL
20ml/kg to 40ml/kg in severe sepsis - Consult before fluid.
Medical
Fluid for third trimester Haemorrhage
What GL
250 aliquots to 1000ml
increase in BP ABOVE NORMOTENSION or decrease in HR with an increase in BP then KVO - 30 ml/hr
20 drops = 1 ml
600 drops = 30ml
60 drops min
1 drop sec
Trauma
Fluid for Severley Crushed
What GL
Severe crush = 4 - 6 hrs - EOC if extended time
Fluid is proportional to crush VIA LARGE BORE CANNULA. Prepare to manage hypovolaemia and potential hypotension
Trauma
Fluid for Dehydration
What GL
Clinical support
Consult for Fluids
Medical
Fluid in Anaphylaxis
What GL
500 ml saline with 500 microg ADR
to achieve ADEQUATE BP - Normotension
Anaphylaxis
Fluid in Life Threatening Asthma
What GL
500 bolus IV to overcome obstructive shock
Asthma
Fluid in Severe Head Injury
What GL
30 degrees - spinal precautions
Systolic of 120mmHg
MAP 90
Severe Head Injury
Fluid in ROSC
when to cease
What GL
Fluid to ACHIEVE A RADIAL PULSE or
SBP 100mmHg - MAX 10ml/kg or 1000ml
Reassess 250ml cease if pul. odema
ROSC
Fluid in Adult Arrest
What GL
Trauma - 20ml/kg further 10ml/kg
Medical - 20ml/kg, reassess 500ml
Consult for more
Adult Arrest
