Fluid Management

Question 1

What is the Na and Cl concentration of 0.9% saline in millimoles/litre?

Answer 1

Na 154 + Cl 154

Question 2

Large volumes of 0.9% saline increases the risk of what?

Answer 2

Hyperchloraemic metabolic acidosis

Question 3

In what patients should Hartmann’s solution be avoided?

Answer 3

In patients with hyperkalaemia

(as contains potassium)

Question 4

What electrolytes does Hartmann’s solution contain?

Answer 4

Na, Cl, K, HCO3

Question 5

What is the max rate that IV potassium can be given?

Answer 5

10mmol/Hour

Question 6

What fluid bolus is given in adult resuscitation? And at what infusion rate?

Answer 6

500ml NACL 0.9% over <15 mins

Question 7

What fluid bolus is given in paediatric resuscitation? And at what infusion rate?

Answer 7

NACL 0.9% 10ml/kg over <10 mins

Question 8

0.15% potassium contains what mmol of potassium?

Answer 8

20mmol/L (Paediatrics)

Question 9

0.3% potassium contains what mmol of potassium?

Answer 9

40mmol/L potassium (Adults)

Question 10

Give 4 cautions for use of 5% glucose infusion

Answer 10

Ischaemic stroke/severe traumatic brain injury

Severe malnutrition (refeeding syndrome)

Thiamine deficiency

Diabetes

Question 11

What fluid is given to treat hypoglycaemia in adults? Also give the infusion rate

Answer 11

10% glucose over 15 mins = 150mls

Question 12

Name 3 drugs high in sodium

Answer 12

Fosfomycin

Paracetamol

Benzylpenicillin

Question 13

How much glucose does 5% glucose contain?

Answer 13

5g in 100ml

(Therefore there’s 50g in 1000ml)

Question 14

Describe the normal daily fluid and electrolyte intake for Routine Maintenance Fluids (Water, electrolytes, glucose)

Answer 14

25ml/Kg/Day Water

1mmol/kg/day (Sodium, potassium, chloride)

50-100g/day glucose
(glucose 5% contains 5g/100ml)

Question 15

What is the maximum infusion rate for potassium?

Answer 15

10mmol/hour

Question 16

What is the maximum mmol of potassium require daily?

Answer 16

80mmol

Question 17

What is the 24 hour fluid requirement for a child under 10kg?

Answer 17

100ml/Kg

Question 18

What is the 24 hour fluid requirement for a child 10-20kg?

Answer 18

100ml/kg for the first 10kg
+
50ml/kg for each 1kg body weight over 10kg.

Question 19

What is the 24 hour fluid requirement for children >20kg?

Answer 19

100ml/kg for the first 10 kg
+
50ml/kg for each 1kg between 10-20kg
+
20ml/kg for each 1kg over 20kg

(Max 2L in females and 2.5L in males)